Primary Care Practitioners' Experiences Managing Urinary Tract Infections: A Qualitative Evidence Synthesis.

Area of Science:

• General Practice
• Infectious Disease Management
• Qualitative Research Synthesis

Background:

• Urinary tract infections (UTIs) are prevalent in primary care settings.
• Management of UTIs by primary care practitioners (PCPs) is influenced by multifaceted factors.

Purpose of the Study:

• To investigate the perspectives and experiences of PCPs regarding UTI management.
• To explore the factors influencing PCP decision-making in UTI cases.

Main Methods:

• Qualitative evidence synthesis of studies conducted in general practice.
• Systematic literature search across four databases and citation searching.
• Braun and Clarke's reflexive thematic analysis for data synthesis.
• Critical Appraisal Skills Programme (CASP) for quality assessment.

Main Results:

• 32 qualitative studies involving 690 PCPs were included.
• Key themes identified: PCP confidence, challenges with specific patient groups ('patient X'), healthcare system pressures, antibiotic risk-benefit assessment, and patient-practitioner relationships.
• Research quality was rated as high using the CASP checklist.

Conclusions:

• PCPs report confidence in UTI management, with uncertainty arising in complex cases (e.g., pediatric, male, elderly, recurrent UTIs).
• Assessing antibiotic risks and benefits presents an ongoing clinical challenge.
• Healthcare system deficiencies (underfunding, staff shortages) and patient expectations exacerbate care complexities, especially for atypical patient presentations.