Improving antimicrobial stewardship and patient education regarding UTIs at a GP practice - patient information leaflets in the telemedicine era

Oliver Skan Royal Free Hospital NHS Trust

Background

• Urinary tract infections (UTIs) are the most common bacterial infection seen in general practice, representing an estimated 1-3% of all consultations.

• Antimicrobial resistance is increasing globally, as well as in the UK.

• Appropriately requesting mid-stream urines (MSUs) for culturing, and correctly prescribing antibiotics, are important both for patient safety and antimicrobial stewardship.

• Educating patients about UTIs is an important aspect of management.

• The expansion of telemedicine during the pandemic provides new avenues of providing patient information, including electronic patient leaflets.

Aims

1) To increase the number of MSUs that are being performed as per NICE guidance (NICE CKS: Urinary tract infection (lower)).

2) To improve correct antimicrobial prescribing for UTIs at the practice (PHE antibiotic prescribing guidelines).

3) To improve patient education regarding UTIs in line with NICE guidance. Specifically, to increase the percentage of patients given advice regarding safety netting, consultation recall, self-care, and avoiding UTI recurrence.

Results

• The percentage of MSUs that were appropriately requested increased from 64% to 91%/92% post intervention.

• Percentage of patients who had MSUs successfully processed (requested, taken, cultured, followed up) increased from 45% to 65%/83% post intervention.

• Correct antibiotic prescribing increased from 73% to 93%/88% post intervention.

• Percentage of patients receiving advice about how to take an MSU, safety netting, appropriate recall, self care advice, and UTI prophylaxis all increased across both dat. collection periods, average scores increasing by 33% and 68.6% across the two periods.

• Project aims discussed with practice team

• Interventions discussed at practice meetings

• Background data collected to assess scope of issue