Abstract：
BACKGROUND: Contrary to current guideline recommendations, second-line antibiotics are still frequently used in the ambulatory treatment of uncomplicated urinary tract infections (UTI), which are associated with a high risk of antibiotic resistance development. The REDARES project (REDuction of Antibiotic RESistance in uncomplicated urinary tract infections by treatment according to national guidelines in ambulatory care), funded by the Federal Joint Committee (Gemeinsamer Bundesausschuss, G-BA)/Innovation Fund is developing a multimodal intervention for primary care physicians to support them in a guideline-based approach. The intervention consists of the following components: (1) provision of local resistance data of pathogens of uncomplicated UTI (Robert Koch Institute), (2) concise guideline content on the therapy of uncomplicated UTI for patients (paper and online), and (3) prescription feedback on practice level and benchmarking among the study participants (anonymized). In a participatory approach and as part of the process evaluation, representatives of the intended target group were interviewed in advance about the acceptance and feasibility of the intervention.
METHODS: Using guided individual interviews, Thuringian GPs were interviewed before the start of the intervention phase. Following a description of the study concept and the planned components of the intervention, the interviewees were asked about their assessment regarding acceptance and feasibility. The individual interviews were recorded, transcribed verbatim and qualitatively analyzed according to Mayring.
RESULTS: A total of ten interviews with an average duration of 29minutes were conducted and evaluated. 40 per cent of the interviewed GPs were female and, on average, 45 years old. The interviewees described the uncomplicated UTI as an easily manageable condition. The practical nature of the research question was described as a reason to potentially participate in the intervention phase; lack of time or human resources were cited as potential barriers. Regarding the intervention elements, the provision of local resistance data of UTI pathogens was considered beneficial to their own work. The extraction of their own antibiotic prescription data from the practice software was basically assessed as feasible. The interviewees differed in their assessment of whether they would take account of the feedback on their prescribing behavior in their daily work.
CONCLUSIONS: The interviews generated a detailed picture of the different diagnostic and therapeutic pathways used by respondents for uncomplicated UTI. Overall, they predominantly regarded both the study concept and the intervention components as feasible. Although the study population is small and not representative, some of the results seem to be transferable to other regions in Germany.
CONCLUSIONS: A research question relating to their daily routine can increase participation of primary care physicians in (intervention) studies. Starting the process evaluation before the intervention seems to be reasonable since the results will be integrated into the design of the intervention. The method of data extraction from practice software by practice teams seems to be promising.
METHODS: Using guided individual interviews, Thuringian GPs were interviewed before the start of the intervention phase. Following a description of the study concept and the planned components of the intervention, the interviewees were asked about their assessment regarding acceptance and feasibility. The individual interviews were recorded, transcribed verbatim and qualitatively analyzed according to Mayring.
RESULTS: A total of ten interviews with an average duration of 29minutes were conducted and evaluated. 40 per cent of the interviewed GPs were female and, on average, 45 years old. The interviewees described the uncomplicated UTI as an easily manageable condition. The practical nature of the research question was described as a reason to potentially participate in the intervention phase; lack of time or human resources were cited as potential barriers. Regarding the intervention elements, the provision of local resistance data of UTI pathogens was considered beneficial to their own work. The extraction of their own antibiotic prescription data from the practice software was basically assessed as feasible. The interviewees differed in their assessment of whether they would take account of the feedback on their prescribing behavior in their daily work.
CONCLUSIONS: The interviews generated a detailed picture of the different diagnostic and therapeutic pathways used by respondents for uncomplicated UTI. Overall, they predominantly regarded both the study concept and the intervention components as feasible. Although the study population is small and not representative, some of the results seem to be transferable to other regions in Germany.
CONCLUSIONS: A research question relating to their daily routine can increase participation of primary care physicians in (intervention) studies. Starting the process evaluation before the intervention seems to be reasonable since the results will be integrated into the design of the intervention. The method of data extraction from practice software by practice teams seems to be promising.
摘要：
背景：与当前的指南建议相反，二线抗生素仍然经常用于非复杂性尿路感染（UTI）的门诊治疗，这与抗生素耐药性发展的高风险有关。REDARES项目（根据门诊护理的国家指南，通过治疗简单的尿路感染来减少抗生素耐药性），由联邦联合委员会(GemeinsamerBundesausschuss，G-BA）/创新基金正在为初级保健医生开发一种多模式干预措施，以基于指南的方法为他们提供支持。干预措施包括以下组成部分：（1）提供不复杂的UTI病原体的局部耐药性数据（罗伯特·科赫研究所），（2）关于患者不复杂UTI治疗的简明指南内容（论文和在线），和（3）关于研究参与者之间的实践水平和基准的处方反馈（匿名）。在参与式方法中，作为过程评估的一部分，预先就干预措施的接受度和可行性采访了预期目标群体的代表。
方法：使用引导式个人访谈，图林根的全科医生在干预阶段开始之前接受了采访。在描述研究概念和干预计划的组成部分之后，受访者被问及他们对接受度和可行性的评估。记录了个人访谈，逐字转录，并根据Mayring进行定性分析。
结果：总共进行了10次访谈，平均持续时间为29分钟。40%的受访全科医生是女性，平均而言,45岁。受访者将简单的UTI描述为易于管理的条件。研究问题的实用性被描述为可能参与干预阶段的原因；缺乏时间或人力资源被认为是潜在的障碍。关于干预要素，提供UTI病原体的局部耐药性数据被认为对他们自己的工作有益.从实践软件中提取自己的抗生素处方数据基本上被评估为可行的。受访者对他们是否会在日常工作中考虑对处方行为的反馈的评估有所不同。
结论：访谈产生了受访者对简单UTI的不同诊断和治疗途径的详细描述。总的来说,他们主要认为研究概念和干预部分都是可行的。虽然研究人群很小，没有代表性，一些结果似乎可以转移到德国的其他地区。
结论：与他们的日常生活有关的研究问题可以增加初级保健医生在（干预）研究中的参与。在干预之前开始过程评估似乎是合理的，因为结果将被整合到干预的设计中。实践团队从实践软件中提取数据的方法似乎很有希望。
方法：使用引导式个人访谈，图林根的全科医生在干预阶段开始之前接受了采访。在描述研究概念和干预计划的组成部分之后，受访者被问及他们对接受度和可行性的评估。记录了个人访谈，逐字转录，并根据Mayring进行定性分析。
结果：总共进行了10次访谈，平均持续时间为29分钟。40%的受访全科医生是女性，平均而言,45岁。受访者将简单的UTI描述为易于管理的条件。研究问题的实用性被描述为可能参与干预阶段的原因；缺乏时间或人力资源被认为是潜在的障碍。关于干预要素，提供UTI病原体的局部耐药性数据被认为对他们自己的工作有益.从实践软件中提取自己的抗生素处方数据基本上被评估为可行的。受访者对他们是否会在日常工作中考虑对处方行为的反馈的评估有所不同。
结论：访谈产生了受访者对简单UTI的不同诊断和治疗途径的详细描述。总的来说,他们主要认为研究概念和干预部分都是可行的。虽然研究人群很小，没有代表性，一些结果似乎可以转移到德国的其他地区。
结论：与他们的日常生活有关的研究问题可以增加初级保健医生在（干预）研究中的参与。在干预之前开始过程评估似乎是合理的，因为结果将被整合到干预的设计中。实践团队从实践软件中提取数据的方法似乎很有希望。
