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233 Improving prophylactic antibiotic use for recurrent urinary tract infections (impart): mixed-methods study to address evidence gaps and develop a decision aid
  1. Leigh Sanyaolu1,
  2. Haroon Ahmed1,
  3. Rebecca Cannings-John2,
  4. Fiona Wood1,
  5. Adrian Edwards1
  1. 1Division of Population Medicine and PRIME Centre Wales, Cardiff University, Cardiff, UK
  2. 2Centre for Trials Research, Cardiff University, Cardiff, UK

Abstract

Introduction 3% of women in the UK have recurrent UTIs (rUTIs) with significant morbidity and healthcare costs. Evidence suggests women would like more information on rUTI prevention. Integrating shared decision- making (SDM) into routine clinical practice is recommended by NICE and could improve rUTI preventive management discussions. Therefore, we aim to develop a patient decision aid (PDA) to improve SDM in this context.

Methods The IPDAS Collaboration and NICE have produced standards on PDA development and our methods align with these. Work-package (WP) 1 involves evidence syntheses of the effectiveness of preventive rUTI treatments using a network meta-analysis and to understand the views of patients and clinicians using a qualitative evidence synthesis (QES). WP2 involves routinely collected data to understand the characteristics of women with rUTIs and to estimate the risk of antimicrobial resistance with prophylactic antibiotics. WP3 involves focus group interviews with women with rUTIs and semi-structured interviews with clinicians to understand their decisional needs. WP4 will involve early user-testing, via ‘Think aloud’ interviews, of a PDA developed based on work from earlier work-packages.

Results This study is ongoing and we will present data so far. The QES and routine data descriptive studies are complete. Our work to date confirms significant numbers of women have rUTIs (92,213) and use prophylactic antibiotics (26,862) and would like more information on non-antibiotic prevention. The network meta-analysis, target trial routine data study and qualitative interviews are ongoing but are anticipated to be completed and a prototype PDA developed prior to the conference.

Discussion This research aims to address evidence gaps in the context of rUTIs and integrate systematic reviews, routine population-linked epidemiological data and patient/clinician decisional needs to develop an evidence-based PDA to support SDM and improve care in this field.

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