Knowledge, attitudes, and practice around urinary tract infections of general practice assistants in the Netherlands: a cross-sectional internet survey

Background: In Dutch general practice, urinary tract infections (UTIs) are the most common indication for prescribing antibiotics. General practice assistants (GPAs) are the first point of contact for patients with UTI-associated symptoms and sometimes even manage these cases without consulting a general practitioner. Nevertheless, literature on how GPAs provide and experience UTI-care is limited. Methods: To investigate the knowledge, attitude, and practice of Dutch GPAs regarding UTIs in general practice, we constructed a cross-sectional online survey. The survey assessed actively working Dutch GPAs’ knowledge, practice, and attitude in UTI-care. Participants were recruited through social media platforms in May and June 2024. Descriptive statistics were used to perform primary data-analysis. Secondary analysis was performed using univariate and multivariate logistic regression models. Results: 478 of the 643 obtained responses were eligible for analysis. Results showed 95.8% of the GPAs think their UTI knowledge is sufficient. However, only one-fourth of respondents selected all correct groups at higher risk of developing a complicated UTI. Additionally, almost 70% of the respondents would perform urinalysis as a precaution if a patient hands in urine, even when UTI-associated symptoms are absent. Nine out of ten GPAs would never disregard urinalysis results. Furthermore, while GPAs indicated to apply shared decision-making often, wait-and-see policies are not regularly advised. Conclusions: GPAs seem to be unaware of their limitations regarding UTI-care, especially overvaluing the urine dipstick as a diagnostic tool. GPAs should adjust their preconceived notions of patient preferences, since patients’ willingness to try non-antibiotic treatments is higher than they think.