Ignite Creation Date:
2024-05-06 @ 8:15 PM
Last Modification Date:
2024-10-26 @ 3:23 PM
Study NCT ID:
NCT06307067
Status:
NOT_YET_RECRUITING
Last Update Posted:
2024-03-12
First Post:
2024-03-06
Brief Title:
Improving Care for Uncomplicated URinary Tract Infection-associated Symptoms in Primary Healthcare Settings in INDOnesia
Sponsor:
Erasmus Medical Center
Organization:
Erasmus Medical Center
Study Overview
Official Title:
Improving Care for Uncomplicated URinary Tract Infection-associated Symptoms in Primary Healthcare Settings in INDOnesia
Status:
NOT_YET_RECRUITING
Status Verified Date:
2024-03
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
URINDO
Brief Summary:
In the present study we aim to analyze the impact of the introduction of a urinary dipstick test for patients presenting with uncomplicated UTI-associated symptoms on antibiotic prescription in primary health care in Indonesia In addition the knowledge of HCW regarding antibiotics and prudent use of antibiotics in the community setting will be investigated
Specific aims of the study
1 To analyze the quality of antibiotic prescriptions for uncomplicated UTI in the primary health care settings in Indonesia before introduction of urinary dipstick testing compared to after introduction of urinary dipstick testing
2 To analyze the knowledge level of healthcare workers on uncomplicated UTI and prudent antibiotic use in primary health care settings in Indonesia
Specific aims of the study
1 To analyze the quality of antibiotic prescriptions for uncomplicated UTI in the primary health care settings in Indonesia before introduction of urinary dipstick testing compared to after introduction of urinary dipstick testing
2 To analyze the knowledge level of healthcare workers on uncomplicated UTI and prudent antibiotic use in primary health care settings in Indonesia
Detailed Description:
Uncomplicated urinary tract infection UTI is one of the most frequent diagnoses and reasons for prescribing antibiotics in primary health care however the laboratory capacity to perform urine cultures in primary health care in Indonesia is limited Consequently inappropriate antibiotic prescriptions for uncomplicated UTI patients in the primary health care may occur
A before-after study will be carried out in primary health care settings in three cities Malang Semarang and Denpasar in Indonesia
The specific aims will be addressed as follows
Aim 1
The study will be divided into three phases pre-intervention 3 months ie in which patients are being treated according to the old method intervention 1 month ie wash-in period HCW will be trained to conduct the urinary dipstick test and post-intervention 3 months ie in which for all patients with urinary complaints a dipstick test will be used Urinary dipstick testing will be introduced as an intervention to rule-out uncomplicated UTI in the primary health care Urine culture will be performed to confirm the diagnosis of uncomplicated UTI based on the bacterial colony count on the MacConkey agar Urine specimen will be inoculated on to MacConkey agar and stored in 2-8oC until incubating in the microbiology laboratory of Dr Saiful Anwar hospital Malang Diponegoro National hospital Semarang or Bali Mandara hospital Denpasar Identification of isolates and antimicrobial susceptibility testing will be performed using Vitek2 bioMérieux The urine culture results will not change the decision of antibiotic therapy to the patients
Qualitative evaluation of antibiotics for uncomplicated UTI in primary health care settings will be performed by the Gyssens algorithm and subsequent comparison before pre-intervention and after urinary dipstick testing post-intervention was applied Hadi U et al 2008 All adult patients with uncomplicated UTI are eligible for inclusion in the study Of each included patient we will collect the following information after written consent basic characteristics eg gender age and UTI complaints eg dysuria and lower abdominal pain by structured interview Participants will provide a clean-catch mid-stream urine for dipstick test and culture However patients who have recurrent episodes of uncomplicated UTI pregnant women and patients with recent antibiotic use any antibiotic use within 3 months before visit will be excluded We will ask patients to return to the same public health center within one week after inclusion if they have the same complains this will be recorded
Sample size 50 patients in each group this would lead to a total sample size of 300 patients
Aim 2
The knowledge on and current practice of uncomplicated UTI management in primary health care settings will be obtained by a survey among HCW in the baseline phase pre-intervention The survey will be partly open-ended questions including the number of uncomplicated UTI cases per month on average the complaints of patient with uncomplicated UTI how the healthcare workers decide to treat and not to treat for patients with suspected uncomplicated UTI what antibiotics the healthcare workers choose and why they choose that kind of antibiotics General knowledge on antibiotics will also be measured
A before-after study will be carried out in primary health care settings in three cities Malang Semarang and Denpasar in Indonesia
The specific aims will be addressed as follows
Aim 1
The study will be divided into three phases pre-intervention 3 months ie in which patients are being treated according to the old method intervention 1 month ie wash-in period HCW will be trained to conduct the urinary dipstick test and post-intervention 3 months ie in which for all patients with urinary complaints a dipstick test will be used Urinary dipstick testing will be introduced as an intervention to rule-out uncomplicated UTI in the primary health care Urine culture will be performed to confirm the diagnosis of uncomplicated UTI based on the bacterial colony count on the MacConkey agar Urine specimen will be inoculated on to MacConkey agar and stored in 2-8oC until incubating in the microbiology laboratory of Dr Saiful Anwar hospital Malang Diponegoro National hospital Semarang or Bali Mandara hospital Denpasar Identification of isolates and antimicrobial susceptibility testing will be performed using Vitek2 bioMérieux The urine culture results will not change the decision of antibiotic therapy to the patients
Qualitative evaluation of antibiotics for uncomplicated UTI in primary health care settings will be performed by the Gyssens algorithm and subsequent comparison before pre-intervention and after urinary dipstick testing post-intervention was applied Hadi U et al 2008 All adult patients with uncomplicated UTI are eligible for inclusion in the study Of each included patient we will collect the following information after written consent basic characteristics eg gender age and UTI complaints eg dysuria and lower abdominal pain by structured interview Participants will provide a clean-catch mid-stream urine for dipstick test and culture However patients who have recurrent episodes of uncomplicated UTI pregnant women and patients with recent antibiotic use any antibiotic use within 3 months before visit will be excluded We will ask patients to return to the same public health center within one week after inclusion if they have the same complains this will be recorded
Sample size 50 patients in each group this would lead to a total sample size of 300 patients
Aim 2
The knowledge on and current practice of uncomplicated UTI management in primary health care settings will be obtained by a survey among HCW in the baseline phase pre-intervention The survey will be partly open-ended questions including the number of uncomplicated UTI cases per month on average the complaints of patient with uncomplicated UTI how the healthcare workers decide to treat and not to treat for patients with suspected uncomplicated UTI what antibiotics the healthcare workers choose and why they choose that kind of antibiotics General knowledge on antibiotics will also be measured
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
False
Is a FDA Regulated Device?:
False
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None