1
|
Milosevic S, Joseph-Williams N, Pell B, Cain E, Hackett R, Murdoch F, Ahmed H, Allen AJ, Bray A, Clarke S, Drake MJ, Drinnan M, Hood K, Schatzberger T, Takwoingi Y, Thomas-Jones E, White R, Edwards A, Harding C. Conducting invasive urodynamics in primary care: qualitative interview study examining experiences of patients and healthcare professionals. Diagn Progn Res 2021; 5:10. [PMID: 34006320 PMCID: PMC8130146 DOI: 10.1186/s41512-021-00100-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 04/29/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Invasive urodynamics is used to investigate the causes of lower urinary tract symptoms; a procedure usually conducted in secondary care by specialist practitioners. No study has yet investigated the feasibility of carrying out this procedure in a non-specialist setting. Therefore, the aim of this study was to explore, using qualitative methodology, the feasibility and acceptability of conducting invasive urodynamic testing in primary care. METHODS Semi-structured interviews were conducted during the pilot phase of the PriMUS study, in which men experiencing bothersome lower urinary tract symptoms underwent invasive urodynamic testing along with a series of simple index tests in a primary care setting. Interviewees were 25 patients invited to take part in the PriMUS study and 18 healthcare professionals involved in study delivery. Interviews were audio-recorded, transcribed verbatim and analysed using a framework approach. RESULTS Patients generally found the urodynamic procedure acceptable and valued the primary care setting due to its increased accessibility and familiarity. Despite some logistical issues, facilitating invasive urodynamic testing in primary care was also a positive experience for urodynamic nurses. Initial issues with general practitioners receiving and utilising the results of urodynamic testing may have limited the potential benefit to some patients. Effective approaches to study recruitment included emphasising the benefits of the urodynamic test and maintaining contact with potential participants by telephone. Patients' relationship with their general practitioner was an important influence on study participation. CONCLUSIONS Conducting invasive urodynamics in primary care is feasible and acceptable and has the potential to benefit patients. Facilitating study procedures in a familiar primary care setting can impact positively on research recruitment. However, it is vital that there is a support network for urodynamic nurses and expertise available to help interpret urodynamic results.
Collapse
Affiliation(s)
- Sarah Milosevic
- Centre for Trials Research, Cardiff University, Cardiff, UK.
| | - Natalie Joseph-Williams
- PRIME Centre Wales, Division of Population Medicine, School of Medicine, Neuadd Meirionnydd, Cardiff University, Cardiff, UK
| | - Bethan Pell
- Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), Cardiff University, Cardiff, UK
| | - Elizabeth Cain
- PRIME Centre Wales, Division of Population Medicine, School of Medicine, Neuadd Meirionnydd, Cardiff University, Cardiff, UK
| | - Robyn Hackett
- PRIME Centre Wales, Division of Population Medicine, School of Medicine, Neuadd Meirionnydd, Cardiff University, Cardiff, UK
| | - Ffion Murdoch
- PRIME Centre Wales, Division of Population Medicine, School of Medicine, Neuadd Meirionnydd, Cardiff University, Cardiff, UK
| | - Haroon Ahmed
- PRIME Centre Wales, Division of Population Medicine, School of Medicine, Neuadd Meirionnydd, Cardiff University, Cardiff, UK
| | - A Joy Allen
- NIHR Newcastle In Vitro Diagnostics Co-operative, Newcastle University, Newcastle upon Tyne, UK
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Alison Bray
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
- Northern Medical Physics and Clinical Engineering, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - Samantha Clarke
- North Bristol NHS Trust, Southmead Hospital, Southmead Road, Westbury-on-Trym, Bristol, UK
| | - Marcus J Drake
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Michael Drinnan
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
- Northern Medical Physics and Clinical Engineering, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - Kerenza Hood
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | - Tom Schatzberger
- Corbridge Health Centre, NHS Northumberland Clinical Commissioning Group, Newcastle Road, Corbridge, Northumberland, UK
| | - Yemisi Takwoingi
- Test Evaluation Research Group, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | | | - Raymond White
- PPI Representative, formerly of Grampian University Hospital Trust, Biomedical Physics and Bioengineering, Foresterhill, Aberdeen, UK
| | - Adrian Edwards
- PRIME Centre Wales, Division of Population Medicine, School of Medicine, Neuadd Meirionnydd, Cardiff University, Cardiff, UK
| | - Chris Harding
- Department of Urology, Newcastle upon Tyne NHS Hospital Trust, Newcastle Freeman Hospital, Freeman Road, High Heaton, Newcastle upon Tyne, UK
| |
Collapse
|