ArticleBMC primary care2026
Practice-level mechanisms contributing to successful implementation of a UTI antibiotic stewardship intervention: a qualitative study in Dutch general practices.
Article in BMC primary care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
Abstract
backgroundA recent multi-country cluster randomised trial (ImpresU) found that implementation of an antibiotic stewardship intervention (ASI) safely reduced antibiotic prescribing for suspected urinary tract infections (UTI) in frail older adults. However, it remains to be elucidated how the ASI achieved organisational change at practice-level. Therefore, the aim in this study, was to unravel practice-level mechanisms contributing to successful implementation of the ImpresU UTI ASI in Dutch general practices.
methodsA qualitative interview study with healthcare professionals from general practices and the older adult care organisations was performed. These general practices and older adult care organisations were part of all six Dutch intervention clusters in the ImpresU trial, where the UTI ASI has led to fewer antibiotic prescribing. Semi-structured interviews were performed with 15 health care professionals between November 2023 and February 2024. Interviews were transcribed verbatim and analysed using thematic analysis.
resultsWe identified four practice-level mechanisms contributing to successful UTI ASI implementation: (1) scheduling a dedicated moment for interprofessional discussions about suspected UTIs, (2) making step-by-step work instructions visually available for all health care professionals involved, (3) structured steps and nudging to facilitate adoption of new practices and (4) enhancing motivation by a team champion. All of the mechanisms together seem to have led to a more adequate UTI care pathway in the general practices, through which they could reduce antibiotic prescribing.
conclusionWe identified four key practice-level mechanisms through which Dutch general practices implemented an ASI to improve their UTI care pathway for frail older adults. In-depth insight into how implementation works through these mechanisms can inform strategies for broader UTI ASI implementation in diverse general practice settings.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.