Conducting invasive urodynamics in primary care: qualitative interview study examining experiences of patients and healthcare professionals

Research output: Contribution to journalArticlepeer-review

Authors

  • Sarah Milosevic
  • Natalie Joseph-Williams
  • Bethan Pell
  • Elizabeth Cain
  • Robyn Hackett
  • Ffion Murdoch
  • Haroon Ahmed
  • A Joy Allen
  • Alison Bray
  • Samantha Clarke
  • Marcus J. Drake
  • Michael Drinnan
  • Kerenza Hood
  • Tom Schatzberger
  • Emma Thomas-Jones
  • Raymond White
  • Adrian Edwards
  • Christopher Harding

Colleges, School and Institutes

External organisations

  • South East Wales Trials Unit
  • Department of Primary Care and Public Health
  • Cardiff University

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.

Details

Original languageEnglish
Article number10
JournalDiagnostic and Prognostic Research
Volume5
Publication statusPublished - 18 May 2021