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

## TL;DR

This study explores how Dutch general practice assistants handle urinary tract infections, finding they overestimate their knowledge and diagnostic tools.

## Contribution

The study provides new insights into the knowledge gaps and practices of GPAs in managing UTIs in the Netherlands.

## Key findings

- 95.8% of GPAs believe their UTI knowledge is sufficient, but few correctly identify high-risk groups.
- 70% of GPAs perform urinalysis even when UTI symptoms are absent.
- GPAs often overvalue urine dipstick results and underestimate patient willingness for non-antibiotic treatments.

## Abstract

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.

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.

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.

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.

The online version contains supplementary material available at 10.1186/s12875-025-03025-3.