Inpatient clinicians' approach to diagnosis of urinary tract infections in older adults using the COM-B model: a qualitative assessment

Sonali D Advani; Nathan Boucher; Alison G C Smith; Connor Deri; Jillian E Hayes; Rebekah Wrenn; Kenneth Schmader

doi:10.1017/ash.2024.401

Inpatient clinicians' approach to diagnosis of urinary tract infections in older adults using the COM-B model: a qualitative assessment

Antimicrob Steward Healthc Epidemiol. 2024 Sep 16;4(1):e134. doi: 10.1017/ash.2024.401. eCollection 2024.

Authors

Sonali D Advani¹, Nathan Boucher², Alison G C Smith³, Connor Deri⁴, Jillian E Hayes⁴, Rebekah Wrenn⁴, Kenneth Schmader^{5

6}

Affiliations

¹ Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine, Durham, NC, USA.
² Sanford School of Public Policy, Duke University, Durham, NC, USA.
³ Department of Medicine, Duke University School of Medicine, Durham, NC, USA.
⁴ Department of Pharmacy, Duke University Hospital, Durham, NC, USA.
⁵ Duke Aging Center, Duke University School of Medicine, Durham, NC, USA.
⁶ Durham VA Medical Center, Durham, NC, USA.

Abstract

Our interviews of inpatient clinicians (physicians, physician assistants) modeled after the Capability, Opportunity, and Motivation Model of Behavior model revealed opportunity and motivation as important drivers for overdiagnosis and overprescribing for asymptomatic bacteriuria in older adults. Understanding these barriers is an important step toward implementing age-friendly stewardship interventions.