Patienten mit Gerinnungsstörungen optimal versorgen : PICANT-Studie setzt auf ein geschultes Praxisteam und die Motivation zu Selbstmanagement

Patienten mit einem erhöhten Risiko für Thrombosen oder Embolien müssen oft ein Leben lang medikamentös behandelt werden. Doch nicht jeder, der Gerinnungshemmer benötigen würde, erhält sie auch, und umgekehrt erhält mancher die Medikamente, obwohl sie nicht indiziert wären. Schließlich kann es sein, dass aufgrund von einer Wechselwirkung mit anderen Medikamenten oder einer fehlerhaften medikamentösen Einstellung das Blutungsrisiko oder das Risiko für Embolien erhöht ist. Um die Versorgung auf diesem Gebiet zu verbessern und Komplikationen durch Blutungen oder Embolien zu reduzieren, hat das Institut für Allgemeinmedizin im März 2012 eine Studie mit hessischen Hausarztpraxen begonnen

Primary care management for optimized antithrombotic treatment [PICANT]: study protocol for a cluster-randomized controlled trial

Background: Antithrombotic treatment is a continuous therapy that is often performed in general practice and requires careful safety management. The aim of this study is to investigate whether a best practice model that applies major elements of case management, including patient education, can improve antithrombotic management in primary health care in terms of reducing major thromboembolic and bleeding events. Methods: This 24-month cluster-randomized trial will be performed in 690 adult patients from 46 practices. The trial intervention will be a complex intervention involving general practitioners, health care assistants and patients with an indication for oral anticoagulation. To assess adherence to medication and symptoms in patients, as well as to detect complications early, health care assistants will be trained in case management and will use the Coagulation-Monitoring-List (Co-MoL) to regularly monitor patients. Patients will receive information (leaflets and a video), treatment monitoring via the Co-MoL and be motivated to perform self-management. Patients in the control group will continue to receive treatment-as-usual from their general practitioners. The primary endpoint is the combined endpoint of all thromboembolic events requiring hospitalization, and all major bleeding complications. Secondary endpoints are mortality, hospitalization, strokes, major bleeding and thromboembolic complications, severe treatment interactions, the number of adverse events, quality of anticoagulation, health-related quality of life and costs. Further secondary objectives will be investigated to explain the mechanism by which the intervention is effective: patients' assessment of chronic illness care, self-reported adherence to medication, general practitioners' and health care assistants' knowledge, patients' knowledge and satisfaction with shared decision making. Practice recruitment is expected to take place between July and December 2012. Recruitment of eligible patients will start in July 2012. Assessment will occur at three time points: baseline (T0), follow-up after 12 (T1) and after 24 months (T2). Discussion: The efficacy and effectiveness of individual elements of the intervention, such as antithrombotic interventions, self-management concepts in orally anticoagulated patients and the methodological tool, case-management, have already been extensively demonstrated. This project foresees the combination of several proven instruments, as a result of which we expect to profit from a reduction in the major complications associated with antithrombotic treatment

Effects of treatment in women with gestational diabetes mellitus: systematic review and meta-analysis

Objective To summarise the benefits and harms of treatments for women with gestational diabetes mellitus

Customization options in consumer health information materials on type-2 diabetes mellitus—an analysis of modifiable features in different types of media

IntroductionThe understanding of health-related information is essential for making informed decisions. However, providing health information in an understandable format for everyone is challenging due to differences in consumers’ health status, disease knowledge, skills, and preferences. Tailoring health information to individual needs can improve comprehension and increase health literacy.ObjectiveThe aim of our research was to analyze the extent to which consumers can customize consumer health information materials (CHIMs) for type-2 diabetes mellitus through various media types.MethodsWe conducted a comprehensive search for various CHIMs across various media types, such as websites, apps, videos, and printed or printable forms. A representative sample of CHIMs was obtained for analysis through blocked randomization across the various media types. We conducted a quantitative content analysis to determine the frequency of user-centered customization options. Cross-comparisons were made to identify trends and variations in modifiable features among the media.ResultsIn our representative sample of 114 CHIMs, we identified a total of 24 modifiable features, which we grouped into five main categories: (i) language, (ii) text, (iii) audiovisual, (iv) presentation, and (v) medical content. Videos offered the most customization opportunities (95%), while 47% of websites and 26% of apps did not allow users to tailor health information. None of the printed or printable materials provided the option to customize the information. Overall, 65% of analyzed CHIMs did not allow users to tailor health information according to their needs.ConclusionOur results show that CHIMs for type-2 diabetes mellitus could be significantly improved by providing more customization options for users. Further research is needed to investigate the effectiveness and usability of these options to enhance the development and appropriate provision of modifiable features in health information

Gender Differences in Perceived Working Conditions of General Practitioners During the COVID-19 Pandemic-a Cross-Sectional Study.

BACKGROUND The ongoing COVID-19 pandemic has revealed gender-specific differences between general practitioners in adapting to the posed challenges. As primary care workforce is becoming increasingly female, in many countries, it is essential to take a closer look at gender-specific influences when the global health care system is confronted with a crisis. OBJECTIVE To explore gender-specific differences in the perceived working conditions and gender-specific differences in challenges facing GPs at the beginning of the COVID-19 pandemic in 2020. DESIGN Online survey in seven countries. PARTICIPANTS 2,602 GPs from seven countries (Austria, Australia, Switzerland, Germany, Hungary, Italy, Slovenia). Of the respondents, 44.4% (n = 1,155) were women. MAIN MEASURES Online survey. We focused on gender-specific differences in general practitioners' perceptions of working conditions at the beginning of the COVID-19 pandemic in 2020. KEY RESULTS Female GPs rated their skills and self-confidence significantly lower than male GPs (f: 7.1, 95%CI: 6.9-7.3 vs. m: 7.6, 95%CI 7.4-7.8; p < .001), and their perceived risk (concerned about becoming infected or infecting others) higher than men (f: 5.7, 95%CI: 5.4-6.0 vs. m: 5.1, 95%CI: 4.8-5.5; p = .011). Among female GPs, low self-confidence in the treatment of COVID-19 patients appear to be common. Results were similar in all of the participating countries. CONCLUSIONS Female and male GPs differed in terms of their self-confidence when dealing with COVID-19-related issues and their perceptions of the risks arising from the pandemic. To ensure optimal medical care, it is important that GPs realistically assess their own abilities and overall risk

COVI-Prim international: Similarities and discrepancies in the way general practices from seven different countries coped with the COVID-19 pandemic.

OBJECTIVES General practitioners (GPs) are frequently patients' first point of contact with the healthcare system and play an important role in identifying, managing and monitoring cases. This study investigated the experiences of GPs from seven different countries in the early phases of the COVID-19 pandemic. DESIGN International cross-sectional online survey. SETTING General practitioners from Australia, Austria, Germany, Hungary, Italy, Slovenia and Switzerland. PARTICIPANTS Overall, 1,642 GPs completed the survey. MAIN OUTCOME MEASURES We focused on how well-prepared GPs were, their self-confidence and concerns, efforts to control the spread of the disease, patient contacts, information flow, testing procedures and protection of staff. RESULTS GPs gave high ratings to their self-confidence (7.3, 95% CI 7.1-7.5) and their efforts to control the spread of the disease (7.2, 95% CI 7.0-7.3). A decrease in the number of patient contacts (5.7, 95% CI 5.4-5.9), the perception of risk (5.3 95% CI 4.9-5.6), the provision of information to GPs (4.9, 95% CI 4.6-5.2), their testing of suspected cases (3.7, 95% CI 3.4-3.9) and their preparedness to face a pandemic (mean: 3.5; 95% CI 3.2-3.7) were rated as moderate. GPs gave low ratings to their ability to protect staff (2.2 95% CI 1.9-2.4). Differences were identified in all dimensions except protection of staff, which was consistently low in all surveyed GPs and countries. CONCLUSION Although GPs in the different countries were confronted with the same pandemic, its impact on specific aspects differed. This partly reflected differences in health care systems and experience of recent pandemics. However, it also showed that the development of structured care plans in case of future infectious diseases requires the early involvement of primary care representatives

Covid-19: Szenarien für Herbst/Winter 2022 – und darüber hinaus

Die vergangenen Monate haben dynamische Entwicklungen der Pandemie verdeutlicht. Als Folge dessen kam es quasi zeitgleich in Österreich im ersten Quartal des Jahres 2022 neben dem Beschluss äußerst restriktiver Vorgaben wie der Impfpflicht auch wieder zur Aufhebung fast aller Schutzmaßnahmen im Zusammenhang mit der COVID-19-Pandemie. Die letzten beiden Jahre haben gezeigt, wie dynamisch und rasch sich die Situation phasenweise in der Pandemie ändern kann. Jede Phase erfordert – und je länger die Pandemie andauert, umso mehr – verstärkt interdisziplinäre Zugänge und klare Zielsetzungen für Public Health Interventionen. Dies ist einerseits im Sinne einer verständlichen Kommunikation gegenüber der allgemeinen Bevölkerung wichtig, und andererseits im Sinne einer effektiven Bekämpfung der Ausbreitung der Pandemie unbedingt erforderlich