scholarly journals Attitudes to and experience of disease management programs in primary care—an exploratory survey of general practitioners in Germany

2021 ◽  
Author(s):  
Julian Wangler ◽  
Michael Jansky
Keyword(s):  
Primary Care ◽  
Disease Management ◽  
Patient Care ◽  
General Practitioners ◽  
Linear Regression Analysis ◽  
Chronically Ill ◽  
Disease Management Programs ◽  
Federal States ◽  
Set Up ◽  
Chronically Ill Patients

Summary Background Disease management programs (DMPs) were set up in Germany in 2003 to improve outpatient care of chronically ill patients. The present study looks at the attitudes and experiences of general practitioners (GPs) in relation to DMPs, how they rate them almost 20 years after their introduction and where they see a need for improvement. Methods A total of 1504 GPs in the Federal States of Rhineland Palatinate, Saarland and Hesse were surveyed between December 2019 and March 2020 using a written questionnaire. Results In total, 58% of respondents rate DMPs positively and regard them as making a useful contribution to primary care. The guarantee of regular, structured patient care and greater compliance are regarded as particularly positive aspects. It was also established that diagnostic and therapeutic knowledge was expanded through participation in DMPs. 57% essentially follow the DMP recommendations for (drug) treatment. Despite positive experiences of DMPs in patient care, the GPs surveyed mention various challenges (documentation requirements, frequent changes to the programmes, inflexibility). Univariant linear regression analysis revealed factors influencing the satisfaction with DMPs, such as improvement of compliance and clearly defined procedures in medical care. Conclusion Most of the GPs surveyed consider the combination of continuous patient care and evidence-based diagnosis and treatment to be a great advantage. To better adapt DMPs to the conditions of primary care, it makes sense to simplify the documentation requirements, to regulate cooperation with other healthcare levels more clearly and to give GPs more decision-making flexibility. Increased inclusion of GP experience in the process of developing and refining DMPs can be helpful.

scholarly journals The role of disease management programs in the health behavior of chronically ill patients

2014 ◽  
Vol 95 (1) ◽  
pp. 137-142 ◽  
Author(s):  
Jane Murray Cramm ◽  
Samantha A. Adams ◽  
Bethany Hipple Walters ◽  
Apostolos Tsiachristas ◽  
Roland Bal ◽  
...  
Keyword(s):  
Disease Management ◽  
Health Behavior ◽  
Chronically Ill ◽  
Disease Management Programs ◽  
Chronically Ill Patients

PatientConcept App � an innovative tool to improve therapy adherence and to implement risk management plans. (Preprint)

2018 ◽  
Author(s):  
Michael Lang ◽  
Martin Mayr ◽  
Stefan Ringbauer ◽  
Lukas Cepek
Keyword(s):  
Risk Management ◽  
Disease Management ◽  
Chronically Ill ◽  
Patient Reported Outcome ◽  
Outcome Data ◽  
Daily Routine ◽  
Software Application ◽  
Patient Reported ◽  
Management Plans ◽  
Chronically Ill Patients

UNSTRUCTURED Background: Adherence constitutes a great challenge for disease management, particularly when treating chronically ill patients facing an extensive, complex and long-term therapy. Earlier studies emphasize the relevance of adherence for improving therapy benefits. Besides the positive impact of increased patient support, the use of mobile health applications has gained importance in disease management. Objective: We aimed to develop a software application providing innovative features to simplify the contact between patients and treating physicians in order to overcome adherence barriers, to implement risk management plans and to collect patient reported outcome data. Methods: A novel software application ensuring data security was developed. Various innovative modules have been implemented, enabling bidirectional communication between treating physicians and patients, supporting therapy monitoring and management and allowing the collection of large sets of anonymous patient data. Results: The PatientConcept app is freely available for download and is tested since 2016, with more than 1800 generated patient IDs and 279 patients documenting health data according to risk management plans online in 2017. The impact on adherence issues is currently tested in larger patient populations. Conclusion: This innovative app provides a feasible and cost-optimized possibility to intensify and simplify the communication between patients and their treating physicians across indications, thus promising an exceptional benefit to both. It may not only support chronically ill patients in managing their daily life and improving adherence, but can also facilitate the implementation of risk management plans through automated monitoring, thus supporting physicians in their daily routine. Furthermore, patient reported outcome data can be collected. Importantly, a secure ID-associated data management ensures patient anonymity complying with highest data safety standards.

Somatoform disorders: A help or hindrance to good patient care?

2004 ◽  
Vol 184 (6) ◽  
pp. 465-467 ◽  
Author(s):  
Michael Sharpe ◽  
Richard Mayou
Keyword(s):  
Primary Care ◽  
Patient Care ◽  
General Practitioners ◽  
Somatoform Disorders ◽  
Somatoform Disorder ◽  
Good Patient ◽  
Specific Category ◽  
Good Patient Care ◽  
Almost All ◽  
Issue Reports

The paper by de Waal and colleagues (2004, this issue) reports on the prevalence of somatoform disorders in Dutch primary care. They found that at least one out of six patients seen by general practitioners could be regarded as having a somatoform disorder, almost all in the non-specific category of undifferentiated somatoform disorder. The prevalence of the condition has major implications for medical services but what does this diagnosis mean? Is receiving a diagnosis of somatoform disorder of any benefit to the patient? Does it help the doctor to provide treatment?

scholarly journals Factors influencing general practitioners’ perception of and attitude towards dementia diagnostics and care—results of a survey among primary care physicians in Germany

2021 ◽  
Author(s):  
Julian Wangler ◽  
Michael Jansky
Keyword(s):  
Primary Care ◽  
Influencing Factors ◽  
General Practitioners ◽  
Primary Care Physicians ◽  
Descriptive Analysis ◽  
Linear Regression Analysis ◽  
Interdisciplinary Cooperation ◽  
Practice Staff ◽  
People With Dementia ◽  
Dementia Diagnostics

SummaryStudies have shown that primary care is not always effective when it comes to caring for people with dementia. In addition, general practitioners do not always use diagnostic instruments consistently. The aim of the study was to identify relevant factors that influence general practitioners’ attitudes and willingness with respect to consistent diagnosis and care. For this purpose, resources, viewpoints, and behavioral patterns of general practitioners with regard to dementia diagnostics as well as common challenges in everyday practice were recorded. In the course of a survey, a total of 2266 general practitioners in Hesse and Baden-Württemberg were interviewed between January and March 2020. In addition to the descriptive analysis, a t-test was used to determine significant differences between two groups. A univariate linear regression analysis was carried out to identify possible influencing factors. 81% of the respondents do provide dementia diagnostics; 51% are involved in the treatment. Most of them see the diagnostic work-up (77%), communication and compliance problems (73%), as well as the therapeutic support (71%) as common challenges. In addition, there are interface problems regarding the interdisciplinary cooperation. Some of the respondents express doubts about the value of early detection (41%). The general practitioners’ attitude with respect to dementia diagnostics and care is determined by influencing factors that relate to geriatric competencies, expectations of self-efficacy, the integration of practice staff, as well as the knowledge of and cooperation with counseling and care services. It seems advisable to strengthen the geriatric competence of general practitioners. Moreover, it appears essential to educate general practitioners more about support structures in the field of dementia care and to integrate them accordingly. In addition, practice staff should be more systematically involved in the identification and care of dementia patients.

scholarly journals Collaboration amongst general practitioners and gynaecologists working in primary health care in Germany: a cross-sectional study

2021 ◽  
Vol 22 ◽  
Author(s):  
Barbara Trusch ◽  
Christoph Heintze ◽  
Elena Petelos ◽  
Lorena Dini
Keyword(s):  
Primary Care ◽  
General Practitioners ◽  
Interprofessional Collaboration ◽  
Cross Sectional Study ◽  
Postal Survey ◽  
Sectional Study ◽  
Healthcare Provision ◽  
Cross Sectional ◽  
Federal States ◽  
Key Competencies

Abstract Aim: This cross-sectional study is the first one to explore the collaboration of the influencing factors thereof amongst general practitioners (GPs) and gynaecologists (Gyns) working in primary care in urban and rural settings in Germany. Background: The number of women aged ≥ 50 years is predicted to increase in the next years in Germany. This coincides with the ageing of primary care specialists providing outpatient care. Whereas delegation of tasks to nurses as a form of interprofessional collaboration has been the target of recent studies, there is no data regarding collaboration amongst physicians in different specialisations working in primary care. We explored collaboration amongst GPs and Gyn regarding the healthcare provision to women aged ≥ 50 years. Methods: A quantitative postal survey was administered to GPs and Gyns in three federal states in Germany, focusing on care provision to women aged ≥ 50 years. A total of 4545 physicians, comprising 3514 GPs (67% of the total GP population) randomly selected, and all 1031 Gyns practicing in these states received the postal survey in March 2018. A single reminder was sent in April 2018 with data collection ending in June 2018. Multiple logistic regressions were performed for collaboration, adjusted by age and sex, alongside descriptive methods. Findings: The overall response rate was 31% (1389 respondents): 861 GPs (25%) and 528 Gyns (51%), with the mean respondent age being 54.4 years. Seventy-two per cent were female. Key competencies of collaboration are associated with working in rural federal states and with network participation. Physicians from rural states [odds ratio (OR) = 1.5, 95% confidence interval (CI) = 1.2, 1.9] and physicians in networks (OR = 3.0, CI = 2.3, 3.9) were more satisfied with collaboration. Collaboration to deliver services for women aged ≥ 50 years is more systematic amongst GPs and Gyns who are members of a network; increased networking could improve collaboration, and ultimately, outcomes too.

scholarly journals Pilot study to build capacity for family medicine with abbreviated, low-cost training programme with minimal impact on patient care for a cohort of 84 general practitioners caring for Palestinian refugees in Jordan

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e028240 ◽  
Author(s):  
Amjad Al Shdaifat ◽  
Therese Zink
Keyword(s):  
Primary Care ◽  
Patient Care ◽  
General Practitioners ◽  
Clinical Skills ◽  
Low Cost ◽  
Training Programme ◽  
Ambulatory Setting ◽  
Secondary Outcome ◽  
Intervention Programme ◽  
Minimal Impact

PurposeStudies document that primary care improves health outcomes and controls costs. In regions of the world where primary care is underdeveloped, building capacity is essential. Most capacity building programmes are expensive and take physicians away from their clinical settings. We describe a programme created, delivered and evaluated from 2013 to 2014 in Jordan.DesignCohort study.SettingPhysicians providing primary care in the United Nations Relief and Works Agency for Palestine Refugees clinics in Jordan.ParticipantsEighty-four general practitioners (GPs) were invited to participate and completed the training and evaluation. GPs are physicians who have a license to practice medicine after completing medical school and a 1 year hospital-based rotating internship. Although GPs provide care in the ambulatory setting, their hospital-based education provides little preparation for delivering ambulatory primary care.Intervention/ProgrammeThis three-stage programme included needs assessment, didactics and on-the-job coaching. First, the learning needs and baseline knowledge of the trainees were assessed and the findings guided curriculum development. During the second stage, 48 hours of didactics covered topics such as communications skills and disease management. The third stage was delivered one on one in the trainee’s clinical setting for a 4 to 6-hour block. The first, middle and final patient interactions were evaluated.Primary and secondary outcome measuresPreknowledge and postknowledge assessments were compared. The clinical checklist, developed for the programme, assessed eight domains of clinical skills such as communication and history taking on a five-point Likert scale during the patient interaction.ResultsPreknowledge and postknowledge assessments demonstrated significantly improved scores, 46% to 81% (p<0.0001). Trainee’s clinical checklist scores improved over the assessment intervals. Satisfaction with the training was high.ConclusionThis programme is a potential model for building primary care capacity at low cost and with little impact on patient care that addresses both knowledge and clinical skills on the job.

scholarly journals Incomplete medication adherence of chronically ill patients in German primary care

2013 ◽  
pp. 237 ◽  
Author(s):  
Jakob Hüther ◽  
von Wolff ◽  
Stange ◽  
Kriston ◽  
Baehr ◽  
...  
Keyword(s):  
Primary Care ◽  
Medication Adherence ◽  
Chronically Ill ◽  
Chronically Ill Patients

scholarly journals Chronic patient care at North West Province clinics

2009 ◽  
Vol 1 (1) ◽  
Author(s):  
Claire Van Deventer ◽  
Ian Couper ◽  
Nontsikelelo Sondzaba
Keyword(s):  
Patient Care ◽  
Chronically Ill ◽  
Chronic Illnesses ◽  
Chronic Patient ◽  
Flow Measurements ◽  
North West ◽  
The North ◽  
Southern District ◽  
North West Province ◽  
Chronically Ill Patients

Background: Chronic illnesses are a significant burden to the health services in South Africa. There is a specific national health plan whereby chronically ill patients who are acceptably controlled should be managed at clinic level. The perception has emerged that the management of primary care has not been optimal in the Southern District of the North West Province. This provided the motivation to initiate this research, namely consideration of chronic patient care at clinics in the North West Province of South Africa.Method: A cross-sectional descriptive study was carried out at four randomly selected clinics covering four sub-districts in the Southern District (North West Province). This was done using charts and registers at the clinics. Inclusion criteria were patients older than 18, and presenting with the following chronic illnesses: asthma/chronic obstructive airways disease (COAD), hypertension, diabetes and epilepsy. The major focus areas were the regular assessment of the patients, the level of control of the illness and the use of the Essential Drugs List and Standard Treatment Guidelines (EDL/STG).Results: In the cases of all the chronic illnesses it was found that regular assessments were poorly done, with asthma (peak flow measurements) being the most poorly done. Control was generally less than 50% for all the illnesses, although the EDL was followed fairly well by the personnel at the clinics.Conclusion: In the light of the burden of chronic illness the results give cause for great concern about the quality of care for chronically ill patients, and reasons were sought for some of the poor results. A subsequent decision was taken to carry out comprehensive quality improvement projects on each of the illnesses over the following five years.

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