Correction to: Evaluating the structural reform of outpatient psychotherapy in Germany (ES-RiP trial) - a qualitative study of provider perspectives

Abstract Background: Access to outpatient mental healthcare can be challenging for patients. In Germany, a national structural reform was implemented in 2017 to accelerate and enhance access to outpatient psychotherapy and reduce waiting times. During the first phase of the study ’Evaluation of a structural reform of the outpatient psychotherapy guideline (ES-RiP)’ and embedded into a process evaluation, the implementation was to be evaluated through assessing general practitioners’ (GPs) and psychotherapists’ (PTs) perspectives regarding utilization of provided new measures, and perceived potential for optimization. Particular focus was on patients with a comorbidity of mental disorders and chronic physical conditions (cMPs). Methods: This exploratory cross-sectional qualitative study used on-site and online focus group discussions and semi-structured open-ended telephone interviews with GPs and outpatient PTs. Generated data were analyzed using thematic framework analysis. Descriptive statistics were used to analyze participant characteristics collected via a socio-demographic questionnaire. Results: Perspectives on the structural reform were heterogenous. GPs and PTs considered the component of timely initial psychotherapeutic assessment consultations beneficial. GPs disapproved of their deficits in detailed information about the structural reform and exchange with outpatient PTs. Improvement suggestions included structured short information exchange and joint quality circles. The overall number of available outpatient PTs in rural areas was perceived as insufficient. For patients with cMPs, GPs saw patient barriers for therapy access and continuity in low intrinsic motivation, physical impediments and older age. PTs also saw patient challenges regarding low intrinsic motivation and keeping scheduled appointments. They considered post-reform administrative efforts to be high and reported that the regulations (conformity) lead to planning difficulties and financial losses. Reform elements were tailored to fit in with PTs key therapy areas. Stronger networking and joint lectures were suggested as remedy for the currently still limited exchange with GPs. Unlike the GPs, PTs emphasized that accepting patients into psychotherapeutic treatment was independent of a possibly present chronic physical disease.Conclusions: The findings contribute to understanding the integration of the delivered structural reform into daily care processes and provides an indication about reached targets and potential improvements. Further phases of the ES-RiP study can build on the findings and broaden insights. Trial registration: Registration-ID DRKS00020344 (DRKS German Register of Clinical Trials; https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00020344)

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Evaluating the structural reform of outpatient psychotherapy in Germany (ES-RiP trial) - a qualitative study of provider perspectives

BMC Health Services Research ◽

10.1186/s12913-021-07220-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Poß-Doering Regina ◽

Hegelow Martin ◽

Borchers Milena ◽

Hartmann Mechthild ◽

Kruse Johannes ◽

...

Keyword(s):

Qualitative Study ◽

Intrinsic Motivation ◽

Rural Areas ◽

Information Exchange ◽

Structural Reform ◽

Framework Analysis ◽

Outpatient Psychotherapy ◽

Psychotherapeutic Treatment ◽

Cross Sectional ◽

Provider Perspectives

Abstract Background Access to outpatient mental healthcare can be challenging for patients. In Germany, a national structural reform was implemented in 2017 to accelerate and enhance access to outpatient psychotherapy and reduce waiting times. During the first phase of the study ‘Evaluation of a structural reform of the outpatient psychotherapy guideline (ES-RiP)’ and embedded into a process evaluation, the implementation was to be evaluated through assessing general practitioners’ (GPs) and psychotherapists’ (PTs) perspectives regarding utilization of provided new measures, and perceived potential for optimization. Particular focus was on patients with a comorbidity of mental disorders and chronic physical conditions (cMPs). Methods This exploratory cross-sectional qualitative study used on-site and online focus group discussions and semi-structured telephone interviews with GPs and outpatient PTs. Generated data were analyzed using thematic framework analysis. Descriptive statistics were used to analyze participant characteristics collected via a socio-demographic questionnaire. Results Perspectives on the structural reform were heterogenous. GPs and PTs considered the component of timely initial psychotherapeutic assessment consultations beneficial. GPs disapproved of their deficits in detailed information about the structural reform and exchange with outpatient PTs. Improvement suggestions included structured short information exchange and joint quality circles. The overall number of available outpatient PTs in rural areas was perceived as insufficient. For patients with cMPs, GPs saw patient barriers for therapy access and continuity in low intrinsic motivation, physical impediments and older age. PTs also saw patient challenges regarding low intrinsic motivation and keeping scheduled appointments. They considered post-reform administrative efforts to be high and reported that the regulations (conformity) lead to planning difficulties and financial losses. Reform elements were tailored to fit in with PTs key therapy areas. Stronger networking and joint lectures were suggested as remedy for the currently still limited exchange with GPs. Unlike the GPs, PTs emphasized that accepting patients into psychotherapeutic treatment was independent of a possibly present chronic physical disease. Conclusions The findings contribute to understanding the integration of the delivered structural reform into daily care processes and provide an indication about reached targets and potential improvements. Further phases of the ES-RiP study can build on the findings and broaden insights. Trial registration Registration-ID DRKS00020344 (DRKS German Register of Clinical Trials.

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Health care provider perspectives on cervical screening for Aboriginal and Torres Strait Islander women: a qualitative study

Australian and New Zealand Journal of Public Health ◽

10.1111/1753-6405.13084 ◽

2021 ◽

Author(s):

Rachael Jaenke ◽

Tamara L. Butler ◽

John Condon ◽

Gail Garvey ◽

Julia M.L. Brotherton ◽

...

Keyword(s):

Health Care ◽

Qualitative Study ◽

Health Care Provider ◽

Care Provider ◽

Torres Strait Islander ◽

Cervical Screening ◽

Provider Perspectives ◽

Torres Strait

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Challenges and Strategies for Implementing Battlefield Acupuncture in the Veterans Administration: A Qualitative Study of Provider Perspectives

Medical Acupuncture ◽

10.1089/acu.2018.1286 ◽

2018 ◽

Vol 30 (5) ◽

pp. 252-261 ◽

Cited By ~ 9

Author(s):

Stephanie L. Taylor ◽

Karleen Giannitrapani ◽

Princess E. Ackland ◽

Jesse Holliday ◽

Kavitha P. Reddy ◽

...

Keyword(s):

Qualitative Study ◽

Veterans Administration ◽

Provider Perspectives ◽

Challenges And Strategies

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A qualitative study on provider perspectives on the barriers to contraceptive use in Kaliro and Iganga districts, Eastern Central Uganda

Christian Journal for Global Health ◽

10.15566/cjgh.v3i2.114 ◽

2016 ◽

Vol 3 (2) ◽

pp. 60-71

Author(s):

Constance Sibongile Shumba ◽

◽

Jonathan Miyonga ◽

Judith Kiconco ◽

Patrick Kerchan ◽

...

Keyword(s):

Qualitative Study ◽

Contraceptive Use ◽

Provider Perspectives

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Transitioning to Person-Centered Care: a Qualitative Study of Provider Perspectives

The Journal of Behavioral Health Services & Research ◽

10.1007/s11414-019-09684-2 ◽

2019 ◽

Vol 47 (3) ◽

pp. 399-408 ◽

Cited By ~ 1

Author(s):

Meredith Doherty ◽

Lynden Bond ◽

Lauren Jessell ◽

Julie Tennille ◽

Victoria Stanhope

Keyword(s):

Qualitative Study ◽

Provider Perspectives ◽

Person Centered Care ◽

Centered Care

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Collaborating across sectors to provide early intervention for Aboriginal and Torres Strait Islander children with disability and their families: a qualitative study of provider perspectives

Journal of Interprofessional Care ◽

10.1080/13561820.2019.1692798 ◽

2019 ◽

Vol 34 (3) ◽

pp. 388-399

Author(s):

Anna Green ◽

Penelope Abbott ◽

Tim Luckett ◽

Patricia Mary Davidson ◽

John Delaney ◽

...

Keyword(s):

Early Intervention ◽

Qualitative Study ◽

Torres Strait Islander ◽

Children With Disability ◽

Provider Perspectives ◽

Torres Strait

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Exploring the Prescribing Process of Domperidone for Low Milk Supply: A Qualitative Study Among Mothers, IBCLCs, and Family Doctors

Journal of Human Lactation ◽

10.1177/0890334420964070 ◽

2020 ◽

pp. 089033442096407

Author(s):

Lara A. Tauritz Bakker ◽

Liset van Dijk ◽

Patricia M. L. A. van den Bemt

Keyword(s):

Qualitative Study ◽

Family Physicians ◽

Milk Supply ◽

Clinical Protocol ◽

Structured Interviews ◽

Cross Sectional ◽

Family Doctors ◽

Provider Perspectives ◽

Lactation Consultants ◽

Dutch Family

Background When mothers are confronted with milk supply problems, taking domperidone is regularly suggested. However, domperidone has been associated with sudden cardiac death and caution in prescribing is advised. In 2016, a multidisciplinary group of authors from a tertiary academic hospital (Erasmus MC) published a clinical protocol in a leading Dutch physicians’ journal to support Dutch family physicians in prescribing domperidone to stimulate lactation. Research aim To explore consumer and health care provider perspectives and experiences regarding the prescribing of domperidone for lactation insufficiency following publication of a national clinical protocol. Methods A cross-sectional qualitative study was performed using semi-structured interviews ( N = 40) based on a topic list covering the prescribing process. Participants were mothers ( n = 18) who had been advised to try domperidone to boost their milk supply between November 2016 and May 2018, their International Board Certified Lactation Consultants ( n = 9), and their family physicians ( n = 15). Another group of participants (mothers; n = 6) answered short questionnaires. All interviews were recorded, transcribed and analyzed using ATLAS.ti software. The resulting list of codes was organized according to the topics. Results In the process leading to domperidone use to stimulate lactation, participant family physicians relied on the IBCLC, pharmacist, or mother to guide the prescription of domperidone, often citing the published national clinical protocol as back up. The medical safeguards incorporated in the protocol (e.g., taking medical history, physical exam, performing electrocardiograms, limiting dosage) were usually not implemented. Conclusions Though the availability of a national clinical protocol in which the prescribing of domperidone for lactation is supported appeared to increase the willingness of participant family physicians to prescribe, gaps were identified between clinical practice and this clinical protocol for prescribing domperidone.

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