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Contains fulltext : 282889.pdf (Publisher’s version ) (Open Access) INTRODUCTION: The use of antibiotics in human medicine is partly responsible for the global increase in antibiotic resistance. Significant reductions in antibiotic prescribing were realised through educational campaigns, communication training and prescribing feedback. Based on data from the cluster-randomised CHANGE-3 trial, the present analysis focuses on the question of patient expectations for an antibiotic in acute respiratory infections. METHODS: 106 of 114 General Practitioner (GP) practices in Baden-Württemberg and Mecklenburg-Western Pomerania took part in the study. 4736 patients who visited the practices with acute respiratory infections from October 2018 to May 2019 filled out a questionnaire after the doctor's consultation. The analysis was descriptive. RESULTS: 16.7 % of patients with acute respiratory infections reported receiving antibiotics from their GP. 13.3 % of patients had hoped for an antibiotic and 5.5 % stated that they had asked their GP for an antibiotic prescription. The lowest prescription rate for antibiotics was reported by patients who had received a diagnosis of influenza from their GP. With specific diagnoses differentiated from uncomplicated respiratory tract infection, an increase in both the number of antibiotics hoped for and the number of antibiotics prescribed was observed. DISCUSSION: Patients still receive antibiotics more often than they actually hope for. On the part of GPs, prescriptions may still be written because of perceived pressure from patients, but this is not reflected in patient expectations. In addition to dealing openly with patients' expectations, strengthening patients' health literacy, mindful doctor-patient communication and offered opportunities for re-presentation in the case of specific diagnoses could further reduce the perceived pressure on GPs.

Hintergrund und Stand (inter)nationaler Forschung: Der Einsatz von Antibiotika ist in Deutschland insgesamt moderat, in der Primärversorgung werden jedoch noch zu häufig Verordnungen bei akuten, unkomplizierten Infektionen ausgestellt. Daher fokussierte eine mit Mitteln des Innovationsausschusses[zum vollständigen Text gelangen Sie über die oben angegebene URL], 19. Deutscher Kongress für Versorgungsforschung (DKVF)

Dominik Ose,1,2 Eva C Winkler,3 Sarah Berger,1 Ines Baudendistel,1 Martina Kamradt,1 Felicitas Eckrich,1 Joachim Szecsenyi1 1Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany; 2Department of Population Health, Health System Innovation and Research, University of Utah, Salt Lake City, UT, USA; 3Program for Ethics and Patient-oriented Care in Oncology, National Centre for Tumour Diseases, University Hospital Heidelberg, Heidelberg, Germany Purpose: Given the inherent complexity of cancer care, in which personal, social, and clinical aspects accumulate and interact over time, self-management support need to become more comprehensive. This study has the following two aims: 1) to analyze and describe the complexity of individual patient situations and 2) to analyze and describe already established self-management strategies of patients to handle this complexity.Methods: A qualitative study was conducted. Ten focus groups were performed collecting perspectives of the following three user groups: patients with colorectal cancer (n=12) and representatives from support groups (n=2), physicians (n=17), and other health care professionals (HCPs; n=16). Data were analyzed using qualitative content analysis.Results: The results showed that cancer patients are struggling with the complexity of their individual situations characterized by the 1) “complexity of disease”, 2) “complexity of care”, and 3) “complexity of treatment-related data”. To deal with these multifaceted situations, patients have established several individual strategies. These strategies are “proactive demanding” (eg,to get support and guidance or a meaningful dialog with the doctor), “proactive behavior” (eg,preparation of visits), and “proactive data management” (eg, in terms of merging treatment-related data and to disseminate these to their health care providers).Conclusion: Patients with colorectal cancer have to handle a high complexity of individual situations within treatment and care of their disease. Private and social challenges have a culminating effect. This complexity increases as patients experience a longer duration of treatment and follow-up as patients have to handle a significantly higher amount of data over time. Self-management support should focus more on the individual complexity in a patient’s life. This includes assisting patients with strategies that have already been established by themselves (like preparation of visits). Keywords: self-management, health care utilization, colorectal cancer, chronic care, health services research, complexity

Hintergrund: Bezogen auf die Gesamtbevölkerung in Deutschland ist der Verbrauch von Antibiotika im ambulanten Bereich am höchsten. Der unsachgemäße Gebrauch von Antibiotika gilt als Hauptursache für die Entwicklung von Resistenzen. Seit einigen Jahren gehören die Themen[zum vollständigen Text gelangen Sie über die oben angegebene URL], 18. Deutscher Kongress für Versorgungsforschung (DKVF)

Hintergrund: Noch zu häufig werden in der Primärversorgung Antibiotika ohne ausreichende Indikation eingesetzt. Um der progredienten Resistenzentwicklung entgegenzuwirken, zielt das Projekt „Antibiotika- Resistenzentwicklung nachhaltig abwenden (ARena)“ auf die Förderung[zum vollständigen Text gelangen Sie über die oben angegebene URL], 53. Kongress für Allgemeinmedizin und Familienmedizin

Hintergrund: In der ambulanten Versorgung werden nach wie vor zu viele Breitspektrum-Antibiotika verordnet und zu häufig Antibiotika zur Therapie akuter, unkomplizierter Infekte eingesetzt. Genau hier setzt ARena (ISRCTN 58150046, gefördert mit Mitteln des Innovationsausschusses beim Gemeinsamen[zum vollständigen Text gelangen Sie über die oben angegebene URL], 53. Kongress für Allgemeinmedizin und Familienmedizin

Hintergrund: Das Projekt besteht aus einer die Öffentlichkeit und Fachkreise adressierenden webbasierten Regionalintervention in Baden-Württemberg und Mecklenburg-Vorpommern sowie einem genesteten RCT. Es wurde ein einheitliches visuelles und textliches Konzept für alle Interventionsmaterialien[zum vollständigen Text gelangen Sie über die oben angegebene URL], 53. Kongress für Allgemeinmedizin und Familienmedizin

Anika Sparla,1 Sebastian Flach-Vorgang,1 Matthias Villalobos,2 Katja Krug,1 Martina Kamradt,1 Kadiatou Coulibaly,1 Joachim Szecsenyi,1 Michael Thomas,2 Sinikka Gusset-Bährer,2 Dominik Ose1,3 1Department of General Practice and Health Services Research, Heidelberg University Hospital, 2Internistische Onkologie der Thoraxtumoren, Thoraxklinik im Universitätsklinikum Heidelberg, Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research, Heidelberg, Germany; 3University of Utah, Department of Population Health Sciences, Health System Innovation and Research, Salt Lake City, UT, USA Purpose: Lung cancer is a disease with a high percentage of patients diagnosed in an advanced stage. In a situation of palliative treatment, both patients and their relatives experience diverse types of distress and burden. Little research has been done to identify the individual difficulties and resources for patients with advanced lung cancer and their relatives. Especially, standardized questionnaire-based exploration may not assess the specific distressing issues that pertain to each individual on a personal level. The purpose of this qualitative study is to explore and compare individual difficulties and resources for lung cancer patients and their relatives within the palliative care context.Methods: Data were collected by qualitative interviews. A total of 18 participants, nine patients diagnosed with advanced lung cancer (International Classification of Diseases, tenth edition, diagnosis C-34, stage IV) starting or receiving palliative treatment and nine relatives, were interviewed. Data were interpreted through qualitative content analysis.Results: We identified four main categories of difficulties: communication and conflicts, home and everyday life, thinking about cancer, and treatment trajectory. In general, difficulties were related to interpersonal relationships as well as to impact of chemotherapy. Family, professional caregivers, and social life were significant resources and offered support to both patients and relatives.Conclusion: Results suggest that patient and relative education could reduce difficulties in several areas. Patients seem to struggle with the fear of not having any perspective in therapy. Relatives seem to experience helplessness regarding their partner’s deterioration and have to handle their own life and the care work simultaneously. The most important resource for both patients and relatives is their family. In addition, professional lung cancer nurses support relatives in an emotional and organizational way. Intense supportive care for relatives should be standardized. Keywords: inoperable lung cancer, palliative care, difficulties, resources, health services research, qualitative research

Hintergrund: In der Primärversorgung werden noch zu häufig Antibiotika zur Therapie akuter, unkomplizierter Infekte eingesetzt, obwohl sie nicht indiziert sind. Die Studie „Antibiotika- Resistenzentwicklung nachhaltig abwenden (ARena*)“ zielt auf die Optimierung des indikationsgerechten[zum vollständigen Text gelangen Sie über die oben angegebene URL], 52. Kongress für Allgemeinmedizin und Familienmedizin

Hintergrund: In der BMG geförderten Studie „Verbesserung des Umgangs mit Antibiotika bei akuten Atemwegsinfekten in der deutschen Primärversorgung (Change-3)“ arbeiten Wissenschaftler des allgemeinmedizinischen Instituts der Universitätsmedizin Rostock mit Hochschullehrern[zum vollständigen Text gelangen Sie über die oben angegebene URL], 52. Kongress für Allgemeinmedizin und Familienmedizin

Hintergrund: Das Vorhandensein von mehreren chronischen Erkrankungen kann die medizinische Versorgung erschweren und somit auch die Qualität dieser beeinflussen. Multimorbide Patienten haben z.B. ein erhöhtes Risiko frühzeitig zu versterben und stationär behandelt zu werden sowie[zum vollständigen Text gelangen Sie über die oben angegebene URL], 16. Deutscher Kongress für Versorgungsforschung (DKVF)

Hintergrund: Das Projekt „INFOrmationstechnologie für eine PATientenorientierte Gesundheitsversorgung“ (INFOPAT, [link:www.infopat.eu*http://www.infopat.eu/]) in der Metropolregion Rhein-Neckar zählt zu einer von fünf durch das Bundesministerium[zum vollständigen Text gelangen Sie über die oben angegebene URL], 15. Deutscher Kongress für Versorgungsforschung

Hintergrund: Bei der Entwicklung von Software-Lösungen für das Gesundheitswesen ist die frühzeitige Einbeziehung aller Nutzergruppen unumgänglich. Scheitern Software-Entwicklungen im Gesundheitswesen, weil entscheidende Rahmenbedingungen des Versorgungsalltags außer Acht gelassen[zum vollständigen Text gelangen Sie über die oben angegebene URL], 14. Deutscher Kongress für Versorgungsforschung