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5. Patient-individual tapering of DMARDs in rheumatoid arthritis patients in a real-world setting.

Author

Birkner, Benjamin, Rech, Jürgen, Edelmann, Edmund, Verheyen, Frank, Schett, Georg, and Stargardt, Tom

Subjects
DISEASE progression, CONFIDENCE intervals, TIME, HEALTH outcome assessment, MEDICAL care costs, ANTIRHEUMATIC agents, TREATMENT effectiveness, HEALTH insurance reimbursement, COMPARATIVE studies, RHEUMATOID arthritis, DRUG therapy, MEDICAL records, DECISION making, KAPLAN-Meier estimator, DESCRIPTIVE statistics, RESEARCH funding, MEDICAL practice, TERMINATION of treatment, LONGITUDINAL method, DISEASE remission, PROPORTIONAL hazards models, EVALUATION
Abstract

Objective We aim to provide real-world evidence on the effectiveness of patient-individual tapering of DMARDs for patients with RA in daily clinical practice using medical records and claims data. Methods We utilize data obtained through a controlled prospective cohort study in Germany conducted from July 2018 to March 2021. Participants consist of RA patients in sustained remission (>6 months) who were eligible for tapering at enrolment. Patients treated with individual tapering based on shared decision making (n  = 200) are compared with patients without any dose reduction (n  = 237). The risk of loss of remission and the risk of flare is assessed with risk-adjusted Kaplan–Meier estimators and Cox regressions. We evaluate differences in costs 1 year before and after baseline based on claims data for the subgroup of patients insured at one major sickness fund in Germany (n  = 76). Results The risk of flare (hazard ratio 0.88, 95% CI 0.59, 1.30) or loss of remission (hazard ratio 1.04, 95% CI 0.73, 1.49) was not statistically different between the individual tapering group and the continuation group. Minor increases of disease activity and decreases of quality of life were observed 12 months after baseline, again with no statistically significant difference. Drug costs decreased by 1017€ in the individual tapering group while they increased by 1151€ in the continuation group (P  < 0.01). Conclusion Individual tapering of DMARDs does not increase the average risk of experiencing flares or loss of remission. Encouraging rheumatologists and patients to apply tapering in shared decision making may be a feasible approach to allow individualization of treatment in RA. [ABSTRACT FROM AUTHOR]

Published
2023
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8. Development and validation of the PROPERmed instrument to identify older patients in general practice at risk of worsening health-related quality of life: an individual participant data meta-analysis (IPD-MA)

Author

González-González, Ana Isabel, Meid, Andreas, Nguyen, Truc Sophia, Blom, Jeanet W., van den Akker, Marjan, Swart, Karin, Küllenberg de Gaudry, Daniela, Thiem, Ulrich, Snell, Kym, Haefeli, Walter Emil, Perera, Rafael, Flaig, Benno, Trampisch, Hans-Joachim, Rudolf, Henrik, Meerpohl, Jörg, Elders, Petra, Verheyen, Frank, Kom, Ghainsom, Glasziou, Paul P., Gerlach, Ferdinand Michael, and Muth, Christiane

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Background: Aging populations are facing multimorbidity and polypharmacy, inappropriate prescriptions, and underuse, which may contribute towards worsening of health-related quality of life (wHRQoL). In heterogeneous primary care populations, it would be helpful to identify those patients at highest[for full text, please go to the a.m. URL], 53. Kongress für Allgemeinmedizin und Familienmedizin

Published
2019

9. Towards predictive modelling in an individual patient data meta-analysis (IPD-MA) of older patients with chronic prescriptions in general practice (PROPERmed)

Author

Gonzalez, Ana Isabel, Nguyen, Truc Sophia, Blom, Jeanet W., van den Akker, Marjan, Swart, Karin, Meid, Andreas D., Küllenberg de Gaudry, Daniela, Thiem, Ulrich, Snell, Kym I.E., Haefeli, Walter E., Perera, Rafael, Trampisch, Hans-Joachim, Rudolf, Henrik, Meerpohl, Joerg J., Elders, Petra J.M., Verheyen, Frank, Flaig, Benno, Gerlach, Ferdinand M., Glasziou, Paul, and Muth, Christiane

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Background/research question: Multimorbidity and inappropriate polypharmacy are common in older patients and may lead to medication-related harm resulting in hospitalization and worsening of health-related quality of life (HRQoL). Considering the complex interplay between conditions and medications[for full text, please go to the a.m. URL], EbM und Digitale Transformation in der Medizin; 20. Jahrestagung des Deutschen Netzwerks Evidenzbasierte Medizin

Published
2019
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10. Replacement of endoprosthetic implants within a two years follow-up period: a statutory health insurance routine data analysis

Author

Linder Roland, Müller Hardy, Grenz-Farenholtz Brigitte, Wagner Caroline, Stockheim Martin, and Verheyen Frank

Subjects
Endoprostheses, Hip joint, Knee joint, Routine data analysis, Arthroplasty register, Diseases of the musculoskeletal system, RC925-935
Abstract

Abstract Background The statutory health insurance system embodies a large amount of data on the treatments of their members. Depending on joint, prosthesis type, patient activity and comorbidity, knee and hip replacements can last up to 20 years. Based on statutory health insurance data the main object of this analysis was to investigate how high the early revision rate of replacements actually is. Methods The number of replacements in the years 2005 and 2006 has been extracted from the TK database for hip (OPS-Code 5-820, n = 20,875), knee (OPS 5-822, n = 13,466), upper limbs (OPS 5-824, n = 901), and lower limbs (OPS 5-826) replacements. This data has then been related to each consecutive operation (i. e. change or excision of joint endoprosthesis) over a joint-specific observation period of two years. Results In 3.7% of the cases joint replacements stood for less than 2 years (hip 3.5%, knee 3.8%, upper limbs 6.5%, and lower limbs 5.5%). There is a significantly positive correlation between the treatment data of the hospitals and the outcome as to low rates of reoperations at early stages. The main reason for short lifetime (76 - 81%) is mechanical failure. Conclusion The percentage of joint endoprostheses with significantly short lifetimes has been unexpectedly high. The de facto lifetimes of joint endoprostheses thus often do not match the manufacturers’ information. The authors strongly support the idea of a national endoprosthesis register as such a register could give detailed information on firstly whether these deficits are due to material defects, osteolysis or dislocation and secondly which products are mainly affected.

Published
2012
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11. Improving the care of children and adolescents with medicines by enhancing medication safety - The KiDSafe Project

Author

Neubert, Antje, Schwab, Matthias, Riedel, Claudia, Urschitz, Michael, Zepp, Fred, Romanos, Marcel, Bertsche, Thilo, Kiess, Wieland, Wenzl, Tobias, Haug, Ulrike, Verheyen, Frank, and Rascher, Wolfgang

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Background: Children and adolescents are disadvantaged in terms of drug treatment. 42-90% of hospitalised children and adolescents are treated with medications outside their product licence (off-label use), in the ambulatory area 46-64% of patients are affected [ref:1], [ref:2].[for full text, please go to the a.m. URL], 24. Jahrestagung der Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie

Published
2017

12. Blood glucose testing and primary prevention of diabetes mellitus type 2 - evaluation of the effect of evidence based patient information

Author

Giani Guido, Roden Michael, Nowotny Bettina, Rathmann Wolfgang, Cole Dennis, Verheyen Frank, Steckelberg Anke, Müller Hardy, Meyer Gabriele, Haastert Burkhard, Genz Jutta, Mielck Andreas, Ohmann Christian, and Icks Andrea

Subjects
Public aspects of medicine, RA1-1270
Abstract

Abstract Background Evidence-based patient information (EBPI) has been recognised as important tool for informed choice in particular in the matter of preventive options. An objective, on the best scientific evidence-based consumer information about subthreshold elevated blood glucose levels (impaired fasting glucose and impaired glucose tolerance) and primary prevention of diabetes, is not available yet. Thus we developed a web-based EBPI and aim to evaluate its effects on informed decision making in people 50 years or older. Methods/Design We conduct a web-based randomised-controlled trial to evaluate the effect of information about elevated blood glucose levels and diabetes primary prevention on five specific outcomes: (i) knowledge of elevated blood glucose level-related issues (primary outcome); (ii) attitudes to a metabolic testing; (iii) intention to undergo a metabolic testing; (iv) decision conflict; (v) satisfaction with the information. The intervention group receives a specially developed EBPI about subthreshold elevated blood glucose levels and diabetes primary prevention, the control group information about this topic, available in the internet. The study population consists of people between 50 and 69 years of age without known diabetes. Participants will be recruited via the internet page of the cooperating health insurance company, Techniker Krankenkasse (TK), and the internet page of the German Diabetes Centre. Outcomes will be measured through online questionnaires. We expect better informed participants in the intervention group. Discussion The design of this study may be a prototype for other web-based prevention information and their evaluation. Trial registration Current Controlled Trial: ISRCTN22060616.

Published
2010
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13. TAVI in der klinischen Versorgung - Marktentwicklung einer medizinischen Innovation

Author

Schneider, Udo, Linder, Roland, Horenkamp-Sonntag, Dirk, Schmid, Andreas, and Verheyen, Frank

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Hintergrund: Interventionen mit kathetergestütztem Aortenklappenersatz (TAVI: Trans-catheter aortic valve implantation) nehmen in Deutschland kontinuierlich zu. Im Jahr 2013 lag die Zahl erstmals über jener für konventionelle Eingriffe (Aortenklappenersatz, AKE). Während im Jahr [zum vollständigen Text gelangen Sie über die oben angegebene URL], 14. Deutscher Kongress für Versorgungsforschung

Published
2015

14. Stentimplantationen bei Patienten mit koronaren Herzerkrankungen - ein Einblick in die Versorgungswirklichkeit

Author

Linder, Roland, Zeidler, J., Schilling, T., Verheyen, Frank, Haverich, A., and Graf Von Der Schulenburg, J.-Matthias

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Der Vorteil einer chirurgischen Koronarrevaskularisation (CABG) gegenüber der perkutanen Koronarintervention (PCI) ist zumindest für die Versorgung der koronaren Dreigefäßerkrankung (TVD) nachgewiesen worden [6, 8-11]. In einer gemeinsamen Auswertung des Registers des American[zum vollständigen Text gelangen Sie über die oben angegebene URL], 14. Deutscher Kongress für Versorgungsforschung

Published
2015
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15. Kosten und Versorgungssituation von inzidenten ADHS-Patienten - Eine Vergleichsanalyse vor und nach der Diagnosestellung anhand von GKV-Routinedaten

Author

Klora, Mike, Zeidler, Jan, Linder, Roland, Verheyen, Frank, and Graf Von Der Schulenburg, J.-Matthias

Subjects
Inzidenz, GKV-Routinedaten, Ressourceninanspruchnahme, Kosten, ddc: 610, ADHS, 610 Medical sciences, Medicine, Deutschland
Abstract

Einleitung: Die Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung (ADHS) stellt mit einer Prävalenzrate von ca. 3 bis 5 % eine der am häufigsten diagnostizierten psychischen Störungen bei Kindern und Jugendlichen dar [ref:1]. Direkte Kosten von 341 Mio. €[zum vollständigen Text gelangen Sie über die oben angegebene URL], GMDS 2015; 60. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie e.V. (GMDS)

Published
2015

16. Wechselwirkung zwischen Sozialvariablen und Interventionseffekt einer evidenzbasierten und Standard-Patienteninformationen zu Blutzuckertest und Primärprävention des Diabetes mellitus Typ 2

Author

Genz, Jutta, Haastert, Burkhard, Müller, Hardy, Verheyen, Frank, Cole, Dennis, Rathmann, Wolfgang, Nowotny, Bettina, Roden, Michael, Giani, Guido, Mielck, Andreas, Ohmann, Christian, and Icks, Andrea

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Hintergrund und Fragestellung: Nachdem im RCT gezeigt wurde, dass evidenzbasierte (EBPI) im Vergleich zu Standard-Patienteninformationen zu Blutzuckertest und Primärprävention des Diabetes das Wissen signifikant erhöht, wurde nun die Wechselwirkung von Sozialvariablen (SES) mit der Intervention[for full text, please go to the a.m. URL], Prävention zwischen Evidenz und Eminenz; 15. Jahrestagung des Deutschen Netzwerks Evidenzbasierte Medizin

Published
2014

17. Konsum legaler und illegaler Drogen einer Stichprobe Jugendlicher in Niedersachsen

Author

Langner, Daria, Wartberg, Lutz, Kiehl, Wolfgang, Verheyen, Frank, and Thomasius, Rainer

Subjects
ddc: 610, Alkohol, Niedersachsen, 610 Medical sciences, Medicine, Prävention, Nikotin, Drogenkonsum, Jugendliche
Abstract

Hintergrund: Drogenkonsum stellt ein wichtiges Problem bei jungen Menschen dar, insbesondere da ein früher regelmäßiger Konsum legaler und illegaler Drogen das Risiko zur Entwicklung späterer substanzbezogener Störungen erhöht. Besonders relevant sind bei Jugendlichen nach[for full text, please go to the a.m. URL], 12. Deutscher Kongress für Versorgungsforschung

Published
2013

18. Projektdatenbank Versorgungsforschung Deutschland - Erste Einblicke

Author

Schmidt, Anna, Scholten, Nadine, Grenz-Farenholtz, Brigitte, Pfaff, Holger, and Verheyen, Frank

Subjects
Versorgungsforschung, Transparenz, ddc: 610, Datenbank, Projekte, 610 Medical sciences, Medicine
Abstract

Hintergrund: 'Versorgungsforschung Deutschland' ([link:http://www.versorgungsforschung-deutschland.de*http://www.versorgungsforschung-deutschland.de]) ist eine kostenfreie und öffentlich zugängliche Datenbank für Projekte der Versorgungsforschung[for full text, please go to the a.m. URL], 12. Deutscher Kongress für Versorgungsforschung

Published
2013

19. Anspruch und Versorgungswirklichkeit: Erfolgen Stentimplantationen bei Patienten mit koronaren Herzerkrankungen leitliniengerecht?

Author

Linder, Roland, Zeidler, Jan, Schilling, Tobias, Verheyen, Frank, Graf Von Der Schulenburg, J.-Matthias, and Haverich, Axel

Subjects
koronare Herzkrankheit, ddc: 610, Leitliniengerechtigkeit, Bypass, 610 Medical sciences, Medicine, Stentimplantation
Abstract

Hintergrund: In der 2006 von der Bundesärztekammer, der Kassenärztlichen Bundesvereinigung und den Arbeitsgemeinschaften der Wissenschaftlichen Medizinischen Fachgesellschaften konsentierten Nationalen Versorgungsleitlinie zur chronischen koronaren Herzkrankheit (KHK) wird bei Vorliegen einer[for full text, please go to the a.m. URL], 12. Deutscher Kongress für Versorgungsforschung

Published
2013

20. Stents hinterfragt: Werden Patienten mit koronaren Herzerkrankungen leitliniengerecht versorgt?

Author

Linder, Roland, Zeidler, Jan, Schilling, Tobias, Verheyen, Frank, Graf Von Der Schulenburg, J.-Matthias, and Haverich, Axel

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Einleitung und Fragestellung: In der 2006 von der Bundesärztekammer, der Kassenärztlichen Bundesvereinigung und den Arbeits-gemeinschaften der Wissenschaftlichen Medizinischen Fachgesellschaften konsentierten Nationalen Versorgungsleitlinie zur chronischen koronaren Herzkrankheit (KHK) wird[for full text, please go to the a.m. URL], GMDS 2013; 58. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie e.V. (GMDS)

Published
2013
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21. Unter welchen Voraussetzungen eignen sich GKV-Routinedaten zur Überprüfung von Leitlinien im Versorgungsalltag? - Eine Analyse anhand der Indikation Herzinsuffizienz

Author

Neubauer, Sarah, Zeidler, Jan, Schilling, Tobias, Engel, Susanne, Linder, Roland, Verheyen, Frank, Haverich, Axel, and Graf Von Der Schulenburg, J.-Matthias

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Einleitung und Fragestellung: Leitlinien spielen eine zentrale Rolle in der Medizin, da sie den aktuellen Stand der Wissenschaft zusammenfassen, Handlungsempfehlungen an die behandelnden Ärzte geben sowie den weiteren Forschungsbedarf aufzeigen. Fraglich ist in diesem Zusammenhang, inwiefern diese[for full text, please go to the a.m. URL], GMDS 2013; 58. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie e.V. (GMDS)

Published
2013

22. The epidemiology of osteoporosis--Bone Evaluation Study (BEST): an analysis of routine health insurance data

Author

Hadji, Peyman, Klein, Silvia, Gothe, Holger, Häussler, Bertram, Kless, Thomas, Schmidt, Torsten, Steinle, Thomas, Verheyen, Frank, and Linder, Roland

Subjects
Aged, 80 and over, Male, Multiple Trauma, Comorbidity, Middle Aged, Age Distribution, Risk Factors, Germany, Insurance, Health, Reimbursement, Correspondence, Prevalence, Humans, Osteoporosis, Original Article, Female, Sex Distribution, Osteoporotic Fractures, Aged
Abstract

Osteoporosis is a widespread disease of the skeleton that becomes more common with advancing age. Its prevalence is still inadequately documented. The goal of this study is to determine how common osteoporosis is in Germany.The routine billing data of a large statutory health insurance carrier in Germany (the TK company) from the years 2006 to 2009 were anonymized and retrospectively analyzed. Insurees aged 50 and above with osteoporosis were identified either from their bearing the diagnosis of osteoporosis or of osteoporosis-related fractures, or from their having received prescription medication for osteoporosis. The prevalence and incidence of osteoporosis and the frequency of osteoporotic fractures were calculated for TK insurees and extrapolated to the overall German population.The prevalence of osteoporosis among persons aged 50 and above, as revealed by diagnoses of osteoporosis or osteoporotic fractures, or by the prescription of medication for osteoporosis, was found to be 14% (240,657 of 1.7 million insurees) in the year 2009; the sex-specific prevalence was 24% in women and 6% in men. An extrapolation of these figures implies that 6.3 million persons in Germany have osteoporosis. The incidence of osteoporosis in the same age group, as revealed by a diagnosis of osteoporosis or prescription of medication for osteoporosis, was found to be 2.1% per year, with 104,528 insurees having an index event for osteoporosis (initial diagnosis of osteoporosis or first prescription of a medication for osteoporosis). An extrapolation of this figure implies that 885,000 persons newly develop osteoporosis in Germany each year. Over the period of observation, 52% of the affected persons (total, 172,473 persons) sustained fractures, many of which were multiple.Osteoporosis is still common in Germany. The large number of insurees with single and multiple fractures implies that the treatment of this disease in Germany needs to be improved.

Published
2012

23. Zufriedenheit in der ambulanten Versorgung aus Patientensicht - ZAP revisited

Author

Petrucci, Marco, Bestmann, Beate, Verheyen, Frank, Dierks, Marie-Luise, and Bitzer, Eva Maria

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Hintergrund: Die Erfassung von Prozesszufriedenheit aus Patientensicht in der Arztpraxis ist Bestandteil aller gängigen Qualitätsmanagementsysteme. Empfohlen wird die Erhebung mit reliablen und validen Befragungsinstrumenten. Der Fragebogen zur Zufriedenheit in der ambulanten Versorgung - [for full text, please go to the a.m. URL], 10. Deutscher Kongress für Versorgungsforschung; 18. GAA-Jahrestagung

Published
2011

24. Notfallmäßige Hospitalisierung wegen Asthma-Beschwerden: externe Validitätsprüfung ärztlicher Angaben in DMP-Dokumentationsbögen

Author

Horenkamp-Sonntag, Dirk, Petereit, Frank, Pieper, Christian, Wildner, Daniel, Ahrens, Susanne, Linder, Roland, and Verheyen, Frank

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Hintergrund: Für strukturierte DMP-Programme nach §137 SGBV ist zum 01.04. 2008 durch die 17. Änderung der Risikostruktur-Ausgleichsverordnung (RSAV) eine vereinfachte indikationsübergreifende Dokumentation in ausschließlich elektronischer Form in Kraft getreten. Seitdem sin[for full text, please go to the a.m. URL], 10. Deutscher Kongress für Versorgungsforschung; 18. GAA-Jahrestagung

Published
2011

25. ADHS: Analyse der Auswirkungen des GBA-Beschlusses vom 16.09.2010 zur Einschränkung der Verordnungsfähigkeit von ADHS-Arzneimitteln

Author

Horenkamp-Sonntag, Dirk, Linder, Roland, Ahrens, Susanne, Düker, Peter, Junkmanns, Claudia, and Verheyen, Frank

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Hintergrund: Es ist bekannt, dass das Verordnungsvolumen für Methylphenidat in den letzten zehn Jahren in Deutschland erheblich zugenommen hat. Hierzu existieren bereits Publikationen, die den Arzneimittelverbrauch im Zusammenhang mit der Prävalenzentwicklung beim Aufmerksamkeitsdefizit /[for full text, please go to the a.m. URL], 10. Deutscher Kongress für Versorgungsforschung; 18. GAA-Jahrestagung

Published
2011
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26. Adherence-Management durch Krankenkassen - erste Ergebnisse einer Analyse von Routinedaten

Author

Groth, Antje, Mueller, Sabrina, Linder, Roland, Ahrens, Susanne, Steimle, Tim, Würdemann, Edda, Verheyen, Frank, and Wilke, Thomas

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Hintergrund: Non-Adherence (NA) von Patienten stellt eine der größten Versorgungsherausforderungen dar. NA ist korreliert mit negativen klinischen Outcomes, höherer Mortalität und höheren Kosten. In einem gemeinsamen Projekt der TK (FB Arzneimittel/WINEG) und des IPAM w[for full text, please go to the a.m. URL], 10. Deutscher Kongress für Versorgungsforschung; 18. GAA-Jahrestagung

Published
2011
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27. Correspondence (reply): In Reply

Author

Linder, Roland, Ahrens, Susanne, Verheyen, Frank, Köppel, Dagmar, and Heilmann, Thomas

Subjects
Adult, Aged, 80 and over, Male, Cost-Benefit Analysis, Health Care Costs, Middle Aged, Hospitalization, Young Adult, Treatment Outcome, Diabetes Mellitus, Type 2, Germany, Correspondence, Prevalence, Humans, Female, Aged
Published
2011

28. Blutzuckertest und Primärprävention des Diabetes mellitus Typ 2 - Evaluation des Effekts einer evidenzbasierten Patienteninformation

Author

Genz, Jutta, Haastert, Burkhard, Müller, Hardy, Verheyen, Frank, Cole, Dennis, Rathmann, Wolfgang, Nowotny, Bettina, Roden, Michael, Giani, Guido, Mielck, Andreas, Ohmann, Christian, and Icks, Andrea

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Hintergrund: Wir entwickelten eine internetbasierte EBPI (evidence-based patient information) über grenzwertig erhöhte Blutglucosespiegel und Primärprävention des Diabetes und evaluierten ihren Einfluss auf die informierte Entscheidung bei Personen im Alter von 40–70 Jahren[for full text, please go to the a.m. URL], EbM & Individualisierte Medizin; 12. Jahrestagung des Deutschen Netzwerks Evidenzbasierte Medizin

Published
2011

29. Fall Risk Increasing Drugs: The Effect on Injuries of the Frail Elderly Estimated from Administrative Data

Author

Bauer, Thomas K., Lindenbaum, Katharina, Stroka, Magdalena A., Ahrens, Susanne, Linder, Roland, and Verheyen, Frank

Subjects
jel:I12, jel:I19, Fall risk increasing drugs,Priscus-List,frail elderly,multivariate regression,count data models,Fall risk increasing drugs,Priscus-List,frail elderly,multivariate regression,count data models
Abstract

Society benefits on a large scale from improved medical care and pharmaceuticals. The prescription of pharmaceuticals, however, also carries risks such as the possibility of an increased risk of falls, which may lead to severe injuries and increased health expenditures associated with these injuries. This study investigates the influence of several fall risk increasing drugs (FRIDs) on the number of injuries of elderly persons using multivariate regression models. Routine data from the Techniker Krankenkasse (TK) of frail elderly persons aged Ï 65 years is analyzed for the year 2009 by estimating count data models, in order to take the data generating process of the number of injuries into account. The results of the count data model are compared to those from logistic regressions, which is the default regression model in this fi eld of research. The empirical results suggest that antidepressants, anxiolytics, hypnotics and sedatives, antiarrhythmics, and drugs from the Priscus-list have a signifi cant positive effect on the number of injuries, while antihypertensives and anti-parkinsonian agents show no and neuroleptics a significant negative eff ect. As recurrent injuries are common, the analysis of the number of injuries rather than just the probability of having an injury provides a more informative analysis of FRIDs.

Published
2011

31. Qualität und Effizienz der Gesundheitsversorgung im internationalen Vergleich

Author

Stöver, Jana, Vöpel, Henning, Manouguian, Maral-Sonja, and Verheyen, Frank

Abstract

Gesundheit ist sowohl individuell als auch gesamtwirtschaftlich eine wichtige Determinante der Produktivität sowie der Lebensqualität und der Wohlfahrt. Die Gesundheitsversorgung erfolgt in den meisten Ländern nicht ausschließlich über private Märkte, sondern ist staatlich reguliert und teilweise öffentlich finanziert. Die Gründe hierfür sind einerseits Marktversagen auf privaten Krankenversicherungsmärkten und andererseits normativ begründete Ziele der Gesundheitspolitik, wie z. B. der gleiche Zugang zu gleicher Gesundheitsversorgung für alle Menschen. Somit werden im Gesundheitswesen nicht nur wirtschaftliche Effizienzziele, sondern auch Verteilungs- und Umverteilungsziele verfolgt. Qualität und Effizienz lassen sich daher nur unter Berücksichtigung dieser Ziele bewerten.

Published
2010

32. Socioeconomic factors and effect of evidence-based patient information about primary prevention of type 2 diabetes mellitus - are there interactions?

Author

Genz, Jutta, primary, Haastert, Burkhard, additional, Müller, Hardy, additional, Verheyen, Frank, additional, Cole, Dennis, additional, Rathmann, Wolfgang, additional, Nowotny, Bettina, additional, Roden, Michael, additional, Giani, Guido, additional, Ohmann, Christian, additional, and Icks, Andrea, additional

Published
2014
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34. The Epidemiology of Osteoporosis

Author

Hadji, Peyman, primary, Klein, Silvia, additional, Gothe, Holger, additional, Häussler, Bertram, additional, Kless, Thomas, additional, Schmidt, Torsten, additional, Steinle, Thomas, additional, Verheyen, Frank, additional, and Linder, Roland, additional

Published
2013
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38. In Reply

Author

Linder, Roland, primary, Ahrens, Susanne, additional, Verheyen, Frank, additional, Köppel, Dagmar, additional, and Heilmann, Thomas, additional

Published
2011
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40. Blood glucose testing and primary prevention of diabetes mellitus type 2 - evaluation of the effect of evidence based patient information

Author

Genz, Jutta, primary, Haastert, Burkhard, additional, Meyer, Gabriele, additional, Steckelberg, Anke, additional, Müller, Hardy, additional, Verheyen, Frank, additional, Cole, Dennis, additional, Rathmann, Wolfgang, additional, Nowotny, Bettina, additional, Roden, Michael, additional, Giani, Guido, additional, Mielck, Andreas, additional, Ohmann, Christian, additional, and Icks, Andrea, additional

Published
2010
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41. Correspondence (reply): In Reply.

Author

Linder R, Ahrens S, Verheyen F, Köppel D, and Heilmann T

Subjects
Adult, Aged, Aged, 80 and over, Cost-Benefit Analysis, Female, Germany epidemiology, Humans, Male, Middle Aged, Prevalence, Treatment Outcome, Young Adult, Diabetes Mellitus, Type 2 economics, Diabetes Mellitus, Type 2 epidemiology, Health Care Costs statistics & numerical data, Hospitalization economics
Published
2011
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42. The benefit and efficiency of the disease management program for type 2 diabetes.

Author

Linder R, Ahrens S, Köppel D, Heilmann T, and Verheyen F

Subjects
Adult, Aged, Aged, 80 and over, Cost-Benefit Analysis, Female, Germany epidemiology, Humans, Male, Middle Aged, Prevalence, Treatment Outcome, Young Adult, Diabetes Mellitus, Type 2 economics, Diabetes Mellitus, Type 2 epidemiology, Health Care Costs statistics & numerical data, Hospitalization economics
Abstract

Background: Euro 1.1 billion were spent in 2009 for disease management programs (DMPs) in Germany, among them the DMP for type 2 diabetes mellitus (T2DM). Earlier studies of DMPs failed to take sufficient account of patient- and physician-related selection effects. We used innovative methods to study the medical benefit of the DMP for T2DM among insurees of the Techniker Krankenkasse, a German health insurance provider., Methods: For this study, we analyzed claims data of the Techniker Krankenkasse from 2006 to 2008. We developed and implemented a sophisticated control group design based on propensity score interval matching. We considered a large number of variables in the baseline assessment, including socio-economic parameters, comorbidities, levels of nursing care, drug expenses, and hospital expenses., Results: The DMP participants did not differ from the control group with respect to the incidence of relevant comorbidities. They underwent emergency hospitalization somewhat less frequently than the control group and also generated lower costs for inpatient treatment. In every three-month period studied, the DMP participants received more prescriptions, had more contacts with physicians in private practice, and submitted higher claims for health insurance benefits than the control group., Conclusion: The current DMP for T2DM in Germany is not adequately effective. This study does not reveal any clear medical benefit from DMP participation. Selection effects were largely eliminated by means of a sophisticated control group design. Analyses of other DMPs with this method are currently being planned.

Published
2011
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