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Christian Buhtz,1 Denny Paulicke,1,2 Karsten Schwarz,1 Patrick Jahn,3 Dietrich Stoevesandt,1 Thomas Frese4 1Dorothea Erxleben Learning Center, Medical Faculty, of Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany; 2International Graduate Academy, Institute for Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany; 3Institute for Health Science, Department Nursing Science, Medical Faculty Tuebingen, Tuebingen, Germany; 4Institute for General Practice and Family Medicine, Medical Faculty of Martin-Luther-University Halle-Wittenberg, Halle (Saale), GermanyCorrespondence: Christian BuhtzDorothea Erxleben Learning Center, Medical Faculty of Martin-Luther-University Halle-Wittenberg, Magdeburger Straße 12, Halle (Saale) 06112, GermanyTel +49 345 557 4099Email christian.buhtz@medizin.uni-halle.deBackground: Challenges to general practitioners (GPs) as family doctors in Germany are growing because of the demographic situation. Technical assistance systems can improve the care for patients provided by GPs and care personnel to preserve autonomy. GPs are key persons in the health care team to recommend and facilitate access to technical solutions to influence their implementation into their patients’ homes.Aim: Explore the general receptiveness of GPs in Germany regarding state-of-the-art and modern assistive technology, as well as their experiences, attitudes and expectations and their training demands.Methods: A cross-sectional survey was conducted among GPs in Germany with a self-developed questionnaire sent by mail.Results: Response rate was 34% (n=194). As expected computers and smartphones are widely used. Data glasses, digital pens and virtual reality and others are often “unknown”. Experience with assistive technology was gained with emergency call systems, smart calendars and tablet dispensers. Self-reported receptiveness to use innovative technology is high but knowledge is low. The majority reported lack of access to training and support. The receptiveness for advanced education about technical solutions is high. In free-text response, some communicated their worries about the replacement of human interaction with technology.Conclusion: The survey showed an overall high receptiveness about assistance technology to GPs and strong demands for education and support. Education for GPs need greater efforts to master the process transforming the digital health care provision.Keywords: general practitioners, physicians, family physicians, self-help devices, technology, outpatients

Thomas Frese, Jarmila Mahlmeister, Tobias Deutsch, Hagen Sandholzer Department of General Practice, Medical Faculty, University of Leipzig, Leipzig, Germany Objective: The aim of this study is to describe the frequency of reasons for elderly patients visits to a general practice (GP) setting. Subjects and methods: Cross-sectional data from 8,877 randomly selected patients were assessed during a 1-year period by 209 GPs in the German federal state of Saxony. The reasons for visits, performed procedures, and results of visits were documented. In this study, the data of patients aged 65 years and older are analyzed and the procedural and nonprocedural reasons for visits are described. Results: In all, 2,866 patients aged 65 years and older were included. The majority of patients (1,807) were female. A total of 4,426 reasons for visits were found, distributed on 363 International Classification of Primary Care-2 codes. In the mean, there were 1.5 reasons for a GP visit from each patient. The top five nonprocedural reasons for visiting the GP were: cough (1.8%), back complaints (1.6%), shoulder complaints (1.3%), knee complaints (1.1%), and dyspnea (1.0% of all reasons for visit). The top five procedural reasons for visiting the GP included follow-up investigations of cardiovascular or endocrine disorders and immunizations. The top 30 nonprocedural reasons for visits covered 21.9% of all reasons for visiting. The top 30 procedural reasons covered 54.3% of all reasons for visits. Conclusion: The current work indicates that people aged 65 years and older consult the GP more frequently for procedural than for nonprocedural reasons. The top 30 procedural and nonprocedural reasons for visits cover ~75% of all reasons for visits in these patients. Keywords: elderly, geriatric, general practice, primary care, reason for visit, reason for consultation

Thomas Frese, Susanne Hein, Hagen SandholzerDepartment of Primary Care of the Leipzig Medical School, Leipzig, GermanyAbstract: The study was designed to evaluate the acceptance of the self-rated version of the Standardized Assessment of Elderly People in primary care in Europe (STEP) by patients and general practitioners, as well as the feasibility, comprehensibility, and usefulness in gaining new information. In all, 1007 of 1540 patients aged 65 and above, from 28 different Saxon general practices took part. We recognized that 96% of the patients were able to fill in the questionnaire by themselves. It took them an average of approximately 20 minutes to do so. Further analysis of 257 randomly selected patients identified 281 previously unknown problems (1.1 per patient). In the practitioners’ opinion, 16% of these problems, particularly physiological and mental ones, could lead to immediate consequences. Remarkably, newly identified psychosocial problems were not followed by any consequences. Fourteen of the 75 questionnaire items were not answered by more than 9% of the participants. Eight of the 14 frequently unanswered items were marked as difficult to understand by the patients. Altogether the self-rating version of the STEP was found to be feasible and useful. It was well accepted among patients; however, some questions need further review to improve their comprehensibility. Furthermore, it should be investigated why some identified problems do not have consequences and whether there is a need to record these issues at all.Keywords: general practice, primary care, geriatric assessment, health-related problems

Background Previous research has revealed a clear relationship between weight gain of persons and their metabolic diseases developing later. These studies have covered only short periods lasting 4-8 years. Our goal was to collect decades' old and often life-long anthropometric data and correlate the figures with the presence of hypertension and diabetes or both. Methods A retrospective international study was planned and organized to compare self-recorded data of lifelong weight gain among 60-70-year-old patients, analyze their correlation with metabolic diseases they developed, with special attention to women's weight gain around pregnancy, delivery and menopause in primary care settings in Germany, Hungary, Italy, Slovakia and the Ukraine. Results Of the recruited 815 participants, 319 men and 496 women presented all the required data. Diabetics of both genders had the highest baseline weight at 20 years of age. The weight and BMI of the whole study population increased steadily until their seventies, but to a lesser extent after their fifties. Compared to the control group, changes over decades were the greatest among diabetics and also greater among patients with hypertension. Weight increase in the first decades (20-30-year-old men and 30-40-year-old women) was a significant risk factor for the development of diabetes (OR = 1.044; p = 0.002; 95 % CI: 1.01-1.07). Among patients with diabetes and hypertension, both diagnoses were set up earlier than among those with a single morbidity. Among females, weight increase around pregnancy and menopause correlated significantly with higher odds for the diagnoses of diabetes and/or hypertension, irrespective of the number of children. Conclusions During their decade-long relationship with their patients, family physicians are expected to identify the higher weight gain of their patients, especially among younger generation and intervene, if necessary. [ABSTRACT FROM AUTHOR]