-
1دورية أكاديمية
المؤلفون: Peter Martus, F Rapp, Hartmut Bertz, A Schmitt, M Hoffmann, B Stein, E Winkler, Stefanie Joos, Barbara Grün, M Wensing, M Reuter, K Muller, J Szecsenyi, A Kestler, Jan Valentini, Daniela Fröhlich, Regina Stolz, Cornelia Mahler, Nadja Klafke, Markus Horneber, Jona Frasch, Klaus Kramer, Katrin Tomaschko-Ubeländer, B Kröger, B Noack, B Wattenberg, E Kaschdailewitsch, H Mauch, K Gauß, K Harder, L Lohmüller, A Seckinger, D Zips, M Busacker-Scharpff, M Krug, S Eismann, B Leicht, C Nagat, C Raff, K Kraus, W Kmietschak, A Battran, A Frohn, B Held, C Perinchery, C Pfister-Jimenéz, H Dürsch, J Bossert, A Kaltenbach, U Boltenhagen, A Behzad, A Leppert, B Broge, C Witte, S Treffert, AOK Baden-Württemberg
المصدر: BMJ Open, Vol 12, Iss 2 (2022)
مصطلحات موضوعية: Medicine
وصف الملف: electronic resource
-
2دورية أكاديمية
المؤلفون: Joachim Szecsenyi, Karl Wegscheider, Antonius Schneider, Jürgen Gallinat, Antonia Zapf, Sebastian Kohlmann, Marco Lehmann, Marion Eisele, Lea-Elena Braunschneider, Gabriella Marx, Stefanie Joos, Gaby Resmark, Christine Allwang, Christoph Nikendei, Sven Schulz, Katja Brenk-Franz
المصدر: BMJ Open, Vol 10, Iss 9 (2020)
مصطلحات موضوعية: Medicine
الوصف: Introduction Approximately one out of six patients in primary care suffers from depression, which often remains undetected. Evidence regarding the efficacy of depression screening in primary care, however, is inconsistent. A previous single-centre randomised controlled trial (RCT) in cardiac patients, the DEPSCREEN-INFO trial, provided the first evidence that written feedback to patients following a positive depression screening reduces depression severity and leads to more comprehensive patient engagement in mental healthcare. To amplify these effects, the feedback should be tailored according to patients’ needs and preferences. The GET.FEEDBACK.GP RCT will test the efficacy of this patient-targeted feedback intervention in primary care.Methods and analysis The multicentre three-arm GET.FEEDBACK.GP RCT aims to recruit a total of 1074 primary care patients from North, East and South Germany. Patients will be screened for depression using the Patient Health Questionnaire-9 (PHQ-9). In the case of a positive depression screening result (PHQ-9 score ≥10), the participant will be randomised into one of three groups to either receive (a) patient-targeted and general practitioner (GP)-targeted feedback regarding the depression screening results, (b) only GP-targeted feedback or (c) no feedback. Patients will be followed over a period of 12 months. The primary outcome is depression severity (PHQ-9) 6 months after screening. Secondary outcomes include patient engagement in mental healthcare, professional depression care and cost-effectiveness. According to a statistical analysis plan, the primary endpoint of all randomised patients will be analysed regarding the intention-to-treat principle.Ethics and dissemination The Ethics Committee of the Hamburg Medical Association approved the study. A clinical trial company will ensure data safety, monitoring and supervision. The multicentre GET.FEEDBACK.GP RCT is the first trial in primary care that tests the efficacy of a patient-targeted feedback intervention as an adjunct to depression screening. Its results have the potential to influence future depression guidelines and will be disseminated in scientific as well as patient-friendly language.Trial registration number NCT03988985.
وصف الملف: electronic resource
-
3
المؤلفون: Jan, Valentini, Daniela, Fröhlich, Regina, Stolz, Cornelia, Mahler, Peter, Martus, Nadja, Klafke, Markus, Horneber, Jona, Frasch, Klaus, Kramer, Hartmut, Bertz, Barbara, Grün, Katrin, Tomaschko-Ubeländer, Stefanie, Joos, Aok, Baden-Württemberg
المصدر: BMJ open. 12(2)
مصطلحات موضوعية: Counseling, Germany, Neoplasms, Quality of Life, Humans, Delivery of Health Care, Qualitative Research
الوصف: According to international literature, patients with cancer wish to have information on complementary and integrative healthcare (CIH). Medical guidelines recommend actively approaching patients with cancer discussing potential benefits and risks of individual CIH methods. While some CIH methods, for example, acupuncture and yoga, have been proven effective in high-quality studies, other CIH methods lack studies or bear the risk of interactions with chemotherapeutics, for example, herbal drugs. Therefore, an evidence-based interprofessional counselling programme on CIH will be implemented at four Comprehensive Cancer Centres in the federal state of Baden-Wuerttemberg, Germany.A complex intervention consisting of elements on patient, provider and system levels will be developed and evaluated within a multilayer evaluation design with confirmatory evaluation on patient level. Patients with a cancer diagnosis within the last 6 months will receive three individual counselling sessions on CIH within 3 months (=intervention on patient level). The counselling will be provided by an interprofessional team of medical and nursing staff. For this purpose, an intensive online training programme, a CIH knowledge database and an interprofessional team-building process were developed and implemented (=intervention on provider level). Moreover, training events on the basics of CIH are offered in the outpatient setting (=intervention on system level). Primary outcome of the evaluation at the patient level is patient activation measured (PAM) with the PAM-13 after 3 months. Secondary outcomes, for example, quality of life, self-efficacy and clinical parameters, will be assessed at baseline, after 3 months and at 6 months follow-up. The intervention group (n=1000) will be compared with a control group (n=500, treatment as usual, no CIH counselling. The outcomes and follow-up times in the control group are the same as in the intervention group. Moreover, the use of health services will be analysed in both groups using routine data. A qualitative-quantitative process evaluation as well as a health economic evaluation will identify relevant barriers and enabling factors for later roll-out.The study has been approved by the appropriate Institutional Ethical Committee of the University of Tuebingen, No. 658/2019BO1. The results of these studies will be disseminated to academic audiences and in the community.DRKS00021779; Pre-results.
-
4
المؤلفون: Antonius Schneider, Sven Schulz, Gaby Resmark, Lea-Elena Braunschneider, Bernd Löwe, Joachim Szecsenyi, Marco Lehmann, Christoph Nikendei, Katja Brenk-Franz, Christine Allwang, Stefanie Joos, Marion Eisele, Sebastian Kohlmann, Martin Scherer, Gabriella Marx, Jürgen Gallinat, Karl Wegscheider, Hans-Helmut König, Martin Härter, Antonia Zapf
المصدر: BMJ Open, Vol 10, Iss 9 (2020)
BMJ Openمصطلحات موضوعية: medicine.medical_specialty, Feedback, law.invention, primary care, Statistical Analysis Plan, Randomized controlled trial, General Practitioners, law, Germany, Intervention (counseling), Clinical endpoint, medicine, Humans, Multicenter Studies as Topic, Depression (differential diagnoses), Language, Randomized Controlled Trials as Topic, Protocol (science), Depression, business.industry, General Medicine, Test (assessment), Clinical trial, Mental Health, depression & mood disorders, Physical therapy, Medicine, adult psychiatry, business
الوصف: IntroductionApproximately one out of six patients in primary care suffers from depression, which often remains undetected. Evidence regarding the efficacy of depression screening in primary care, however, is inconsistent. A previous single-centre randomised controlled trial (RCT) in cardiac patients, the DEPSCREEN-INFO trial, provided the first evidence that written feedback to patients following a positive depression screening reduces depression severity and leads to more comprehensive patient engagement in mental healthcare. To amplify these effects, the feedback should be tailored according to patients’ needs and preferences. The GET.FEEDBACK.GP RCT will test the efficacy of this patient-targeted feedback intervention in primary care.Methods and analysisThe multicentre three-arm GET.FEEDBACK.GP RCT aims to recruit a total of 1074 primary care patients from North, East and South Germany. Patients will be screened for depression using the Patient Health Questionnaire-9 (PHQ-9). In the case of a positive depression screening result (PHQ-9 score ≥10), the participant will be randomised into one of three groups to either receive (a) patient-targeted and general practitioner (GP)-targeted feedback regarding the depression screening results, (b) only GP-targeted feedback or (c) no feedback. Patients will be followed over a period of 12 months. The primary outcome is depression severity (PHQ-9) 6 months after screening. Secondary outcomes include patient engagement in mental healthcare, professional depression care and cost-effectiveness. According to a statistical analysis plan, the primary endpoint of all randomised patients will be analysed regarding the intention-to-treat principle.Ethics and disseminationThe Ethics Committee of the Hamburg Medical Association approved the study. A clinical trial company will ensure data safety, monitoring and supervision. The multicentre GET.FEEDBACK.GP RCT is the first trial in primary care that tests the efficacy of a patient-targeted feedback intervention as an adjunct to depression screening. Its results have the potential to influence future depression guidelines and will be disseminated in scientific as well as patient-friendly language.Trial registration numberNCT03988985.
-
5
المؤلفون: Kayvan Bozorgmehr, Christine Schneider, Stefanie Joos
المصدر: BMJ Open
مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Adolescent, Population, Health Services Accessibility, Young Adult, PRIMARY CARE, Environmental health, Germany, Health care, Global health, Odds Ratio, Medicine, media_common.cataloged_instance, EPIDEMIOLOGY, Humans, European union, Healthcare Disparities, education, Health policy, media_common, education.field_of_study, Refugees, business.industry, Public health, Research, Health services research, Age Factors, General Medicine, Health Status Disparities, Middle Aged, Health indicator, Cross-Sectional Studies, Feasibility Studies, Female, Health Services Research, PUBLIC HEALTH, business
الوصف: Objectives To assess disparities in health and healthcare between asylum seekers (AS) and residents in Germany as a proof of concept using European Core Health Indicators (ECHI). Design Population-based cross-sectional feasibility study. Participants All AS (aged 18 years or above) registered in three counties in Germany during a 3-month study period (N=1017). Cross-sectional data on the resident population were taken from the German Health Interview (2008–2011, N=8152), and the European Union Statistics on Income and Living Conditions (2012, N=23 065). Outcome measures Self-reported health status and healthcare access (utilisation and unmet medical need) in line with ECHI. Method Inequalities in health and access to healthcare were quantified both by crude and age-stratified/sex-stratified ORs with 95% CI using cross-tabulations. Results A total of N=156 AS (15.34%) participated in the study. Compared with residents, AS were significantly more likely to report a bad health status (OR=1.72 (1.23 to 2.41)), activity limitations (OR=1.97 (1.39 to 2.79)) or (only younger age groups) any chronic morbidity (18–24 years: OR=6.23 (2.62 to 14.57); 25–49 years: OR=2.05 (1.23 to 3.37)). AS had significantly lower odds for consulting any physician (OR=0.1 (0.07 to 0.16)) or general practitioners (OR=0.44 (0.31 to 0.62)), but higher odds for hospital admissions (OR=2.29 (1.54 to 3.34)), visits to psychotherapists (OR=4.07 (2.48 to 6.43)) and unmet needs (OR=3.74 (2.62 to 5.21)). The direction of healthcare-related associations was consistent across all strata despite variation in magnitude and statistical significance. Conclusions Quantifying disparities between AS and the resident population by means of selected ECHI proved to be feasible. The approach yielded first quantitative evidence for disparities in health and access to healthcare in the German context. Further research is needed to generate representative estimates, for example, by including AS in national health monitoring programmes.
إعادة تعيين المنقحات
عرض المنقحات (%%عد%%)
Full Text Finder