@article{MuschallaKesslerSchwantesetal.2013, author = {Muschalla, Beate and Kessler, U. and Schwantes, U. and Linden, M.}, title = {Rehabilitationsbedarf bei Hausarztpatienten mit psychischen St{\"o}rungen}, series = {Die Rehabilitation : Zeitschrift f{\"u}r Praxis und Forschung in der Rehabilitation}, volume = {52}, journal = {Die Rehabilitation : Zeitschrift f{\"u}r Praxis und Forschung in der Rehabilitation}, number = {4}, publisher = {Thieme}, address = {Stuttgart}, issn = {0034-3536}, doi = {10.1055/s-0032-1327587}, pages = {252 -- 257}, year = {2013}, abstract = {Hintergrund: Rehabilitationsmedizin ist nach \S 2 und \S 26 SGB IX die medizinische Spezialdisziplin zur Vorbeugung, Diagnostik und Behandlung chronischer Erkrankungen. Dies betrifft in besonderem Maße psychische Erkrankungen. Die Behandlung chronischer Erkrankungen erfordert in der Regel eine komplexe und multimodale Langzeitbetreuung, bei der niedergelassenen {\"A}rzten eine zentrale Rolle zukommt. Allerdings gibt es bislang nur wenig ausgearbeitete Konzepte zu den rehabilitationsmedizinischen Aufgaben niedergelassener {\"A}rzte und den ihnen zur Verf{\"u}gung stehenden diesbez{\"u}glichen Behandlungsoptionen. Methoden: Zur Kl{\"a}rung der Frage, welche Rolle rehamedizinische Aspekte in der Hausarztpraxis haben, wurden im ersten Schritt 40 niedergelassene {\"A}rzte zum gesch{\"a}tzten Anteil chronisch psychisch kranker Patienten in ihrer Praxis befragt. Im zweiten Schritt wurden 1 451 Patienten im Alter von 18 bis 60 Jahren mittels des WHO-5-Screenings zum psychischen Wohlbefinden, dem IMET-Fragebogen zu Teilhabest{\"o}rungen, der Burvillskala zur Multimorbidit{\"a}t und Fragen zum psychischen Erkrankungsstatus und Arbeitsstatus untersucht. Ergebnisse:Im Durchschnitt sch{\"a}tzten die Haus{\"a}rzte den Anteil ihrer Patienten mit psychischen Erkrankungen auf 41,9\% (SD=18,2; Range 15-90\%).Von den Patienten gaben 46,5\% an, unter psychischen Beschwerden zu leiden. 38,3\% der Patienten sagten, dass die Probleme bereits seit 6 Monaten oder l{\"a}nger bestehen (chronisch), und 26,9\% erkl{\"a}rten, dass sie die Beschwerden in den letzten 6 Monaten durchg{\"a}ngig erlebt haben (persistierend). Insgesamt litten 29,7\% der 18- bis 60-j{\"a}hrigen Hausarztpatienten unter chronischen psychischen Beschwerden mit zus{\"a}tzlich relevanten Teilhabest{\"o}rungen. Schlussfolgerungen: Patienten mit chronischen psychischen Problemen und Teilhabest{\"o}rungen sind in Praxen niedergelassener {\"A}rzte h{\"a}ufig anzutreffen. Niedergelassene {\"A}rzte und insbesondere Haus{\"a}rzte sind demnach zu einem wesentlichen Teil ihrer T{\"a}tigkeit als Rehabilitationsmediziner anzusehen. In ihren H{\"a}nden liegt die Diagnostik, Behandlung, Koordinierung und Langzeitf{\"u}hrung der chronisch Kranken, wie auch die sozialmedizinische Betreuung, von der Feststellung einer Arbeitsunf{\"a}higkeit bis hin zur Einleitung station{\"a}rer Rehamaßnahmen. Die Bedeutung der niedergelassenen {\"A}rzte im Rehaprozess verdient organisatorisch wie wissenschaftlich mehr Aufmerksamkeit.}, language = {de} } @article{WetzelKochPreiseretal.2022, author = {Wetzel, Anna-Jasmin and Koch, Roland and Preiser, Christine and M{\"u}ller, Regina and Klemmt, Malte and Ranisch, Robert and Ehni, Hans-J{\"o}rg and Wiesing, Urban and Rieger, Monika A. and Henking, Tanja and Joos, Stefanie}, title = {Ethical, legal, and social implications of symptom checker Apps in primary Health Care (CHECK.APP)}, series = {JMIR Research Protocols}, volume = {11}, journal = {JMIR Research Protocols}, number = {5}, publisher = {JMIR Research Protocols}, address = {Toronto}, issn = {1929-0748}, doi = {10.2196/34026}, pages = {11}, year = {2022}, abstract = {Background: Symptom checker apps (SCAs) are accessible tools that provide early symptom assessment for users. The ethical, legal, and social implications of SCAs and their impact on the patient-physician relationship, the health care providers, and the health care system have sparsely been examined. This study protocol describes an approach to investigate the possible impacts and implications of SCAs on different levels of health care provision. It considers the perspectives of the users, nonusers, general practitioners (GPs), and health care experts. Objective: We aim to assess a comprehensive overview of the use of SCAs and address problematic issues, if any. The primary outcomes of this study are empirically informed multi-perspective recommendations for different stakeholders on the ethical, legal, and social implications of SCAs. Methods: Quantitative and qualitative methods will be used in several overlapping and interconnected study phases. In study phase 1, a comprehensive literature review will be conducted to assess the ethical, legal, social, and systemic impacts of SCAs. Study phase 2 comprises a survey that will be analyzed with a logistic regression. It aims to assess the user degree of SCAs in Germany as well as the predictors for SCA usage. Study phase 3 will investigate self-observational diaries and user interviews, which will be analyzed as integrated cases to assess user perspectives, usage pattern, and arising problems. Study phase 4 will comprise GP interviews to assess their experiences, perspectives, self-image, and concepts and will be analyzed with the basic procedure by Kruse. Moreover, interviews with health care experts will be conducted in study phase 3 and will be analyzed by using the reflexive thematical analysis approach of Braun and Clark. Results: Study phase 1 will be completed in November 2021. We expect the results of study phase 2 in December 2021 and February 2022. In study phase 3, interviews are currently being conducted. The final study endpoint will be in February 2023. Conclusions: The possible ethical, legal, social, and systemic impacts of a widespread use of SCAs that affect stakeholders and stakeholder groups on different levels of health care will be identified. The proposed methodological approach provides a multifaceted and diverse empirical basis for a broad discussion on these implications.}, language = {en} } @article{KonradBohlkenRappetal.2016, author = {Konrad, Marcel and Bohlken, Jens and Rapp, Michael Armin and Kostev, Karel}, title = {Depression risk in patients with heart failure in primary care practices in Germany}, series = {International psychogeriatrics}, volume = {28}, journal = {International psychogeriatrics}, publisher = {Cambridge Univ. Press}, address = {New York}, issn = {1041-6102}, doi = {10.1017/S1041610216000867}, pages = {1889 -- 1894}, year = {2016}, abstract = {Background: The goal of this study was to estimate the prevalence of and risk factors for diagnosed depression in heart failure (HF) patients in German primary care practices. Methods: This study was a retrospective database analysis in Germany utilizing the Disease Analyzer (R) Database (IMS Health, Germany). The study population included 132,994 patients between 40 and 90 years of age from 1,072 primary care practices. The observation period was between 2004 and 2013. Follow-up lasted up to five years and ended in April 2015. A total of 66,497 HF patients were selected after applying exclusion criteria. The same number of 66,497 controls were chosen and were matched (1:1) to HF patients on the basis of age, sex, health insurance, depression diagnosis in the past, and follow-up duration after index date. Results: HF was a strong risk factor for diagnosed depression (p < 0.0001). A total of 10.5\% of HF patients and 6.3\% of matched controls developed depression after one year of follow-up (p < 0.001). Depression was documented in 28.9\% of the HF group and 18.2\% of the control group after the five-year follow-up (p < 0.001). Cancer, dementia, osteoporosis, stroke, and osteoarthritis were associated with a higher risk of developing depression. Male gender and private health insurance were associated with lower risk of depression. Conclusions: The risk of diagnosed depression is significantly increased in patients with HF compared to patients without HF in primary care practices in Germany.}, language = {en} }