@article {452, title = {Interventions to reduce inappropriate polypharmacy: Implications for research and practice.}, journal = {Maturitas}, volume = {97}, year = {2017}, month = {2017 Mar}, pages = {66-68}, issn = {1873-4111}, doi = {10.1016/j.maturitas.2016.12.007}, author = {Johansson, Tim and Flamm, Maria and S{\"o}nnichsen, Andreas and Schuler, Jochen} } @article {301, title = {Der Facharzt f{\"u}r Allgemeinmedizin und Familienmedizin {\textendash} warum es ihn ben{\"o}tigt}, year = {2016}, publisher = {{\"A}rzte Krone}, author = {Thomas Jungblut} } @article {453, title = {Impact of strategies to reduce polypharmacy on clinically relevant endpoints: a systematic review and meta-analysis.}, journal = {Br J Clin Pharmacol}, volume = {82}, year = {2016}, month = {2016 Aug}, pages = {532-48}, abstract = {

AIM: The aim of the present study was to explore the impact of strategies to reduce polypharmacy on mortality, hospitalization and change in number of drugs.

METHODS: Systematic review and meta-analysis: a systematic literature search targeting patients >=65 years with polypharmacy (>=4 drugs), focusing on patient-relevant outcome measures, was conducted. We included controlled studies aiming to reduce polypharmacy. Two reviewers independently assessed studies for eligibility, extracted data and evaluated study quality.

RESULTS: Twenty-five studies, including 10 980 participants, were included, comprising 21 randomized controlled trials and four nonrandomized controlled trials. The majority of the included studies aimed at improving quality or the appropriateness of prescribing by eliminating inappropriate and non-evidence-based drugs. These strategies to reduce polypharmacy had no effect on all-cause mortality (odds ratio 1.02; 95\% confidence interval 0.84, 1.23). Only single studies found improvements, in terms of reducing the number of hospital admissions, in favour of the intervention group. At baseline, patients were taking, on average, 7.4 drugs in both the intervention and the control groups. At follow-up, the weighted mean number of drugs was reduced (-0.2) in the intervention group but increased (+0.2) in controls.

CONCLUSIONS: There is no convincing evidence that the strategies assessed in the present review are effective in reducing polypharmacy or have an impact on clinically relevant endpoints. Interventions are complex; it is still unclear how best to organize and implement them to achieve a reduction in inappropriate polypharmacy. There is therefore a need to develop more effective strategies to reduce inappropriate polypharmacy and to test them in large, pragmatic randomized controlled trials on effectiveness and feasibility.

}, keywords = {Aged, Drug-Related Side Effects and Adverse Reactions, Hospitalization, Humans, Inappropriate Prescribing, Outcome Assessment, Health Care, Polypharmacy, Practice Patterns, Physicians{\textquoteright}, Randomized Controlled Trials as Topic}, issn = {1365-2125}, doi = {10.1111/bcp.12959}, author = {Johansson, Tim and Abuzahra, Muna E and Keller, Sophie and Mann, Eva and Faller, Barbara and Sommerauer, Christina and H{\"o}ck, Jennifer and L{\"o}ffler, Christin and K{\"o}chling, Anna and Schuler, Jochen and Flamm, Maria and S{\"o}nnichsen, Andreas} } @booklet {562, title = {Schnittstellenmanagement bei der Hausstaubmilben-Allergie}, year = {2016}, keywords = {orp-publications}, author = {Elisabeth Brettlecker and Renate Hoffmann-Dorninger and Reinhart Jarisch and Johannes Neuhofer and Otto Pichlh{\"o}fer and Erwin Rebhandl and Gunter Sturm and Felix Wantke and Rudolf Schmitzberger} } @article {12, title = {The impact of preoperative testing for blood glucose concentration and haemoglobin A1c on mortality, changes in management and complications in noncardiac elective surgery: a systematic review.}, journal = {Eur J Anaesthesiol}, volume = {32}, year = {2015}, month = {2015 Mar}, pages = {152-9}, abstract = {

BACKGROUND: The risks associated with surgery are elevated in patients with diabetes mellitus. For this reason, preoperative diagnostics frequently include the measurement of blood glucose and haemoglobin A1c (HbA1c), but it is unclear whether these tests contribute to improved perioperative or postoperative outcomes.

OBJECTIVES: This systematic review aimed to evaluate the evidence that preoperative testing for blood glucose and HbA1c might influence the following outcome parameters: changes in clinical management; mortality; and the incidence of perioperative and postoperative complications in patients undergoing elective, noncardiac surgery.

DESIGN: We performed a systematic search of the literature from January 2001 to March 2013, thus updating a review carried out by the National Institute for Health and Clinical Excellence (NICE) up to the year 2001.

ELIGIBILITY CRITERIA: Controlled studies including cohort and case-control studies with a population of at least 60 patients were eligible.

RESULTS: The search retrieved 1346 records (including hand-search). Twenty-two studies met all inclusion criteria and were included in the review. Fifteen cohort and two case-control studies evaluated the effectiveness of preoperative blood glucose testing and nine studies the effectiveness of testing HbA1c. Four of the included studies evaluated both tests. There were no data derived from high-quality studies supporting routine preoperative testing for blood glucose or HbA1c in otherwise healthy adult patients undergoing elective noncardiac surgery. Only in vascular and orthopaedic surgery may screening identify patients at an increased risk.

CONCLUSION: Preoperative blood glucose testing and testing for HbA1c is not required in nondiabetic patients unless there are clinical sings arousing suspicion. Patients scheduled for vascular and orthopaedic surgery carry an elevated risk justifying preoperative testing for blood glucose or HbA1c as a screening tool.

}, keywords = {Biomarkers, Blood Glucose, Diabetes Mellitus, Elective Surgical Procedures, Glycated Hemoglobin, Humans, Orthopedic Procedures, Predictive Value of Tests, Preoperative Care, Risk Assessment, Risk Factors, Time Factors, Treatment Outcome, Vascular Surgical Procedures}, issn = {1365-2346}, doi = {10.1097/EJA.0000000000000117}, author = {Bock, Matthias and Johansson, Tim and Fritsch, Gerhard and Flamm, Maria and Hansbauer, Bernhard and Mann, Eva and S{\"o}nnichsen, Andreas} } @booklet {370, title = {Traumberuf Hausarzt}, year = {2014}, abstract = {

In zukunftsweisenden Gesundheitssystemen hat die haus{\"a}rztliche Versorgung gro{\ss}e Bedeutung. In den weltweit stattfindenden Neuorientierungen ist der Blick derzeit in erster Linie auf die medizinische Grundversorgung gerichtet. Dementsprechend ist Allgemeinmedizin auch im Rahmen der in Diskussion befindlichen Reform des {\"o}sterreichischen Gesundheitssystems ebenfalls ein Hoffnungstr{\"a}ger geworden.
{\quotedblbase}Haus{\"a}rztin{\textquotedblleft} und {\quotedblbase}Hausarzt{\textquotedblleft} sind Begriffe, die in der Bev{\"o}lkerung einen guten Klang haben. Sie stehen f{\"u}r Vertrauen, N{\"a}he, Gesamtschau, Langzeitbeziehung, Familienbetreuung, freundschaftliche Beziehungen und {\"a}hnliches.
Gleichzeitig gibt es Botschaften der Geringsch{\"a}tzung, des Infragestellens und der Ger{\"u}chte um eine Abl{\"o}se niedergelassener haus{\"a}rztlicher T{\"a}tigkeit durch andere Versorgungsstrukturen. Lohnt es sich da, diesen Beruf zu ergreifen, ihm seine Ausbildung zu widmen und f{\"u}r sp{\"a}ter ein erf{\"u}lltes, gl{\"u}ckliches Leben zu erhoffen? Wem soll man in der F{\"u}lle des Geschriebenen, Geklagten und Bef{\"u}rchteten glauben?

In den universit{\"a}ren allgemeinmedizinischen Lehrpraxen und in von {\"A}rzten f{\"u}r Allgemeinmedizin gehaltenen Vorlesungen wird Studierenden vermehrt Wissen um generalistische Arbeit ebenso wie entsprechende praktische Fertigkeiten vermittelt. Medizinische Universit{\"a}ten beginnen zu verstehen, dass die medizinische Grund- und Langzeitversorgung und generalistische Arbeitsans{\"a}tze durchaus auch f{\"u}r die Forschung interessant sind.

In der postgraduale Ausbildung wird in K{\"u}rze der dreij{\"a}hrige Ausbildungsturnus zum Arzt f{\"u}r Allgemeinmedizin durch eine zeitgem{\"a}{\ss}ere Ausbildung ersetzt werden. Die Voraussetzung f{\"u}r die {\"U}bernahme eines den heutigen Anforderungen entsprechenden Versorgungsauftrages wird damit endlich geschaffen. Die Einf{\"u}hrung der verpflichtenden praktischen Ausbildung in einer allgemeinmedizinischen Lehrpraxis {\textendash} eine absolute Notwendigkeit {\textendash} steht kurz vor dem Beschluss. Die derzeit g{\"u}ltige Ausbildungszeit ist f{\"u}r eine moderne Allgemeinmedizin zu kurz, als {\quotedblbase}Wartezone{\textquotedblleft} f{\"u}r eine fach{\"a}rztliche Ausbildung in einem anderen Fach ist sie zu lang. Diese Ausbildung wird nun um wesentliche Teile, insbesondere aber um eine angemessene Lehrpraxiszeit erweitert. Die Verantwortlichen in immer mehr Bundesl{\"a}ndern bem{\"u}hen sich um eine bessere fi nanzielle Wertsch{\"a}tzung allgemeinmedizinischer T{\"a}tigkeit. In {\"a}hnlicher Weise kommen auch die organisatorischen Rahmenbedingungen bzw. die M{\"o}glichkeiten f{\"u}r verschiedene, dem heutigen Wirtschaftsverst{\"a}ndnis angepasste, besser lebbare Zusammenarbeitsformen in Bewegung. Nicht
zuletzt ist in diesen Diskussionen sp{\"u}rbar, dass verst{\"a}rkt auf die Lebensqualit{\"a}t von Haus{\"a}rztin und Hausarzt Bedacht genommen werden muss.

Dies alles stimmt positiv und soll junge {\"A}rztinnen und {\"A}rzte ermuntern, diesen sch{\"o}nen, vielf{\"a}ltigen und verantwortungsvollen Beruf zu ergreifen. In diesem Sonderheft {\quotedblbase}Traumberuf Hausarzt{\textquotedblleft} wird vieles im Detail angesprochen, nicht um die derzeitige Situation der Allgemeinmedizin allzu rosig darzustellen, aber um zu zeigen, dass Optimismus berechtigt ist, dass sich der haus{\"a}rztliche Beruf im Aufwind befi ndet und es sich lohnt, ihn anzustreben.

}, author = {Reinhold Glehr and Rabady, Susanne and Hockl, Wolfgang and Burghuber, Franz and Neuber, Nina-Maria and Cybulski, Martin and Heckenthaler, Walter and Wendler, Maria and Thomas Jungblut and Modler, Elisabeth and Hofbaur, Benedikt and Braunschmid, Karl and Thalhammer, Gottfried and Bernhard Panhofer and Kaiba, Wilfried and Croy, Cornelia} } @article {16, title = {Effectiveness of non-cardiac preoperative testing in non-cardiac elective surgery: a systematic review.}, journal = {Br J Anaesth}, volume = {110}, year = {2013}, month = {2013 Jun}, pages = {926-39}, abstract = {

Elective surgery is usually preceded by preoperative diagnostics to minimize risk. The results are assumed to elicit preventive measures or even cancellation of surgery. Moreover, physicians perform preoperative tests as a baseline to detect subsequent changes. This systematic review aims to explore whether preoperative testing leads to changes in management or reduces perioperative mortality or morbidity in unselected patients undergoing elective, non-cardiac surgery. We systematically searched all relevant databases from January 2001 to February 2011 for studies investigating the relationship between preoperative diagnostics and perioperative outcome. Our methodology was based on the manual of the Ludwig Boltzmann Institute for Health Technology Assessment, the Scottish Intercollegiate Guidelines Network (SIGN) handbook, and the PRISMA statement for reporting systematic reviews. One hundred and one of the 25 281 publications retrieved met our inclusion criteria. Three test grid studies used a randomized controlled design and 98 studies used an observational design. The test grid studies show that in cataract surgery and ambulatory surgery, there are no significant differences between patients with indicated preoperative testing and no testing regarding perioperative outcome. The observational studies do not provide valid evidence that preoperative testing is beneficial in healthy adults undergoing non-cardiac surgery. There is no evidence derived from high-quality studies that supports routine preoperative testing in healthy adults undergoing non-cardiac surgery. Testing according to pathological findings in a patient{\textquoteright}s medical history or physical examination seems justified, although the evidence is scarce. High-quality studies, especially large randomized controlled trials, are needed to explore the effectiveness of indicated preoperative testing.

}, keywords = {C-Reactive Protein, Elective Surgical Procedures, Hematocrit, Hemoglobins, Humans, Kidney Function Tests, Leukocyte Count, Liver Function Tests, Preoperative Care, Randomized Controlled Trials as Topic}, issn = {1471-6771}, doi = {10.1093/bja/aet071}, author = {Johansson, T and Fritsch, G and Flamm, M and Hansbauer, B and Bachofner, N and Mann, E and Bock, M and S{\"o}nnichsen, A C} } @article {552, title = {Assessment of publication output in the field of general practice and family medicine and by general practitioners and general practice institutions.}, journal = {Fam Pract}, volume = {27}, year = {2010}, month = {2010 Oct}, pages = {582-9}, abstract = {

PURPOSE: The discipline of family medicine (FM) lacks a comprehensive methodology, which can be applied as a standard for assessing overall research output in both the field of FM and by general practitioners (GPs)/general practice institutions. It was the aim of this study to develop a sensitive search strategy for assessing publication output in the field of FM independent of the author{\textquoteright}s profession or affiliation and by GPs/general practice institutions independent of their field of scientific interest.

METHODS: Literature searches limited to the year 2005 were conducted in PubMed and ISI Web of Sciences (ISI WoS). In PubMed, all relevant MeSH terms were used. Search terms possibly contained in the author{\textquoteright}s affiliations have been collected. In ISI WoS, the same entry terms including their abbreviations and plural forms were applied. The final queries were validated by manual review and matching results with selected FM journals.

RESULTS: A comprehensive list of combined search terms could be defined. For the field of general practice/FM more publications could be retrieved in PubMed. Almost twice as many publications by GPs/general practice institutions could be retrieved in ISI WoS, where--in contrast to PubMed--the affiliation is documented for all authors.

CONCLUSIONS: To quantitatively assess publication output in the field of FM, PubMed was identified as the preferable database. To assess publication output by GPs/general practice institutions, the ISI WoS is recommended as the preferable database. Apparently, the ISI WoS is more suitable to compare the research productivity of different countries, authors or institutions.

}, keywords = {Bibliometrics, Biomedical Research, Databases, Bibliographic, Family Practice, General Practice, General Practitioners, Periodicals as Topic, PubMed}, issn = {1460-2229}, doi = {10.1093/fampra/cmq032}, url = {http://dx.doi.org/10.1093/fampra/cmq032}, author = {Jelercic, Stasa and Lingard, Heide and Spiegel, Wolfgang and Pichlh{\"o}fer, Otto and Maier, Manfred} }