@article {548, title = {Clinical presentation and management of stable coronary artery disease in Austria.}, journal = {PLoS One}, volume = {12}, year = {2017}, month = {2017}, pages = {e0176257}, abstract = {

BACKGROUND: Cardiovascular disease is the main cause of death in Austria. However, no systematic information exists regarding characteristics and treatments of contemporary patients with stable coronary artery disease (CAD) in Austria. We assembled two retrospective physicians{\textquoteright} databases to describe demographics, clinical profiles, and therapeutic strategies in patients with stable CAD. In addition, we compared patient profiles of secondary care internists and hospital-based cardiologists with those of general practitioners in a primary care setting outside of hospital.

METHODS: The study population was identified from retrospective chart review of 1020 patients from 106 primary care physicians in Austria (ProCor II registry), and was merged with a previous similar database of 1280 patients under secondary care (ProCor I registry) to yield a total patient number of 2300.

RESULTS: Female patients with stable CAD were older, had more angina and/or heart failure symptoms, and more depression than males. Female gender, type 2 diabetes mellitus, higher CCS class and asthma/COPD were predictors of elevated heart rate, while previous coronary events/revascularization predicted a lower heart rate in multivariate analysis. There were no significant differences with regard to characteristics and management of patients of general practitioners in the primary care setting versus internists in secondary care.

CONCLUSIONS: Characteristics and treatments of unselected patients with stable ischemic heart disease in Austria resemble the pattern of large international registries of stable ischemic heart disease, with the exception that diabetes and systemic hypertension were more prevalent.

}, keywords = {Aged, Aged, 80 and over, Austria, Coronary Artery Disease, Female, Heart Rate, Humans, Male, Middle Aged, Retrospective Studies}, issn = {1932-6203}, doi = {10.1371/journal.pone.0176257}, url = {http://dx.doi.org/10.1371/journal.pone.0176257}, author = {Pichlh{\"o}fer, Otto and Maier, Manfred and Badr-Eslam, Roza and Ristl, Robin and Zebrowska, Magdalena and Lang, Irene M} } @article {430, title = {An das Ministerium}, year = {2017}, publisher = {{\"A}rzte Krone}, keywords = {Gesundheitsreform}, author = {Oliver Lammel} } @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} } @article {11, title = {Effect of person-centred care on antipsychotic drug use in nursing homes (EPCentCare): study protocol for a cluster-randomised controlled trial.}, journal = {Implement Sci}, volume = {10}, year = {2015}, month = {2015 Jun 04}, pages = {82}, abstract = {

BACKGROUND: The majority of nursing home residents with dementia experience behavioural and psychological symptoms like apathy, agitation, and anxiety. According to analyses of prescription prevalence in Germany, antipsychotic drugs are regularly prescribed as first-line treatment of neuropsychiatric symptoms in persons with dementia, although guidelines clearly prioritise non-pharmacological interventions. Frequently, antipsychotic drugs are prescribed for inappropriate reasons and for too long without regular reviewing. The use of antipsychotics is associated with adverse events like increased risk of falling, stroke, and mortality. The aim of the study is to investigate whether a person-centred care approach, successfully evaluated in nursing homes in the United Kingdom, can be implemented in German nursing homes and, in comparison with a control group, can result in a clinically relevant reduction of the proportion of residents with antipsychotic prescriptions.

METHODS/DESIGN: The study is a cluster-randomised controlled trial comparing an intervention group (two-day initial training on person-centred care and ongoing training and support programme) with a control group. Both study groups will receive, as optimised usual care, a medication review by an experienced psychiatrist/geriatrician providing feedback to the prescribing physician. Overall, 36 nursing homes in East, North, and West Germany will be randomised. The primary outcome is the proportion of residents receiving at least one antipsychotic prescription (long-term medication) after 12~months of follow-up. Secondary outcomes are residents{\textquoteright} quality of life, agitated behaviour, as well as safety parameters like falls and fall-related medical attention. A health economic evaluation and a process evaluation will be performed alongside the study.

DISCUSSION: To improve care, a reduction of the current high prescription rate of antipsychotics in nursing homes by the intervention programme is expected.

TRIAL REGISTRATION: ClinicalTrials.gov: NCT02295462.

}, keywords = {Accidental Falls, Antipsychotic Agents, Costs and Cost Analysis, Dementia, Drug Utilization, Germany, Homes for the Aged, Humans, Inservice Training, Mental Disorders, Nursing Homes, Patient-Centered Care, Psychomotor Agitation, Quality of Life, Research Design}, issn = {1748-5908}, doi = {10.1186/s13012-015-0268-3}, author = {Richter, Christin and Berg, Almuth and Fleischer, Steffen and K{\"o}pke, Sascha and Balzer, Katrin and Fick, Eva-Maria and S{\"o}nnichsen, Andreas and L{\"o}scher, Susanne and Vollmar, Horst Christian and Haastert, Burkhard and Icks, Andrea and Dintsios, Charalabos-Markos and Mann, Eva and Wolf, Ursula and Meyer, Gabriele} } @booklet {549, title = {Versorgungsmodell f{\"u}r Betroffene mit {Chronisch-Entz{\"u}ndlichen} Darmerkrankungen in Wien {\textendash} Interdisziplin{\"a}r konsentierte Versorgungspfade gem{\"a}{\ss} der Wiener Zielsteuerung Gesundheit}, year = {2015}, author = {Vogelsang, Harald and Maier, Manfred and Novacek, Gottfried and Feichtenschlager, Thomas and Pichlh{\"o}fer, Otto and Beyer, Anita and Gross, Evelyn and Linsbichler, Susanna and Sokele, Sigrid and Stift, Anton and Pichlbauer, Ernest G} } @article {553, title = {Depression and anxiety among migrants in Austria: a population based study of prevalence and utilization of health care services.}, journal = {J Affect Disord}, volume = {151}, year = {2013}, month = {2013 Oct}, pages = {220-8}, abstract = {

BACKGROUND: Although migrants form a large part of the Austrian population, information about mental health of migrants in Austria is scarce. Therefore, we compared the prevalence of dysphoric disorders (depression and anxiety) and the corresponding utilization of health care services of Eastern European, western and other migrants with the non-migrant population in Austria.

METHODS: We performed a telephone survey on a random sample of the general population of Austria aged 15 years and older (n=3509) between October 2010 and September 2011. Depression and anxiety were measured with the Patient Health Questionnaire-4 and utilization of health care services in the last 4 weeks was inquired.

RESULTS: 15.0\% of our sample had a migration background. Female migrants from Eastern Europe, first and second generation, had a higher prevalence of dysphoric disorders (29.7\% and 33.4\% respectively) than Austrian women (15.2\%) (p<0.001). The prevalence in the other migrant groups did not differ significantly from the Austrian population. There was no gender difference in dysphoric disorders in the Austrian population. After adjustment for age and chronic diseases, having a dysphoric disorder was associated with a higher utilization of health care services among migrant and Austrian women, but not among men.

LIMITATIONS: Because of the explorative nature of the study multiple testing correction was not performed. The reason for health care utilization was not assessed.

CONCLUSIONS: Mental health of female migrants from Eastern Europe should be studied in more detail; men could be an underserved group, both in migrants and Austrians.

}, keywords = {Adolescent, Adult, Aged, Anxiety, Austria, Data Collection, Delivery of Health Care, Depression, Female, Humans, Male, Middle Aged, Prevalence, Sex Factors, Transients and Migrants, Young Adult}, issn = {1573-2517}, doi = {10.1016/j.jad.2013.05.081}, url = {http://dx.doi.org/10.1016/j.jad.2013.05.081}, author = {Kerkenaar, Marlies M E and Maier, Manfred and Kutalek, Ruth and Lagro-Janssen, Antoine L M and Ristl, Robin and Pichlh{\"o}fer, Otto} } @article {15, title = {Information technology interventions to improve medication safety in primary care: a systematic review.}, journal = {Int J Qual Health Care}, volume = {25}, year = {2013}, month = {2013 Oct}, pages = {590-8}, abstract = {

PURPOSE: Improving medication safety has become a major topic in all clinical settings. Information technology (IT) can play an important role to prevent adverse drug events (ADEs), but data on the effectiveness of IT interventions are controversial. The objective of this paper is to provide a systematic review about the effects of IT interventions on medication safety in primary care.

DATA SOURCES: PubMed, International Pharmaceutical Abstracts, EMBASE, Cochrane Database of Systematic Reviews, handsearching reference lists from full-text articles.

STUDY SELECTION: Randomized controlled trials (RCTs), if interventions based on IT, performed in primary care and outcomes reported on medication safety. Data extraction Study characteristics and outcome data independently extracted by two reviewers. Disagreement resolved by discussion with a third reviewer.

RESULTS OF DATA SYNTHESIS: Out of 3918 studies retrieved, 10 RCTs met the inclusion criteria. Of the six studies evaluating computerized provider order entry (CPOE) with clinical decision support (CDS) only 3 studies effectively reduced unsafe prescribing. Both pharmacist-led IT interventions decreased the prescription of potentially inappropriate medication or unsafe prescribing in pregnancy. No reduction of ADEs was achieved by a web program or a TeleWatch system intervention.

CONCLUSION: Only 5 of 10 RCTs revealed a reduction of medication errors. CPOE with CDS was effective if targeted at a limited number of potentially inappropriate medications. The positive results of pharmacist-led IT interventions indicate that IT interventions with inter-professional communication appear to be effective. The unequivocal results of the included RCTs stress the necessity of rigorous evaluation prior to large-scale implementation.

}, keywords = {Humans, Medical Informatics, Medication Errors, Patient Safety, Primary Health Care, Quality Improvement}, issn = {1464-3677}, doi = {10.1093/intqhc/mzt043}, author = {Lainer, Miriam and Mann, Eva and S{\"o}nnichsen, Andreas} } @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} }