TY - Generic T1 - Allgemeinmedizin bietet einen Ort, der soziale Ungleichheit reduziert Y1 - 2017 A1 - Rabady, Susanne KW - Hausarztmedizin PB - Ärzte Krone IS - 03 ER - TY - JOUR T1 - Clinical presentation and management of stable coronary artery disease in Austria. JF - PLoS One Y1 - 2017 A1 - Pichlhöfer, Otto A1 - Maier, Manfred A1 - Badr-Eslam, Roza A1 - Ristl, Robin A1 - Zebrowska, Magdalena A1 - Lang, Irene M KW - Aged KW - Aged, 80 and over KW - Austria KW - Coronary Artery Disease KW - Female KW - Heart Rate KW - Humans KW - Male KW - Middle Aged KW - Retrospective Studies AB -

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' 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.

VL - 12 UR - http://dx.doi.org/10.1371/journal.pone.0176257 IS - 4 U1 - https://www.ncbi.nlm.nih.gov/pubmed/28448602?dopt=Abstract ER - TY - Generic T1 - Ärzte mit Herz und Hirn Y1 - 2016 A1 - Christofer Patrick Reichel KW - WONCA PB - Ärzte Krone IS - 14-16 ER - TY - Generic T1 - Editorial 17-2016 Y1 - 2016 A1 - Rabady, Susanne KW - Gesundheitsreform KW - PHC PB - Ärzte Krone IS - 17 ER - TY - Generic T1 - ELGA ante portas Y1 - 2016 A1 - Rabady, Susanne PB - Ärzte Krone IS - 11 ER - TY - Generic T1 - Fragebogenerhebung zur Evaluierung des quantitativen und inhaltlichen Forschungsinteresses und möglicher hemmender und fördernder Faktoren der Allgemeinmediziner_innen in der Steiermark Y1 - 2016 A1 - Manuel Reinisch ED - Andrea Siebenhofer-Kroitzsch ED - Stephanie Poggenburg AB -

Einleitung

Nachhaltige  und  effiziente Versorgungsforschung  benötigt  die  aktive  Mitarbeit forschungswilliger Hausärztinnen und Hausärzte (HA). Österreich steht im internationalen  Vergleich zurück und  besitzt  kein  flächendeckendes  und  zentralorganisiertes  Forschungspraxen-Netzwerk. In dieser Studie soll daher untersucht werden, wie viele der steirischen Allgemeinmediziner/innen an der Forschung in ihrem Gebiet interessiert sind, wie sie  soziodemografisch  beschaffen  sind,  welche  hemmenden  und  motivierenden  Faktoren für die Forschung existieren und welche Forschungsthemen aus der Sicht der HA relevant sind.

Material und Methoden

Im Rahmen einer bundeslandweiten Querschnittserhebung wurden  alle  niedergelassenen Allgemeinmediziner/innen der  Steiermark  unter  Zuhilfenahme eines  selbstentwickelten  und  standardisierten  Fragebogens  in  einem  Zeitrahmen  von  zwei Monaten  befragt. Die  statistische  Analyse  der  erhobenen  Daten  erfolgte  unterstützt  durch "Statistical Product and Service Solutions" (SPSS) mittels deskriptiver Methoden.

Ergebnisse

Von 1015 angeschriebenen Allgemeinmediziner/innen (100%) schickten 135 (13,3  %)  den  Fragebogen  zurück.  106  (78  %)  der  Befragten  waren  prinzipiell  bereit,  an Forschungsprojekten  in  der  eigenen Praxis teilzunehmen.  Als  motivierenden  Faktor  für eine Projektteilnahme nannten die Grundversorgenden in erster  Linie die  praktische Relevanz und Nützlichkeit der gewonnen Evidenz für die tägliche Versorgung von Patientinnen
und  Patienten.  Zusätzlich  soll  die  Forschung  der  Aufwertung  und  Weiterentwicklung  der Allgemeinmedizin  als  eigene  Fachdisziplin  dienen  und  den  Ausbau  des  persönlichen Netzwerkes, inklusive einem fachlichen Austausch mit Kolleginnen und Kollegen, begünstigen. Zeitmangel und hoher bürokratischer Aufwand konnten als die zwei dominierenden Hemmfaktoren für die Forschung in der eigenen Praxis identifiziert werden. 66 HA formulierten 132 für sie interessante und relevante Forschungsfragen und Forschungsthemen.

Schlussfolgerung

Die Mehrheit der antwortenden steirischen HA sind zur aktiven Mitarbeit an Forschungsprojekten in der eigenen Praxis bereit. Das neu gegründete IAMEV versteht  sich  als  akademische  Vertretung der Allgemeinmedizin und  wird  somit  in  Versorgungsforschungsfragen  als  erster  Ansprechpartner  der HA fungieren.  Die  Ergebnisse dieser  Studie können die  Erstellung  von motivierenden Rahmenbedingungen  für  organisierte Forschung begünstigen.

JF - Instiut für Allgemeinmedizin und evidenzbasierte Versorgungsforschung PB - Medizinischen Universität Graz CY - Graz VL - Doktor der gesamten Heilkunde (Dr. med. univ.) ER - TY - Generic T1 - "Lasst uns die Qualität systematisieren" Y1 - 2016 A1 - Rabady, Susanne KW - Editorial PB - Ärzte Krone IS - 13 ER - TY - ABST T1 - Schnittstellenmanagement bei der Hausstaubmilben-Allergie Y1 - 2016 A1 - Elisabeth Brettlecker A1 - Renate Hoffmann-Dorninger A1 - Reinhart Jarisch A1 - Johannes Neuhofer A1 - Otto Pichlhöfer A1 - Erwin Rebhandl A1 - Gunter Sturm A1 - Felix Wantke A1 - Rudolf Schmitzberger KW - orp-publications ER - TY - Generic T1 - Sprachbarrieren im Gesundheitswesen Schwierigkeiten und Lösungsansätze am Beispiel der allgemeinmedizinischen Praxis Y1 - 2016 A1 - Reindl, Eva Maria ED - Ruth Kutalek JF - Unit Ethnomedizin und International Health, Zentrum für Public Health PB - Medizinische Universität Wien CY - Wien VL - Doktorin der gesamten Heilkunde (Dr. med. univ.) ER - TY - JOUR T1 - Effect of person-centred care on antipsychotic drug use in nursing homes (EPCentCare): study protocol for a cluster-randomised controlled trial. JF - Implement Sci Y1 - 2015 A1 - Richter, Christin A1 - Berg, Almuth A1 - Fleischer, Steffen A1 - Köpke, Sascha A1 - Balzer, Katrin A1 - Fick, Eva-Maria A1 - Sönnichsen, Andreas A1 - Löscher, Susanne A1 - Vollmar, Horst Christian A1 - Haastert, Burkhard A1 - Icks, Andrea A1 - Dintsios, Charalabos-Markos A1 - Mann, Eva A1 - Wolf, Ursula A1 - Meyer, Gabriele KW - Accidental Falls KW - Antipsychotic Agents KW - Costs and Cost Analysis KW - Dementia KW - Drug Utilization KW - Germany KW - Homes for the Aged KW - Humans KW - Inservice Training KW - Mental Disorders KW - Nursing Homes KW - Patient-Centered Care KW - Psychomotor Agitation KW - Quality of Life KW - Research Design AB -

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' 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.

VL - 10 U1 - https://www.ncbi.nlm.nih.gov/pubmed/26037324?dopt=Abstract ER - TY - JOUR T1 - Assessment tools for determining appropriateness of admission to acute care of persons transferred from long-term care facilities: a systematic review. JF - BMC Geriatr Y1 - 2014 A1 - Renom-Guiteras, Anna A1 - Uhrenfeldt, Lisbeth A1 - Meyer, Gabriele A1 - Mann, Eva KW - Emergency Service, Hospital KW - Humans KW - Long-Term Care KW - Patient Admission KW - Patient Transfer KW - Residential Facilities AB -

BACKGROUND: Residents of long-term care facilities have a high risk of acute care admission. Estimates of the frequency of inappropriate transfers vary substantially throughout the studies and various assessment tools have been used. The purpose of this study is to systematically review and describe the internationally existing assessment tools used for determining appropriateness of hospital admissions among long-term care residents.

METHOD: Systematic review of the literature of two databases (PubMed and CINAHL®). The search covered seven languages and the period between January 2000 and December 2012. All quantitative studies were included if any assessment tool for appropriateness of hospital and/or emergency department admission of long-term care residents was used. Two pairs of independent researchers extracted the data.

RESULTS: Twenty-nine articles were included, covering study periods between 1991 and 2009. The proportion of admissions considered as inappropriate ranged from 2% to 77%. Throughout the studies, 16 different assessment tools were used; all were based on expert opinion to some extent; six also took into account published literature or interpretation of patient data. Variation between tools depended on the concepts studied, format and application, and aspects evaluated. Overall, the assessment tools covered six aspects: specific medical diagnoses (assessed by n = 8 tools), acuteness/severity of symptoms (n = 7), residents' characteristics prior to admission (n = 6), residents' or families' wishes (n = 3), existence of a care plan (n = 1), and availability or requirement of resources (n = 10). Most tools judged appropriateness based on one fulfilled item; five tools judged appropriateness based on a balance of aspects. Five tools covered only one of these aspects and only six considered four or more aspects. Little information was available on the psychometric properties of the tools.

CONCLUSIONS: Most assessment tools are not comprehensive and do not take into account residents' individual aspects, such as characteristics of residents prior to admission and wishes of residents or families. The generalizability of the existing tools is unknown. Further research is needed to develop a tool that is evidence-based, comprehensive and generalizable to different regions or countries in order to assess the appropriateness of hospital admissions among long-term care residents.

VL - 14 U1 - https://www.ncbi.nlm.nih.gov/pubmed/24952409?dopt=Abstract ER - TY - RPRT T1 - Möglichkeiten und Grenzen des Brustkrebsscreening Y1 - 2014 A1 - Rabady, Susanne A1 - Andrea Fried ED - Gerald Gartlehner ED - Michael Stierer ED - Irmgard Schiller-Frühwirt ED - Andrea Siebenhofer-Kroitzsch ED - Herbert Bachler ED - Reinhold Glehr KW - Bias KW - Brustkrebs KW - Früherkennung KW - Mammakarzinom KW - Mammographie KW - Screening PB - Österreichische Gesellschaft für Allgemeinmedizin (ÖGAM) CY - Wien ER - TY - ABST T1 - Traumberuf Hausarzt Y1 - 2014 A1 - Reinhold Glehr A1 - Rabady, Susanne A1 - Hockl, Wolfgang A1 - Burghuber, Franz A1 - Neuber, Nina-Maria A1 - Cybulski, Martin A1 - Heckenthaler, Walter A1 - Wendler, Maria A1 - Thomas Jungblut A1 - Modler, Elisabeth A1 - Hofbaur, Benedikt A1 - Braunschmid, Karl A1 - Thalhammer, Gottfried A1 - Bernhard Panhofer A1 - Kaiba, Wilfried A1 - Croy, Cornelia AB -

In zukunftsweisenden Gesundheitssystemen hat die hausärztliche Versorgung große 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 österreichischen Gesundheitssystems ebenfalls ein Hoffnungsträger geworden.
„Hausärztin“ und „Hausarzt“ sind Begriffe, die in der Bevölkerung einen guten Klang haben. Sie stehen für Vertrauen, Nähe, Gesamtschau, Langzeitbeziehung, Familienbetreuung, freundschaftliche Beziehungen und ähnliches.
Gleichzeitig gibt es Botschaften der Geringschätzung, des Infragestellens und der Gerüchte um eine Ablöse niedergelassener hausärztlicher Tätigkeit durch andere Versorgungsstrukturen. Lohnt es sich da, diesen Beruf zu ergreifen, ihm seine Ausbildung zu widmen und für später ein erfülltes, glückliches Leben zu erhoffen? Wem soll man in der Fülle des Geschriebenen, Geklagten und Befürchteten glauben?

In den universitären allgemeinmedizinischen Lehrpraxen und in von Ärzten für Allgemeinmedizin gehaltenen Vorlesungen wird Studierenden vermehrt Wissen um generalistische Arbeit ebenso wie entsprechende praktische Fertigkeiten vermittelt. Medizinische Universitäten beginnen zu verstehen, dass die medizinische Grund- und Langzeitversorgung und generalistische Arbeitsansätze durchaus auch für die Forschung interessant sind.

In der postgraduale Ausbildung wird in Kürze der dreijährige Ausbildungsturnus zum Arzt für Allgemeinmedizin durch eine zeitgemäßere Ausbildung ersetzt werden. Die Voraussetzung für die Übernahme eines den heutigen Anforderungen entsprechenden Versorgungsauftrages wird damit endlich geschaffen. Die Einführung der verpflichtenden praktischen Ausbildung in einer allgemeinmedizinischen Lehrpraxis – eine absolute Notwendigkeit – steht kurz vor dem Beschluss. Die derzeit gültige Ausbildungszeit ist für eine moderne Allgemeinmedizin zu kurz, als „Wartezone“ für eine fachärztliche 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 Bundesländern bemühen sich um eine bessere fi nanzielle Wertschätzung allgemeinmedizinischer Tätigkeit. In ähnlicher Weise kommen auch die organisatorischen Rahmenbedingungen bzw. die Möglichkeiten für verschiedene, dem heutigen Wirtschaftsverständnis angepasste, besser lebbare Zusammenarbeitsformen in Bewegung. Nicht
zuletzt ist in diesen Diskussionen spürbar, dass verstärkt auf die Lebensqualität von Hausärztin und Hausarzt Bedacht genommen werden muss.

Dies alles stimmt positiv und soll junge Ärztinnen und Ärzte ermuntern, diesen schönen, vielfältigen und verantwortungsvollen Beruf zu ergreifen. In diesem Sonderheft „Traumberuf Hausarzt“ 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 hausärztliche Beruf im Aufwind befi ndet und es sich lohnt, ihn anzustreben.

ER - TY - JOUR T1 - Depression and anxiety among migrants in Austria: a population based study of prevalence and utilization of health care services. JF - J Affect Disord Y1 - 2013 A1 - Kerkenaar, Marlies M E A1 - Maier, Manfred A1 - Kutalek, Ruth A1 - Lagro-Janssen, Antoine L M A1 - Ristl, Robin A1 - Pichlhöfer, Otto KW - Adolescent KW - Adult KW - Aged KW - Anxiety KW - Austria KW - Data Collection KW - Delivery of Health Care KW - Depression KW - Female KW - Humans KW - Male KW - Middle Aged KW - Prevalence KW - Sex Factors KW - Transients and Migrants KW - Young Adult AB -

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.

VL - 151 UR - http://dx.doi.org/10.1016/j.jad.2013.05.081 IS - 1 U1 - https://www.ncbi.nlm.nih.gov/pubmed/23810358?dopt=Abstract ER - TY - JOUR T1 - Prevalence and associations of potentially inappropriate prescriptions in Austrian nursing home residents: secondary analysis of a cross-sectional study. JF - Wien Klin Wochenschr Y1 - 2013 A1 - Mann, Eva A1 - Haastert, Burkhard A1 - Böhmdorfer, Birgit A1 - Frühwald, Thomas A1 - Iglseder, Bernhard A1 - Roller-Wirnsberger, Regina A1 - Meyer, Gabriele KW - Adult KW - Age Distribution KW - Aged KW - Austria KW - Cognition Disorders KW - Comorbidity KW - Cross-Sectional Studies KW - Diclofenac KW - Female KW - Humans KW - Inappropriate Prescribing KW - Lorazepam KW - Male KW - Middle Aged KW - Nursing Care KW - Nursing Homes KW - Prescriptions KW - Prevalence KW - Psychomotor Agitation KW - Psychotropic Drugs KW - Risk Assessment AB -

BACKGROUND: Potentially inappropriate prescriptions (PIP) are an important cause of adverse medication-related events and increases morbidity, hospitalization, and health care costs, especially in nursing home residents. However, little is known about the associations between PIP and residents' characteristics.

OBJECTIVE: The aim of our study was to analyse the prevalence and associations of PIP with residents' and facilities' characteristics.

METHODS: We performed a secondary analysis of a cross-sectional study with 48 out of 50 eligible nursing homes and 1,844 out of 2,005 eligible residents in a defined rural-urban area in Austria. The Austrian list of potentially inappropriate medications was applied for the evaluation of inappropriate prescribing. Cluster-adjusted multiple regression analysis was used to investigate institutional and residents' characteristics associated with PIP.

RESULTS: Mean cluster-adjusted prevalence of residents with at least one PIP was 70.3 % (95 % CI 67.2-73.4). The number of residents with at least one psychotropic PIP was 1.014 (55 %). The most often prescribed PIP were Prothipendyl (25.9 % residents), Lorazepam (14.5 %) and Diclofenac (6.1 %). Multiple regression analysis showed an inverse association of PIP with cognitive impairment and significant positive associations with permanent restlessness and permanent negative attitude. The associations of PIP with age and male gender were inconsistent. No significant associations were found for PIP and the ratio of staff nurses to residents.

CONCLUSIONS: Our study results confirm that PIP is highly prevalent in the nursing home population. These results urgently call for effective interventions. Initiatives and successful interventions performed in other countries could serve as examples for safer prescribing in residents in Austria.

VL - 125 IS - 7-8 U1 - https://www.ncbi.nlm.nih.gov/pubmed/23536016?dopt=Abstract ER - TY - JOUR T1 - Potentially inappropriate medication in geriatric patients: the Austrian consensus panel list. JF - Wien Klin Wochenschr Y1 - 2012 A1 - Mann, Eva A1 - Böhmdorfer, Birgit A1 - Frühwald, Thomas A1 - Roller-Wirnsberger, Regina E A1 - Dovjak, Peter A1 - Dückelmann-Hofer, Christine A1 - Fischer, Peter A1 - Rabady, Susanne A1 - Iglseder, Bernhard KW - Aged KW - Aged, 80 and over KW - Austria KW - Female KW - Humans KW - Inappropriate Prescribing KW - Male AB -

BACKGROUND: The practice of inappropriate medication and drug prescription is a major risk factor for adverse drug reactions in geriatric patients and increases the individual, as well as overall, rates of hospital admissions, resulting in increased health care expenditures. A consensus-based list of drugs, generally to be avoided in geriatric patients, is a practical tool to possibly improve the quality of prescribing.

OBJECTIVE: The aim was to develop a consensus-based list of potentially inappropriate medications (PIM) for geriatric patients in Austria. Local market characteristics and documented prescribing regimens were considered in detail.

METHODS: A two-round Delphi process involving eight experts in the field of geriatric medicine was undertaken to create a list of potentially inappropriate medications. Using a 5-point Likert scale (from strong agreement to strong disagreement), mean ratings from the experts were evaluated for each drug selected in the first round. The participants were first asked to comment on the potential inappropriateness of a preliminary list of drugs, and to propose alternate substances missing in the previous questionnaire for a second rating process. All drugs whose upper limit of the 95% CI was less than 3.0 were classified as potentially inappropriate. Drugs with a 95% CI enclosing 3.0 entered a second rating by the experts, in addition to other substances suggested during the first questionnaire. Drugs in the second rating were evaluated in comparable fashion to the first one. The final list was synthesized from the results in both rounds.

RESULTS: Out of a preliminary list of 102 drugs, 61 drugs (59.2%) were classified as potentially inappropriate for geriatric persons in the first Delphi- round. In the second rating, six drugs that were reevaluated, and six drugs proposed additionally, were rated as potentially inappropriate. The final list contains 73 drugs to be avoided in older patients because of an unfavorable benefit/risk profile and/or unproven effectiveness. The list also contains suggestions for therapeutic alternatives and information about pharmacological and pharmacokinetic characteristics of all drugs judged as potentially inappropriate.

CONCLUSION: The current Austrian list of potentially inappropriate medications may be a helpful tool for clinicians to increase the quality of prescribing in older patients. Like all explicit lists previously published, its validity needs to be proven in validation studies.

VL - 124 IS - 5-6 U1 - https://www.ncbi.nlm.nih.gov/pubmed/22134410?dopt=Abstract ER - TY - JOUR T1 - Prevalence of psychotropic medication use among German and Austrian nursing home residents: a comparison of 3 cohorts. JF - J Am Med Dir Assoc Y1 - 2012 A1 - Richter, Tanja A1 - Mann, Eva A1 - Meyer, Gabriele A1 - Haastert, Burkhard A1 - Köpke, Sascha KW - Age Distribution KW - Aged KW - Aged, 80 and over KW - Austria KW - Cluster Analysis KW - Cross-Sectional Studies KW - Dementia KW - Dose-Response Relationship, Drug KW - Drug Administration Schedule KW - Drug Utilization KW - Female KW - Geriatric Assessment KW - Germany KW - Homes for the Aged KW - Humans KW - Logistic Models KW - Long-Term Care KW - Male KW - Nursing Homes KW - Prevalence KW - Psychotropic Drugs KW - Risk Assessment KW - Sex Distribution AB -

BACKGROUND: Despite increasing knowledge about the limited effectiveness and severe adverse effects, the prescription rate of psychotropic medications in frail elderly persons remains high. Prescriptions are mainly made to control behavioral and psychological symptoms of dementia, although factors associated with prescriptions are rarely reported. However, such information is a prerequisite to develop intervention programs aiming to safely reduce psychotropic medication in nursing home residents.

METHODS: We report the comparison of cross-sectional data of psychotropic medication prescription rates from 3 large studies including nursing home residents in Germany and Austria. We aimed to compare the prevalence of (1) psychotropic medication, (2) different classes of psychotropic medication, (3) psychotropic medication administered for bedtime use, and (4) associations between prescription of psychotropics and institutional and residents' characteristics. Confidence intervals of prevalences and multiple logistic regression analyses were adjusted for cluster correlation.

RESULTS: Data from 5336 residents in 136 long term care facilities were included. In Austria, 74.6% (95% CI 72.0-77.2%) of all residents had a prescription of at least one psychotropic medication compared to Germany with about 51.8% (95% CI 48.3-55.2%) and 52.4% (95% CI 48.7-56.1%). Of all antipsychotics, 66% (Austria) and 47% (Germany) were prescribed for bedtime use. Most prescriptions were conventional, low-potency antipsychotics. In all 3 studies, there was no statistically significant association between psychotropic medication prescription and nursing home characteristics. On the level of residents, consistent positive associations were found for higher level of care dependency and permanent restlessness. Consistent negative associations were found for older age and male gender.

CONCLUSION: Frequency of psychotropic and especially antipsychotic medication is substantial in nursing home residents in Germany and Austria. The high number of prescriptions is likely to be an indicator for a perceived or actual lack of strategies to handle behavioral and psychological symptoms of dementia.

VL - 13 IS - 2 U1 - https://www.ncbi.nlm.nih.gov/pubmed/21549645?dopt=Abstract ER - TY - JOUR T1 - [Current diagnosis of acute pharyngitis]. JF - Wien Med Wochenschr Y1 - 2009 A1 - Reichardt, Berthold A1 - Pichlhöfer, Otto A1 - Zehetmayer, Sonja A1 - Maier, Manfred KW - Antigens, Bacterial KW - Austria KW - Cephalosporins KW - Child KW - Cohort Studies KW - Cross-Sectional Studies KW - Early Diagnosis KW - Family Practice KW - Humans KW - Penicillins KW - Pharyngitis KW - Predictive Value of Tests KW - Reagent Kits, Diagnostic KW - Streptococcal Infections KW - Streptococcus pyogenes AB -

BACKGROUND: Throat infections with Group A Streptococci have a high incidence and are, therefore, a considerable health problem. It is, therefore, desirable to distinguish this bacterial infections from viral infections of the upper respiratory tract. We report about the application of an immunologic rapid antigen detection test for Group A Streptococci and its medical and economic implications.

METHODS: In a cross-sectional cohort study, 30 family physicians documented the application of the test in 519 patients. Follow-up costs were compared with 109 family physicians who did not have access to the test.

RESULTS: 40.27% of tests performed were positive for Streptococci. 99% of those patients received antibiotic treatment - predominantly with Penicillin. From those patients who had shown a negative test result, only 18.4% received antibiotic treatment. Both patients and physicians welcomed the availability of the test. We did not find any significant difference regarding the economic effect of the test.

CONCLUSIONS: The employment of a rapid antigen detection test for Group A Streptococci in patients with acute pharyngitis increases therapeutic certitude and guideline-conform prescription of antibiotics among family physicians. We, therefore, assume that potential side effects of unnecessary antibiotic treatments could be minimized.

VL - 159 IS - 7-8 U1 - https://www.ncbi.nlm.nih.gov/pubmed/19412695?dopt=Abstract ER - TY - JOUR T1 - Antibiotikaeinsatz verbessern – Schnelldiagnosetest erleichtert bei Racheninfekten die Differenzierung in bakteriell oder viral. JF - Ärztewoche Y1 - 2009 A1 - Berthold Reichardt A1 - Otto Pichlhöfer A1 - Sonja Zehetmayer A1 - Manfred Maier KW - orp-publications AB -

Racheninfekte mit Gruppe-A- Streptokokken sind ein häufiges Krankheitsbild und damit auch ein beträchtliches Gesundheits- problem. Eine klare Differenzie- rung zu viralen Infekten ist nicht zuletzt deshalb wünschenswert, weil sich dadurch potentielle Ne- benwirkungen durch unnötigen Antibiotikagebrauch reduzieren lassen. Eine zeitgemäße Diag- nostik der akuten Pharyngitis hilft dem niedergelassenen Arzt bei der Entscheidungsfindung.

ER -