A5018424227- Chronic Disease Management Strategies
- Health and Medical Studies
- Clinical practice guidelines implementation
- Primary Care and Health Outcomes
- Nitric Oxide and Endothelin Effects
- Cardiovascular Function and Risk Factors
- Cardiac Valve Diseases and Treatments
- Health Systems, Economic Evaluations, Quality of Life
- Cardiac electrophysiology and arrhythmias
- Cardiac Imaging and Diagnostics
- Medical Malpractice and Liability Issues
- Patient Safety and Medication Errors
- Cardiac and Coronary Surgery Techniques
- Medical Practices and Rehabilitation
- Heart Failure Treatment and Management
- Acute Myocardial Infarction Research
- Cardiac pacing and defibrillation studies
- Health Promotion and Cardiovascular Prevention
- Interprofessional Education and Collaboration
- Healthcare Policy and Management
- Electron Spin Resonance Studies
- Psychiatric care and mental health services
- Pharmaceutical Practices and Patient Outcomes
- Tissue Engineering and Regenerative Medicine
- Electrospun Nanofibers in Biomedical Applications
Harvard University
2024-2025
Medizinisches Versorgungszentrum Prof. Mathey, Prof. Schofer
2024
Medizinische Hochschule Hannover
1998-2024
Goethe University Frankfurt
2013-2023
University of Tübingen
1997-2020
University of Rostock
2017-2018
University Hospital Augsburg
2010-2016
Heidelberg University
2016
University Hospital Heidelberg
2016
University of Copenhagen
2016
Multimorbidity is a health issue mostly dealt with in primary care practice. As result of their generalist and patient-centered approach, long-lasting relationships patients, responsibility for continuity coordination care, family physicians are particularly well placed to manage patients multimorbidity. However, conflicts arising from the application multiple disease oriented guidelines burden diseases treatments often make consultations challenging. To provide orientation decision making...
This study was carried out to compare the HRQoL of patients in general practice with differing chronic diseases without conditions, evaluate Germany compared population, and explore influence different on patients' HRQoL, independently effects multiple confounding variables. A cross-sectional questionnaire survey including SF-36, EQ-5D demographic questions conducted 20 practices Germany. 1009 consecutive aged 15–89 participated. The SF-36 scale scores were those conditions. Differences...
Introduction: Cardiac amyloidosis (CA) and hypertrophic cardiomyopathy (HCM) are important differential diagnosis of left ventricular hypertrophy. The aim this study was to investigate if three‐dimensional (3D) speckle tracking‐derived functional parameters enabled differentiation CA HCM by a disease‐specific pattern. Methods: Twelve patients with 12 were included. diagnosed contrast‐enhanced cardiovascular magnetic resonance (CMR). Three‐dimensional tracking echocardiography wall motion...
Objectives Investigate the effectiveness of a complex intervention aimed at improving appropriateness medication in older patients with multimorbidity general practice. Design Pragmatic, cluster randomised controlled trial practice as unit randomisation. Setting 72 practices Hesse, Germany. Participants 505 randomly sampled, cognitively intact (≥60 years, ≥3 chronic conditions under pharmacological treatment, ≥5 long-term drug prescriptions systemic effects); 465 and 71 completed study....
Cutaneous squamous cell carcinoma (cSCC) is a common cancer capable of metastasis. Sentinel lymph node biopsy (SLNB) may be valuable adjunct for patients with cSCC at high risk However, data on factors metastasis and results SLNB from are limited.To evaluate in large cohort study long-term follow-up to determine the value SLNB.We retrospectively analysed all records who underwent excision between January 2005 August 2009 tertiary referral centre. In total, 143 were included cohort, including...
Background: Patients with multiple chronic conditions are at high risk for potentially avoidable hospitalizations, which may be reduced by care coordination and self-management support. Medical assistants an increasingly available resource patient in primary practices. Objective: To determine whether protocol-based management delivered medical improves patients future hospitalization care. Design: Two-year cluster randomized clinical trial. (Current Controlled Trials: ISRCTN56104508)...
<h3>Background:</h3> Incident reporting systems have been established primarily in the inpatient setting. Their goal is identification of safety risks healthcare as a precondition for improvements overall quality care. Knowledge about medical errors general practice sparse, are patient this This article describes development, structure and initial results an incident system practices German-speaking countries. <h3>Methods:</h3> Jeder Fehler Zaehlt (JFZ; www.jeder-fehler-zaehlt.de) web-based...
Abstract In 2004, Germany introduced a program based on voluntary contracting to strengthen the role of general practice care in healthcare system. Key components include structured management chronic diseases, coordinated access secondary care, data-driven quality improvement, computerized clinical decision-support, and capitation-based reimbursement. Our aim was determine long-term effects this risk hospitalization specific categories high-risk patients. Based insurance claims data, we...
At the WONCA Europe conference 2009 recently published 'Research Agenda for General Practice/Family Medicine and Primary Health Care in Europe' was presented. The Research is a background paper reference manual GPs/ family doctors, researchers policy makers, providing advocacy of general practice/family medicine GP/FM Europe. summarizes evidence relating to core competencies characteristics definition GP/FM, its meaning makers. Evidence gaps research needs are pointed out provide basis...
ICD-10-coded diagnoses from claims records are frequently used as morbidity indicators for research well risk adjustment purposes in quality management and remuneration. A requirement this application is the high validity of diagnoses. In GP practices particular, it questionable whether claims-based realistically reflect health problems patients treated over a one year period.In retrospective cross-sectional study random sample 250 10 we examined whether, on basis patients' medical records,...
The recently published 'Research Agenda for General Practice/Family Medicine and Primary Health Care in Europe' summarizes the evidence relating to core competencies characteristics of Wonca Europe definition GP/FM, its implications general practitioners/family doctors, researchers policy makers. European Journal Practice publishes a series articles based on this document. In first article, background, objectives, methodology were discussed. second results two 'primary care management'...
Care management programmes are an effective approach to care for high risk patients with complex needs resulting from multiple co-occurring medical and non-medical conditions. These likely be hospitalized a potentially "avoidable" cause. Nurse-led elderly showed promising results. based on health assistants (HCAs) targeting adult of hospitalisation may innovative deliver cost-efficient intensified most in need.PraCMan is cluster randomized controlled trial primary practices as unit...
Patients with chronic kidney disease (CKD) are at increased risk for inappropriate or potentially harmful prescribing. The aim of this study was to examine whether a multifaceted intervention including the use software programme estimation creatinine clearance and recommendation individual dosage requirements may improve correct adjustment relevant medications patients CKD in primary care. A cluster-randomized controlled trial conducted between January December 2007 small care practices...
Background —Thrombolytic therapy in patients with acute myocardial infarction (AMI) is hampered by procoagulant effects. In vitro studies have indicated that plasmin stimulation activates the kallikrein–contact-phase system, resulting thrombin activation. This prospective comparative study was designed to examine effects of streptokinase or alteplase AMI. Methods and Results —Sixty-one AMI received 1.5 million U front-loaded (up 100 mg) systemic heparin. Twenty-four no thrombolytic 30...
Objective To improve medication appropriateness and adherence in elderly patients with multimorbidity, we developed a complex intervention involving general practitioners (GPs) their healthcare assistants (HCA). In accordance the Medical Research Council guidance on developing evaluating interventions, prepared for main study by testing feasibility of design cluster randomised pilot study. Setting 20 practices Hesse, Germany. Participants 100 cognitively intact ≥65 years ≥3 chronic...
Abstract Background Depression is a disorder with high prevalence in primary health care and significant burden of illness. The delivery for depression, as well other chronic illnesses, has been criticized several reasons new strategies to address the needs these illnesses have advocated. Case management patient-centered approach which shown efficacy treatment depression highly organized Health Maintenance Organization (HMO) settings might also be effective other, less structured settings....
Background: Since prevalence of and reasons for infertility were unclear in survivors childhood cancer we conducted a two centre survey 2006 nationwide 2008. In 2008/2009 undertook study entitled "Hormone Sperm Analyses after Chemo- Radiotherapy Childhood Adolescence".
Complex care management is seen as an approach to face the challenges of ageing society with increasing numbers patients complex needs. The Medical Research Council in United Kingdom has proposed a framework for development and evaluation interventions that will be used develop evaluate primary care-based program chronically ill at high risk future hospitalization Germany. We present multi-method procedure implement aimed reducing potentially avoidable hospitalizations type 2 diabetes...
Older patients, suffering from numerous diseases and taking multiple medications are the rule rather than exception in primary care. A manifold of medical conditions often associated with poor outcomes, their raise additional risks polypharmacy. Such patients account for most healthcare expenditures. Effective approaches needed to manage such complex This paper describes results a scoping exercise, including two-day workshop 17 professionals six countries, experienced general practice care...
Background Expected growth in the demand for health services has generated interest more effective deployment of care assistants. Programs encouraging German general practitioners (GPs) to share responsibility with specially qualified assistants family practice (VERAHs) have existed several years. But no studies been conducted on tasks GPs are willing rely personnel perform, what they prepared delegate all non-physician staff and prefer do themselves. Methods As part an evaluation study...