HbA1c as a shared treatment goal in type 2 diabetes? A secondary analysis of the DEBATE trial.

Background: Type 2 diabetes mellitus (T2DM) is a major health problem in the western world. Despite a widespread implementation of integrated care programs there are still patients with poorly controlled T2DM. Shared goal setting within the process of Shared Decision Making (SDM) may increase patient's compliance and adherence to treatment regimen.

The value of the GP's clinical judgement in predicting dementia: a multicentre prospective cohort study among patients in general practice.

Background: Clinical judgement is intrinsic to diagnostic strategies in general practice; however, empirical evidence for its validity is sparse.

Aim: To ascertain whether a GP's global clinical judgement of future cognitive status has an added value for predicting a patient's likelihood of experiencing dementia.

Design And Setting: Multicentre prospective cohort study among patients in German general practice that took place from January 2003 to October 2016.

Which patients with type 2 diabetes mellitus are perceived as 'difficult' by general practitioners?

Aims: To find factors that are associated with a general practitioner's (GP's) subjective impression of a patient being 'difficult' within a sample of patients with type 2 diabetes mellitus (T2DM).

Methods: Secondary cross-sectional analysis of a cohort of GP patients with T2DM. GP questionnaire on clinical data and GPs' subjective ratings of patient attributes (including 'patient difficulty').

General practitioners' attitudes towards patients with poorly controlled type 2 diabetes: a qualitative study.

Background: Patients with type 2 diabetes mellitus (T2DM) with poor glycaemic control can represent a challenge from the perspective of the general practitioner (GP). Apart from patient-sided factors, the understanding of GPs' attitudes may provide ideas for improved management in these patients. The aim of this study is to reveal attitudes of GPs towards T2DM patients with poor metabolic control.

Narrative medicine-based intervention in primary care to reduce polypharmacy: results from the cluster-randomised controlled trial MultiCare AGENDA.

Objectives: To determine if patient-centred communication leads to a reduction of the number of medications taken without reducing health-related quality of life.

Design: Two-arm cluster-randomised controlled trial.

Setting: 55 primary care practices in Hamburg, Düsseldorf and Rostock, Germany.

The Prevention and Treatment of Retinal Complications in Diabetes.

Background: Microvascular complications of diabetes mellitus can cause retino pathy and maculopathy, which can irreversibly damage vision and lead to blindness. The prevalence of retinopathy is 9-16% in patients with type 2 diabetes and 24-27% in patients with type 1 diabetes. 0.

From hypertension control to global cardiovascular risk management: an educational intervention in a cluster-randomised controlled trial.

Background: Guidelines on hypertension management recommend adjusting therapeutic efforts in accordance with global cardiovascular risk (CVR) rather than by blood pressure levels alone. However, this paradigm change has not yet arrived in German General Practice. We have evaluated the effect of an educational outreach visit with general practitioners (GPs), encouraging them to consider CVR in treatment decisions for patients with hypertension.

[Ambulatory care of patients with asthma in Germany and disease management program for asthma from the view of statutory health insured patients. A postal survey of statutory health insured patients].

Background: In spite of a decline in mortality due to asthma in Germany various studies point towards deficits in asthma care. Our investigation should collect data about ambulatory care from the view of statutory health insured patients (SHI), who participate in the disease management program asthma (DMP-P) or do not (NP). Primary question was, if there is a difference between asthma control.

Willingness to participate in mammography screening: a randomized controlled questionnaire study of responses to two patient information leaflets with different factual content.

Background: From 2010 onward, a new leaflet about mammography screening for breast cancer, more informative than the preceding version, has been sent to women in Germany aged 50 to 69 with the invitation to undergo screening. The purpose of this study was to determine the effect of different informational content on the decision whether or not to be screened.

Methods: In a randomized and blinded design, 792 women aged 48 to 49 were sent either the old or the new leaflet.

Are there differences between patients with and without the homozygous--13910CC genetic variant in the MCM-6 gene upstream from the lactase gene?--A non-randomised, two armed intervention study without control group.

Background: Patients with chronic abdominal complaints are a diagnostic challenge for general practitioners (GP). Lactose intolerance (LI) often remains undiagnosed in these patients. Genetic testing for the homozygous -13910CC variant of the MCM-6 gene (LI+) combined with a lactose-restricted diet (LRD) seems to be an acceptable approach.

[Association of diabetes type 2 and depression - behavioural and biological aspects].

Background And Objective: Type 2 diabetes and depression often appear together. Although health behaviour and risk factors partially explain this association, other potential mechanisms have yet to be elucidated.

Methods: Explorative literature research for reviews on the topic in PubMed.

Management of low back pain in general practice - is it of acceptable quality: an observational study among 25 general practices in South Tyrol (Italy).

Background: There are several guidelines dealing with the management of low back pain (LBP), but only few studies on the quality of care provided within General Practices as judged against those guidelines.The objective of this study is to analyse the management of LBP in Italian General Practice and compare it with guideline recommendations.

Methods: In this observational study, all patients visiting their General Practitioners (GPs) for treatment of LBP within a 8-week period were monitored for at least four weeks with regard to symptoms and diagnostic and therapeutic interventions.

Effects of different information brochures on women's decision-making regarding mammography screening: study protocol for a randomized controlled questionnaire study.

Background: In order to give informed consent for mammography screening, women need to be told the relevant facts; however, screening information often remains vague because of the worry that detailed information might deter women from participating in recommended screening programs. Since September 2010, German women aged 50 to 69 invited for mammography screening have received a new, comprehensive information brochure that frankly discusses the potential benefit and harm of mammography screening. In contrast, the brochure that was in use before September 2010 contained little relevant information.

Risk-adjusted versus overall blood pressure control rate for identifying the need for intensified cardiovascular risk reduction: lessons from a cross-sectional study.

Objective: To compare a cardiovascular risk (CVR)-adjusted with the traditional blood pressure (BP) control rate for assessing BP control and consequent target populations for intensified treatment.

Methods: Model calculation using cross-sectional data retrieved from 89 German general practices; a random sample of 3355 patients with known hypertension was consecutively enrolled by their general practitioners. Cardiovascular history and risk factors were documented.

Accuracy in diagnosing deep and pelvic vein thrombosis in primary care: an analysis of 395 cases seen by 58 primary care physicians.

Background: Ruling out a deep vein thrombosis (DVT) is difficult in general practice because the clinical manifestations of DVT are nonspecific and more often due to other diseases. The aim of diagnostic screening in primary care must be to rule out a DVT with high accuracy in most patients, so that only those who are likely to have a DVT will undergo further testing. In this study, we tested the accuracy of exclusion of DVT by the combination of a clinical score (the Wells score) with either a bedside D-dimer test or selective compression sonography.

Advance directives in nursing homes: prevalence, validity, significance, and nursing staff adherence.

Background: The German Advance Directives Act of 2009 confirms that advance directives (ADs) are binding. Little is known, however, about their prevalence in nursing homes, their quality, and whether they are honored.

Methods: In 2007, we carried out a cross-sectional survey in all 11 nursing homes of a German city in the state of North Rhine-Westphalia (total nursing home population, 1089 residents).