Non-random relations in drug use expressed as patterns comprising prescription and over-the-counter drugs in multimorbid elderly patients in primary care: Data of the exploratory analysis of the multicentre, observational cohort study MultiCare.

Background: The elderly population deals with multimorbidity (three chronic conditions) and increasinged drug use with age. A comprehensive characterisation of the medication - including prescription and over-the-counter (OTC) drugs - of elderly patients in primary care is still insufficient.

Objectives: This study aims to characterise the medication (prescription and OTC) of multimorbid elderly patients in primary care and living at home by identifying drug patterns to evaluate the relationship between drugs and drug groups and reveal associations with recently published multimorbidity clusters of the same cohort.

Health behaviour, social support, socio-economic status and the 5-year progression of multimorbidity: Results from the MultiCare Cohort Study.

Background: Multimorbidity in elderly patients is a major challenge for physicians, because of a high prevalence of and associations with many adverse outcomes. However, the mechanisms of progressing multimorbidity are not well-understood. The aim of our study was to determine if the progression of multimorbidity is influenced by health behaviour and social support and to analyse if the patients' socio-economic status had an effect on these prognostic factors.

Colorectal cancer stage at diagnosis in migrants and non-migrants: a cross-sectional analysis of the KoMigra Study in Germany.

Background:  Colorectal cancer is one leading cause of cancer-related morbidity and mortality. Its prognosis depends largely on tumour stage at diagnosis. Migration status was associated with late stage at diagnosis in some studies, yet results are inconsistent.

[Subjective and objective work stress among ophthalmologists in private practice in Thuringia : Results of a state-wide survey].

Background: Physicians are highly vulnerable to work-related stress; however, little is known about the workload of ophthalmologists.

Material And Methods: In March 2017 a cross-sectional and paper-based survey of all practice-based ophthalmologists in the federal state of Thuringia was conducted. Additionally, data from 2016 and 2009 using physician fee schedule datasets provided by the Thuringian Association of Statutory Health Insurance Physicians were analyzed.

A novel superior medication-based chronic disease score predicted all-cause mortality in independent geriatric cohorts.

Objectives: On the basis of current treatment guidelines, we developed and validated a medication-based chronic disease score (medCDS) and tested its association with all-cause mortality of older outpatients.

Study Design And Setting: Considering the most prevalent chronic diseases in the elderly German population, we compiled a list of evidence-based medicines used to treat these disorders. Based on this list, a score (medCDS) was developed to predict mortality using data of a large longitudinal cohort of older outpatients (training sample; MultiCare Cohort Study).

The readiness of German GPs to recommend and conduct cancer screening is associated with patient-physician gender concordance. Results of a survey.

Background: Cancer screening participation rates in Germany differ depending on patients' gender. International studies have found that patient-physician gender concordance fosters recommendation and conducting of cancer screening, and especially cancer screening for women.

Objectives: We aimed to ascertain whether gender concordance influences general practitioners' (GPs') rating of the usefulness of cancer screening, as well as their recommendations and readiness to conduct cancer screening in general practice in Germany.

Birth weight and subsequent risk of childhood primary brain tumors: An updated meta-analysis.

Background: Primary brain tumors are common in childhood, but the etiology is largely unclear. As studies on birth weight as a risk factor for the occurrence of histologically specified tumors have been inconclusive, we decided to update a 2008 meta-analysis on the subject.

Methods: A search strategy was performed in Medline and EMBASE for the period 2007-2016.

Positive family history of colorectal cancer in a general practice setting [FRIDA.Frankfurt]: study protocol of a of a cross-sectional study.

Background: Although the risk of developing colorectal cancer (CRC) is 2-4 times higher in case of a positive family history, risk-adapted screening programs for family members related to CRC- patients do not exist in the German health care system. CRC screening recommendations for persons under 55 years of age that have a family predisposition have been published in several guidelines. The primary aim of this study is to determine the frequency of positive family history of CRC (1st degree relatives with CRC) among 40-54 year old persons in a general practitioner (GP) setting in Germany.

Relevance to family practice of English-language guidelines on breast, colorectal and prostate cancer: a review.

Background: GPs regard cancer guidelines as useful yet criticise their limited applicability to the primary care setting.

Objectives: To determine the extent to which English-language breast, colorectal and prostate cancer guidelines contain recommendations that are relevant to GPs and to find out which of the GPs' roles in cancer care the recommendations refer to.

Methods: Evidence- and consent-based English-language breast, colorectal and prostate cancer guidelines were searched for in guideline databases and selected guideline providers' web pages, and checked against inclusion and exclusion criteria.

Complementary medicine for cancer patients in general practice: qualitative interviews with german general practitioners.

Background: The aim of this study was to investigate how general practitioners react when their cancer patients show interest in complementary medicine, and how their reaction is related to their knowledge in the field.

Methods: We conducted semi-structured interviews with 10 German general practitioners. Interviewees came from 5 different federal states and varied in terms of urban/rural setting, single/joint practice, additional certifications, gender and length of professional experience.

Implementation of chronic illness care in German primary care practices--how do multimorbid older patients view routine care? A cross-sectional study using multilevel hierarchical modeling.

Background: In primary care, patients with multiple chronic conditions are the rule rather than the exception. The Chronic Care Model (CCM) is an evidence-based framework for improving chronic illness care, but little is known about the extent to which it has been implemented in routine primary care. The aim of this study was to describe how multimorbid older patients assess the routine chronic care they receive in primary care practices in Germany, and to explore the extent to which factors at both the practice and patient level determine their views.

Depressive mood mediates the influence of social support on health-related quality of life in elderly, multimorbid patients.

Background: It is not well established how psychosocial factors like social support and depression affect health-related quality of life in multimorbid and elderly patients. We investigated whether depressive mood mediates the influence of social support on health-related quality of life.

Methods: Cross-sectional data of 3,189 multimorbid patients from the baseline assessment of the German MultiCare cohort study were used.

Colorectal cancer stage at diagnosis in migrants versus non-migrants (KoMigra): study protocol of a cross-sectional study in Germany.

Background: In Germany, about 20% of the total population have a migration background. Differences exist between migrants and non-migrants in terms of health care access and utilisation. Colorectal cancer is the second most common malignant tumour in Germany, and incidence, staging and survival chances depend, amongst other things, on ethnicity and lifestyle.

German general practitioners' views on their involvement and role in cancer care: a qualitative study.

Background: The multidisciplinary and sequential nature of cancer care makes continuity of care for patients difficult. Cancer patients have often known their general practitioners (GPs) for years and are often in constant contact with them. Objective(s).

Self-rated health in multimorbid older general practice patients: a cross-sectional study in Germany.

Background: With increasing life expectancy the number of people affected by multimorbidity rises. Knowledge of factors associated with health-related quality of life in multimorbid people is scarce. We aimed to identify the factors that are associated with self-rated health (SRH) in aged multimorbid primary care patients.

Involvement of general practitioners in palliative cancer care: a qualitative study.

Purpose: General practitioners play an important role in palliative care for cancer patients. The intensity of care and its medical complexity make palliative care a demanding task for general practitioners. This study explored general practitioners' perceptions of their involvement in palliative cancer care and the constraints they confront.

Relative impact of multimorbid chronic conditions on health-related quality of life--results from the MultiCare Cohort Study.

Background: Multimorbidity has a negative impact on health-related quality of life (HRQL). Previous studies included only a limited number of conditions. In this study, we analyse the impact of a large number of conditions on HRQL in multimorbid patients without preselecting particular diseases.

A comparative study demonstrated that prevalence figures on multimorbidity require cautious interpretation when drawn from a single database.

Objective: We investigated the degree of comparability of the prevalence of chronic diseases and disease combinations in the elderly in two databases comparable with regard to diseases included, sex and age of the patients (65-85 years), and cutoff score for case definition.

Study Design And Setting: One study is based on chart-supported interviews with the primary care physicians within a cohort study of 3,189 multimorbid elderly patients. The second study analyzed claims data from ambulatory care delivered to the multimorbid members of one German Health Insurance (n = 70,031).

The influence of age, gender and socio-economic status on multimorbidity patterns in primary care. First results from the multicare cohort study.

Background: Multimorbidity is a phenomenon with high burden and high prevalence in the elderly. Our previous research has shown that multimorbidity can be divided into the multimorbidity patterns of 1) anxiety, depression, somatoform disorders (ADS) and pain, and 2) cardiovascular and metabolic disorders. However, it is not yet known, how these patterns are influenced by patient characteristics.

Synaptic input of rat spinal lamina I projection and unidentified neurones in vitro.

Spinal lamina I projection neurones that transmit nociceptive information to the brain play a pivotal role in hyperalgesia in various animal models of inflammatory and neuropathic pain. Consistently, activity-dependent long-term potentiation can be induced at synapses between primary afferent C-fibres and lamina I projection neurones but not unidentified neurones in lamina I. The specific properties that enable projection neurones to undergo long-term potentiation and mediate hyperalgesia are not fully understood.