Deprescribing of antidepressants: development of indicators of high-risk and overprescribing using the RAND/UCLA Appropriateness Method.

Background: Antidepressants are first-line medications for many psychiatric disorders. However, their widespread long-term use in some indications (e.g.

[Tiredness/Fatigue-S3 guideline update].

Background: Fatigue is one of the most common reasons for seeking medical counseling in the family medicine (FM), often entailing diagnostic uncertainty. Patients use terms describing emotional, cognitive, physical, and behavioral aspects. A number of biological, mental, and social causes may underlie the symptom of fatigue, often in combination.

[Examining in General Practice: Licensure Examinations in a General Practice Setting].

General practitioners play a major role in the health care of the population. Only a small proportion of patients receives care from specialised consultants, in a hospital or in a university hospital. Most of the patients consult a general practitioner.

Fatigue as the Chief Complaint–Epidemiology, Causes, Diagnosis, and Treatment.

Background: Fatigue is a main or secondary reason for 10-20% of all consultations with a primary care physician.

Methods: This review is based on pertinent publications retrieved by a comprehensive, selective literature search on the epidemiology, etiology, and diagnostic evaluation of fatigue as a leading symptom of disease, as well as on the treatment of its common causes. Information was also included from the literature search we conducted for the German clinical practice guideline on fatigue that was issued by the German College of General Practitioners and Family Physicians (Deutsche Gesellschaft für Allgemeinmedizin und Familienmedizin, DEGAM).

Didactic qualification of teaching staff in primary care medicine - a position paper of the Primary Care Committee of the Society for Medical Education.

Having teaching staff with didactic qualifications in university teaching leads to a measurable improvement in academic skills among students. Previous recommendations on the type and scope of medical didactic qualification measures primarily apply to teaching staff at university and in-patient settings. The situation of primary care medicine, which often employs external lecturers and whose teaching takes place to a considerable extent in decentralized training facilities (teaching practices) is not adequately addressed.

Prescription of Benzodiazepines and Related Drugs in Patients with Mild Cognitive Deficits and Alzheimer's Disease.

Introduction: Benzodiazepines and related drugs (BZDR) should be avoided in patients with cognitive impairment. We evaluated the relationship between a BZDR treatment and the health status of patients with Alzheimer's disease (AD).

Methods: Cross-sectional study in 395 AD patients using bivariate and multiple logistic analyses to assess correlations between the prescription of BZDR and patients' characteristics (cognitive and functional capacity, health-related quality of life (HrQoL), neuropsychiatric symptoms).

Antidepressant medication in a German cohort of patients with Alzheimer's disease .

Objective: The use of antidepressant drugs in dementia patients is associated with the risk of adverse events, and the evidence for relevant effects is scarce. We aimed to determine the associations between the prescription of antidepressants and patients' sociodemographic (e.g.

Antipsychotic treatment of community-dwelling and institutionalised patients with dementia in Germany.

Objective: A restrictive use of antipsychotic drugs in patients with Alzheimer's disease (AD) is recommended due to an increased risk of cerebrovascular events and mortality. We hypothesise that the prescription of antipsychotics is associated with the patients' socio-demographic and clinical status (e.g.

Seminar program for postgraduate specialty training in general practice: proposal for a 5-year thematic catalogue.

: In different German regions, seminar programs have been conducted for General practice residents. In each region, selection and teaching of learning content is conducted in a different manner. So far, no structured, standardized curriculum has been implemented nationwide.

Use of antidementia drugs in German patients with Alzheimer's disease.

The objective of this study was to evaluate the use of antidementia drugs (ADDs) in patients with Alzheimer's disease (AD) regarding German guideline recommendations and to assess correlations between the use of ADDs and the patients' characteristics. A total of 395 community-dwelling and institutionalized patients with AD across all severity stages of dementia were recruited in this cross-sectional study. Associations between the prescription of ADDs and patients' sociodemographic and clinical parameters (neuropsychiatric symptoms, cognitive capacity, daily activities, and health-related quality of life) were analyzed in multiple logistic regression analyses.

Psychological risk and protective factors for disability in chronic low back pain - a longitudinal analysis in primary care.

Background: Utilizing psychological resources when dealing with chronic low back pain might aid the prevention of disability. The observational study at hand examined the longitudinal impact of resilience and coping resources on disability in addition to established risk factors.

Methods: Four hundred eighty four patients with chronic low back pain (>3 months) were recruited in primary care practices and followed up for one year.

[Differences Between Self- and Proxy-Assessment of Health-Related Quality of Life in Patients with Mild Cognitive Impairment and Alzheimer's Disease].

Objective: The self-assessment of health-related quality of life (HrQoL) in patients with Alzheimer's disease (AD) and mild cognitive impairment is commonly higher than the proxy-assessment by caregivers. This study aims at evaluating sociodemographic and clinical factors to explain this difference.

Methods: HrQoL of 241 community-dwelling patients was analysed using the dementia-specific Quality of Life-Alzheimer's Disease questionnaire (QoL-AD).

The differential diagnosis of tiredness: a systematic review.

Background: Tiredness is one of the most frequent complaints in primary care. Although often self-limiting and frequently associated with psychosocial stress, patients but also their physicians are often uncertain regarding a serious cause and appropriate diagnostic work-up. We conducted a systematic review and meta-analysis of studies reporting on differential diagnosis of fatigue in primary care.

Feedback promotes learning success! Which kind of feedback for the faculty is given by an interdisciplinary OSCE with focus on decision-making?

Clinical skills such as history taking, diagnostic reasoning, therapy planning, and giving advice are even more complex than practical skills like lung auscultation and have to be applied in complex clinical situations. We judged this competence in an interdisciplinary formative OSCE conducted with students of Marburg University. Results of 218 students passing 643 OSCE stations composed of 37 different scenarios were analyzed.

Influence of thyroid hormone therapy on the fracture rate - A claims data cohort study.

Introduction: It has been debated for years whether long-term thyroid hormone intake causes fractures. Not only have previous studies suffered from design limitations, they also reached contradictory conclusions. We investigated thyroid hormones (thyroxine) as a possible risk factor for fractures in a cohort of 6.

Health-Related Quality of Life in Patients with Alzheimer's Disease in Different German Health Care Settings.

The purpose of this study is to evaluate the health-related quality of life (HrQoL) of patients with Alzheimer's disease (AD) in different care settings (institutionalized versus community-dwelling) across all severity stages of dementia. Patients were consecutively recruited with their primary caregivers (123 inpatients and 272 outpatients), and the impact of patient-related parameters such as behavioral and psychological symptoms of dementia (BPSD) (Geriatric Depression Scale [GDS] and Neuropsychiatric Inventory [NPI]) and functional capacity (Alzheimer's Disease Cooperative Study-Activities of Daily Living [ADCS-ADL]) on HrQoL was analyzed. Patients' HrQoL was assessed using self-reported and caregiver-rated generic (EuroQoL Instrument) and dementia-specific (Quality of Life-Alzheimer's Disease [Qol-AD]) scales.

Diagnosing skin disease in primary care: a qualitative study of GPs' approaches.

Background: Skin diseases are a common reason for consulting a GP. This regular occurrence happens despite most GPs' lack of knowledge and training in skin disease.

Objectives: We aimed to explore different diagnostic approaches of GPs in patients presenting with a dermatological problem.

A standardised questionnaire for evaluating hospital-based rotations in general practice vocational training.

Introduction: The residency period of vocational training is a fundamental component for a general practitioner's (GP's) qualification. During the residency, teaching is given by consultants and staff from different medical disciplines who do not necessarily know the GP registrar's training objectives.

Aim: To develop a standardised feedback questionnaire to evaluate residency attachments and enable GP registrars and their supervisors to discuss the actual training environment and areas for improvement.

Even Worse - Risk Factors and Protective Factors for Transition from Chronic Localized Low Back Pain to Chronic Widespread Pain in General Practice: A Cohort Study.

Study Design: Prospective cohort study with patients with chronic low back pain (CLBP) at primary care setting.

Objective: The aim of our study was to identify predictors for transition from localized CLBP to chronic widespread pain in general practice. In contrast to the typically investigated risk factors, this study also focuses intensively on protective factors, which decrease the probability of chronic widespread pain.

Recommendations for undergraduate training in the primary care sector--position paper of the GMA-Primary Care Committee.

During their studies to become medical professionals, all students are obliged to become familiar with various aspects of primary care. The aim is to provide all students with a high quality training which ensures the best possible cooperation across all sectors of the medical system. Primary care comprises the primary use of the medical service by an unfiltered set of patients as well as continued patient care--including home-care.