Voluntarily stopping eating and drinking (VSED): A systematic mixed-methods review focusing on the carers' experiences.

Background: Voluntary stopping of eating and drinking (VSED) is a way to end one's life prematurely. We synthesized the empirical data on VSED.

Methods: In this systematic mixed-methods review, we searched MEDLINE, CINAHL, PsycINFO, Google Scholar, and BELIT for English and German articles published between January 1, 2013 and November 12, 2021.

Somatoform Disorders in Primary Care-An Exploratory Mixed-Methods Study on Experiences, Challenges and Coping Strategies of General Practitioners in the Federal Republic of Germany.

Somatoform symptoms are widely spread in outpatient care. For treating physicians, it can be challenging to establish a relationship that is conducive to compliance and to take stabilising action when dealing with affected patients. As primary care providers, GPs are usually the first point of contact for patients with somatoform disorders; they set the course for stabilisation and further care.

[Ensuring primary care in Germany-findings from a quantitative survey of general practitioners].

Background: Given the risk of a shortage of general practitioners in private practice, the question arises as to which concepts can make an effective contribution. To date, there is a lack of studies that comprehensively shed light on how general practitioners, based on their professional experience, view different approaches to ensuring primary care in the long term.

Objectives: The aim of the study was to determine the positions, attitudes, and experiences of general practitioners with regard to ensuring primary care.

[DemStepCare: Risk-stratified support for primary care-based dementia care - evaluation from general practitioner's view].

Objective: The innovation fund project DemStepCare aimed to optimize multi-professional care through case management, risk stratification, and crisis outpatient clinic. Here, the evaluation results from the perspective of the general practitioners are presented.

Methods: A quantitative survey was carried out at three time points regarding acceptance, benefit assessment and sensitivity to dementia of the general practitioners.

Primary care involvement in clinical research - prerequisites, motivators, and barriers: results from a study series.

Background: Long-term reinforcement in the role of primary care and improvement the healthcare system as a whole requires the involvement of GPs in clinical research processes. However, many clinical studies fail due to failure to achieve sample population targets amongst GPs and their patients. This issue has been identified and discussed, but effective strategies to overcome it are still lacking.

Using normalization process theory to evaluate the use of patient-centred outcome measures in specialist palliative home care-a qualitative interview study.

Background: Standardised use of patient-centred outcome measures (PCOMs) improves aspects of quality of care. Normalization Process Theory (NPT) considers the social (inter-)actions of implementation processes operationalised through four constructs: coherence-building, cognitive participation, collective action and reflexive monitoring. The aim of the study was to identify barriers and enablers for the successful use of PCOMs in specialist palliative home care (SPHC) using NPT, to collect clinically meaningful and reliable data to improve patient outcomes.

Symptom and problem clusters in German specialist palliative home care - a factor analysis of non-oncological and oncological patients' symptom burden.

Background: Specialist palliative home care (SPHC) aims to maintain and improve patients' quality of life in the community setting. Symptom burden may differ between oncological and non-oncological patients. However, little is known about diagnosis-related differences of SPHC patients.

How are people with obesity managed in primary care? - results of a qualitative, exploratory study in Germany 2022.

Background: Counselling and management of overweight and obesity are tasks for which general practitioners possess favourable qualifications. Based on a long-term doctor-patient relationship, GPs have various options for actions to deal with overweight problems. To date, however, there is only little evidence on the experiences which people with obesity have made with the primary physician model and the care needs and wishes they actually address to their GPs.

Structural characteristics and contractual terms of specialist palliative homecare in Germany.

Background: Multi-professional specialist palliative homecare (SPHC) teams care for palliative patients with complex symptoms. In Germany, the SPHC directive regulates care provision, but model contracts for each federal state are heterogeneous regarding staff requirements, cooperation with other healthcare providers, and financial reimbursement. The structural characteristics of SPHC teams also vary.

What requirements do primary care physicians have with regard to dementia diagnostics and dementia care? - a survey study among general practitioners in Germany 2022/2023.

Background: General practice offers good conditions to detect and provide care for dementia-related diseases. Nonetheless, the effectiveness of dementia care in general practice is repeatedly criticised. To date, few studies have attempted to form a comprehensive picture of the status quo of dementia care in general practice that focuses on GP perspectives of experience and action.

[A regional comparison of outcomes quality and costs of general and specialized palliative care in Germany: a claims data analysis].

Background: The main framework conditions for palliative care are set at the regional level. The scope of the forms of care used (outpatient, inpatient, general, specialized) varies widely. What is the quality of outcomes achieved by the palliative care provided on a federal states level? What are the associated costs of care?

Method: Retrospective observational study using BARMER claims data from 145,372 individuals who died between 2016 and 2019 and had palliative care in the last year of life.

How can primary care be secured in the long term? - a qualitative study from the perspective of general practitioners in Germany.

Background: Securing primary care is an important issue for health policy. Given a threatened shortage of GPs in Germany, there are discussions about what actions to take to guarantee primary care.

Objectives: The aim was to obtain opinions of German GPs towards (a) the status quo and development of primary care, (b) favoured actions to secure it and (c) assessment of the actions taken.

Online enquiries and health concerns - a survey of German general practitioners regarding experiences and strategies in patient care.

Aim: Increasingly at GP practices, patients appear who are extremely worried as a result of health information researched online and consequently affected by doubts and concerns. The study highlights GP attitudes and experiences with regard to this patient group. Moreover, it identifies strategies adopted by GPs to respond appropriately to worried or scared patients.

[Acquiring general practitioner roles during the outpatient postgraduate training section and profession-forming postgraduate training conditions in family physician practices - A survey among family medicine residents in Rhineland-Palatinate during their postgraduate training in general medicine].

Background: Postgraduate training in general medicine should be oriented on competencies and profession-forming, as is suggested by the German Regulations on Specialist Training of federal and state governments and the Competence-based Curriculum General Medicine. The learnability of general practitioner (GP) roles and the profession-forming orientation of the postgraduate training conditions during the outpatient postgraduate training period were investigated.

Methods: A cross-sectional study in questionnaire design was conducted from October until December 2019 among 220 physicians in postgraduate training who were registered at the Association of Statutory Health Insurance-Accredited Physicians in Rhineland-Palatinate for the specialty of general medicine.

Promotion of Exercise and Health for Older People in Primary Care: A Qualitative Study on the Potential, Experiences and Strategies of General Practitioners in Germany.

In advanced age, physical activity becomes an important element in maintaining one's individual health. GPs are considered to be well suited for advising and attending to older patients according to the principles of (preventive) healthcare. The subject was examined in the context of a study that determined options for action, experiences and strategies relating to the physical activation of older patients by GPs.

Two years of approved digital health applications in Germany - Perspectives and experiences of general practitioners with an affinity for their use.

Background: Since 2020, physicians in Germany can prescribe approved digital health applications (DHAs) with the costs covered by the health system. There has so far been a lack of studies on attitudes and experiences amongst GPs in using DHAs.

Objectives: The aim was to elucidate the experiences and observations of GPs that have used DHAs in health care and to examine the conditions necessary for DHAs to gain a foothold in primary care according to the GPs.

Attitudes and experiences of registered diabetes specialists in using health apps for managing type 2 diabetes: results from a mixed-methods study in Germany 2021/2022.

Background: Hardly any area of application for health apps is seen to be as promising as health and lifestyle support in type 2 diabetes mellitus. Research has emphasised the benefits of such mHealth apps for disease prevention, monitoring, and management, but there is still a lack of empirical data on the role that health apps play in actual type 2 diabetes care. The aim of the present study was to gain an overview of the attitudes and experiences of physicians specialising in diabetes with regard to the benefits of health apps for type 2 diabetes prevention and management.

[What potential and added value do DiGA offer for primary care?-Results of a survey of general practitioners in Germany].

Background: For almost two years, physicians have been able to prescribe digital health applications (DiGA) to patients. So far, there has been a lack of studies that shed light on the possible use of DiGA in the context of primary care and take stock of the benefits and potential for optimization.

Objectives: This study explores general practitioners' (GPs) attitudes, expectations, and experiences with regard to the application potential of DiGA.

Attitudes, attributions, and usage patterns of primary care patients with regard to over-the-counter drugs-a survey in Germany.

Studies show that over-the-counter drugs are widely used by consumers. Moreover, there is a huge selection available and they are prominently featured in advertising. To date, there exist only a few studies that shed light on the attitudes, attributions, and usage patterns of patients with regard to use of over-the-counter drugs.

[Clarification of increased liver values in primary care - Findings from a series of studies from a general practitioner and specialist perspective].

Introduction: In primary care, elevated liver values are often an incidental finding. In addition to observing symptoms, it is crucial for an effective clarification which liver values are included as indicators and when patients are referred for further diagnostics. It also depends on regular cooperation between general practitioner and specialist care level.

Experiences with Innovation Fund healthcare models in primary care: a qualitative study amongst German general practitioners.

The Innovation Fund was set up in 2015 with the aim of improving medical care in the German statutory health insurance system. Primary care needs to be involved in testing interventions and new forms of care for effectiveness and inclusion in standard care. There has so far been hardly any research on how far Innovation Fund models accommodate the primary care setting, or on the experience general practitioners have had with these models.

Evaluation of elevated liver values in primary care - a series of studies on the status quo of care in Germany with special reference to alcoholic liver disease.

Background: In primary care, elevated liver values often appear as incidental findings. As well considering the presenting symptoms, key factors in effective diagnosis are which liver values to include as indicators and when to refer patients for further diagnostics. It is also important that there is coordinated collaboration between GPs and specialists.

[The German Innovation Fund and primary care-What expectations and experiences do general practitioners have with regard to participating in innovative care models?].

Background: In 2015, the German Innovation Fund was established to promote improvements in the quality of medical care. In order for new care models and interventions to be tested and incorporated into standard care in the future, primary care must be included.

Objectives: The study explores general practitioners' (GPs') attitudes, participation-relevant expectations, and experiences with regard to Innovation Fund projects.

Slowing dementia symptoms - a qualitative study on attitudes and experiences of general practitioners in Germany.

Background: There is currently no cure for dementia but general practitioners (GPs) have therapeutic options available to counteract the progression of mild cognitive impairment, including drug and non-drug treatment. So far, few studies have investigated treatment strategies preferred by GPs.

Objectives: This study aimed to gain an overview of GPs' attitudes towards influencing the progression of dementia, their involvement regarding dementia prevention and perceived effective approaches.

[Team players or lone fighters? Importance and utilization of practice staff in primary care dementia detection].

Background: General practitioners (GP) face major challenges in everyday practice when it comes to identifying dementia cases as early as possible under the condition of time and resource constraints. The involvement of the practice staff promises decisive advantages in detection and diagnosis. So far, there has been a lack of studies exploring the extent to which non-medical practice employees in general practices are integrated into dementia detection, what experiences they have had and how they assess their own potential to contribute to more efficient dementia detection.