Utilisation and trends of laboratory testing and point-of-care testing in primary care in Germany: an analysis of claims data.

Objectives: German general practitioners (GPs) either order laboratory tests from external laboratories (initiated laboratory services (ILS)) or perform point-of-care tests (POCTs) within the GP practice. This study investigated the current use and time trends of laboratory testing in German GP practices with a particular focus on POC testing.

Design: Retrospective consecutive cross-sectional study by analysis of complete outpatient healthcare claims data (2017-2022).

Web-based telemedicine approach for treatment of post-COVID-19 in Thuringia (WATCH).

Objective: After infection with SARS-CoV-2, a substantial proportion of patients develop long-lasting sequelae. These sequelae include fatigue (potentially as severe as that seen in ME/CFS cases), cognitive dysfunction, and psychiatric symptoms. Because the pathophysiology of these sequelae remains unclear, existing therapeutic concepts address the symptoms through pacing strategies, cognitive training, and psychological therapy.

Evaluation of utilization and consequences of CRP point-of-care-testing in primary care practices: qualitative interviews with general practitioners from Germany.

Background: The use and advantages of point-of-care tests (POCTs) for C-reactive protein (CRP) in general practice, especially for upper respiratory tract infections (uRTIs), have been studied extensively. However, there is limited knowledge about test indications, prerequisites, and integration of these tests into everyday practice.

Aim: This study aims to investigate the attitudes and experiences of general practitioners (GPs) in Germany regarding the use of semi-quantitative CRP-POCTs.

Utilization and consequences of CRP point-of-care-testing in primary care practices: a real-world multicentre observational study with 1,740 patient cases in Germany.

Background: Point-of-care tests (POCTs) for C-reactive protein can support clinical decision-making of general practitioners (GPs) but are not widely used in German general practices.

Aim: To investigate the utilization of semi-quantitative CRP-POCTs in routine primary care.

Design & Setting: Prospective observational study in 49 general practices in Germany (Nov/2022 to Apr/2023).

[Changes in the provision and utilization of health care in German primary care practices during the COVID-19 pandemic - A survey of patients in three federal states].

Introduction: During the COVID-19 pandemic general practitioners (GP) practice teams were temporally confronted with major challenges which were accompanied by changes in practice organization and service provision. So far, little has been known about the views of patients who visited the GP practice for other than COVID-related reasons with regard to provision and use of GP services, the adjustments in the practice and the work of the practice team members.

Methods: The patient survey is a sub-study of the mixed-methods study VeCo-Praxis (GP healthcare for patients not suffering from COVID during the Corona pandemic) of the research practice network RESPoNsE (Research Practice Network East), which was conducted in the federal states of Berlin, Brandenburg and Thuringia.

[Evaluation of electronic medical records from general practices using the example of the diagnosis of community-acquired pneumonia: A qualitative feasibility study].

Background: Data collected by general practitioners (GPs) may provide potential for health services research. In this study, we investigated if clinical questions can be answered with GPs' electronic medical records (EMRs) by means of diagnosing community-acquired pneumonia (CAP).

Method: Patients diagnosed with CAP, defined as ICD code J18.

GPs' Perspective on a Multimodal Intervention to Enhance Guideline-Adherence in Uncomplicated Urinary Tract Infections: A Qualitative Process Evaluation of the Multicentric RedAres Cluster-Randomised Controlled Trial.

Urinary tract infections (UTIs) are among the most common reasons patients seeking health care and antibiotics to be prescribed in primary care. However, general practitioners' (GPs) guideline adherence is low. The RedAres randomised controlled trial aims to increase guideline adherence by implementing a multimodal intervention consisting of four elements: information on current UTI guidelines (1) and regional resistance data (2); feedback regarding prescribing behaviour (3); and benchmarking compared to peers (4).

[Attitudes of general practitioners and medical practice assistants towards the delegation of medical services: Results of a survey in Berlin, Brandenburg and Thuringia].

Introduction: The delegation of tasks and responsibilities from general practitioners (GPs) to medical practice assistants (MPAs) can contribute to ensuring primary care in Germany. The aim of the study was to collect and analyze attitudes and procedures of GPs and MPAs regarding the delegation of physician-related tasks and activities.

Methodology: A self-designed, piloted questionnaire was sent to all GPs listed within the regional Associations of Statutory Health Insurance Physicians (KV) in Thuringia, Berlin, and Brandenburg (n=5,516) and their MPAs.

Effects of a multimodal intervention in primary care to reduce second line antibiotic prescriptions for urinary tract infections in women: parallel, cluster randomised, controlled trial.

Objectives: To evaluate whether a multimodal intervention in general practice reduces the proportion of second line antibiotic prescriptions and the overall proportion of antibiotic prescriptions for uncomplicated urinary tract infections in women.

Design: Parallel, cluster randomised, controlled trial.

Setting: General practices in five regions in Germany.

What motivates GPs to train medical students in their own practice? A questionnaire survey on the motivation of medical practices to train students as an approach to acquire training practices.

Background: With the new licensing regulations for doctors coming into force, medical faculties are faced with the task of recruiting and qualifying more GP colleagues to train students in their practices.

Objective: The aim of the study was to determine the motivation of GPs to train students in their own medical practices.

Method: A cross-sectional survey of Thuringian GPs was conducted from April to May 2020.

Point-of-care measurement of C-reactive protein promotes de-escalation of treatment decisions and strengthens the perceived clinical confidence of physicians in out-of-hours outpatient emergency medical services.

Objectives: Out-of-hours outpatient emergency medical services (OEMS) provide healthcare for patients with non-life-threatening conditions in need for urgent care when outpatient practices are closed. We studied the use of point-of-care-testing of C-reactive protein (CRP-POCT) at OEMS.

Design: Cross-sectional questionnaire-based survey.

[Outpatient Long/Post-COVID Care: Barriers and Desires of Affected Persons to Medical Care].

Introduction: Persistent and new-onset symptoms after SARS-CoV-2 infection (so-called Long/Post-COVID syndrome) represent a major challenge for our healthcare system. However, there have been limited data on primary outpatient care and care planning, complicating patient flow management and ultimately patient care. Assessing the care reality of patients with Long/Post-COVID-symptoms, as well as their difficulties and desires in receiving medical care, is a necessary first step toward improving outpatient care.

Point-of-care laboratory testing in primary care: utilization, limitations and perspectives of general practitioners in Germany.

Background: Due to their fast turnaround time and user-friendliness, point-of-care tests (POCTs) possess a great potential in primary care. The purpose of the study was to assess general practitioners' (GPs) perspectives on POCT use in German primary care, including utilization, limitations and requirements.

Methods: We conducted a cross-sectional survey study among GPs in Germany (federal states of Thuringia, Bremen and Bavaria (Lower Franconia), study period: 04/22-06/2022).

Outpatient teaching in specialist practices - a qualitative study with doctors about attitudes, influencing factors and specialist features.

Aim: The aim is to record existing attitudes, influencing factors and specialised requirements with regard to the training of medical students in specialist outpatient care with doctors working in outpatient care.

Method: Between September 2020 and May 2021, individual interviews with 15 specialists employed in outpatient care were held as part of this qualitative study. The recorded interviews were evaluated structurally in accordance with the Kuchartz method.

Perspectives of physicians and medical assistants on the implementation of NAAT-based point-of-care testing for SARS-CoV-2 in primary care in Germany.

Introduction: Given their high diagnostic accuracy and fast turnaround time, rapid SARS-CoV-2 tests based on nucleic acid amplification technologies (NAAT) have great potential to expand access to testing and decrease delays in diagnosis of COVID-19.

Objectives: The aim of this study was to investigate feasibility, acceptance, organizational consequences and other implementation aspects of the use of a NAAT-based SARS-CoV-2 rapid test (ID NOW™ COVID-19, Abbott Diagnostics) for symptomatic primary care patients with a suspected SARS-CoV-2 infection.

Methods: Cross-sectional survey among primary care physicians and medical assistants from Thuringia (Germany) during the third wave of the COVID-19 pandemic in March and April 2021.

Research on point-of-care tests in outpatient care in Germany: A scoping review and definition of relevant endpoints in evaluation studies.

Background: The fast turnaround time and user-friendliness of point-of-care tests (POCTs) offer a great potential to improve outpatient health care where clinical decisions have to be made during the physician-patient encounter and time resources are limited. The aim of this scoping review is to describe the extent and nature as well as gaps in German research activities on POCT in outpatient care. In addition, we define research endpoints that should be addressed in the comprehensive evaluation of POCTs targeted for outpatient care.

"It Was Very Comforting to Find Out Right Away." - Patient Perspectives on Point-of-Care Molecular SARS-CoV-2 Testing in Primary Care.

Background: The use of point-of-care tests (POCTs) has been a central strategy to cope with the COVID-19 pandemic. Yet, evidence on the application and consequences of POCTs within medical settings is rare.

Purpose: To assess and understand patient perspectives on molecular point-of-care SARS-CoV-2 testing conducted in primary care.

Post-COVID-19 condition is not only a question of persistent symptoms: structured screening including health-related quality of life reveals two separate clusters of post-COVID.

Purpose: Some patients experience long-term sequelae after infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, despite a present post-COVID condition, defined as "any symptom lasting longer than 12 weeks," only a subset of patients search for medical help and therapy.

Method: We invited all adults with a positive real-time polymerase chain reaction (RT-PCR) for SARS-CoV-2 between March 2020 and September 2021 (n = 4091) in the city of Jena to answer a standardized questionnaire including demographic information, the course of the acute infection and current health status.

[Participation rate of diabetes patients in structured education programs and reasons for non-participation: A cross-sectional survey among patients with diabetes mellitus in Thuringia].

Background And Aim: Structured education programs for patients with diabetes mellitus are an important and effective component of therapy. The aim of this survey is to assess the rate of participation in education programs in selected practices in Thuringia. Furthermore, we intend to identify factors that influence participation in order to derive strategies to increase participation.

[Emergency situations and emergency department visits in nursing homes-a scoping review about circumstances and healthcare interventions].

Background: Nursing home residents are more likely to be hospitalized as non-institutionalized peers. A large number of emergency medical services (EMS) and emergency department visits are classified as potentially avoidable.

Objectives: To identify circumstances that increase the number of emergency situations in nursing homes and approaches to reduce hospital admissions in order to illustrate the complexity and opportunities for action.

Nurses' perspectives on the role of relatives in emergency situations in nursing homes: a qualitative study from Germany.

Background: In nursing homes, emergencies often result in unnecessary hospital transfers, which may negatively affect residents' health. Emergency management in nursing homes is complicated by structural conditions, uncertainties and difficulties communicating with the treating healthcare professionals. The present study investigated the role played by relatives in this emergency management, as perceived by nursing staff.

[The general practitioner perspective of a multimodal intervention for the adequate use of antibiotics in urinary tract infection - a qualitative interview study].

Introduction: Contrary to current guideline recommendations, second-line antibiotics are still frequently used in the ambulatory treatment of uncomplicated urinary tract infections (UTI), which are associated with a high risk of antibiotic resistance development. The REDARES project (REDuction of Antibiotic RESistance in uncomplicated urinary tract infections by treatment according to national guidelines in ambulatory care), funded by the Federal Joint Committee (Gemeinsamer Bundesausschuss, G-BA)/Innovation Fund is developing a multimodal intervention for primary care physicians to support them in a guideline-based approach. The intervention consists of the following components: (1) provision of local resistance data of pathogens of uncomplicated UTI (Robert Koch Institute), (2) concise guideline content on the therapy of uncomplicated UTI for patients (paper and online), and (3) prescription feedback on practice level and benchmarking among the study participants (anonymized).