The effectiveness of a multi-domain electronic feedback report on the performance of quality indicators for chronic conditions: Protocol for a randomized controlled trial in general practice.

Background: Chronic conditions are a significant public health concern due to their rising prevalence, association with high mortality, and substantial healthcare costs. General practitioners play a crucial role in managing these conditions, and quality indicators are essential tools for assessing the quality of care. Electronic feedback reports incorporating quality indicator performance have shown promise in improving care quality.

Blood pressure control and antihypertensive treatment in Swiss general practice: a cross-sectional study using routine data.

Aims Of The Study: Arterial hypertension is a major global health risk. Global surveys indicate that only half of patients with arterial hypertension receive pharmacotherapy, and only a quarter achieve the primary blood pressure target recommended by guidelines. This study aimed to evaluate the achievement of the primary blood pressure target in Swiss general practice, provide insights into arterial hypertension treatment, and identify factors associated with achieving this goal.

Ferritin Cutoffs and Diagnosis of Iron Deficiency in Primary Care.

Importance: Ferritin is often measured by general practitioners, but the association of different cutoffs with the rates of iron deficiency diagnoses, particularly nonanemic iron deficiency, is unknown.

Objective: To investigate the association of the ferritin cutoff choice with the incidence of nonanemic and anemic iron deficiency diagnoses in primary care.

Design, Setting, And Participants: In this retrospective cohort study, patients 18 years or older with at least 1 consultation with a general practitioner participating in the Family Medicine Research Using Electronic Medical Records (FIRE) project, an electronic medical records database of Swiss primary care, from January 1, 2021, to November 30, 2023, were evaluated.

Developing and testing a framework for coding general practitioners' free-text diagnoses in electronic medical records - a reliability study for generating training data in natural language processing.

Background: Diagnoses entered by general practitioners into electronic medical records have great potential for research and practice, but unfortunately, diagnoses are often in uncoded format, making them of little use. Natural language processing (NLP) could assist in coding free-text diagnoses, but NLP models require local training data to unlock their potential. The aim of this study was to develop a framework of research-relevant diagnostic codes, to test the framework using free-text diagnoses from a Swiss primary care database and to generate training data for NLP modelling.

Changes in the attractiveness of medical careers and career determinants during the bachelor's program at Zurich medical schools.

Background: Monitoring the career intentions of medical students during their undergraduate studies could help to address the shortage of physicians, particularly in general practice. This study aimed to investigate changes in medical students' career openness, attractiveness and determinants of medical career choice during their bachelor's studies.

Methods: The design was cross-sectional, recruiting all medical students who started a bachelor's program in one of the four different educational tracks in Zurich, Switzerland, in the fall of 2019 (first survey) and completed it in the summer of 2022 (second survey).

[New/direct oral anticoagulants (DOAK)].

Due to their advantageous benefit-risk-profile, direct oral anticoagulants (DOACs) are preferred over vitamin-K-antagonists for stroke prevention in atrial fibrillation as well as therapy and secondary prevention of venous thromboembolism. This guideline provides information on the practical use of DOACs, their advantages and disadvantages and limitations. It is based on recommendations from international guidelines (ESC, EHRA, DGA) and adapts them for the general practitioner setting in Switzerland.

Elevated TSH Levels: A Database Study of General Practitioners' Course of Action.

Objective: To investigate general practitioners' course of action after detection of elevated thyroid stimulating hormone (TSH) levels regarding repeat testing, direct levothyroxine replacement, or neither.

Methods: We conducted a retrospective study of adults without prior evidence of thyroid disease and with a first detection of elevated TSH levels from January 1, 2015, to December 31, 2020, using data from electronic medical records of a Swiss primary care database. We determined the occurrence of either repeat TSH testing or direct levothyroxine initiation in primary care during 12-month follow-up and determined associations with demographic and clinical factors.

[Vaccination against the Infodemic].

Misinformation about vaccination leads to vaccination hesitancy. During the SARS-CoV-2 pandemic, different patterns were observed in how misinformation spread on social media, which coined the term "infodemic." There are different approaches to counter misinformation in vaccination, some of which can be implemented in medical practice.

[Why Switzerland needs evidence-based guidelines for its general practice medicine].

Medical guidelines summarize evidence based knowledge and give helpful recommendations for diagnostics and therapy in daily practice. Most Swiss medical societies therefore adapt international guidelines for the Swiss setting. In primary care this adaption must not only take into account the specific Swiss healthcare system, but also the specific setting of primary care, which is characterized by a low prevalence of most diseases as well as by chronic conditions and multimorbidity.

Importance of different electronic medical record components for chronic disease identification in a Swiss primary care database: a cross-sectional study.

Background: Primary care databases collect electronic medical records with routine data from primary care patients. The identification of chronic diseases in primary care databases often integrates information from various electronic medical record components (EMR-Cs) used by primary care providers. This study aimed to estimate the prevalence of selected chronic conditions using a large Swiss primary care database and to examine the importance of different EMR-Cs for case identification.

[Implementation of an electronic clinical decision aid to support quality of care for COPD in family medicine].

Background: Electronic clinical decision aids (eCDAs) have the potential to improve the quality of chronic disease management (CDM) and, therefore, patient relevant outcomes. However, eCDAs are only sparsely implemented in primary care for chronic obstructive pulmonary disease (COPD). The aim of this pilot study was to develop and implement of an eCDA for COPD primary care in two Swiss primary care practices.

Quality and variation of care for chronic kidney disease in Swiss general practice: A retrospective database study.

Background: Chronic kidney disease (CKD) is a common condition in general practice. Data about quality and physician-level variation of CKD care provided by general practitioners is scarce. In this study, we evaluated determinants and variation of achievement of 14 quality indicators for CKD care using electronic medical records data from Swiss general practice during 2013-2019.

Attractiveness of medical disciplines amongst Swiss first-year medical students allocated to different medical education tracks: cross-sectional study.

Background: As most countries, Switzerland is experiencing a shortage of physicians especially in general practice and new medical education tracks with respective focusses have been started in response. This study investigated Swiss medical students' career openness and attractiveness of different medical disciplines as well as the concordance of students' career intentions with assigned medical education tracks.

Methods: Cross-sectional study surveying first year medical students assigned to four different Swiss medical education tracks with distinctive additional education focuses (ETH Zurich: medical technology and engineering, University of St.

Prescription Rates, Polypharmacy and Prescriber Variability in Swiss General Practice-A Cross-Sectional Database Study.

The frequency of medication prescribing and polypharmacy has increased in recent years in different settings, including Swiss general practice. We aimed to describe patient age- and sex-specific rates of polypharmacy and of prescriptions of the most frequent medication classes, and to explore practitioner variability in prescribing. Retrospective cross-sectional study based on anonymized electronic medical records data of 111 811 adult patients presenting to 116 Swiss general practitioners in 2019.

Testing and Prescribing Vitamin B12 in Swiss General Practice: A Survey among Physicians.

Testing and prescribing vitamin B12 (also known as cobalamin) is increasing in Switzerland but substantial variation among general practitioners (GPs) with respect to testing has been noted. In this study, we aimed at exploring GPs' mindsets regarding vitamin B12 testing and prescribing. A cross-sectional study was conducted using an online survey distributed by e-mail to Swiss GPs.

Potentially inappropriate proton-pump inhibitor prescription in the general population: a claims-based retrospective time trend analysis.

Background: Proton-pump inhibitors (PPI) are among the most prescribed drugs worldwide, and a large body of evidence raises concerns about their inappropriate use. Previous estimates of inappropriate use varied due to different definitions and study populations.

Aims: We aimed to measure the population-based incidence and time trends of PPI and potentially inappropriate PPI prescriptions (PIPPI) with a novel method, continuously assessing excessive cumulative doses based on clinical practice guidelines.

Effects of Vitamin B12 Supplementation on Cognitive Function, Depressive Symptoms, and Fatigue: A Systematic Review, Meta-Analysis, and Meta-Regression.

Vitamin B12 is often used to improve cognitive function, depressive symptoms, and fatigue. In most cases, such complaints are not associated with overt vitamin B12 deficiency or advanced neurological disorders and the effectiveness of vitamin B12 supplementation in such cases is uncertain. The aim of this systematic review and meta-analysis of randomized controlled trials (RCTs) is to assess the effects of vitamin B12 alone (B12 alone), in addition to vitamin B12 and folic acid with or without vitamin B6 (B complex) on cognitive function, depressive symptoms, and idiopathic fatigue in patients without advanced neurological disorders or overt vitamin B12 deficiency.

Characteristics, Preferences and Health Care Utilization in Patients Using a Dietary Supplement for Improving Sleeping Disturbances: Results from an Explorative Online Survey.

Purpose: Sleeping disturbances are highly prevalent in the general population, and pharmacological drug treatment harbours the risk of serious side effects. Many affected persons use dietary supplements for self-treating their symptoms, but little is known about the specific characteristics and preferences of these patients. Even less evidence exists about the consequences of a specific dietary supplement usage on health care utilization.

Trends in Micronutrient Laboratory Testing in Switzerland: A 7-Year Retrospective Analysis of Healthcare Claims Data.

Background: Micronutrient laboratory tests (MLT) are increasing in many healthcare systems. This study assessed time trends of annual MLT incidence in the Swiss population and examined the frequency of specific MLT, defined as the number of yearly tests performed in individual persons.

Methods: For annual time trends, we used a longitudinal design with a seven-year observation period (2012-2018) and for yearly testing frequency we used a cross-sectional design (2018 only).

Guideline Concordance of Statin Treatment Decisions: A Retrospective Cohort Study.

Guidelines recommend initiation of statins depending on cardiovascular risk and low-density lipoprotein cholesterol (LDL-C) levels. In this retrospective cohort study, we aimed to assess guideline concordance of statin treatment decisions and to find determinants of undertreatment in Swiss primary care in the period 2016-2019. We drew on electronic medical records of 8060 statin-naive patients (50.

The Impact of the 2019 European Guideline for Cardiovascular Risk Management: A Cross-Sectional Study in General Practice.

The aim of this study was to assess the impact of the 2019 published European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) guideline on cardiovascular (CV) risk management compared with its predecessor from 2016 in a cohort in general practice. We performed a cross-sectional retrospective study with data from electronic medical records. The study cohort included 103,351 patients with known CV risk.

What interventions do general practitioners recommend avoiding? A nationwide survey from Switzerland.

Background: To address low-value interventions in healthcare, “Choosing Wisely” campaigns provide recommendations of interventions to avoid (RIAs). These are usually developed by expert panels rather than general practitioners (GPs). The aim of our study was to develop RIAs for ambulatory general medicine based on the suggestions of GPs, with their involvement from the very beginning.

Trends and Between-Physician Variation in Laboratory Testing: A Retrospective Longitudinal Study in General Practice.

Laboratory tests are frequently ordered by general practitioners (GPs), but little is known about time trends and between-GP variation of their use. In this retrospective longitudinal study, we analyzed over six million consultations by Swiss GPs during the decade 2009-2018. For 15 commonly used test types, we defined specific laboratory testing rates (sLTR) as the percentage of consultations involving corresponding laboratory testing requests.

Statin treatment and LDL target value achievement in Swiss general practice - a retrospective observational study.

Aims: Statins decrease the risk of fatal CVD by lowering low-density lipoprotein (LDL) levels. Guidelines suggest that statin treatment strategies should be guided by CV risk, but little is known about statin treatment in Swiss general practice. In this study, we aimed to investigate statin treatment and LDL target achievement rates, including their predictors, in patients treated by Swiss general practitioners (GPs).