Back on track - digital health applications to treat back pain of rheumatic patients? Results of a qualitative interview study.

Non-specific low back pain (NLBP) is prevalent among patients with rheumatic conditions. Digital health applications (DiGAs) provide reimbursed, personalized home treatment for patients, promising to overcome limitations of traditional healthcare systems. However, the adoption and effectiveness of back pain-specific DiGAs in rheumatology are not well understood.

mHealth Apps for Hypertension Self-Management: Interview Study Among Patient-Users.

Background: Hypertension is a major risk factor for cardiovascular disease, affecting over a billion people worldwide. Mobile health (mHealth) apps have emerged as effective tools for managing hypertension, offering capabilities for monitoring blood pressure, fostering lifestyle changes, and improving treatment adherence.

Objective: This study aimed to explore patient-users' perspectives on the hypertension care mHealth app Hypertension.

Cross-disciplinary advance care planning in oncology and palliative care amidst a pandemic: a best practice implementation project.

Introduction: Advance care planning (ACP) ensures that patients receive medical care aligned with their values, goals, and preferences, especially regarding end-of-life decisions in serious chronic illnesses.

Objective: This project aimed to introduce and promote evidence-based ACP in oncology and palliative care at a midsized hospital near Berlin, Germany, during the COVID-19 pandemic.

Methods: This project was guided by the JBI Evidence Implementation Framework and used a mixed methods audit cycle.

[Obtaining a Second Opinion in Germany: an Analysis of the Billing Data of the Health Insurer AOK Nordost].

Objectives: The aim of this billing data analysis was to examine the implementation of the second opinion directive in Germany and to investigate how often informing patients about their right to a second opinion (SO) and obtaining a SO are documented.

Methods: To examine the frequency of "informing about SO" and "obtaining an SO", insured patients who received an indication for tonsillectomy, tonsillotomy or hysterectomy in 2019 or 2020 were included, as well as insured patients who received an indication for shoulder arthroscopy in Q2-Q3 2020. Data were analyzed descriptively.

"Let's put it this way: you can't really live without it" - digital technologies in routine palliative care delivery: an explorative qualitative study with patients and their family caregivers in Germany.

Background: Despite ongoing efforts to integrate palliative care into the German healthcare system, challenges persist, particularly in areas where infrastructure does not fully support digital technologies (DT). The increasing importance of digital technology (DT) in palliative care delivery presents both opportunities and challenges.

Objective: This study aimed to explore the perspectives and preferences of palliative care patients and their family caregivers regarding the use of DT in care delivery.

Evaluation of a hybrid telehealth care pathway for patients with axial spondyloarthritis including self-sampling at home: results of a longitudinal proof-of-concept mixed-methods study (TeleSpactive).

Patients with axial spondyloarthritis (axSpA) require close monitoring to achieve the goal of sustained disease remission. Telehealth can facilitate continuous care while relieving scarce healthcare resources. In a mixed-methods proof-of-concept study, we investigated a hybrid telehealth care axSpA pathway in patients with stable disease over 6 months.

Pre-assessment of patients with suspected axial spondyloarthritis combining student-led clinics and telemedicine: a qualitative study.

Objective: Patients referred to rheumatologists are currently facing months of inefficient waiting time due to the increasing demand and rising workforce shortage. We piloted a pre-assessment of patients with suspected axial spondyloarthritis (axSpA) combining student-led clinics and telemedicine (symptom assessment, symptom monitoring and at-home capillary self-sampling) to improve access to rheumatology care. The aim of this study was to explore (1) current challenges accessing axSpA care and (2) patients' first-hand experiences.

Does the second opinion directive in Germany reach the patient? A parallel-convergent mixed-methods study.

Background: A Second Opinion Directive (SOD) was introduced in Germany in December 2018 for elective surgeries such as hysterectomy, tonsillotomy, tonsillectomy, and shoulder arthroscopy. The aim of the SOD is to avoid surgeries which are not medically induced and to support patients in their decision-making process. A physician who indicates an SOD-relevant procedure must inform the patient about the SOD and its specifications.

Digital preventive measures for arterial hypertension (DiPaH) - a mixed-methods study protocol for health services research.

Introduction: Digital health measures promise to further improve the quality of cardiovascular care but have not yet been widely implemented in routine care. The research project Digital preventive measures for arterial hypertension (DiPaH) will systematically identify structural and individual factors in different stakeholders that influence the use of digital preventive measures in patients with arterial hypertension in Germany. Special focus is given to remote and sparsely populated areas, the age-specific impact, as well as influence of digital health literacy.

Digital technologies in routine palliative care delivery: an exploratory qualitative study with health care professionals in Germany.

Objective: To explore health care professionals' (HCPs) perspectives, experiences and preferences towards digital technology use in routine palliative care delivery.

Methods: HCPs (n = 19) purposively selected from a sample of settings that reflect routine palliative care delivery (i.e.

At-home blood self-sampling in rheumatology: a qualitative study with patients and health care professionals.

Background: The goal of the study was to investigate patients' with systemic rheumatic diseases and healthcare professionals' experiences and preferences regarding self-sampling of capillary blood in rheumatology care.

Methods: Patients performed a supervised and consecutive unsupervised capillary blood self-collection using an upper arm based device. Subsequently, patients (n = 15) and their attending health care professionals (n = 5) participated in an explorative, qualitative study using problem-centered, telephone interviews.

Second opinion opportunity declined: patient typology and experiences regarding the decision-making process preceding elective surgeries in Germany.

Background: To address the problem of overuse of elective surgery and to support patients in their decision-making process, a Second Opinion Directive was introduced in Germany, which enables patients with statutory health insurance to obtain a second opinion for certain surgical indications. The study aims to identify, based on the experiences of patients who have undergone elective surgery, the role of seeking a second opinion in reaching their decision.

Methods: Sixty-two patients who had undergone an elective surgery (hysterectomy, tonsillectomy, shoulder arthroscopy) were recruited using purposive sampling and interviewed during October to December 2020.

Physicians' Perspectives on the Implementation of the Second Opinion Directive in Germany-An Exploratory Sequential Mixed-Methods Study.

A new Second Opinion Directive (SOD) was introduced in Germany in December 2018 for hysterectomy, tonsillotomy, and tonsillectomy to support shared decision making and to avoid unnecessary surgeries. Owing to its recent implementation, evidence and insights regarding outcomes and challenges encountered with the SOD are lacking, notably from the physicians' perspective. To assess this, we undertook an exploratory sequential mixed-methods design with an initial qualitative phase followed by a quantitative evaluation.

Unmet Information Needs of Patients with Rheumatic Diseases: Results of a Cross-Sectional Online Survey Study in Germany.

To effectively self-manage a chronic disease, patients require specific education. In clinical routines, rheumatologists and other healthcare professionals often cannot devote the necessary time to adequately educate their patients. Digital technologies such as mobile applications represent promising tools to overcome this problem.

Mental and Physical Well-Being and Burden in Palliative Care Nursing: A Cross-Setting Mixed-Methods Study.

The working routines in palliative care nursing are associated with a variety of causes of stress with regional and setting-specific differences in Germany. This mixed-methods study aimed to investigate the mental and physical well-being among nurses in German palliative and hospice care and to gain a deeper understanding of procedural and structural aspects that may influence the mental and physical burden in palliative nursing care. The mixed-methods approach combined qualitative interviews, ( = 16) an online survey ( = 101), and subsequent data validation in a focus group ( = 6).

[Opportunities and challenges for the use of video consultations in nursing homes from the caregiver perspective: a qualitative pre-post study].

Introduction: The implementation of medical video consultations in nursing homes can support primary care in rural areas and counteract the shortage of physicians. So far, video consultations have been limited to pilot projects and have not yet been comprehensively implemented. The present study addresses potentials of video consultations and challenges that may arise during the implementation of medical video consultations.

Challenges in current nursing home care in rural Germany and how they can be reduced by telehealth - an exploratory qualitative pre-post study.

Background: Telemedical care of nursing home residents in Germany, especially in rural areas, is limited to a few pilot projects and is rarely implemented as part of standard care. The possible merits of implementing video consultations in longer-term nursing care currently lack supporting evidence. In particular, there is little documentation of experiences and knowledge about the effects and potential benefits of the implementation in presently existing structures.

The impact of the COVID-19 pandemic on professional practice and patient volume in medical practices: A survey among German physicians and psychotherapists.

Introduction: This study examines the consequences of the COVID-19 pandemic on outpatient care in the German federal state of Brandenburg during the first 'lockdown' between 22 March and 4 May 2020, focusing on the burden for physicians and psychotherapists in outpatient practices and on alternative ways to provide care, in particular telehealth.

Methods: We conducted an online cross-sectional survey among outpatient health care professionals. The responses of n=277 physicians and n=87 psychotherapists were included in the analysis.

Second opinion programmes in Germany: a mixed-methods study protocol.

Introduction: Second opinion programmes aim to support the patients' decision-making process and to avoid treatments that are unnecessary from a medical perspective. The German second opinion directive, introduced in December 2018, constitutes a new legal framework in statutory health insurance for seeking second opinions for elective procedures and so far includes tonsillectomy, tonsillotomy, hysterectomy and shoulder arthroscopy. The directive mandates physicians who recommend one of the above-mentioned surgeries to inform their patients of their legal right to visit a certified second opinion provider.