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.

Correction: Siegel et al. PEN-13: A New Generic 13-Item Questionnaire for Measuring Patient Enablement (German Version). 2019, , 4867.

In the original publication [...

PEN-13: A New Generic 13-Item Questionnaire for Measuring Patient Enablement (German Version).

: The purpose of our study was to develop and psychometrically test a German-language survey instrument that measures patient enablement generically and in greater detail than previous instruments. : A multidisciplinary team developed 13 items to capture individual aspects of patient enablement (PEN-13). A pre-test with 26 subjects was followed by a random sample survey of = 1168 subjects.

Local, collaborative, stepped and personalised care management for older people with chronic diseases (LoChro): study protocol of a randomised comparative effectiveness trial.

Background: Multimorbid older adults suffering from a long-term health condition like depression, diabetes mellitus type 2, dementia or frailty are at high risk of losing their autonomy. Disability and multimorbidity in the older population are associated with social inequality and lead to soaring costs. Our local, collaborative, stepped and personalised care management for older people with chronic diseases (LoChro-Care) aims at improving outcomes for older multimorbid patients with chronic conditions whose social and medical care must be improved.

Well informed physician-patient communication in consultations on back pain - study protocol of the cluster randomized GAP trial.

Background: Back pain is one of the most frequent causes of health-related work absence. In Germany, more than 70% of adults suffer from at least one back pain episode per annum. It has strong impact on health care costs and patients' quality of life.

Cost-effectiveness analysis of collaborative treatment of late-life depression in primary care (GermanIMPACT).

Background: Late-life depression is a highly prevalent disorder that causes a large economic burden. A stepped collaborative care program was set up in order to improve care for patients with late-life depression in primary care in Germany: GermanIMPACT is the adaption of the Improving Mood-Promoting Access to Collaborative Treatment (IMPACT) program that has already been established in primary care in the USA. The aim of this study was to determine the cost-effectiveness of GermanIMPACT compared with treatment as usual from a societal perspective.

Coordinated Treatment of Depression in Elderly People in Primary Care.

Background: Depression in the elderly is mainly treated by primary care physicians; the treatment is often suboptimal because of the limited resources available in pri- mary care. New models of care in which treatment by a primary care physician is supplemented by the provision of brief, low-threshold interventions mediated by care managers are showing themselves to be a promising approach.

Methods: In this open, cluster-randomized, controlled study, we sought to determine the superiority of a model of this type over the usual form of treatment by a primary care physician.

Encouraging Self-Management in Cardiovascular Disease Prevention.

Background: Cardiovascular diseases are among the most common causes of death in industrialized countries. The goal of the DECADE study ("decision aid, action planning, and follow-up support for patients to reduce the 10-year risk of cardiovascular diseases") is to improve patient activation and health-related behavior by means of structured cardiovascular risk counseling and DECADE brochures. In this pilot study, the applicability of DECADE and the potential effects of the intervention on patients with cardiovascular risk factors were investigated.

[Individual patient satisfaction in 'Gesundes Kinzigtal': Interim results of a trend study].

Introduction: The integrated health care pilot model "Gesundes Kinzigtal" (GK) is recognized as a reference model for integrated healthcare in Germany. The aim of GK is to improve the health of the insured persons and, at the same time, to decrease their healthcare costs compared to usual care. The evaluation of GK has so far shown that GK might reach this aim.

New paths in post-graduate medical training in general practice - 8 years of experience with the pilot project Verbundweiterbildung Baden-Württemberg.

In face of the looming shortage of general practitioners, primary healthcare providers and post-graduate training in general practice are increasingly becoming part of the political agenda in Germany. In 2009 the program "Verbundweiterbildung Baden-Württemberg" (VWB BW) was developed by the Competence Center for General Practice in Baden-Wuerttemberg to ensure primary healthcare in the future by enhancing the attractiveness of general medicine. This paper describes the experiences that have been gathered in developing a post-graduate training-program for physicians undergoing specialist training in general practice.

Three years of experience with a workshop for medical specialty examiners in South Baden: A project report and initial evaluation results.

An oral exam (30-60 minutes) is administered at the end of every post-graduate medical specialty program or is required to attain additional specialized qualifications. In both undergraduate and post-graduate medical education oral exams are not considered to be very objective or reliable. To improve the quality of exams in medical specialties, the Regional Medical Association for South Baden (Bezirksärztekammer Südbaden) decided in 2013 to offer a training program for head examiners and others responsible for administering exams in medical specialties.

DECADE-pilot: decision aid, action planning, and follow-up support for patients to reduce the 10-year risk of cardiovascular diseases-a protocol of a randomized controlled pilot trial.

Background: A healthy lifestyle can reduce cardiovascular risk (CVR) and prevent premature death. Usually most patients at increased CVR have difficulties implementing the necessary health behavior changes, such as smoking cessation, increasing of physical activity, healthy diet, stress reduction, etc. In this pilot study, a new intervention (DECADE) that includes a cardiovascular risk calculation, evidence-based decision aids, action planning, and follow-up support for patients to reduce their 10-year risk of cardiovascular diseases will be tested in primary care.

Herbal medicinal products - Evidence and tradition from a historical perspective.

Background: Aside from the fully licensed herbal medicines there are products on the European pharmaceutical market which are registered by virtue of their longstanding traditional use. The normal registration procedure does not apply to them because presently they do not meet the legal requirements for a full license as set out in the relevant European Union Directive. One of these requirements, "proof of tradition", has so far been dealt with in different ways and fails to meet the criteria of good practice.

[How do general practitioners evaluate collaborative care of elderly depressed patients? Results of a qualitative study].

Background: Depression is a very common disease among the elderly. Various studies demonstrated the need to improve the care for elderly depressed patients. Within the GermanIMPACT trial specifically trained care managers were engaged to cooperate with general practitioners (GPs).

Effects of culture-sensitive adaptation of patient information material on usefulness in migrants: a multicentre, blinded randomised controlled trial.

Objectives: To evaluate the usefulness of culture-sensitive patient information material compared with standard translated material.

Design: Multicentre, double-blind randomised controlled trial.

Setting: 37 primary care practices.

Declaration and Handling of Conflicts of Interest in Guidelines: A Study of S1 Guidelines From German Specialist Societies From 2010-2013.

Background: Authors' conflicts of interest may affect the content of medical guidelines. In April 2010, the Association of Scientific Medical Societies in Germany (AWMF) issued recommendations on how such conflicts of interest should be dealt with. Most AWMF guidelines are so-called S1 guidelines developed by informal consensus in a group of experts.

Collaborative treatment of late-life depression in primary care (GermanIMPACT): study protocol of a cluster-randomized controlled trial.

Background: Depression is not a normal side effect of aging, however it is one of the most prevalent mental health issues in later life, imposing a tremendous burden on patients, their families, and the healthcare system. We describe the experimental implementation of a collaborative, stepped-care model for the treatment of late-life depression (GermanIMPACT trial) in the German primary care context. GermanIMPACT was developed as an adaptation of a successful and widely used American model.

Does the pharmaceutical industry influence guidelines?: two examples from Germany.

Background: The recommendations in clinical guidelines are based on clinical trial findings and expert opinion. The influence of drug companies on these two factors is illustrated with two examples.

Methods: A judicially ordered expert review revealed that the market authorization holder (MAH) of gabapentin manipulated study data.

Shared decision-making in antihypertensive therapy: a cluster randomised controlled trial.

Background: Hypertension is one of the key factors causing cardiovascular diseases. A substantial proportion of treated hypertensive patients do not reach recommended target blood pressure values. Shared decision making (SDM) is to enhance the active role of patients.

Implementation of shared decision making by physician training to optimise hypertension treatment. Study protocol of a cluster-RCT.

Background: Hypertension is one of the key factors causing cardiovascular diseases which make up the most frequent cause of death in industrialised nations. However about 60% of hypertensive patients in Germany treated with antihypertensives do not reach the recommended target blood pressure. The involvement of patients in medical decision making fulfils not only an ethical imperative but, furthermore, has the potential of higher treatment success.

[Bringing evidence to practice: obstacles and barriers].

Translating clinical research findings into daily medical practice is a complex procedure and subject to multiple impacts. Studies sponsored by drug manufacturers produce positive results more frequently than would be expected by chance alone; positive studies have a better chance to be published than negative ones. There is a lack of effective implementation strategies for medical guidelines.

[Evidence-based treatment of depression: what does the new S3- and national healthcare guideline Unipolar Depression really recommend?].

The paper reflects central recommendations and methodological issues of the new German guidelines for the treatment of depression, as discussed in the article New German Guidelines for the Treatment of Depression - The Central Role of Psychotherapy (Schauenburg et al. 2009). Members of the steering group for these guidelines disagree with the authors' description in several points, especially with reference to the efficacy of pharmacotherapy with antidepressants and psychotherapy, as well as the relationship between both strategies of therapy and their combination in diverse phases of treatment (acute/maintenance).