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1.
J Eur CME ; 10(1): 1987119, 2021.
Article in English | MEDLINE | ID: covidwho-1522069

ABSTRACT

The Covid-19 pandemic induced a radical shift towards digitally enhanced learning and teaching (DELT). Success of this adaptation depended on how much DELT had been provided before. The Bavarian Virtual University (BVU) is a university network to fund, promote and support DELT. The Ludwig-Maximilians-University Munich as a part of this network implemented the DELT course "Shared decision making (SDM) - a part of evidence-based medicine" in 2015. Based on regular evaluations and due to the latest developments, a media-didactic and content-related adaptation will be conducted now. Clinical cases will be embedded in a framework structure of SDM. Videos, podcasts and literature of doctor-patient interaction will be provided. To enable different health care professions to have a positive learning experience, the course will be linguistically adapted. The interaction between students and teacher will be enhanced by a transparent distribution of tasks and an issue-specific chat forum. SDM is an interdisciplinary general concept. With regard to the academization of different health care professions, the demand for DELT will increase. However, medical competencies can`t be taught fully online, since face-to-face patient interaction is mandatory. Communication skills can be practiced theoretically but have to be applied in reality.

2.
Z Evid Fortbild Qual Gesundhwes ; 161: 42-49, 2021 Apr.
Article in German | MEDLINE | ID: covidwho-1386770

ABSTRACT

BACKGROUND: The current SARS-CoV-2 pandemic requires high influenza vaccination rates for the chronically ill in order to avoid additional strain on the health care system. Despite clear evidence of the safety and effectiveness of influenza vaccination, vaccination coverage has internationally remained at inadequate levels in recent years. The general practitioner is of central importance for the care of this population. Therefore, the aim of this systematic review was to evaluate various measures in general practice to increase seasonal influenza vaccination rates for the chronically ill, taking into account various international health systems. METHODS: A systematic literature search was carried out in MEDLINE, CENTRAL, EMBASE and ERIC as well as manually in trial registers and literature lists. Only randomized controlled studies were taken into account. The methodology was defined in advance in a study protocol and published (PROSPERO CRD42018114163). RESULTS: A total of 14 studies within the framework of a national health service (United Kingdom), a state (Australia) and social (Switzerland) health insurance system and a private health care system (USA) were included in our review. Analog patient reminders and automated physician reminders as well as changes in professional roles have led to a significant increase in influenza vaccination rates, but only in the private health care system. In the national health service, none of the interventions we analyzed achieved a significant increase in vaccination rates, although the National Health Service in the United Kingdom documented relatively good basic influenza vaccination rates before the studies were carried out, regardless of the intervention. Good results were achieved in the social and state health insurance systems of Switzerland and Australia by training events for practice teams and SMS reminders. CONCLUSIONS: In Germany, training events for medical teams and centrally organized invitation and monitoring systems might improve vaccination rates among the chronically ill. That the federal government pays for the vaccination costs seems to ensure a good basic influenza vaccination coverage for indicated patients in various health systems.


Subject(s)
COVID-19 , Influenza Vaccines , Influenza, Human , Australia , Germany , Humans , Influenza, Human/prevention & control , SARS-CoV-2 , State Medicine , Switzerland , Vaccination
3.
BMJ Open ; 11(2): e040533, 2021 02 10.
Article in English | MEDLINE | ID: covidwho-1079069

ABSTRACT

BACKGROUND: Patients surviving critical illnesses, such as sepsis, often suffer from long-term complications. After discharge from hospital, most patients are treated in primary care. Little is known how general practitioners (GPs) perform critical illness aftercare and how it can be improved. Within a randomised controlled trial, an outreach training programme has been developed and applied. OBJECTIVES: The aim of this study is to describe GPs' views and experiences of caring for postsepsis patients and of participating a specific outreach training. DESIGN: Semistructured qualitative interviews. SETTING: 14 primary care practices in the metropolitan area of Berlin, Germany. PARTICIPANTS: 14 GPs who had participated in a structured sepsis aftercare programme in primary care. RESULTS: Themes identified in sepsis aftercare were: continuity of care and good relationship with patients, GP's experiences during their patient's critical illness and impact of persisting symptoms. An outreach education as part of the intervention was considered by the GPs to be acceptable, helpful to improve knowledge of the management of postintensive care complications and useful for sepsis aftercare in daily practice. CONCLUSIONS: GPs provide continuity of care to patients surviving sepsis. Better communication at the intensive care unit-GP interface and training in management of long-term complications of sepsis may be helpful to improve sepsis aftercare. TRIAL REGISTRATION NUMBER: ISRCTN61744782.


Subject(s)
General Practitioners , Sepsis , Attitude of Health Personnel , Berlin , Germany , Humans , Qualitative Research , Sepsis/therapy
4.
Int J Environ Res Public Health ; 18(2)2021 01 07.
Article in English | MEDLINE | ID: covidwho-1024574

ABSTRACT

Targeting dementia prevention, first trials addressing multiple modifiable risk factors showed promising results in at-risk populations. In Germany, AgeWell.de is the first large-scale initiative investigating the effectiveness of a multi-component lifestyle intervention against cognitive decline. We aimed to investigate the recruitment process and baseline characteristics of the AgeWell.de participants to gain an understanding of the at-risk population and who engages in the intervention. General practitioners across five study sites recruited participants (aged 60-77 years, Cardiovascular Risk Factors, Aging, and Incidence of Dementia/CAIDE dementia risk score ≥ 9). Structured face-to-face interviews were conducted with eligible participants, including neuropsychological assessments. We analyzed group differences between (1) eligible vs. non-eligible participants, (2) participants vs. non-participants, and (3) between intervention groups. Of 1176 eligible participants, 146 (12.5%) dropped out before baseline; the study population was thus 1030 individuals. Non-participants did not differ from participants in key sociodemographic factors and dementia risk. Study participants were M = 69.0 (SD = 4.9) years old, and 52.1% were women. The average Montreal Cognitive Assessment/MoCA score was 24.5 (SD = 3.1), indicating a rather mildly cognitively impaired study population; however, 39.4% scored ≥ 26, thus being cognitively unimpaired. The bandwidth of cognitive states bears the interesting potential for differential trial outcome analyses. However, trial conduction is impacted by the COVID-19 pandemic, requiring adjustments to the study protocol with yet unclear methodological consequences.


Subject(s)
Cognitive Dysfunction/prevention & control , Life Style , Patient Selection , Aged , Female , Germany , Healthy Aging , Humans , Male , Middle Aged , Neuropsychological Tests
5.
MMW Fortschr Med ; 162(10): 5, 2020 05.
Article in German | MEDLINE | ID: covidwho-825384
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