ABSTRACT
BACKGROUND: Type 2 diabetes mellitus (T2DM) and coronary heart disease (CHD) are two chronic diseases that cause a tremendous burden. To reduce this burden, several programmes for optimising the care for these diseases have been developed. In Germany, so-called disease management programmes (DMPs), which combine components of Disease Management and the Chronic Care Model, are applied. These DMPs have proven effective. Nevertheless, there are opportunities for improvement. Current DMPs rarely address self-management of the disease, make no use of peer support, and provide no special assistance for persons with low health literacy and/or low patient activation. The study protocol presented here is for the evaluation of a programme that addresses these possible shortcomings and can be combined with current German DMPs for T2DM and CHD. This programme consists of four components: 1) Meetings of peer support groups 2) Personalised telephone-based health coaching for patients with low literacy and/or low patient activation 3) Personalised patient feedback 4) A browser-based web portal METHODS: Study participants will be adults enrolled in a DMP for T2DM and/or CHD and living in North Rhine-Westphalia, a state of the Federal Republic of Germany. Study participants will be recruited with the assistance of their general practitioners by the end of June 2021. Evaluation will be performed as a pragmatic randomised controlled trial with one intervention group and one waiting control group. The intervention group will receive the intervention for 18 months. During this time, the waiting control group will continue with usual care and the usual measures of their DMPs. After 18 months, the waiting control group will also receive a shortened intervention. The primary outcome is number of hospital days. In addition, the effects on self-reported health-state, physical activity, nutrition, and eight different psychological variables will be investigated. Differences between values at month 18 and at the beginning will be compared to judge the effectiveness of the intervention. DISCUSSION: If the intervention proves effective, it may be included into the DMPs for T2DM and CHD. TRIAL REGISTRATION: The study was registered in the German Clinical Trials Registry (Deutsches Register Klinischer Studien (DRKS)) in early 2019 under the number 00020592. This registry has been affiliated with the WHO Clinical Trials Network ( https://www.drks.de/drks_web/setLocale_EN.do ) since 2008. It is based on the WHO template, but contains some additional categories for which information has to be given ( https://www.drks.de/drks_web/navigate.do?navigationId=entryfields&messageDE=Beschreibung%20der%20Eingabefelder&messageEN=Description%20of%20entry%20fields ). A release and subsequent number assignment only take place when information for all categories has been given.
Subject(s)
Coronary Disease , Diabetes Mellitus, Type 2 , Self-Management , Adult , Coronary Disease/diagnosis , Coronary Disease/therapy , Diabetes Mellitus, Type 2/diagnosis , Diabetes Mellitus, Type 2/therapy , Disease Management , Germany , HumansABSTRACT
OBJECTIVES: In consideration of ADHD subtype we assessed burden of disease of adult ADHD patients and neuroticism. METHODS: 511 adult ADHD patients were enrolled in the study. We measured ADHD symptoms categorically and dimensionally by the "Homburger ADHS-Skalen für Erwachsene (HASE)". All participants rated their ADHD associated level of suffering. To assess personality traits, the psychometric instrument NEO-PI-R was used. RESULTS: In patients with higher levels of neuroticism, there was no significant difference in the level of suffering between the ADHD subtypes. In the group of ADHD patients which scored low on the neuroticism scale, ADHD combined patients are significant more affected compared to the predominantly hyperactive-impulsive or the predominantly inattentive type. CONCLUSIONS: These results underline the hypothesis that the burden of disease is not only related to the level of ADHD symptoms and subtype but also moderated by neuroticism.
Subject(s)
Anxiety Disorders/classification , Anxiety Disorders/diagnosis , Attention Deficit Disorder with Hyperactivity/classification , Attention Deficit Disorder with Hyperactivity/diagnosis , Cost of Illness , Adult , Anxiety Disorders/psychology , Attention Deficit Disorder with Hyperactivity/psychology , Comorbidity , Female , Germany , Humans , Male , NeuroticismABSTRACT
OBJECTIVE: General and specific deficits in the recognition of facial expressed emotions of ADHD and controls were examined. METHODS: Affect recognition abilities were assessed with the FEEL-Test in a sample of 138 adults with ADHD and 40 healthy controls. RESULTS: Adults with ADHD showed deficits in recognition of the negative emotions anger, disgust, and sadness. CONCLUSION: Deficits in recognition of negative facial expressed emotions might be associated with the development of social problems in the daily life of adults with ADHD and might also provide an approach for therapeutical interventions.
