21 results on '"Hoffmann, Kathryn"'
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2. “We literally worked in parking lots, cars, garages, and separately set up party tents”: qualitative study on the experiences of GPs in the frame of the SARS-CoV-2 pandemic in Austria
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Rabady, Susanne, Mayrhofer, Mira, Szabo, Nathalie, Erber, Patrick, and Hoffmann, Kathryn
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- 2023
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3. Recruitment, data collection, participation rate, and representativeness of the international cross-sectional PRICOV-19 study across 38 countries
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Tatsioni, Athina, Groenewegen, Peter, Van Poel, Esther, Vafeidou, Kyriaki, Assenova, Radost, Hoffmann, Kathryn, Schaubroeck, Emmily, Stark, Stefanie, Tkachenko, Victoria, and Willems, Sara
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- 2023
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4. Insights into the use of telemedicine in primary care in times of the SARS-CoV-2 pandemic - a cross-sectional analysis based on the international PRICOV-19 study in Austria
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Stummer, Florian Odilo, Voggenberger, Lisa, Gomez Pellin, Maria de la Cruz, van Poel, Esther, Willems, Sara, and Hoffmann, Kathryn
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- 2023
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5. General practitioners’ deprescribing decisions in older adults with polypharmacy: a case vignette study in 31 countries
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Jungo, Katharina Tabea, Mantelli, Sophie, Rozsnyai, Zsofia, Missiou, Aristea, Kitanovska, Biljana Gerasimovska, Weltermann, Birgitta, Mallen, Christian, Collins, Claire, Bonfim, Daiana, Kurpas, Donata, Petrazzuoli, Ferdinando, Dumitra, Gindrovel, Thulesius, Hans, Lingner, Heidrun, Johansen, Kasper Lorenz, Wallis, Katharine, Hoffmann, Kathryn, Peremans, Lieve, Pilv, Liina, Šter, Marija Petek, Bleckwenn, Markus, Sattler, Martin, van der Ploeg, Milly, Torzsa, Péter, Kánská, Petra Bomberová, Vinker, Shlomo, Assenova, Radost, Bravo, Raquel Gomez, Viegas, Rita P. A., Tsopra, Rosy, Pestic, Sanda Kreitmayer, Gintere, Sandra, Koskela, Tuomas H., Lazic, Vanja, Tkachenko, Victoria, Reeve, Emily, Luymes, Clare, Poortvliet, Rosalinde K. E., Rodondi, Nicolas, Gussekloo, Jacobijn, and Streit, Sven
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- 2021
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6. Beyond the “information deficit model” - understanding vaccine-hesitant attitudes of midwives in Austria: a qualitative study
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Lehner, Lisa, Gribi, Janna, Hoffmann, Kathryn, Paul, Katharina T., and Kutalek, Ruth
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- 2021
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7. Correction to: “With fever it’s the real flu I would say”: laypersons’ perception of common cold and influenza and their differences - a qualitative study in Austria, Belgium and Croatia
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Mayrhuber, Elisabeth Anne-Sophie, Peersman, Wim, van de Kraats, Nina, Petricek, Goranka, Divjak, Asja Ćosić, Wojczewski, Silvia, and Hoffmann, Kathryn
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- 2019
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8. “With fever it’s the real flu I would say”: laypersons’ perception of common cold and influenza and their differences - a qualitative study in Austria, Belgium and Croatia
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Mayrhuber, Elisabeth Anne-Sophie, Peersman, Wim, van de Kraats, Nina, Petricek, Goranka, Ćosić Diviak, Asja, Wojczewski, Silvia, and Hoffmann, Kathryn
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- 2018
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9. Variation in GP decisions on antihypertensive treatment in oldest-old and frail individuals across 29 countries.
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Streit, Sven, Verschoor, Marjolein, Rodondi, Nicolas, Bonfim, Daiana, Burman, Robert A., Collins, Claire, Biljana, Gerasimovska Kitanovska, Gintere, Sandra, Bravo, Raquel Gómez, Hoffmann, Kathryn, Iftode, Claudia, Johansen, Kasper L., Kerse, Ngaire, Koskela, Tuomas H., Peštić, Sanda Kreitmayer, Kurpas, Donata, Mallen, Christian D., Maisoneuve, Hubert, Merlo, Christoph, and Mueller, Yolanda
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HYPERTENSION ,THERAPEUTICS ,ANTIHYPERTENSIVE agents ,CARDIOVASCULAR agents ,CARDIOVASCULAR diseases ,DECISION making in clinical medicine ,HYPERTENSION epidemiology ,BLOOD pressure ,CLINICAL competence ,COMPARATIVE studies ,RESEARCH methodology ,MEDICAL cooperation ,GENERAL practitioners ,RESEARCH ,WORLD health ,EVALUATION research ,DISEASE prevalence ,ODDS ratio ,PHARMACODYNAMICS - Abstract
Background: In oldest-old patients (>80), few trials showed efficacy of treating hypertension and they included mostly the healthiest elderly. The resulting lack of knowledge has led to inconsistent guidelines, mainly based on systolic blood pressure (SBP), cardiovascular disease (CVD) but not on frailty despite the high prevalence in oldest-old. This may lead to variation how General Practitioners (GPs) treat hypertension. Our aim was to investigate treatment variation of GPs in oldest-olds across countries and to identify the role of frailty in that decision.Methods: Using a survey, we compared treatment decisions in cases of oldest-old varying in SBP, CVD, and frailty. GPs were asked if they would start antihypertensive treatment in each case. In 2016, we invited GPs in Europe, Brazil, Israel, and New Zealand. We compared the percentage of cases that would be treated per countries. A logistic mixed-effects model was used to derive odds ratio (OR) for frailty with 95% confidence intervals (CI), adjusted for SBP, CVD, and GP characteristics (sex, location and prevalence of oldest-old per GP office, and years of experience). The mixed-effects model was used to account for the multiple assessments per GP.Results: The 29 countries yielded 2543 participating GPs: 52% were female, 51% located in a city, 71% reported a high prevalence of oldest-old in their offices, 38% and had >20 years of experience. Across countries, considerable variation was found in the decision to start antihypertensive treatment in the oldest-old ranging from 34 to 88%. In 24/29 (83%) countries, frailty was associated with GPs' decision not to start treatment even after adjustment for SBP, CVD, and GP characteristics (OR 0.53, 95%CI 0.48-0.59; ORs per country 0.11-1.78).Conclusions: Across countries, we found considerable variation in starting antihypertensive medication in oldest-old. The frail oldest-old had an odds ratio of 0.53 of receiving antihypertensive treatment. Future hypertension trials should also include frail patients to acquire evidence on the efficacy of antihypertensive treatment in oldest-old patients with frailty, with the aim to get evidence-based data for clinical decision-making. [ABSTRACT FROM AUTHOR]- Published
- 2017
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10. Primary health care teams put to the test a cross-sectional study from Austria within the QUALICOPC project.
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Hoffmann, Kathryn, George, Aaron, Dorner, Thomas E., Süß, Katharina, Schäfer, Willemijn L. A., and Maier, Manfred
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CHI-squared test , *CONFIDENCE intervals , *FISHER exact test , *HEALTH care teams , *METROPOLITAN areas , *PRIMARY health care , *QUESTIONNAIRES , *RESEARCH funding , *RURAL conditions , *STATISTICS , *DATA analysis , *CROSS-sectional method , *DATA analysis software , *DESCRIPTIVE statistics , *ONE-way analysis of variance - Abstract
Background: Multidisciplinary Primary Health Care Teams (PHCT) provide a comprehensive approach to address the social and health needs of communities. It was the aim of this analysis to assess the number of PHCT in Austria, a country with a weak PHC system, and to compare preventive activities, psychosocial care, and work satisfaction between GPs who work and those who do not work in PHCT. Method: Within the QUALICOPC study, data collection was performed between November 2011 and May 2012, utilizing a standardized questionnaire for GPs. A stratified sample of GPs from across Austria was invited. Statistical analyses included descriptive statistics and tests. Results: Data from 171 GPs questionnaires were used for this analysis. Of these, 61.1 % (n = 113) had a mono-disciplinary office, 26.3 % (n = 45) worked in an office consisting of GP, receptionist and one additional primary care profession, and 7.6 % (n = 13) worked in a larger PHCT. GPs that worked in larger PHCT were younger and more involved in psychosocial and preventive care. No differences were found with regard to work satisfaction or workload. Conclusions: This study gives insight into the structures of PHC in Austria. The results indicate a low number of PHCT; however, the overall return rate in our sample was low with more male GPs, more GPs from urban areas and more GPs working in offices together with other physicians than the national average. Younger GPs demonstrate a greater tendency to implement this primary care practice model in their practices, which seems to be associated with an emphasis in psychosocial and preventive care. If Austria is to increase the number of PHC teams, the country should embrace the work of young GPs and should offer relevant support for PHCT. Future developments could be guided by considering effective models of good practice and governmental support as in other countries. [ABSTRACT FROM AUTHOR]
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- 2015
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11. Associations between the prevalence of influenza vaccination and patient's knowledge about antibiotics: a cross-sectional study in the framework of the APRES-project in Austria.
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Hoffmann, Kathryn, van Bijnen, Evelien M. E., George, Aaron, Kutalek, Ruth, Jirovsky, Elena, Wojczewski, Silvia, Maier, Manfred, and van Bijnen, Evelien Me
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INFLUENZA vaccines , *PATIENT education , *ANTIBIOTICS , *CROSS-sectional method , *PRIMARY health care , *SUBGROUP analysis (Experimental design) , *LOGISTIC regression analysis , *INFLUENZA prevention , *FAMILY medicine , *HEALTH attitudes , *IMMUNIZATION , *MEDICAL personnel , *INFORMATION literacy , *DISEASE prevalence , *ODDS ratio , *VACCINATION , *THERAPEUTICS - Abstract
Background: This study aimed to identify associations between GP patient's knowledge about the spectrum of effectiveness of antibiotics and the probability of vaccination against influenza. The underlying hypothesis was that individuals with an understanding that antibiotics are ineffective against viruses, common colds, and flu were more likely to be vaccinated than persons lacking this knowledge.Methods: This cross-sectional study was conducted within the context of the European APRES project in Austria. Between November 2010 and July 2011, patients were recruited from GP practices to complete questionnaires about their knowledge about antibiotics and their influenza vaccination status. Statistical analyses included subgroup analyses and logistic regression models.Results: Data of 3224 patients was analyzed, demonstrating that patients with better knowledge concerning antibiotics had a significantly higher likelihood of being vaccinated (OR 1.35, CI 95 % 1.18-1.54). While the overall vaccination rate was low (18.6 % in 2009/2010 and 14.0 % in 2010/2011), elderly compared to younger adults (OR 0.06 CI 95 % 0.03-0.13) and healthcare workers (OR 2.24, CI 95 % 1.42-3.54) demonstrated higher likelihood of vaccination. Additionally, female GPs had significantly more vaccinated patients than male GPs (OR 2.90, CI 95 % 1.32-6.40).Discussion: There has been little prior study on the association between a patient's knowledge of the effectiveness spectrum of antibiotics and influenza vaccination status. Given the public health imperative to increase annual prevalence of influenza vaccination, understanding this educational gap can improve specificity in counseling as well as vaccination rates. Ultimately, we found that those with a better knowledge on about antibiotics had a significantly higher likelihood of being vaccinated.Conclusions: The results of this study demonstrate that vaccination prevalence is associated with patient's knowledge about antibiotics. It can be concluded that one strategy to improve the overall low vaccination rates for seasonal influenza in Austria would be, particularly for male GPs, to have a specific discussion with patients about these circumstances by focusing on younger patients. Further, public health efforts could supplement in-office strategies to improve this area of health literacy. [ABSTRACT FROM AUTHOR]- Published
- 2015
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12. Prevalence and resistance patterns of commensal S. aureus in community-dwelling GP patients and socio-demographic associations. A cross-sectional study in the framework of the APRES-project in Austria.
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Hoffmann, Kathryn, den Heijer, Casper D. J., George, Aaron, Apfalter, Petra, and Maier, Manfred
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STAPHYLOCOCCUS aureus , *DRUG resistance in bacteria , *MULTIDRUG resistance in bacteria , *DISEASE prevalence , *SOCIODEMOGRAPHIC factors , *LOGISTIC regression analysis - Abstract
Background: The aim of the present study was to assess the prevalence and resistance of commensal S. aureus in the nasal microbiota of community-dwelling persons in Austria, as well as to identify possible associations with socio-demographic factors. Multi-drug resistance in this population was additionally studied. Method: This cross-sectional study was conducted within the context of the European APRES project. In nine European countries, nasal swabs were collected from 32,206 general practice patients who received care for non-infectious reasons. In Austria, 20 GPs attempted to recruit 200 consecutive patients without infectious diseases, with each patient completing demographic questionnaires as well as providing a nose swab sample. Isolation, identification, and resistance testing of S. aureus were performed. Statistical analyses included subgroup analyses and logistic regression models. Results: 3309 nose swabs and corresponding questionnaires from Austrian subjects were analyzed. S. aureus was identified in 16.6 % (n = 549) of nose swabs, of which 70.1 % were resistant against one or more antibiotics, mainly penicillin. S. aureus carrier status was significantly associated with male sex (OR 1.6; 1.3-2.0), younger age (OR 1.3; 1.0-1.8), living in a rural area (OR 1.4; 1.1-1.7) and working in the healthcare sector (OR 1.5; 1.0-2.1). Multi-drug resistances were identified in 13.7 % (n = 75) of the S. aureus carriers and 1.5 % (n = 8) tested positive for MRSA. The highest resistance rate was observed against penicillin (64.8 %), followed by azithromycin (13.5 %) and erythromycin with 13.3 %. Conclusion: This study describes the prevalence and resistance patterns of commensal S. aureus in community-dwelling persons in Austria and shows that differences exist between socio-demographic groups. Demographic associations have been found for S. aureus carriers but not for carriers of resistant S. aureus strains. Only two thirds of S. aureus strains were found to be resistant against small spectrum penicillin. As it is recognized that one of the corner stones for the containment of antibiotic resistance is the appropriate prescription of antibiotics in the outpatient sector, this finding lends support to the avoidance of prescription of broad-spectrum antibiotics to treat S. aureus infections in the community. [ABSTRACT FROM AUTHOR]
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- 2015
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13. Oral contraceptives and antibiotics. A cross-sectional study about patients' knowledge in general practice.
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Hoffmann, Kathryn, George, Aaron, Heschl, Lukas, Leifheit, Anna Katharina, and Maier, Manfred
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ANTIBIOTICS , *CHI-squared test , *DRUG interactions , *FAMILY medicine , *LONGITUDINAL method , *ORAL contraceptives , *GENERAL practitioners , *QUESTIONNAIRES , *RESEARCH funding , *STATISTICS , *LOGISTIC regression analysis , *INFORMATION literacy , *JUDGMENT sampling , *DATA analysis , *CROSS-sectional method , *HEALTH literacy , *DATA analysis software , *DESCRIPTIVE statistics , *ODDS ratio - Abstract
Background: The evidence regarding oral contraceptives and its effectiveness with concomitant ingestion of antibiotics is conflicting. Until evidence becomes clearer, patients should be aware of this possible interaction. The aim of this study was to assess the knowledge and the source of information about this interaction in GP patients in Austria. Methods: Within the framework of the APRES study, 20 Austrian GPs were purposefully selected from among a GP research network and were asked to recruit 200 patients each. The patient cohort was asked to complete a questionnaire. Subsequent analysis included descriptive statistics, statistical tests and logistic regression models. Findings: Overall, 3280 questionnaires could be used for analysis. Of these, 29.7 % (n = 974) of patients acknowledged an awareness of the interaction of antibiotics with OCPs. Women under the age of 46 years acknowledged this interaction in 52.3 % of cases. Positive associations for the belief in an existing interaction in women were identified with age (OR 2.2) and having read the package inserts (OR 1.6). Further, belief was recognized in males based on age (OR 2.5) and tertiary education (OR 2.0). The main source of information regarding antibiotics was the GP (55.9 %). Conclusions: Less than one-third of all participants and half of the women in the reproductive age acknowledged an interaction between antibiotics and OCPs. Since the GP is the main source of information, this finding depicts a large potential for knowledge transfer within the primary health care setting. A multifaceted strategy is needed at both the population and the GP level to improve awareness and to address these educational gaps. [ABSTRACT FROM AUTHOR]
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- 2015
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14. "Why should I have come here?" - a qualitative investigation of migration reasons and experiences of health workers from sub-Saharan Africa in Austria.
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Jirovsky, Elena, Hoffmann, Kathryn, Maier, Manfred, and Kutalek, Ruth
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QUALITATIVE research , *EMIGRATION & immigration , *DISCRIMINATION (Sociology) - Abstract
Background:There are many health professionals from abroad working in the European Union and in Austria. The situation of sub-Saharan health workers in particular has now been studied for the first time. The objective was to explore their reasons for migration to Austria, as well as their personal experiences concerning the living and working situation in Austria. Methods: We conducted semi-structured, qualitative interviews with African health workers. They were approached via professional networks and a snowball system. The interviews were transcribed and analysed using atlas.ti. Results: For most of our participants, the decision to migrate was not professional but situation dependent. Austria was not their first choice as a destination country. Several study participants left their countries to improve their overall working situation. The main motivation for migrating to Austria was partnership with an Austrian citizen. Other immigrants were refugees. Most of the immigrants found the accreditation process to work as a health professional to be difficult and hindering. This resulted in some participants not being able to work in their profession, while others were successful in their profession or in related fields. There have been experiences of discrimination, but also positive support. Conclusions: Austria is not an explicit target country for health workers from sub-Saharan Africa. Most of the study participants experienced bad work and study conditions in their home countries, but they are in Austria mostly because of personal connections. The competencies of those who are here are not fully utilised. The major reason is Austria's current resident and work permit regulations concerning African citizens. In addition, the accreditation process and the German language appear to be barriers. [ABSTRACT FROM AUTHOR]
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- 2015
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15. Predictors of participation in preventive health examinations in Austria.
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Brunner-Ziegler, Sophie, Rieder, Anita, Stein, Katharina Viktoria, Koppensteiner, Renate, Hoffmann, Kathryn, and Dorner, Thomas Ernst
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PERIODIC health examinations ,HEALTH of adults ,HEALTH surveys ,HEALTH counseling ,PREVENTIVE health services ,SOCIAL status ,CHRONIC diseases ,SURVEYS - Abstract
Background Preventive health check-ups in Austria are offered free of charge to all insured adults (98% of the population) and focus on early detection of chronic diseases, primary prevention, and health counseling. The study aims to explore predictors of compliance with the recommended interval of preventive health check-up performance. Methods Source of data was the Austrian Health Interview Survey 2006/07 (15,474 subjects). Participation in a preventive health examination during the last three years was used as dependent variable. Socio-demographic and health-related characteristics were used as independent variables in a multivariate logistic regression analysis. Results show that 41.6% of men and 41.8% of women had attended a preventive health check-up within the last three years. In multivariate analysis, subjects ≥40 years, with higher education, higher income or born in Austria were significantly more likely to attend a preventive health check-up. Furthermore, a chronic disease was associated with a higher attendance rate (OR: 1.21; CI: 1.07-1.36 in men; OR: 1.19; CI: 1.06-1.33 in women). Conclusions Attendance rates for health check-ups in the general Austrian population are comparatively high but not equally distributed among subgroups. Health check-ups must increase among people at a young age, with a lower socio-economic status, migration background and in good health. [ABSTRACT FROM AUTHOR]
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- 2013
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16. Antibacterial resistances in uncomplicated urinary tract infections in women: ECO SENS II data from primary health care in Austria.
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Kamenski, Gustav, Wagner, Gernot, Zehetmayer, Sonja, Fink, Waltraud, Spiegel, Wolfgang, and Hoffmann, Kathryn
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WOMEN'S health ,DISEASES in women ,COMMUNITY health services ,CIPROFLOXACIN ,QUINOLONE antibacterial agents - Abstract
Background: Uncomplicated urinary tract infections (UTI) are a frequent reason for consultation of women in primary health care. To avoid therapy failure and development of resistances, the choice of an antibiotic should be based on the knowledge of recent local resistance data but these data are scarce for the Austrian primary health care sector. Within the context of the ECO·SENS II study it was the aim to obtain appropriate and relevant local resistance data and describe the changes in the resistance pattern in comparison to the ECO·SENS study. Methods: 23 GPs from different parts of Austria participated in the study between July 2007 and November 2008. According to the defined inclusion- and exclusion criteria female patients with symptoms of an uncomplicated UTI were included and a midstream urine sample was collected. In case of significant bacteriuria susceptibility testing of E. coli against 14 antibiotics was performed. Descriptive statistical methods were used. Results: In 313 patients included in the study, a total of 147 E. coli isolates (47%) were detected and tested. The resistance rates were in %: Mecillinam (0.0), nitrofurantoin (0.7), fosfomycin trometamol (0.7), gentamycin (1.4), cefotaxime (2.7), ceftazidime (2.7), Cephadroxil (4.1) and ciprofloxacin (4.1). Higher resistance rates were found in amoxicillin/clavulanic acid (8.9), nalidixic acid (9.6), trimethoprim/sulphamethoxazole (14.4), trimethoprim (15.8), sulphamethoxazole (21.2) and ampicillin (28.8). Additionally, the comparison of these results with the results of the ECO·SENS study demonstrated an increase in resistance rates of ampicillin, amoxicillin/clavulanic acid, nalidixic acid and ciprofloxacin. Conclusions: The resistance data for E. coli in uncomplicated UTIs in women gained by this study are the most recent data for this disease in Austria at the moment. The increased resistance rates of amoxicillin/clavulanic acid, ciprofloxacin and nalidixic acid should be respected when choosing an appropriate antibiotic for uncomplicated UTIs. The use of ampicillin, sulphamethoxazole, trimethoprim and trimethoprim/sulphametoxazole in uncomplicated UTIs in women should be questioned at all. The findings of this study should result in a regular surveillance system of resistances emerging in the ambulatory sector designed after the model of the EARS-Net. [ABSTRACT FROM AUTHOR]
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- 2012
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17. More than a "touch of the flu": a response to Mayrhuber et al's ""with fever it's the real flu I would say": laypersons' perception of common cold and influenza and their differences - a qualitative study in Austria, Belgium and Croatia".
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Jutel, Annemarie, Peersman, Wim, van de Kraats, Nina, Petricek, Goranka, Ćosić Diviak, Asja, Wojczewski, Silvia, and Hoffmann, Kathryn
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COMMON cold ,INFLUENZA ,QUALITATIVE research ,FEVER ,LAYPERSONS - Abstract
This short reply contests two assumptions made by the authors of Mayrhuber et al's. "With fever it's the real flu I would say." The first is that there is influenza can be reliably defined by a medical case definition. The second is that this small qualitative study can be generalisable. However, it does underline the important point that technical diagnostic terms may be used on different registers by a variety of actors in the medical setting. [ABSTRACT FROM AUTHOR]
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- 2019
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18. General practitioners' deprescribing decisions in older adults with polypharmacy: a case vignette study in 31 countries
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Jungo, Katharina Tabea, Mantelli, Sophie, Rozsnyai, Zsofia, Missiou, Aristea, Kitanovska, Biljana Gerasimovska, Weltermann, Birgitta, Mallen, Christian, Collins, Claire, Bonfim, Daiana, Kurpas, Donata, Petrazzuoli, Ferdinando, Dumitra, Gindrovel, Thulesius, Hans, Lingner, Heidrun, Johansen, Kasper Lorenz, Wallis, Katharine, Hoffmann, Kathryn, Peremans, Lieve, Pilv, Liina, Šter, Marija Petek, Bleckwenn, Markus, Sattler, Martin, van der Ploeg, Milly, Torzsa, Péter, Kánská, Petra Bomberová, Vinker, Shlomo, Assenova, Radost, Bravo, Raquel Gomez, Viegas, Rita P A, Tsopra, Rosy, Pestic, Sanda Kreitmayer, Gintere, Sandra, Koskela, Tuomas H, Lazic, Vanja, Tkachenko, Victoria, Reeve, Emily, Luymes, Clare, Poortvliet, Rosalinde K E, Rodondi, Nicolas, Gussekloo, Jacobijn, and Streit, Sven
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610 Medicine & health ,360 Social problems & social services ,3. Good health - Abstract
BACKGROUND General practitioners (GPs) should regularly review patients' medications and, if necessary, deprescribe, as inappropriate polypharmacy may harm patients' health. However, deprescribing can be challenging for physicians. This study investigates GPs' deprescribing decisions in 31 countries. METHODS In this case vignette study, GPs were invited to participate in an online survey containing three clinical cases of oldest-old multimorbid patients with potentially inappropriate polypharmacy. Patients differed in terms of dependency in activities of daily living (ADL) and were presented with and without history of cardiovascular disease (CVD). For each case, we asked GPs if they would deprescribe in their usual practice. We calculated proportions of GPs who reported they would deprescribe and performed a multilevel logistic regression to examine the association between history of CVD and level of dependency on GPs' deprescribing decisions. RESULTS Of 3,175 invited GPs, 54% responded (N = 1,706). The mean age was 50 years and 60% of respondents were female. Despite differences across GP characteristics, such as age (with older GPs being more likely to take deprescribing decisions), and across countries, overall more than 80% of GPs reported they would deprescribe the dosage of at least one medication in oldest-old patients (> 80 years) with polypharmacy irrespective of history of CVD. The odds of deprescribing was higher in patients with a higher level of dependency in ADL (OR =1.5, 95%CI 1.25 to 1.80) and absence of CVD (OR =3.04, 95%CI 2.58 to 3.57). INTERPRETATION The majority of GPs in this study were willing to deprescribe one or more medications in oldest-old multimorbid patients with polypharmacy. Willingness was higher in patients with increased dependency in ADL and lower in patients with CVD.
19. Assessing refugee healthcare needs in Europe and implementing educational interventions in primary care: a focus on methods.
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Lionis, Christos, Petelos, Elena, Mechili, Enkeleint-Aggelos, Sifaki-Pistolla, Dimitra, Chatzea, Vasiliki-Eirini, Angelaki, Agapi, Rurik, Imre, Pavlic, Danica Rotar, Dowrick, Christopher, Dückers, Michel, Ajdukovic, Dean, Bakic, Helena, Jirovsky, Elena, Mayrhuber, Elisabeth Sophie, van den Muijsenbergh, Maria, and Hoffmann, Kathryn
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REFUGEES ,GOVERNMENT agencies ,ENDOWMENTS ,INTEGRATED health care delivery ,MEDICAL needs assessment ,PRIMARY health care ,PATIENT-centered care - Abstract
The current political crisis, conflicts and riots in many Middle Eastern and African countries have led to massive migration waves towards Europe. European countries, receiving these migratory waves as first port of entry (POE) over the past few years, were confronted with several challenges as a result of the sheer volume of newly arriving refugees. This humanitarian refugee crisis represents the biggest displacement crisis of a generation. Although the refugee crisis created significant challenges for all national healthcare systems across Europe, limited attention has been given to the role of primary health care (PHC) to facilitate an integrated delivery of care by enhancing care provision to refugees upon arrival, on transit or even for longer periods. Evidence-based interventions, encompassing elements of patient-centredness, shared decision-making and compassionate care, could contribute to the assessment of refugee healthcare needs and to the development and the implementation of training programmes for rapid capacity-building for the needs of these vulnerable groups and in the context of integrated PHC care. This article reports on methods used for enhancing PHC for refugees through rapid capacity-building actions in the context of a structured European project under the auspices of the European Commission and funded under the 3rd Health Programme by the Consumers, Health, Agriculture and Food Executive Agency (CHAFEA). The methods include the assessment of the health needs of all the people reaching Europe during the study period, and the identification, development, and testing of educational tools. The developed tools were evaluated following implementation in selected European primary care settings. [ABSTRACT FROM AUTHOR]
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- 2018
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20. Antibacterial resistances in uncomplicated urinary tract infections in women: ECO·SENS II data from primary health care in Austria.
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Kamenski, Gustav, Wagner, Gernot, Zehetmayer, Sonja, Fink, Waltraud, Spiegel, Wolfgang, and Hoffmann, Kathryn
- Abstract
Background: Uncomplicated urinary tract infections (UTI) are a frequent reason for consultation of women in primary health care. To avoid therapy failure and development of resistances, the choice of an antibiotic should be based on the knowledge of recent local resistance data but these data are scarce for the Austrian primary health care sector. Within the context of the ECO·SENS II study it was the aim to obtain appropriate and relevant local resistance data and describe the changes in the resistance pattern in comparison to the ECO·SENS study.Methods: 23 GPs from different parts of Austria participated in the study between July 2007 and November 2008. According to the defined inclusion- and exclusion criteria female patients with symptoms of an uncomplicated UTI were included and a midstream urine sample was collected. In case of significant bacteriuria susceptibility testing of E. coli against 14 antibiotics was performed. Descriptive statistical methods were used.Results: In 313 patients included in the study, a total of 147 E. coli isolates (47%) were detected and tested. The resistance rates were in %: Mecillinam (0.0), nitrofurantoin (0.7), fosfomycin trometamol (0.7), gentamycin (1.4), cefotaxime (2.7), ceftazidime (2.7), Cephadroxil (4.1) and ciprofloxacin (4.1). Higher resistance rates were found in amoxicillin/clavulanic acid (8.9), nalidixic acid (9.6), trimethoprim/sulphamethoxazole (14.4), trimethoprim (15.8), sulphamethoxazole (21.2) and ampicillin (28.8). Additionally, the comparison of these results with the results of the ECO·SENS study demonstrated an increase in resistance rates of ampicillin, amoxicillin/clavulanic acid, nalidixic acid and ciprofloxacin.Conclusions: The resistance data for E. coli in uncomplicated UTIs in women gained by this study are the most recent data for this disease in Austria at the moment. The increased resistance rates of amoxicillin/clavulanic acid, ciprofloxacin and nalidixic acid should be respected when choosing an appropriate antibiotic for uncomplicated UTIs. The use of ampicillin, sulphamethoxazole, trimethoprim and trimethoprim/sulphametoxazole in uncomplicated UTIs in women should be questioned at all. The findings of this study should result in a regular surveillance system of resistances emerging in the ambulatory sector designed after the model of the EARS-Net. [ABSTRACT FROM AUTHOR]- Published
- 2012
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21. Antibiotic resistance in primary care in Austria - a systematic review of scientific and grey literature.
- Author
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Hoffmann K, Wagner G, Apfalter P, and Maier M
- Subjects
- Austria, Bacteria isolation & purification, Humans, Primary Health Care, Bacteria drug effects, Bacterial Infections microbiology, Drug Resistance, Bacterial
- Abstract
Background: Antibiotic resistance is an increasing challenge for health care services worldwide. While up to 90% of antibiotics are being prescribed in the outpatient sector recommendations for the treatment of community-acquired infections are usually based on resistance findings from hospitalized patients. In context of the EU-project called "APRES - the appropriateness of prescribing antibiotic in primary health care in Europe with respect to antibiotic resistance" it was our aim to gain detailed information about the resistance data from Austria in both the scientific and the grey literature., Methods: A systematic review was performed including scientific and grey literature published between 2000 and 2010. Inclusion and exclusion criteria were defined and the review process followed published recommendations., Results: Seventeen scientific articles and 23 grey literature documents could be found. In contrast to the grey literature, the scientific publications describe only a small part of the resistance situation in the primary health care sector in Austria. Merely half of these publications contain data from the ambulatory sector exclusively but these data are older than ten years, are very heterogeneous concerning the observed time period, the number and origin of the isolates and the kind of bacteria analysed. The grey literature yields more comprehensive and up-to-date information of the content of interest. These sources are available in German only and are not easily accessible. The resistance situation described in the grey literature can be summarized as rather stable over the last two years. For Escherichia coli e.g. the highest antibiotic resistance rates can be seen with fluorochiniolones (19%) and trimethoprim/sulfamethoxazole (27%)., Conclusion: Comprehensive and up-to-date antibiotic resistance data of different pathogens isolated from the community level in Austria are presented. They could be found mainly in the grey literature, only few are published in peer-reviewed journals. The grey literature, therefore, is a very valuable source of relevant information. It could be speculated that the situation of published literature is similar in other countries as well.
- Published
- 2011
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