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Objectives To validate the urinary tract infection-Symptom and Impairment Questionnaire (UTI-SIQ-8), a questionnaire that consists of four items to assess the symptom severity for dysuria, urgency, frequenc, and low abdominal pain and four items to assess the resulting impairment of activity by UTIs. Design Prospective observation study. Setting German primary care practices. Participants An unselected population of women with UTI. Women could participate online via a web application for smartphones, smartwatches and tablets or use a paper-and-pencil version. Main outcomes Psychometric properties of the UTI-SIQ-8 regarding reliability, validity and sensitivity to change by using factor analysis and multilevel and network analysis. Results Data from 120 women with a total of 769 symptom reports across 7 days of measurement were analysed. The majority of the participating patients (87/120) used the web application via smartphones or other devices. The reliability of the UTI-SIQ-8 was high, with Cronbach’s alpha of.86 at intake; convergent and discriminant validity was satisfactory. Intraclass correlation demonstrated high sensitivity to change, with 68% of the total variance being due to time differences. These daily changes in an individual’s symptoms moved parallel with daily changes in the EQ-5D-5L (b=1.68, SE=0.12, p

Hintergrund/Fragestellung: Im Krankenhaus erhalten besonders ältere Patient/innen bei Ein- und Durchschlafproblemen schlafanstoßende Arzneimittel, die häufig zu den potentiell inadäquaten Medikamenten laut PRISCUS-Liste gehören. Zwischen April 2014 bis Juni 2017 haben[zum vollständigen Text gelangen Sie über die oben angegebene URL], Nützliche patientenrelevante Forschung; 21. Jahrestagung des Deutschen Netzwerks Evidenzbasierte Medizin

Background Many elderly patients receive psychotropic drugs. Treatment with psychotropic agents is associated with serious side effects including an increased risk of falls and fractures. Several psychotropic drugs are considered potentially inappropriate for treatment of the elderly. Methods A retrospective chart review was conducted covering all patients aged ≥ 65 years who were admitted to Evangelisches Krankenhaus Göttingen-Weende between 01/01/2013 and 03/31/2013. Psychotropic drugs reviewed for included benzodiazepines, Z-drugs, antidepressants and neuroleptics, but not drugs for sedation during artificial ventilation or pre-medication before surgery. Potentially inappropriate drugs were identified according to the PRISCUS list. To assess which factors were associated with the administration of psychotropic drugs, univariate and multivariable logistic regression analyses were performed. Results The charts of 2130 patients (1231 women) were analyzed. 53.9% of all patients received at least one psychotropic medication (29.5% benzodiazepines, 12.6% Z-drugs, 22.2% antidepressants, 11.9% neuroleptics). The mean number of psychotropic drugs prescribed per patient with at least one prescription was 1.6. Patients treated in the geriatric department most often received antidepressants (45.0%), neuroleptics (20.6%) and Z-drugs (27.5%). Benzodiazepines and Z-drugs were prescribed mostly as medication on demand (77.7% of benzodiazepines, 73.9% of Z-drugs). Surgical patients most frequently received benzodiazepines (37.1%). Nearly one-third of all patients ≥ 65 years was treated with at least one potentially inappropriate psychotropic medication. The mean number of potentially inappropriate psychotropic medications per patient with at least one psychotropic prescription was 0.69. The percentage of patients with potentially inappropriate psychotropic medication was highest in the surgical departments (74.1%). Female gender (adjusted OR 1.36; 95% CI 1.14 to 1.63), stay in the Department of Geriatrics (2.69; 2.01 to 3.60) or the interdisciplinary intensive care unit (1.87; 1.33 to 2.64) and age ≥ 85 years (1.33; 1.10 to 1.60) were associated with psychotropic drug treatment. Conclusions A high percentage of patients aged ≥ 65 years received psychotropic drugs. The chance that a potentially inappropriate psychotropic drug would be administered was highest in the surgical departments. Antidepressants, neuroleptics and Z-drugs were used surprisingly often in geriatric medicine. Educational strategies could reduce the use of psychotropic drugs and the prescription of potentially inappropriate medications.

Hintergrund: Für die Versorgung von Patientinnen mit unkompliziertem Harnwegsinfekt (HWI) stehen verschiedene Behandlungsoptionen zur Verfügung. Es ist nicht bekannt, inwieweit diese Optionen in der ärztlichen Praxis ausgeschöpft werden. Auch ist unklar, ob zwischen Management und[zum vollständigen Text gelangen Sie über die oben angegebene URL], 53. Kongress für Allgemeinmedizin und Familienmedizin

Hintergrund: Schlaf- und Beruhigungsmittel gehören zu den am häufigsten eingesetzten Medikamenten im Krankenhaus. Oft handelt es sich dabei um stark wirksame Medikamente aus der Gruppe der Hypnotika und Sedativa, z. B. Benzodiazepine und sogenannte Z-Substanzen – mit hohem Risikopotential[zum vollständigen Text gelangen Sie über die oben angegebene URL], 17. Deutscher Kongress für Versorgungsforschung (DKVF)

Appendix. SAS code for the multilevel factor analysis, exemplified for clinical supervisors. (DOCX 19 kb)

Background: Hypnotics and sedatives, such as benzodiazepines, are still regularly prescribed in the hospital setting for patients with sleeping problems—in spite of well-known safety concerns, such as craving, withdrawal symptoms upon discontinuation and increased falls, especially in older and[for full text, please go to the a.m. URL], 16. Deutscher Kongress für Versorgungsforschung (DKVF)

Hintergrund: Geriatrische Patienten sind durch ihr Alter, Komorbiditäten, Multimedikation und aktuelle oder drohende funktionelle Einschränkungen gekennzeichnet. In der geriatrischen Rehabilitation arbeiten verschiedene Berufsgruppen aus Medizin, Pflege und Therapie zusammen. Gemeinsames Ziel[zum vollständigen Text gelangen Sie über die oben angegebene URL], 16. Deutscher Kongress für Versorgungsforschung (DKVF)

Hintergrund: Schlaf- und Beruhigungsmittel gehören zu den am häufigsten eingesetzten Medikamenten im Krankenhaus. Oft handelt es sich dabei um Medikamente aus der Gruppe der Hypnotika und Sedativa, z. B. Benzodiazepine. Somit lernen Patienten in der Akutsituation im Krankenhaus stark wirksame[zum vollständigen Text gelangen Sie über die oben angegebene URL], 16. Deutscher Kongress für Versorgungsforschung (DKVF)

OBJECTIVE: People with type 2 diabetes often report pressure to abstain from many of life's pleasures. We tried to reconstruct these patients' sense of pressure to better understand how people with diabetes make sense of, and integrate, these feelings into their life. DESIGN, SETTING AND PARTICIPANTS: A secondary analysis of narrative interviews with 14 patients with type 2 diabetes who are part of a website project. MAIN OUTCOME MEASURES: Grounded theory-based analysis of narrative interviews, consisting of open, axial and selective coding. RESULTS: People with type 2 diabetes felt obliged to give up many pleasures and live a life of abstinence. They perceived a pressure to display a modest culinary lifestyle via improved laboratory test results and weight. Their verbal efforts to reassure and distance themselves from excessiveness indicate a high moral pressure. With regard to the question of how to abstain, food and behaviour were classified into healthy and unhealthy. Personal rules sometimes led to surprising experiences of freedom. CONCLUSIONS: People with diabetes have internalised that their behaviour is a barrier to successful treatment. They experience an intensive pressure to show abstinence and feel misjudged when their efforts have no visible effect. Taking into account this moral pressure, and listening to patients' personal efforts and strategies to establish healthy behaviours, might help to build a trusting relationship with healthcare providers. peerReviewed

(Searching algorithm for matched controlsâ identification). (PDF 21 kb)