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Background and Objective: Although polypharmacy is not inappropriate per se, it increases the risk of adverse drug reactions (ADRs), especially in older patients. The aim of the PARTNER cluster-randomised trial is to evaluate the effectiveness, cost-effectiveness and implementation of a patient-centred structured care pathway of general practitioner (GP)-pharmacist collaboration in German primary care, focused on deprescribing of psychotropic and anticholinergic drugs. Method: The study design is a multicentre, two-arm cluster-randomised trial accompanied by a health economic and process evaluation. Clusters consist of one GP practice and one or more collaborating community pharmacies, which are randomly assigned to either the PARTNER intervention group or a control group. At least 45 GP practices will enroll a total of 352 patients (≥ 65 years with polypharmacy and use of ≥ 1 psychotropic/anticholinergic drugs) across three study sites, starting in October 2022. In the PARTNER intervention arm, intervention components comprise (A) educational material for GPs and pharmacists on psychotropic/anticholinergic deprescribing, (B) a moderated interprofessional workshop, (C) patient empowerment via a pre-planned patient-pharmacist consultation facilitated by empowerment leaflets, and (D) shared decision making as part of a pre-planned patient-GP consultation. The only intervention component in the PARTNER control arm is a pre-planned patient-pharmacist consultation to update medication plans and conduct a medication safety check with no particular focus on psychotropic/anticholinergic drugs. Main outcome measures: The primary endpoint of the study is a patient level reduction in psychotropic/anticholinergic exposure, reflected by a reduction of 0.15 points or more on the Drug Burden Index. Secondary endpoints examine the effect of the intervention on prevalent vs incident use of target drugs, on clinical symptoms and on patient-reported outcomes. Results: This cluster-randomised trial will establish whether the PARTNER intervention can reduce the use of psychotropic/anticholinergic drugs in older people, its benefit-risk ratio as well as barriers and facilitators to its implementation. Conclusion: Infrastructural and political developments offer new opportunities for intensified collaboration between GPs and pharmacies in German primary care. The PARTNER project provides insights into whether broad implementation of the PARTNER intervention is effective, efficient, and appropriate, but also how collaboration between GPs and pharmacies can succeed in order to increase patient safety.

Background: Little research exists on the cumulative effect of simultaneously used medicines that may increase the risk of falls. A promising approach is the definition of scores to characterise the overall risk of specific Fall Risk Increasing Adverse Reactions (FRIARs). Problem: Can FRIAR scores [for full text, please go to the a.m. URL]

Background: People with long-term need of care, together with their relatives, nursing staff and general practitioners are most clearly affected by the Covid-19 pandemic. The Bavarian State Ministry for Health and Care has initiated BaCoM to improve the living situation of those in need of care in the [for full text, please go to the a.m. URL]

Hintergrund: Das „Post Intensive Care“ -Syndrom (PICS) ist eine Kombination aus Beeinträchtigungen in den Bereichen kognitive, psychische und körperliche Gesundheit, welche bei Überlebenden einer kritischen Erkrankung und nach einer intensivmedizinischen Behandlung auftreten [zum vollständigen Text gelangen Sie über die oben angegebene URL]

Hintergrund: Die randomisiert-kontrollierte Studie IMPROVE-MH-Förderung der psychischen Gesundheit bei geflüchteten Eltern und ihren Kindern – ist ein Konsortialprojekt, an dem eine psychologische und drei allgemeinmedizinische universitäre Institutionen beteiligt sind. Hauptziel [zum vollständigen Text gelangen Sie über die oben angegebene URL]

Hintergrund: Das Chronic Care Model beinhaltet evidenzbasierte Empfehlungen zur Verbesserung der Versorgung von Patienten mit chronischen Erkrankungen. Der Patient Assessment of Chronic Illness Care Questionnaire (PACIC) ist ein weit verbreitetes Instrument zur Beurteilung der ambulanten Versorgung [zum vollständigen Text gelangen Sie über die oben angegebene URL]

Hintergrund: ADHS bei Erwachsenen ist häufig in der Primärversorgung, leider teilweise fehldiagnostiziert und beeinträchtigend, aber hoch sensitiv für eine Behandlung. Neben Medikamenten hat kognitive Verhaltenstherapie einen positiven Effekt auf die Symptome. Fragestellung: [zum vollständigen Text gelangen Sie über die oben angegebene URL]

Hintergrund: Der kumulative Effekt von gleichzeitig eingenommenen Fall-Risk-Increasing-Drugs (FRIDs) ist bisher kaum erforscht. Ein vielversprechender Ansatz hierfür ist die Definition von Scores, die auf Patientenebene die Gesamtbelastung mit bestimmten Fall-Risk-Increasing-Adverse-Reactions (FRIARs) [zum vollständigen Text gelangen Sie über die oben angegebene URL]

Hintergrund: Pflegebedürftige Menschen sind gemeinsam mit ihren Angehörigen, den Pflegekräften und betreuenden Hausärzt*innen stark von der Covid-19-Pandemie betroffen. Das Bayerische Staatsministerium für Gesundheit und Pflege hat BACOM zur Verbesserung der Lebenssituation [zum vollständigen Text gelangen Sie über die oben angegebene URL]

Hintergrund: Überlebende einer schweren Sepsis leiden oft nach der intensivmedizinischen Behandlung unter Langzeitfolgen. Darunter fallen auch depressive Symptome. Über deren Verlauf ist bislang wenig bekannt. Die meisten dieser Patienten werden in der Hausarztpraxis nachbetreut. Fragestellung: [zum vollständigen Text gelangen Sie über die oben angegebene URL]

Background: Due to strict time management General Practitioners (GPs) prefer short instruments when identifying suicidal behaviour in their patients. We summarize the available studies reporting diagnostic accuracy of brief instruments for suicidal behaviour in primary care. Method: Databases MEDLINE, EMBASE, PsychINFO, PSYNDEX, and Cochrane Library were searched without any time constraints. Risk of bias and applicability concerns were assessed using the QUADAS-2 tool. The certainty of evidence was rated via GRADEpro. We included studies on primary care patients or participants from the general population. Suicidal behaviour was the defined target condition. With respect to the applicability in a primary care setting we included only studies assessing brief screening instruments; a brief instrument was defined as having no more than twelve items. We assessed sensitivity, specificity, and positive and negative predictive value. Results: A total of 9,969 studies was identified; of those, six fulfilled all strong criteria and were included. The range of sensitivity was 0.26-1.00, specificity was 0.64-0.99, positive predictive value 0.06-0.91, negative predictive value 0.86-1.00. Risk of bias was rated moderate and concerns regarding applicability acceptable. A required sensitivity of at least 0.80 and specificity of 0.50 with a moderate to high GRADE rating was achieved by six of nine index tests. Conclusions: Brief screening instruments can support ruling-out suicidality, but are less suitable for ruling-in. They may support GPs in an initial assessment, but in case of a positive test result, a valid diagnostic assessment should be done by a structured clinical interview.