@article{LindertWehrweinKlempereretal., author = {Lindert, Jutta and Wehrwein, Annette and Klemperer, David and Walter, Ulla}, title = {Lehre von Public Health in gesundheitsbezogenen Studieng{\"a}ngen in Deutschland: die Sicht von Studiengangsverantwortlichen}, series = {Gesundheitswesen}, volume = {81}, journal = {Gesundheitswesen}, number = {8-9}, publisher = {Thieme}, doi = {10.1055/s-0043-116940}, pages = {599 -- 605}, abstract = {Hintergrund Inhalte von Public Health werden in Deutschland in gesundheitsbezogenen Studieng{\"a}ngen an Hochschulen und Universit{\"a}ten gelehrt. Ziel dieser Studie war es, Daten zur Lehre und zur Kooperation von Lehrenden von Public Health in gesundheitsbezogenen Studieng{\"a}ngen in Deutschland zur Verf{\"u}gung zu stellen. Methode Eine Querschnittsuntersuchung wurde online-basiert vom 01.06. bis 15.09.2015 an 93 Hochschulen/Universit{\"a}ten in Deutschland mit 351 Studiengangsverantwortlichen aus gesundheitsbezogenen Studieng{\"a}ngen durchgef{\"u}hrt. Einbezogen wurden Public Health Studieng{\"a}nge und gesundheitsbezogene Studieng{\"a}nge, deren Hochschulen bzw. Universit{\"a}ten entweder Mitglied in der „Deutschen Gesellschaft f{\"u}r Sozialmedizin und Pr{\"a}vention" (DGSMP) oder in der Gesellschaft „Hochschulen f{\"u}r Gesundheit" (HOGE) sind. Teilgenommen an dieser Studie haben N=104 Studiengangsverantwortliche (43\% M{\"a}nner, 57\% Frauen). In Public Health Studieng{\"a}ngen wurden „Global Health" und „Umwelt und Gesundheit" als Studieninhalte h{\"a}ufiger als in gesundheitsbezogenen Studieng{\"a}ngen benannt; in gesundheitsbezogenen Studieng{\"a}ngen wurden h{\"a}ufiger „Ethik" und „Gesundheitspsychologie" als Lehrinhalte benannt. Finanzielle Unterst{\"u}tzungen durch die Hochschulen/ Universit{\"a}ten sowie strukturierte Partnerschaften zwischen Hochschulen und/ oder Universit{\"a}ten werden von Lehrenden an Hochschulen (36\%) und an Universit{\"a}ten (40\%) gew{\"u}nscht. Lehrende an Hochschulen w{\"u}nschen dar{\"u}ber hinaus Promotionspartnerschaften. Schlussfolgerung Bisher gibt es in Deutschland keine einheitlichen fachlichen Qualit{\"a}tskriterien f{\"u}r Absolvierende von Public Health bzw. gesundheitsbezogenen Studieng{\"a}ngen. Zudem gibt es nach Aussage der Studiengangsverantwortlichen dieser Studieng{\"a}nge wenig Kooperation zwischen Lehrenden der Public Health bzw. der gesundheitsbezogenen Studieng{\"a}nge.}, language = {de} } @article{BraunKlemperer, author = {Braun, Bernard and Klemperer, David}, title = {Patientenorientierung ernst nehmen}, series = {Public Health Forum}, volume = {23}, journal = {Public Health Forum}, number = {1}, publisher = {De Gruyter}, doi = {10.1515/pubhef-2015-0008}, pages = {17 -- 18}, abstract = {Die Orientierung an und auf die Bedarfe, Bed{\"u}rfnisse und Pr{\"a}ferenzen von Patienten geh{\"o}rt seit vielen Jahren zum Basisrepertoire der Gesundheitsrhetorik. Trotz einiger praktischer Schritte in diese Richtung, sieht der Alltag im deutschen Gesundheitswesen aber noch deutlich anders aus. Erst wenn Versorgungsforscher, gesundheitspolitisch Verantwortliche und Versorgungspraktiker Patientenorientierung zum archimedischen Punkt ihrer Sicht- und Handlungsweise machen, wird sich daran etwas {\"a}ndern.}, language = {de} } @article{Klemperer, author = {Klemperer, David}, title = {Replik}, series = {Forum M{\´e}dical Suisse ‒ Swiss Medical Forum}, volume = {15}, journal = {Forum M{\´e}dical Suisse ‒ Swiss Medical Forum}, doi = {10.4414/fms.2015.02520}, pages = {50 -- 51}, language = {de} } @unpublished{GrabitzFriedmannGeppetal., author = {Grabitz, Peter and Friedmann, Zoe and Gepp, Sophie and Hess, Leonard U. and Specht, Lisa and Struck, Maja and Tragert, Sophie Kira and Walther, Tobias and Klemperer, David}, title = {Conflict of Interest Policies at German medical schools - A long way to go}, doi = {10.1101/809723}, abstract = {Abstract Background Most medical students are in contact with the pharmaceutical or medical device industry during their studies. Medical schools play an important role in protecting students from undue commercial influence and educating them about pharmaceutical marketing practices. Such influence has been shown to affect later prescribing behaviour with potential adverse effects for patient care. While in North America, many medical schools formulated and implemented conflicts of interest (COI) policies, only few such institutional policies have been reported in Germany. We aimed to analyze the quantity and quality of policies and curricula on COI at medical schools across Germany. Methods We collected relevant COI policies and teaching activities by conducting a search of the websites of all 38 German medical schools using standardized keywords for COI policies and teaching. Further, we surveyed all medical schools' dean's offices and adapted a scoring system for obtained results with 13 categories based on prior similar studies. Results We identified relevant policies for one medical school via the web-search. The response rate of the deans' survey was 16 of 38 (42.1\%). In total, we identified COI-related policies for 2 of 38 (5.3\%) German medical schools, yet no policy was sufficient to address all COI-related categories that were assessed in this study. The maximum score achieved was 12 of 26. 36 (94.7\%) schools scored 0. No medical school reported curricular teaching on COI. Conclusion Our results indicate a low level of action by medical schools to protect students from undue commercial influence. No participating dean was aware of any curriculum or instruction on COI at their respective school. The German Medical Students Association and international counterparts have called for a stronger focus on COI in the classroom. We conclude that for German medical schools there is still a long way to go.}, language = {en} } @article{Klemperer, author = {Klemperer, David}, title = {Choosing wisely in Germany - adapting an international initiative to a national healthcare agenda}, series = {European Psychiatry}, volume = {33}, journal = {European Psychiatry}, number = {Issue S1: Abstracts of the 24th European Congress of Psychiatry}, publisher = {Elsevier}, doi = {10.1016/j.eurpsy.2016.01.783}, pages = {S5}, abstract = {Overuse and underuse in healthcare is a chronic problem in most healthcare systems. Inspired by the North American Choosing Wisely Initiative, the Association of Scientific Medical Societies in Germany (AWMF), which actually counts 173 member organisations, decided to address the problem. The aim of the German "Gemeinsam klug entscheiden" (deciding together wisely)-initiative is to reduce overuse, underuse and misuse of health interventions in areas where recommendations of clinical practice guidelines (CPG) are not adequately implemented or missing. Starting point are the positive and negative recommendations of the CPGs, which the AWMF-member societies have developed for more than 20 years, following the manual and rules set up by AWMF. To identify and select recommendations methodological criteria have been developed by a working group in a consensus-based process. The development of AWMF-CPGs follows a methodology that aims to ensure the full integration of evidence, an interdisciplinary and interprofessional perspective, the prevention of bias as a consequence of conflicts of interest and full transparency of the development process.}, language = {en} } @article{SainiGarciaArmestoKlempereretal., author = {Saini, Vikas and Garcia-Armesto, Sandra and Klemperer, David and Paris, Valerie and Elshaug, Adam G. and Brownlee, Shannon and Ioannidis, John P. A. and Fisher, Elliott S.}, title = {Drivers of poor medical care}, series = {The Lancet}, volume = {390}, journal = {The Lancet}, number = {10090}, publisher = {Elsevier}, doi = {10.1016/S0140-6736(16)30947-3}, pages = {178 -- 190}, abstract = {The global ubiquity of overuse and underuse of health-care resources and the gravity of resulting harms necessitate an investigation of drivers to inform potential solutions. We describe the network of influences that contribute to poor care and suggest that it is driven by factors that fall into three domains: money and finance; knowledge, bias, and uncertainty; and power and human relationships. In each domain the drivers operate at the global, national, regional, and individual level, and are modulated by the specific contexts within which they act. We discuss in detail drivers of poor care in each domain.}, language = {en} } @article{RoggeBaurBlettneretal., author = {Rogge, Alize A. and Baur, Isabel and Blettner, Gabriele and Holtkamp, Ulrike and Horneber, Markus and Jahn, Patrick and Joos, Stefanie and Keberle, Silva and Kettelgerdes, Anita and Klemperer, David and Laengler, Alfred and Voiss, Petra and Weis, Joachim and Witt, Claudia M.}, title = {Defining Criteria for Guiding Cancer Patients to Find a Reputable Complementary Medicine Provider}, series = {Patient Preference and Adherence}, volume = {14}, journal = {Patient Preference and Adherence}, publisher = {DOVE MEDICAL PRESS}, doi = {10.2147/PPA.S230705}, pages = {747 -- 755}, abstract = {Purpose: Even in cases of positive evidence for complementary medicine (CM) therapies, it is still difficult for cancer patients to identify reputable providers. The aim of this study was to develop and evaluate a criteria list to provide guidance to cancer patients seeking a reputable CM provider. Methods: The design combined a literature review, an expert consensus procedure (n=15) and an assessment from three stakeholder perspectives (patients (n=18), CM providers (n=26) and oncology physicians (n=20)). Results: A total of 30 existing CM criteria were extracted from the literature, and 12 more were added by the experts. The main challenge was to define criteria that could easily be applied by the patients. A final comprehensive list of 8 criteria guiding cancer patients to find a reputable CM provider was developed. Conclusion: Health professionals and cancer information services might find the criteria list helpful when aiming to strengthen patients' awareness of quality-related factors associated with CM providers. The criteria developed might be helpful when standards are established for quality assurance in CM in oncology.}, language = {en} } @article{GeraedtsBusseJaeckeletal., author = {Geraedts, Max and Busse, Reinhard and J{\"a}ckel, Wilfried H. and Klemperer, David and Mauersberg, Susanne and Sauerland, Dirk and Volbracht, Eckhard and Schwenk, Uwe}, title = {Wie r{\"u}ckt Qualit{\"a}t in den Fokus der Gesundheitsversorgung?}, series = {Zeitschrift f{\"u}r Evidenz, Fortbildung und Qualit{\"a}t im Gesundheitswesen}, volume = {104}, journal = {Zeitschrift f{\"u}r Evidenz, Fortbildung und Qualit{\"a}t im Gesundheitswesen}, number = {2}, publisher = {Elsevier}, doi = {10.1016/j.zefq.2009.12.028}, pages = {120 -- 130}, abstract = {Obwohl es in Deutschland inzwischen eine Vielzahl an gesetzlichen Vorgaben, Konzepten und Instrumenten zur Qualit{\"a}tsf{\"o}rderung gibt, scheint das Gesundheitswesen von einer lebendigen Qualit{\"a}tskultur noch weit entfernt zu sein. Um Wege aufzuzeigen, wie die Entwicklung und Umsetzung einer Qualit{\"a}tskultur in der deutschen Gesundheitsversorgung gelingen k{\"o}nnte, hat die Bertelsmann Stiftung im Sommer 2009 eine Delphi-Befragung von sieben wissenschaftlich mit dem Thema Qualit{\"a}t im Gesundheitswesen befassten Experten sowie eine Online-Befragung von insgesamt 239 Akteuren aus den Bereichen Medizin, Selbstverwaltung, Politik, Industrie und Patientenvertretung durchgef{\"u}hrt. Auf dieser Basis wurden 31 Thesen aus zw{\"o}lf Themenbereichen formuliert und beurteilt, die notwendige Bausteine daf{\"u}r beschreiben, dass Qualit{\"a}t in den Fokus der Gesundheitsversorgung in Deutschland r{\"u}ckt. Bei einer Dichotomisierung der vorgegebenen Antwortskala (Schulnoten von 1-6) erhielten 28 der 31 Thesen zu mehr als 2/3 eine Zustimmung der Akteure mit den Notenwerten 1 oder 2 im Vergleich zu 3-6. Die zehn Thesen mit den h{\"o}chsten Zustimmungswerten erhielten von jeweils 85\% und mehr Akteuren Notenwerte von 1 oder 2. Den Hauptergebnissen der Befragungen folgend, erfordert die Etablierung einer vom Großteil der Befragten gew{\"u}nschten Qualit{\"a}tskultur, vordringlich ergebnisorientierte Qualit{\"a}tsziele und Qualit{\"a}tsindikatoren zu definieren, Qualit{\"a}tsmanagement st{\"a}rker in der Ausbildung zu beachten und eine auf m{\"o}glichst objektiver Qualit{\"a}tstransparenz beruhende, mit Anreizen versehene Qualit{\"a}tsf{\"o}rderung einzuf{\"u}hren. Die hohe {\"U}bereinstimmung von Experten und Akteuren im Hinblick auf die notwendigen Schritte zur Etablierung einer lebendigen Qualit{\"a}tskultur im deutschen Gesundheitswesen geben Hoffnung, dass die konkrete Umsetzung dieser Schritte gemeinsam gelingen k{\"o}nnte.}, language = {de} } @article{Klemperer, author = {Klemperer, David}, title = {{\"U}ber- und Unterversorgung in der Medizin}, series = {Swiss Medical Forum - Schweizerisches Medizin-Forum}, volume = {15}, journal = {Swiss Medical Forum - Schweizerisches Medizin-Forum}, number = {39}, publisher = {Swiss Medical Forum}, doi = {10.4414/smf.2015.02416}, pages = {866 -- 871}, abstract = {Die Medizin verf{\"u}gt {\"u}ber st{\"a}ndig wachsendes Wissen und immer mehr Behandlungsm{\"o}glichkeiten. Was fehlt: eine Orientierung auf den Nutzen f{\"u}r kranke und gesunde Menschen. Wenn alle Verantwortlichen handlungsbereit w{\"a}ren, d{\"u}rften viele Probleme mit dem vorhandenen Wissen kurzfristig l{\"o}sbar sein. Mit zus{\"a}tzlichem Wissen aus der Versorgungsforschung w{\"u}rde die Neuausrichtung des Gesundheitssystems auf die Interessen der Patienten und B{\"u}rger zus{\"a}tzliche Dynamik gewinnen.}, language = {de} } @article{KochStollKlempereretal., author = {Koch, Cora and Stoll, Marlene and Klemperer, David and Lieb, Klaus}, title = {Transparency of Conflicts of Interest: A Mixed Blessing? The Patients' Perspective}, series = {American Journal of Bioethics}, volume = {17}, journal = {American Journal of Bioethics}, number = {6}, publisher = {ROUTLEDGETAYLOR \& FRANCIS}, doi = {10.1080/15265161.2017.1313338}, pages = {27 -- 29}, language = {en} } @article{KuehleinMaibaumKlemperer, author = {K{\"u}hlein, Thomas and Maibaum, Thomas and Klemperer, David}, title = {"Quart{\"a}re Pr{\"a}vention" oder die Verhinderung nutzloser Medizin}, series = {Zeitschrift f{\"u}r Allgemeinmedizin}, volume = {94}, journal = {Zeitschrift f{\"u}r Allgemeinmedizin}, number = {4}, publisher = {Deutscher {\"A}rzteverlag}, pages = {174 -- 178}, abstract = {Nicht alles, was statistisch signifikant ist, ist auch klinisch relevant. Statistische Signifikanz vorausgesetzt, kann die Frage der Relevanz f{\"u}r die meisten Problemstellungen nur individuell beantwortet werden. Die entscheidende Kennzahl daf{\"u}r ist die Effektgr{\"o}ße einer Maßnahme, wie sie sich vor allem aus randomisiert kontrollierten Studien ergibt. Kleine Therapieeffekte k{\"o}nnen im Individualfall relevant sein, auch wenn sie f{\"u}r die meisten Patienten entbehrlich sind - und umgekehrt. In diesem Artikel geht es um quart{\"a}re Pr{\"a}vention: die Verhinderung irrelevanter oder nutzloser Medizin. Die Unterscheidung zwischen „illness" (Leiden des Patienten) und „disease" (Diagnose des Arztes) erm{\"o}glicht ein besseres Verst{\"a}ndnis der pr{\"a}ventiven Aufgaben der Prim{\"a}rmedizin und erleichtert die Abgrenzung von sinnvoller zu nutzloser Medizin. Man kann mithilfe dieser Differenzierung die Pr{\"a}vention in vier Formen einteilen: Prim{\"a}re Pr{\"a}vention - der Einsatz medizinischer Maßnahmen, obwohl der Patient kein Leiden versp{\"u}rt und auch keine Diagnose vorliegt, wie zum Beispiel Impfungen. Sekund{\"a}re Pr{\"a}vention - Fr{\"u}herkennungsmaßnahmen bei Personen mit Risikofaktoren, die aber bisher nicht krank sind. Terti{\"a}re Pr{\"a}vention - Verhinderung weiterer Ereignisse bei bereits erkrankten Patienten. Die quart{\"a}re Pr{\"a}vention meint im weiteren Sinne die Verhinderung nutzloser Medizin und bezieht sich auf die in der Prim{\"a}rmedizin h{\"a}ufige Situation, dass zwar ein Leiden vorliegt, {\"a}rztlicherseits jedoch keine behandlungsbed{\"u}rftige Krankheit diagnostiziert werden kann (und man deshalb mit Diagnostik und Therapie besonders zur{\"u}ckhaltend sein sollte).}, language = {de} } @article{Klemperer, author = {Klemperer, David}, title = {{\"U}berversorgung und Unterversorgung}, series = {G \& S : Gesundheits- und Sozialpolitik}, volume = {71}, journal = {G \& S : Gesundheits- und Sozialpolitik}, number = {3-4}, publisher = {Nomos}, doi = {10.5771/1611-5821-2017-3-4-63}, pages = {63 -- 67}, abstract = {{\"U}berversorgung und Unterversorgung f{\"u}gen Patienten betr{\"a}chtliche Sch{\"a}den zu und bedeuten eine Verschleuderung von Ressourcen. Als Problem werden sie zunehmend anerkannt und nicht mehr ignoriert oder geleugnet. Die Entwicklung einer Strategie zur Minderung von {\"U}berversorgung und Unterversorgung und einer Gesundheitsversorgung, in der die Patienten darauf vertrauen k{\"o}nnen, Leistungen zu erhalten, die ihrem objektiven und subjektiven Bedarf entsprechen, steht aus und ist ein ethischer und politischer Imperativ. Dieser Beitrag fokussiert auf {\"U}berversorgung und Unterversorgung infolge unzureichende Ber{\"u}cksichtigung der Patientenpr{\"a}ferenz sowie auf Maßnahmen und Strategien, die Patientenorientierung in der Versorgung zu st{\"a}rken.}, language = {de} } @incollection{Klemperer, author = {Klemperer, David}, title = {Wer zahlt, wenn es nichts n{\"u}tzt? : Leistungen und Kosten}, series = {{\"A}rztliche Kommunikation: Praxisbuch zum Masterplan Medizinstudium 2020}, booktitle = {{\"A}rztliche Kommunikation: Praxisbuch zum Masterplan Medizinstudium 2020}, editor = {J{\"u}nger, Jana and Nagel, Eckhard and Akbar, Michael}, publisher = {Schattauer}, address = {Stuttgart}, isbn = {978-3-608-43252-7}, pages = {338 -- 342}, language = {de} } @incollection{Klemperer, author = {Klemperer, David}, title = {Gesundheitsinformationen richtig anbieten und Kompetenzen f{\"o}rdern}, series = {Health Literacy/Gesundheitsf{\"o}rderung - Wissenschaftliche Definitionen, empirische Befunde und gesellschaftlicher Nutzen}, booktitle = {Health Literacy/Gesundheitsf{\"o}rderung - Wissenschaftliche Definitionen, empirische Befunde und gesellschaftlicher Nutzen}, editor = {N{\"o}cker, Guido}, publisher = {Bundeszentrale f{\"u}r Gesundheitliche Aufkl{\"a}rung}, isbn = {978-3-946692-15-7}, pages = {40 -- 45}, abstract = {Der Gedanke, B{\"u}rger und Patienten in ihrer Position im Gesundheitssystem durch Informationen zu st{\"u}tzen und zu st{\"a}rken hat in den letzten zwei Jahrzehnten an Einfluss gewonnen. Hintergrund ist der zunehmende Wunsch nach Selbstbestimmung in Gesundheitsfragen und die schwindende Akzeptanz einer Arzt-Patient-Beziehung, die vom Paternalismus gepr{\"a}gt ist. Der Wunsch und das Bed{\"u}rfnis, sich eigenst{\"a}ndig {\"u}ber Gesundheitsfragen zu informieren sind weit verbreitet, ebenso wie der Wunsch, bei gegebenen unterschiedlichen Behandlungsm{\"o}glichkeiten darin unterst{\"u}tzt zu werden, eine informierte Entscheidung zu treffen. Das Gesundheitssystem in Deutschland ist darauf noch nicht ausreichend vorbereitet. Eine kritische Gesundheitskompetenz auf Seiten von B{\"u}rgern und Patienten bzw. ihren Vertretern stellt ein wichtiges Element zur Durchsetzung der Patientenorientie- rung im Gesundheitswesen dar.}, language = {de} } @incollection{Klemperer, author = {Klemperer, David}, title = {Wem dient die Medizin wirklich? Interessen, Zielkonflikte und Patientenwohl in der Klinik}, series = {Interessen und Gewissen : Moralische Zielkonflikte in der Medizin}, booktitle = {Interessen und Gewissen : Moralische Zielkonflikte in der Medizin}, editor = {Frewer, Andreas and Bergemann, Lutz and J{\"a}ger, Christian}, publisher = {K{\"o}nigshausen \& Neumann}, address = {W{\"u}rzburg}, isbn = {3-8260-6071-7}, pages = {27 -- 50}, language = {de} } @article{HahlwegBieberBruettetal., author = {Hahlweg, Pola and Bieber, Christiane and Br{\"u}tt, Anna Levke and Dierks, Marie-Luise and Dirmaier, J{\"o}rg and Donner-Banzhoff, Norbert and Eich, Wolfgang and Geiger, Friedemann and Klemperer, David and Koch, Klaus and K{\"o}rner, Mirjam and M{\"u}ller, Hardy and Scholl, Isabelle and H{\"a}rter, Martin}, title = {Moving towards patient-centered care and shared decision-making in Germany}, series = {Zeitschrift f{\"u}r Evidenz, Fortbildung und Qualit{\"a}t im Gesundheitswesen}, volume = {171}, journal = {Zeitschrift f{\"u}r Evidenz, Fortbildung und Qualit{\"a}t im Gesundheitswesen}, publisher = {Elsevier}, issn = {1865-9217}, doi = {10.1016/j.zefq.2022.04.001}, pages = {49 -- 57}, abstract = {The main focus of this paper is to describe the development and current state of policy, research and implementation of patient-centered care (PCC) and shared decision-making (SDM) in Germany. What is the current state in health policy? Since 2013, the Law on Patients' Rights has standardized all rights and responsibilities regarding medical care for patients in Germany. This comprises the right to informed decisions, comprehensive and comprehensible information, and decisions based on a clinician-patient partnership. In addition, reports and action plans such as the German Ethics Council's report on patient well-being, the National Health Literacy Action Plan, or the National Cancer Plan emphasize and foster PCC and SDM on a policy level. There are a number of public organizations in Germany that support PCC and SDM. How are patients and the public involved in health policy and research? Publishers and funding agencies increasingly demand patient and public involvement. Numerous initiatives and organizations are involved in publicizing ways to engage patients and the public. Also, an increasing number of public and research institutions have established patient advisory boards. How is PCC and SDM taught? Great progress has been made in introducing SDM into the curricula of medical schools and other health care providers' (HCPs) schools (e.g., nursing, physical therapy). What is the German research agenda? The German government and other public institutions have constantly funded research programs in which PCC and SDM are important topics. This yielded several large-scale funding initiatives and helped to develop SDM training programs for HCPs in different fields of health care and information materials. Recently, two implementation studies on SDM have been conducted. What is the current uptake of PCC and SDM in routine care, and what implementation efforts are underway? Compared to the last country report from 2017, PCC and SDM efforts in policy, research and education have been intensified. However, many steps are still needed to reliably implement SDM in routine care in Germany. Specifically, the further development and uptake of decision tools and countrywide SDM trainings for HCPs require further efforts. Nevertheless, an increasing number of decision support tools - primarily with support from health insurance funds and other public agencies - are to be implemented in routine care. Also, recent implementation efforts are promising. For example, reimbursement by health insurance companies of hospital-wide SDM implementation is being piloted. A necessary next step is to nationally coordinate the gathering and provision of the many PCC and SDM resources available.}, subject = {Patientenorientierte Krankenpflege}, language = {en} } @inproceedings{GerlachSchloesslerSteinbucketal., author = {Gerlach, Navina and Schl{\"o}ßler, Kathrin and Steinbuck, Joana and Bleek, Julian and G{\"u}nster, Christian and Marschall, Ursula and Schneider, Udo and Horenkamp-Sonntag, Dirk and Sundmacher, Leonie and K{\"o}nig, Hans-Helmut and Zeymer, Uwe and Schneider, Steffen and Werdan, Karl and Weber, Michael and Sch{\"a}fer, Corinna and Klemperer, David and Kopp, Ina and Nothacker, Monika and Donner-Banzhoff, Norbert}, title = {104 Reducing unwarranted variations in frequency of coronary angiographies in germany by describing, understanding and modifying local practice}, series = {BMJ Evidence-Based Medicine, Poster and conversation presentations : Preventing Overdiagnosis, Abstracts, August 2018, Copenhagen}, booktitle = {BMJ Evidence-Based Medicine, Poster and conversation presentations : Preventing Overdiagnosis, Abstracts, August 2018, Copenhagen}, publisher = {BMJ Publishing Group Ltd}, doi = {10.1136/bmjebm-2018-111070.104}, abstract = {Objectives Germany has one of the highest numbers of coronary angiography worldwide. Nevertheless, we find a great variation between German regions for both, diagnostic coronary angiographies and percutaneous coronary interventions (PCI). We assume that this variation is not only due to variation in morbidity but also reflects factors such as guideline adherence, physician-patient communication and access to care. In this mixed method project, we aim to first describe the variation of coronary angiographies and PCIs in different German regions. Secondly, we explore current practices and motives for (non-)adherences to guidelines in the diagnostic process of patients with suspected CHD. Based on these results, we consequently plan to develop a complex intervention (treatment pathway) to improve guideline adherence and thus appropriateness of coronary angiography. Method The projects will be organized according to the recommendation of the Medical Research Council for the development and evaluation of complex interventions. The first study will use descriptive methods based on routine data of three German Health Care Insurances and registry data to describe status quo and associated factors of coronary angiography. The second study will use qualitative methods to understand barriers and facilitators of guideline adherence and medical decision making. Furthermore, we will discuss variations in care and thereby identify implementation targets for the planned treatment pathway. Based on this information, we will develop local treatment pathways in four selected regions. Relevant peers will develop the local pathway in group discussions. Using this bottom-up approach, we directly address implementation challenges.}, language = {en} } @article{GrabitzFriedmannGeppetal., author = {Grabitz, Peter and Friedmann, Zoe and Gepp, Sophie and Hess, Leonard U. and Specht, Lisa and Struck, Maja and Tragert, Sophie Kira and Walther, Tobias and Klemperer, David}, title = {Quantity and quality of conflict of interest policies at German medical schools}, series = {BMJ open}, volume = {10}, journal = {BMJ open}, number = {9}, publisher = {BMJ Publishing Group}, doi = {10.1136/bmjopen-2020-039782}, pages = {1 -- 8}, abstract = {OBJECTIVES: To assess the quantity and evaluate the quality of policies and curricula focusing on conflicts of interests (COI) at medical schools across Germany. DESIGN: Cross-sectional study, survey of medical schools, standardised web search. SETTING: Medical schools, Germany. PARTICIPANTS: 38 German medical schools. - INTERVENTIONS: We collected relevant COI policies, including teaching activities, by conducting a search of the websites of all 38 German medical schools using standardised keywords for COI policies and teaching. Further, we surveyed all medical schools' dean's offices. Finally, we adapted a scoring system for results we obtained with 13 categories based on prior similar studies. MAIN OUTCOMES AND MEASURES: Presence or absence of COI-related policies, including teaching activities at medical school. The secondary outcome was the achieved score on a scale from 0 to 26, with high scores representing restrictive policies and sufficient teaching activities. RESULTS: We identified relevant policies for one medical school via the web search. The response rate of the deans' survey was 16 of 38 (42.1\%). In total, we identified COI-related policies for 2 of 38 (5.3\%) German medical schools, yet no policy was sufficient to address all COI-related categories that were assessed in this study. The maximum score achieved was 12 of 26. 36 (94.7\%) schools scored 0. No medical school reported curricular teaching on COI. CONCLUSIONS: Our results indicate a low level of action by medical schools to protect students from undue commercial influence. No participating dean was aware of any curriculum or instruction on COI at the respective school and only two schools had policies in place. The German Medical Students Association and international counterparts have called for a stronger focus on COI in the classroom. We conclude that for German medical schools, there is still a long way to go.}, language = {en} } @article{Klemperer, author = {Klemperer, David}, title = {Interessenkonflikte und Beeinflussung}, series = {Zeitschrift f{\"u}r Evidenz, Fortbildung und Qualit{\"a}t im Gesundheitswesen}, volume = {103}, journal = {Zeitschrift f{\"u}r Evidenz, Fortbildung und Qualit{\"a}t im Gesundheitswesen}, number = {3}, publisher = {Elsevier}, doi = {10.1016/j.zefq.2009.03.023}, pages = {133 -- 135}, language = {de} } @article{Klemperer, author = {Klemperer, David}, title = {Physicians' and Patients' Knowledge of Cancer Screening - A Wake-Up Call}, series = {Oncology research and treatment}, volume = {37}, journal = {Oncology research and treatment}, number = {3}, publisher = {Karger}, doi = {10.1159/000363459}, pages = {8 -- 10}, language = {en} } @article{Klemperer, author = {Klemperer, David}, title = {Patient Involvement as a Means to Improving Care Quality}, series = {Deutsches {\"A}rzteblatt international}, volume = {112}, journal = {Deutsches {\"A}rzteblatt international}, number = {40}, publisher = {{\"A}rzteblatt}, doi = {10.3238/arztebl.2015.0663}, pages = {663 -- 664}, language = {en} } @article{KlempererBauerFranckeetal., author = {Klemperer, David and Bauer, Ullrich and Francke, Robert and Dierks, Marie-Luise and Robra, Bernt-Peter and Rosenbrock, Rolf and Windeler, J{\"u}rgen}, title = {Positionspapier zur Weiterentwicklung der Gesundheitsversorgungsforschung und zu Themen f{\"u}r k{\"u}nftige Ausschreibungen von Forschungsvorhaben}, series = {Public Health Forum}, volume = {23}, journal = {Public Health Forum}, number = {1}, publisher = {De Gruyter}, doi = {10.1515/pubhef-2015-0019}, pages = {47 -- 50}, language = {de} } @article{Klemperer, author = {Klemperer, David}, title = {Positionspapier (Einf{\"u}hrung)}, series = {Public Health Forum}, volume = {23}, journal = {Public Health Forum}, number = {1}, publisher = {De Gruyter}, doi = {10.1515/pubhef-2015-0018}, pages = {46}, language = {de} } @article{Klemperer, author = {Klemperer, David}, title = {Sur- et sous-approvisionnement en m{\´e}decine}, series = {Forum M{\´e}dical Suisse - Swiss Medical Forum}, volume = {15}, journal = {Forum M{\´e}dical Suisse - Swiss Medical Forum}, number = {39}, doi = {10.4414/fms.2015.02416}, pages = {866 -- 871}, language = {de} } @article{StrechFollmannKlempereretal., author = {Strech, Daniel and Follmann, Markus and Klemperer, David and Lelgemann, Monika and Ollenschl{\"a}ger, G{\"u}nter and Raspe, Heiner and Nothacker, Monika}, title = {When Choosing Wisely meets clinical practice guidelines}, series = {Zeitschrift f{\"u}r Evidenz, Fortbildung und Qualit{\"a}t im Gesundheitswesen : ZEFQ = The journal of evidence and quality in health care}, volume = {108}, journal = {Zeitschrift f{\"u}r Evidenz, Fortbildung und Qualit{\"a}t im Gesundheitswesen : ZEFQ = The journal of evidence and quality in health care}, number = {10}, publisher = {Elsevier}, issn = {1865-9217}, doi = {10.1016/j.zefq.2014.10.014}, pages = {601 -- 603}, abstract = {The American Board of Internal Medicine (ABIM) Foundation launched the Choosing Wisely campaign in 2012 and until today convinced more than 50 US specialist societies to develop lists of interventions that may not improve people's health but are potentially harmful. We suggest combining these new efforts with the already existing efforts in clinical practice guideline development. Existing clinical practice guidelines facilitate a more participatory and evidence-based approach to the development of top 5 lists. In return, adding top 5 lists (for overuse and underuse) to existing clinical practice guidelines nicely addresses a neglected dimension to clinical practice guideline development, namely explicit information on which Do or Don't do recommendations are frequently disregarded in practice.}, language = {en} } @misc{NothackerSchaeferGogoletal., author = {Nothacker, Monika and Schaefer, Corinna and Gogol, Manfred and Klemperer, David and Lynen-Jansen, Petra and Kopp, Ina}, title = {Gemeinsam Klug Entscheiden - Initiative der AWMF und ihrer Fachgesellschaften - ein Werkstattberich}, series = {Zeitschrift f{\"u}r Gerontologie und Geriatrie}, volume = {50}, journal = {Zeitschrift f{\"u}r Gerontologie und Geriatrie}, number = {Suppl 1}, publisher = {Springer Nature}, pages = {S9}, abstract = {Gemeinsam Klug Entscheiden ist eine Initiative der AWMF und ihrer Fachgesellschaften, mit dem Ziel, Empfehlungen zu Versorgungsaspek- ten in die Versorgung zu bringen, f{\"u}r die ein großes Verbesserungspoten- tial besteht. Der Impuls daf{\"u}r wurde durch die TOP-5-Listen der Choosing Wisely Kampagne gegeben. Ziel des Posters ist es das Vorgehen und die Methodik f{\"u}r eine evidenzbasierte Entwicklung bekannt zu machen und zu diskutieren im Hinblick auf Machbarkeit und Verbesserungspotential.}, language = {en} } @article{SchottKlempererLieb, author = {Schott, Gisela and Klemperer, David and Lieb, Klaus}, title = {Arzneimittel: Sinnvolle Studien nach der Zulassung}, series = {Deutsches {\"A}rzteblatt}, volume = {118}, journal = {Deutsches {\"A}rzteblatt}, number = {23}, publisher = {Deutscher {\"A}rzteverlag}, address = {Berlin}, pages = {A-1148 / B-945}, abstract = {Die Arzneimittelkommission der deutschen {\"A}rzteschaft erkl{\"a}rt, an welchen Postzulassungsstudien {\"A}rztinnen und {\"A}rzte teilnehmen sollten - und an welchen nicht.}, language = {de} } @article{LempertSchottKoebberlingetal., author = {Lempert, Thomas and Schott, Gisela and K{\"o}bberling, Johannes and Klemperer, David and Lieb, Klaus}, title = {Fortbildungen: Keine Punkte bei Sponsoring}, series = {Deutsches {\"A}rzteblatt}, volume = {116}, journal = {Deutsches {\"A}rzteblatt}, number = {13}, publisher = {Deutscher {\"A}rzteverlag}, address = {Berlin}, pages = {A620 -- A621}, language = {de} } @article{LindertWehrweinKlempereretal., author = {Lindert, Jutta and Wehrwein, Annette and Klemperer, David and Walter, U.}, title = {Public health education in health-related study programs in Germany: Perspectives from course coordinators}, series = {Gesundheitswesen}, volume = {81}, journal = {Gesundheitswesen}, publisher = {Thieme}, doi = {10.1055/s-0043-116940}, pages = {599 -- 605}, abstract = {Hintergrund Inhalte von Public Health werden in Deutschland in gesundheitsbezogenen Studieng{\"a}ngen an Hochschulen und Universit{\"a}ten gelehrt. Ziel dieser Studie war es, Daten zur Lehre und zur Kooperation von Lehrenden von Public Health in gesundheitsbezogenen Studieng{\"a}ngen in Deutschland zur Verf{\"u}gung zu stellen. Methode Eine Querschnittsuntersuchung wurde online-basiert vom 01.06. bis 15.09.2015 an 93 Hochschulen/Universit{\"a}ten in Deutschland mit 351 Studiengangsverantwortlichen aus gesundheitsbezogenen Studieng{\"a}ngen durchgef{\"u}hrt. Einbezogen wurden Public Health Studieng{\"a}nge und gesundheitsbezogene Studieng{\"a}nge, deren Hochschulen bzw. Universit{\"a}ten entweder Mitglied in der "Deutschen Gesellschaft f{\"u}r Sozialmedizin und Pr{\"a}vention" (DGSMP) oder in der Gesellschaft "Hochschulen f{\"u}r Gesundheit" (HOGE) sind. Teilgenommen an dieser Studie haben N=104 Studiengangsverantwortliche (43\% M{\"a}nner, 57\% Frauen). In Public Health Studieng{\"a}ngen wurden „Global Health" und "Umwelt und Gesundheit" als Studieninhalte h{\"a}ufiger als in gesundheitsbezogenen Studieng{\"a}ngen benannt; in gesundheitsbezogenen Studieng{\"a}ngen wurden h{\"a}ufiger "Ethik" und "Gesundheitspsychologie" als Lehrinhalte benannt. Finanzielle Unterst{\"u}tzungen durch die Hochschulen/ Universit{\"a}ten sowie strukturierte Partnerschaften zwischen Hochschulen und/ oder Universit{\"a}ten werden von Lehrenden an Hochschulen (36\%) und an Universit{\"a}ten (40\%) gew{\"u}nscht. Lehrende an Hochschulen w{\"u}nschen dar{\"u}ber hinaus Promotionspartnerschaften. Schlussfolgerung Bisher gibt es in Deutschland keine einheitlichen fachlichen Qualit{\"a}tskriterien f{\"u}r Absolvierende von Public Health bzw. gesundheitsbezogenen Studieng{\"a}ngen. Zudem gibt es nach Aussage der Studiengangsverantwortlichen dieser Studieng{\"a}nge wenig Kooperation zwischen Lehrenden der Public Health bzw. der gesundheitsbezogenen Studieng{\"a}nge.}, language = {en} } @article{HaerterDirmaierScholletal., author = {Haerter, Martin and Dirmaier, J{\"o}rg and Scholl, Isabelle and Donner-Banzhoff, Norbert and Dierks, Marie-Luise and Eich, Wolfgang and M{\"u}ller, Hardy and Klemperer, David and Koch, Klaus and Bieber, Christiane}, title = {The long way of implementing patient-centered care and shared decision making in Germany}, series = {Zeitschrift f{\"u}r Evidenz, Fortbildung und Qualit{\"a}t im Gesundheitswesen}, volume = {123}, journal = {Zeitschrift f{\"u}r Evidenz, Fortbildung und Qualit{\"a}t im Gesundheitswesen}, publisher = {Elsevier}, doi = {10.1016/j.zefq.2017.05.006}, pages = {46 -- 51}, abstract = {The main focus of the paper is on the description of the development and current state of research and implementation of patient-centered care (PCC) and shared decision making (SDM) after fifteen years of substantial advances in health policy and health services research. What is the current state of SDM in health policy? The "Patients' Rights Act" from 2013 standardizes all rights and responsibilities within the framework of medical treatment for German citizens and legal residents. This comprises the right to informed decisions, comprehensive and comprehensible information for patients, and decisions based on a clinician-patient-partnership. What is the current state of SDM interventions and patient decision support tools? SDM training programs for healthcare professionals have been developed. Their implementation in medical schools has been successful. Several decision support tools - primarily with support from health insurance funds and other public agencies - are to be implemented in routine care, specifically for national cancer screening programs. What is the current state of research and routine implementation? The German government and other public institutions are constantly funding research programs in which patient-centered care and shared decision-making are important topics. The development and implementation of decision tools for patients and professionals as well as the implementation of CME trainings for healthcare professionals require future efforts. What does the future look like? With the support of health policy and scientific evidence, transfer of PCC and SDM to practice is regarded as meaningful. Research can help to assess barriers, facilitators, and needs, and subsequently to develop and evaluate corresponding strategies to successfully implement PCC and SDM in routine care, which remains challenging.}, language = {en} } @incollection{KlempererKuhnRobra, author = {Klemperer, David and Kuhn, Joseph and Robra, Bernt-Peter}, title = {Pandemiemanagement durch nicht-pharmakologische Interventionen in der COVID-19-Pandemie}, series = {Leitbegriffe der Gesundheitsf{\"o}rderung und Pr{\"a}vention: Glossar zu Konzepten, Strategien und Methoden}, booktitle = {Leitbegriffe der Gesundheitsf{\"o}rderung und Pr{\"a}vention: Glossar zu Konzepten, Strategien und Methoden}, organization = {Bundeszentrale f{\"u}r gesundheitliche Aufkl{\"a}rung (BZgA)}, doi = {10.17623/BZGA:Q4-LBPGF-23}, abstract = {Nicht-pharmakologische Interventionen (NPIs) sind Public Health-Interventionen ohne Einsatz von Medikamenten oder Impfstoffen mit dem Ziel, die Ausbreitung eines Krankheitserregers zu reduzieren. Im Zusammenhang mit der SARS-CoV-2-Pandemie wurden vor allem Maßnahmen ergriffen, um {\"u}bertragungsrelevante Kontakte zu reduzieren oder sicherer zu machen. Die Wirksamkeit einzelner Maßnahmen auf Bev{\"o}lkerungsebene ist schwer zu beurteilen, die von Maßnahmenb{\"u}ndeln kann als gesichert gelten. Die rechtlichen Grundlagen f{\"u}r die grundrechtseinschr{\"a}nkenden Maßnahmen erscheinen noch nicht gesichert.}, language = {de} }