TY - CHAP A1 - Gerlach, Navina A1 - Schlößler, Kathrin A1 - Steinbuck, Joana A1 - Bleek, Julian A1 - Günster, Christian A1 - Marschall, Ursula A1 - Schneider, Udo A1 - Horenkamp-Sonntag, Dirk A1 - Sundmacher, Leonie A1 - König, Hans-Helmut A1 - Zeymer, Uwe A1 - Schneider, Steffen A1 - Werdan, Karl A1 - Weber, Michael A1 - Schäfer, Corinna A1 - Klemperer, David A1 - Kopp, Ina A1 - Nothacker, Monika A1 - Donner-Banzhoff, Norbert T1 - 104 Reducing unwarranted variations in frequency of coronary angiographies in germany by describing, understanding and modifying local practice T2 - BMJ Evidence-Based Medicine, Poster and conversation presentations : Preventing Overdiagnosis, Abstracts, August 2018, Copenhagen N2 - 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. Y1 - 2018 U6 - https://doi.org/10.1136/bmjebm-2018-111070.104 PB - BMJ Publishing Group Ltd ER - TY - JOUR A1 - Strech, Daniel A1 - Follmann, Markus A1 - Klemperer, David A1 - Lelgemann, Monika A1 - Ollenschläger, Günter A1 - Raspe, Heiner A1 - Nothacker, Monika T1 - When Choosing Wisely meets clinical practice guidelines JF - Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen : ZEFQ = The journal of evidence and quality in health care N2 - 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. T2 - Wenn "Choosing Wisely" auf Leitlinien trifft Y1 - 2014 U6 - https://doi.org/10.1016/j.zefq.2014.10.014 SN - 1865-9217 SN - 2212-0289 VL - 108 IS - 10 SP - 601 EP - 603 PB - Elsevier ER - TY - GEN A1 - Nothacker, Monika A1 - Schaefer, Corinna A1 - Gogol, Manfred A1 - Klemperer, David A1 - Lynen-Jansen, Petra A1 - Kopp, Ina T1 - Gemeinsam Klug Entscheiden – Initiative der AWMF und ihrer Fachgesellschaften – ein Werkstattberich T2 - Zeitschrift für Gerontologie und Geriatrie N2 - Gemeinsam Klug Entscheiden ist eine Initiative der AWMF und ihrer Fachgesellschaften, mit dem Ziel, Empfehlungen zu Versorgungsaspek- ten in die Versorgung zu bringen, für die ein großes Verbesserungspoten- tial besteht. Der Impuls dafür wurde durch die TOP-5-Listen der Choosing Wisely Kampagne gegeben. Ziel des Posters ist es das Vorgehen und die Methodik für eine evidenzbasierte Entwicklung bekannt zu machen und zu diskutieren im Hinblick auf Machbarkeit und Verbesserungspotential. Y1 - 2017 VL - 50 IS - Suppl 1 SP - S9 PB - Springer Nature ER -