TY - JOUR A1 - Hahlweg, Pola A1 - Bieber, Christiane A1 - Brütt, Anna Levke A1 - Dierks, Marie-Luise A1 - Dirmaier, Jörg A1 - Donner-Banzhoff, Norbert A1 - Eich, Wolfgang A1 - Geiger, Friedemann A1 - Klemperer, David A1 - Koch, Klaus A1 - Körner, Mirjam A1 - Müller, Hardy A1 - Scholl, Isabelle A1 - Härter, Martin T1 - Moving towards patient-centered care and shared decision-making in Germany JF - Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen N2 - 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. KW - Patientenorientierte Krankenpflege KW - Entscheidungsfindung KW - Patient KW - Deutschland KW - Gesundheitswesen KW - Patient-centered care KW - Patient involvement KW - Shared decision-making KW - Health policy KW - Implementation Y1 - 2022 U6 - https://doi.org/10.1016/j.zefq.2022.04.001 SN - 1865-9217 VL - 171 SP - 49 EP - 57 PB - Elsevier ER - 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 - Grabitz, Peter A1 - Friedmann, Zoe A1 - Gepp, Sophie A1 - Hess, Leonard U. A1 - Specht, Lisa A1 - Struck, Maja A1 - Tragert, Sophie Kira A1 - Walther, Tobias A1 - Klemperer, David T1 - Quantity and quality of conflict of interest policies at German medical schools BT - a cross-sectional study and survey JF - BMJ open N2 - 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. KW - Conflict of Interest KW - Cross-Sectional Studies KW - Curriculum KW - Germany KW - Humans KW - Policy KW - Schools, Medical Y1 - 2020 U6 - https://doi.org/10.1136/bmjopen-2020-039782 VL - 10 IS - 9 SP - 1 EP - 8 PB - BMJ Publishing Group ER - TY - JOUR A1 - Klemperer, David T1 - Interessenkonflikte und Beeinflussung JF - Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen Y1 - 2009 U6 - https://doi.org/10.1016/j.zefq.2009.03.023 VL - 103 IS - 3 SP - 133 EP - 135 PB - Elsevier ER - TY - JOUR A1 - Klemperer, David T1 - Physicians' and Patients' Knowledge of Cancer Screening - A Wake-Up Call JF - Oncology research and treatment KW - Overdiagnosis KW - United States Y1 - 2014 U6 - https://doi.org/10.1159/000363459 VL - 37 IS - 3 SP - 8 EP - 10 PB - Karger ER - TY - JOUR A1 - Klemperer, David T1 - Patient Involvement as a Means to Improving Care Quality JF - Deutsches Ärzteblatt international Y1 - 2015 U6 - https://doi.org/10.3238/arztebl.2015.0663 VL - 112 IS - 40 SP - 663 EP - 664 PB - Ärzteblatt ER - TY - JOUR A1 - Klemperer, David A1 - Bauer, Ullrich A1 - Francke, Robert A1 - Dierks, Marie-Luise A1 - Robra, Bernt-Peter A1 - Rosenbrock, Rolf A1 - Windeler, Jürgen T1 - Positionspapier zur Weiterentwicklung der Gesundheitsversorgungsforschung und zu Themen für künftige Ausschreibungen von Forschungsvorhaben JF - Public Health Forum Y1 - 2015 U6 - https://doi.org/10.1515/pubhef-2015-0019 VL - 23 IS - 1 SP - 47 EP - 50 PB - De Gruyter ER - TY - JOUR A1 - Klemperer, David T1 - Positionspapier (Einführung) JF - Public Health Forum Y1 - 2015 U6 - https://doi.org/10.1515/pubhef-2015-0018 VL - 23 IS - 1 PB - De Gruyter ER - TY - JOUR A1 - Klemperer, David T1 - Sur- et sous-approvisionnement en médecine JF - Forum Médical Suisse - Swiss Medical Forum Y1 - 2015 U6 - https://doi.org/10.4414/fms.2015.02416 VL - 15 IS - 39 SP - 866 EP - 871 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 - TY - JOUR A1 - Schott, Gisela A1 - Klemperer, David A1 - Lieb, Klaus T1 - Arzneimittel: Sinnvolle Studien nach der Zulassung JF - Deutsches Ärzteblatt N2 - Die Arzneimittelkommission der deutschen Ärzteschaft erklärt, an welchen Postzulassungsstudien Ärztinnen und Ärzte teilnehmen sollten – und an welchen nicht. T2 - Drugs: Useful trials after the approval Y1 - 2021 UR - https://www.aerzteblatt.de/archiv/219443/Arzneimittel-Sinnvolle-Studien-nach-der-Zulassung VL - 118 IS - 23 SP - A-1148 / B-945 PB - Deutscher Ärzteverlag CY - Berlin ER - TY - JOUR A1 - Lempert, Thomas A1 - Schott, Gisela A1 - Köbberling, Johannes A1 - Klemperer, David A1 - Lieb, Klaus T1 - Fortbildungen: Keine Punkte bei Sponsoring JF - Deutsches Ärzteblatt T2 - Continuing education: No credits in sponsoring Y1 - 2019 VL - 116 IS - 13 SP - A620 EP - A621 PB - Deutscher Ärzteverlag CY - Berlin ER - TY - JOUR A1 - Lindert, Jutta A1 - Wehrwein, Annette A1 - Klemperer, David A1 - Walter, U. T1 - Public health education in health-related study programs in Germany: Perspectives from course coordinators JF - Gesundheitswesen N2 - Hintergrund Inhalte von Public Health werden in Deutschland in gesundheitsbezogenen Studiengängen an Hochschulen und Universitäten gelehrt. Ziel dieser Studie war es, Daten zur Lehre und zur Kooperation von Lehrenden von Public Health in gesundheitsbezogenen Studiengängen in Deutschland zur Verfügung zu stellen. Methode Eine Querschnittsuntersuchung wurde online-basiert vom 01.06. bis 15.09.2015 an 93 Hochschulen/Universitäten in Deutschland mit 351 Studiengangsverantwortlichen aus gesundheitsbezogenen Studiengängen durchgeführt. Einbezogen wurden Public Health Studiengänge und gesundheitsbezogene Studiengänge, deren Hochschulen bzw. Universitäten entweder Mitglied in der "Deutschen Gesellschaft für Sozialmedizin und Prävention" (DGSMP) oder in der Gesellschaft "Hochschulen für Gesundheit" (HOGE) sind. Teilgenommen an dieser Studie haben N=104 Studiengangsverantwortliche (43% Männer, 57% Frauen). In Public Health Studiengängen wurden „Global Health" und "Umwelt und Gesundheit" als Studieninhalte häufiger als in gesundheitsbezogenen Studiengängen benannt; in gesundheitsbezogenen Studiengängen wurden häufiger "Ethik" und "Gesundheitspsychologie" als Lehrinhalte benannt. Finanzielle Unterstützungen durch die Hochschulen/ Universitäten sowie strukturierte Partnerschaften zwischen Hochschulen und/ oder Universitäten werden von Lehrenden an Hochschulen (36%) und an Universitäten (40%) gewünscht. Lehrende an Hochschulen wünschen darüber hinaus Promotionspartnerschaften. Schlussfolgerung Bisher gibt es in Deutschland keine einheitlichen fachlichen Qualitätskriterien für Absolvierende von Public Health bzw. gesundheitsbezogenen Studiengängen. Zudem gibt es nach Aussage der Studiengangsverantwortlichen dieser Studiengänge wenig Kooperation zwischen Lehrenden der Public Health bzw. der gesundheitsbezogenen Studiengänge. T2 - Lehre von Public Health in gesundheitsbezogenen Studiengängen in Deutschland: die Sicht von Studiengangsverantwortlichen KW - public hearlth KW - gesundheitsbezogene Studiengänge KW - Lehre Y1 - 2019 U6 - https://doi.org/10.1055/s-0043-116940 VL - 81 SP - 599 EP - 605 PB - Thieme ER - TY - JOUR A1 - Haerter, Martin A1 - Dirmaier, Jörg A1 - Scholl, Isabelle A1 - Donner-Banzhoff, Norbert A1 - Dierks, Marie-Luise A1 - Eich, Wolfgang A1 - Müller, Hardy A1 - Klemperer, David A1 - Koch, Klaus A1 - Bieber, Christiane T1 - The long way of implementing patient-centered care and shared decision making in Germany JF - Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen N2 - 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. KW - COMMUNICATION KW - DISORDERS KW - health policy KW - implementation KW - INFORMATION KW - MANAGEMENT KW - MULTIPLE-SCLEROSIS KW - NEEDS KW - patient involvement KW - patient-centered care KW - PHYSICIANS KW - PSYCHOMETRIC PROPERTIES KW - QUESTIONNAIRE KW - SATISFACTION KW - shared decision making Y1 - 2017 U6 - https://doi.org/10.1016/j.zefq.2017.05.006 VL - 123 SP - 46 EP - 51 PB - Elsevier ER - TY - CHAP A1 - Klemperer, David A1 - Kuhn, Joseph A1 - Robra, Bernt-Peter T1 - Pandemiemanagement durch nicht-pharmakologische Interventionen in der COVID-19-Pandemie T2 - Leitbegriffe der Gesundheitsförderung und Prävention: Glossar zu Konzepten, Strategien und Methoden N2 - 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 übertragungsrelevante Kontakte zu reduzieren oder sicherer zu machen. Die Wirksamkeit einzelner Maßnahmen auf Bevölkerungsebene ist schwer zu beurteilen, die von Maßnahmenbündeln kann als gesichert gelten. Die rechtlichen Grundlagen für die grundrechtseinschränkenden Maßnahmen erscheinen noch nicht gesichert. KW - COVID-19 KW - SARS-CoV-2 KW - Coronavirus KW - Pandemiemanagement KW - Nicht-pharmakologische Maßnahmen Y1 - 2023 U6 - https://doi.org/10.17623/BZGA:Q4-LBPGF-23 ER -