Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen最新文献

{"title":"Chancen und Herausforderungen der Digitalisierung der Arzneimittelversorgung: eine qualitative Studie mit relevanten ExpertInnen","authors":"Christopher Johannes Preetz,&nbsp;Michaela Hesse,&nbsp;Martin Mücke,&nbsp;Gülay Ateş","doi":"10.1016/j.zefq.2025.06.003","DOIUrl":"10.1016/j.zefq.2025.06.003","url":null,"abstract":"<div><h3>Background</h3><div>The supply of pharmaceuticals is undergoing structural change due to internet mail orders, a shortage of skilled workers, and the decreasing density of community pharmacies. Since January 1, 2024, Germany also has an electronic prescription procedure, the e-prescription. This study aims to answer the question how digitalization has changed access to pharmaceuticals.</div></div><div><h3>Methods</h3><div>Semi-structured expert interviews were conducted between September 2023 and March 2024. Relevant experts were identified and surveyed about their experience with the influence of digitalization that has so far been observed, about its practicality, and their expectations and outlook regarding the consequences for the supply of medicines. Therefore, only experts from self-governing bodies, the Gematik GmbH, payers, and patient representatives were selected. The interviews were recorded and transcribed. The transcripts were analyzed using MAXQDA.</div></div><div><h3>Results</h3><div>A total of 9 interviews were conducted. Regarding the effects of digitalization on patient care provided by community and mail order pharmacies, the experts overall regarded mail order pharmacies as high-performance companies that comply with the safety principles required in the pharmaceutical trade. All experts could see the mail order trade’s impact on the density of community pharmacies. The shortage of skilled workers was confirmed by all experts, and digitalization can help mitigate this problem. However, an excessive expansion of mail order companies can disadvantage patients. Concerning e-prescriptions, the expert interviews revealed that e-prescriptions and the telematics infrastructure (TI) are still experiencing difficulties. Despite the costs, the experts surveyed believe that improvements in patient care and patient safety will enhance patient rights.</div></div><div><h3>Discussion</h3><div>Digitization has a beneficial effect by increasing access to pharmaceutical care. People can access medicines more easily through mail orders and e-prescriptions depending on how they are dispensed. However, some groups of people do not benefit from the new advantages, resulting in the need to further reduce this imbalance in the future. The preservation of community pharmacies for the purpose of individual advice and emergency pharmacy services is another challenge that we have to face as a result of digitalization.</div></div><div><h3>Conclusion</h3><div>The e-prescription still has its shortcomings and is currently testing the patience of doctors, pharmacists, and prescription recipients. If stable, it will improve both patient care and patient safety. Future studies will need to demonstrate that the access-to-medicines gap can be filled and technical difficulties further reduced.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"197 ","pages":"Pages 10-18"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erhebung der Arbeitsbelastung in der hausärztlichen Versorgung während der SARS-CoV-2-Pandemie – eine „Proof-of-Concept“-Studie","authors":"Thomas Kloppe ,&nbsp;Jan Hendrik Oltrogge-Abiry ,&nbsp;Maren Ehrhardt,&nbsp;Dagmar Lühmann,&nbsp;Thomas Zimmermann,&nbsp;Martin Scherer","doi":"10.1016/j.zefq.2025.07.003","DOIUrl":"10.1016/j.zefq.2025.07.003","url":null,"abstract":"<div><h3>Objective</h3><div>One of the conclusions from the experience with the SARS-CoV-2 pandemic of 2020 to 2022 was the requirement for data on primary care/ambulatory care to assess the severity of the pandemic in a timely manner. Since most patients with COVID-19 in Germany had been primarily cared for by general practitioners, the question arose whether the incidence course of a pandemic can be mapped by means of a regular evaluation of GP workload and number of patients.</div></div><div><h3>Methods</h3><div>From January 2021 to June 2021, 12 replicative, internet-based cross-sectional surveys were conducted fortnightly. Invitations were sent out to all members of the German Society of General Practice/Family Medicine (DEGAM) and selected federal/regional member organizations of the German Association of General Practitioners. They were asked about increases in personal workload, number of patients with COVID-19, and other conditions of patient care.</div></div><div><h3>Results</h3><div>On average, 697 general practitioners (GPs) participated in each survey and completed a total of 8,369 questionnaires. The composition of participants remained consistent across the 12 survey periods, with 82.9–87.2 % being practice owners and 32.0–40.7 % working in group practices. Over time, the proportion of physicians reporting an increased workload reached a minimum of 24.2 % in February 2021; from March 2021 onward, there was a trend reversal with a peak (88.1 %) in May 2021. The change in the GPs’ workload developed in phases that ran parallel to the official RKI reporting data on the COVID-19 incidence. The reported increase in the care deficit for patients with chronic diseases or social problems did not show a temporal dynamic comparable to the reported incidence trend.</div></div><div><h3>Discussion</h3><div>A replicative survey among GPs conducted between January 2021 and June 2021 revealed changes in the workload of general practitioners under pandemic conditions. The progression of the SARS-CoV-2 pandemic during the same period and the observed change in workload developed in parallel. The methodology used (an internet-based, replicative survey among GPs) could therefore be a low-threshold, resource-saving approach to assessing the course of a pandemic. Despite the increasing workload during the different waves of the pandemic, the care for chronically ill patients reported by the GPs was not subject to any pandemic-related dynamics.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"197 ","pages":"Pages 38-46"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inhaltsverzeichnis / Table of Contents","authors":"","doi":"10.1016/S1865-9217(25)00184-9","DOIUrl":"10.1016/S1865-9217(25)00184-9","url":null,"abstract":"","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"197 ","pages":"Pages iii-iv"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Taking a look behind the scenes: Updating health information on Gesundheitsinformation.de","authors":"Milly Schröer-Günther,&nbsp;Klaus Koch,&nbsp;Inger Scheike","doi":"10.1016/j.zefq.2025.04.002","DOIUrl":"10.1016/j.zefq.2025.04.002","url":null,"abstract":"<div><div>The website Gesundheitsinformation.de and its English sister website InformedHealth.org are a service of the Institute for Quality and Efficiency in Health Care<span> (IQWiG). IQWiG has the legal mandate to provide all citizens with independent and scientifically proven free health information. The website currently comprises information on more than 300 diseases and health issues (“topics”). Evidence-based medicine (EBM) forms the base of Gesundheitsinformation.de. Regular updates are therefore an important quality criterion. Usually, the information is updated every three years. The paper will describe a major update process of the individual topics on Gesundheitsinformation.de. The major process includes 10 steps (e.g., evidence search, medical writing, editorial revisions, and translation). The updating process is currently being reviewed to see whether the effort required for individual tasks can be reduced. The aim is to update/produce more health information with the same resources and without any loss of quality.</span></div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"197 ","pages":"Pages 73-76"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Herausgeberkollegium / Editorial Board","authors":"","doi":"10.1016/S1865-9217(25)00183-7","DOIUrl":"10.1016/S1865-9217(25)00183-7","url":null,"abstract":"","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"197 ","pages":"Page ii"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gut und kosteneffektiv palliativ versorgt in Westfalen-Lippe – aber warum? Ergebnisse einer Mixed-Methods Studie","authors":"Anastasia Suslow ,&nbsp;Nino Chikhradze ,&nbsp;Bianka Ditscheid ,&nbsp;Chantal Giehl ,&nbsp;Horst Christian Vollmar ,&nbsp;Antje Freytag ,&nbsp;Ina Carola Otte","doi":"10.1016/j.zefq.2025.06.001","DOIUrl":"10.1016/j.zefq.2025.06.001","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;The organization of palliative care in Germany varies from region to region. Previous studies show that palliative care in Westphalia-Lippe (WL) – measured by quality and cost indicators – performs better than in other regions. The Westphalian model for outpatient care emphasizes a close cooperation between general practitioners (GPs) and palliative care consultation services (PCS). The basis is a contractual regulation of general and specialized care within a joint outpatient palliative care contract according to Sect. 140a SGB V. The VESPAL study (on the &lt;em&gt;Quality of care in outpatient palliative care based on the example of Westphalia-Lippe&lt;/em&gt;), which was funded by the Professional Association of Palliative Care Physicians in Westfalen-Lippe (Berufsverband der Palliativmediziner in Westfalen-Lippe e.V.) and the Association of Statutory Health Insurance Physicians (Kassenärztliche Vereinigung Westfalen-Lippe e.V.), was conducted between 02/2022 and 07/2023 and examined which characteristics of outpatient palliative care in WL could be identified from the correlation of quantitative key figures with qualitative interview quotes that might contribute to high-quality care and cost-effectiveness.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;A complex mixed-methods design was applied. Quantitative and qualitative data were collected and analyzed simultaneously, were used as a basis for further qualitative research, and then merged (QUAL+QUAN → QUAL). The quantitative data were derived from a routine data analysis on the utilization and quality of palliative care from data of deceased patients who had been covered by the BARMER health insurance, while qualitative data were obtained using five non-participant observations, interviews with 50 care providers (general practitioners, palliative care physicians, coordinators, nurses), and three focus groups. Both data sets were analyzed independently, with the quantitative results being complemented by qualitative insights to provide a more comprehensive understanding of the WL care model.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The quantitative parameters used to measure the quality of care included, in particular: the hospital as place of death, the number of hospital cases, and the number of ambulance call-outs in the last 30 days of life. The qualitative study results show that these parameters can be improved by a close cooperation and specific arrangements with emergency services and nursing homes. According to the interviewees, the typical Westphalian organization of cooperation between doctors and PCS enables providers to respond quickly and provide care which is focused on the needs of patients and their relatives and can be flexibly “ramped up and down”. Providers emphasized the flexibility of the model, the close cooperation, and the lack of competitive pressure from each other as reasons for the high quality of care perceived.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;The r","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"197 ","pages":"Pages 19-29"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abschlusseditorial","authors":"Waldemar Siemens ,&nbsp;Claudia Breuer ,&nbsp;Jörg J. Meerpohl","doi":"10.1016/j.zefq.2025.06.006","DOIUrl":"10.1016/j.zefq.2025.06.006","url":null,"abstract":"","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"197 ","pages":"Pages 77-78"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144761703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial: Digitization and artificial intelligence in healthcare - Gamechanger or nightmare?","authors":"Gerald Sendlhofer, Karin Wolf-Ostermann","doi":"10.1016/j.zefq.2025.08.001","DOIUrl":"https://doi.org/10.1016/j.zefq.2025.08.001","url":null,"abstract":"","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Applying qualitative comparative analysis in a systematic review: Lessons learned","authors":"Dorothee Bauernschmidt ,&nbsp;Janina Wittmann ,&nbsp;Julian Hirt ,&nbsp;Gabriele Meyer ,&nbsp;Anja Bieber","doi":"10.1016/j.zefq.2025.03.013","DOIUrl":"10.1016/j.zefq.2025.03.013","url":null,"abstract":"<div><h3>Background</h3><div>Evidence synthesis of primary studies assessing complex interventions poses challenges due to the heterogeneity of study populations, interventions, outcomes, or study designs. Qualitative comparative analysis (QCA) aims to identify conditions or combinations of conditions that lead to a specific outcome and may be an appropriate instrument to deal with heterogeneity and complexity.</div></div><div><h3>Objective</h3><div>We aimed to describe the lessons learned when applying QCA in a systematic review on technology-based counselling interventions in dementia.</div></div><div><h3>Methods</h3><div>The lessons learned were generated through research team reflection and discussion of the challenges and problems encountered in the process of applying the initial steps of the QCA. As the QCA remained incomplete, a brief account of aspects to be considered when using QCA methodology for data synthesis within a systematic review is presented.</div></div><div><h3>Results</h3><div>The lessons learned comprise the importance of clear eligibility criteria representing the core elements of interventions and the need for a consistent dataset based on sufficient reporting and suitable publication types. We also recommend adoption of a multi-perspective view by integrating theoretical and practical knowledge.</div></div><div><h3>Conclusion</h3><div>QCA may increase knowledge gain in systematic reviews by capturing the complexity of interventions and contexts. An adequate dataset is needed to enable systematic comparison. To achieve this, adherence to frameworks guiding the development, implementation, and evaluation of complex interventions as well as to reporting guidelines is essential.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"196 ","pages":"Pages 82-86"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kommunikation, Kooperation und Austausch mit Psychotherapeut*innen aus der Sicht von Primärversorger*innen – Befragungsergebnisse im Rahmen des Projekts „Evaluation der Psychotherapie-Richtlinie“","authors":"Pauline Birte Schlesiger ,&nbsp;Jürgen Wasem ,&nbsp;Luisa Friedrich ,&nbsp;Sandra Werner ,&nbsp;Sarah Schlierenkamp ,&nbsp;Gerald Lux ,&nbsp;Anke Walendzik ,&nbsp;Carina Abels ,&nbsp;Klemens Höfer ,&nbsp;Kathrin Klipker ,&nbsp;Ursula Marschall ,&nbsp;Dieter Best ,&nbsp;Christa Schaff ,&nbsp;Helene Timmermann ,&nbsp;Silke Neusser","doi":"10.1016/j.zefq.2025.04.005","DOIUrl":"10.1016/j.zefq.2025.04.005","url":null,"abstract":"<div><h3>Background</h3><div>General practitioners (GPs) and psychotherapists fulfill a variety of functions in the care for individuals with mental illness. However, little is currently known about the exchange and communication between these two groups. To address this gap, an exploratory study has been conducted from the perspective of primary care providers to analyze the nature of exchange and communication with psychotherapists.</div></div><div><h3>Methodology</h3><div>A standardized cross-sectional survey was conducted among primary care providers for adults (PEW) and children/adolescents (PKJ) as part of the ’Evaluation of the Psychotherapy Guideline’ project. In July 2021, a random sample from the pool of a target group of specialists with N = 1,700 people from each group were contacted by mail. Another random sample of N = 1,700 from each group was contacted in November 2021. The survey questionnaire included, among other things, questions about the exchange with psychotherapists. The exploratory analysis was descriptive.</div></div><div><h3>Results</h3><div>A total of N = 255 and N = 444 valid survey questionnaires from PEW and PKJ was analyzed. The majority of primary care providers are over 50 years old (PEW 72.8%; PKJ 62.0%), and more than half are female (PEW 53.8%; PKJ 53.7%). As reported by PEW, the primary modes of communication and exchange with psychotherapists are via written correspondence (20.4%) and telephone (18.0%). For PKJ, the predominant mode of communication is by phone (22.6%). The majority of primary care providers expressed their dissatisfaction with the exchange with psychotherapists, with the highest rates being observed during (PEW 60.8%; PKJ 47.4%) and after referral (PEW 57.4%; PKJ 49.2%). Satisfaction is influenced by a number of factors, including integration into networks, which has been shown to have a positive effect.</div></div><div><h3>Conclusion</h3><div>The cross-sectional survey provides insight into the communication and collaboration between primary care providers and psychotherapists. To facilitate improvements, further research is needed on the barriers to interdisciplinary cooperation and communication.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"196 ","pages":"Pages 53-64"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}