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  1. Article ; Online: Quality of care in patients with hypertension: a retrospective cohort study of primary care routine data in Germany.

    Strumann, Christoph / Engler, Nicola J / von Meissner, Wolfgang C G / Blickle, Paul-Georg / Steinhäuser, Jost

    BMC primary care

    2024  Volume 25, Issue 1, Page(s) 54

    Abstract: Background: Hypertension is a leading cause of morbidity and mortality if not properly managed. Primary care has a major impact on these outcomes if its strengths, such as continuity of care, are deployed wisely. The analysis aimed to evaluate the ... ...

    Abstract Background: Hypertension is a leading cause of morbidity and mortality if not properly managed. Primary care has a major impact on these outcomes if its strengths, such as continuity of care, are deployed wisely. The analysis aimed to evaluate the quality of care for newly diagnosed hypertension in routine primary care data.
    Methods: In the retrospective cohort study, routine data (from 2016 to 2022) from eight primary care practices in Germany were exported in anonymized form directly from the electronic health record (EHR) systems and processed for this analysis. The analysis focused on five established quality indicators for the care of patients who have been recently diagnosed with hypertension.
    Results: A total of 30,691 patients were treated in the participating practices, 2,507 of whom have recently been diagnosed with hypertension. Prior to the pandemic outbreak, 19% of hypertensive patients had blood pressure above 140/90 mmHg and 68% received drug therapy (n = 1,372). After the pandemic outbreak, the proportion of patients with measured blood pressure increased from 63 to 87%, while the other four indicators remained relatively stable. Up to 80% of the total variation of the quality indicators could be explained by individual practices.
    Conclusion: For the majority of patients, diagnostic procedures are not used to the extent recommended by guidelines. The analysis showed that quality indicators for outpatient care could be mapped onto the basis of routine data. The results could easily be reported to the practices in order to optimize the quality of care.
    MeSH term(s) Humans ; Retrospective Studies ; Hypertension/diagnosis ; Hypertension/drug therapy ; Hypertension/epidemiology ; Blood Pressure ; Vital Signs ; Primary Health Care
    Language English
    Publishing date 2024-02-11
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 2731-4553
    ISSN (online) 2731-4553
    DOI 10.1186/s12875-024-02285-9
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Notfälle in der Hausarztpraxis – Zusammenarbeit mit dem Rettungsdienst

    Kuhnke, Rico / Cittadino, Jonas / von Meißner, Wolfgang C.G.

    Allgemeinmedizin up2date

    2023  Volume 04, Issue 01, Page(s) 57–75

    Keywords Hausarztpraxis ; Notfalltriage ; Algorithmen ; Schnittstelle ; Rettungsdienst
    Language German
    Publishing date 2023-02-01
    Publisher Georg Thieme Verlag KG
    Publishing place Stuttgart ; New York
    Document type Article
    ISSN 2699-870X ; 2699-8696
    ISSN (online) 2699-870X
    ISSN 2699-8696
    DOI 10.1055/a-1449-1914
    Database Thieme publisher's database

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  3. Article: Kommunikationstheorie ganz praktisch – das Patientengespräch

    Kuhnke, Rico / von Meißner, Wolfgang C.G.

    retten!

    2023  Volume 12, Issue 02, Page(s) 86–90

    Language German
    Publishing date 2023-04-01
    Publisher Georg Thieme Verlag KG
    Publishing place Stuttgart ; New York
    Document type Article
    ISSN 2193-2395 ; 2193-2387
    ISSN (online) 2193-2395
    ISSN 2193-2387
    DOI 10.1055/a-1967-7210
    Database Thieme publisher's database

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  4. Article: Kommunikationstheorie ganz praktisch – Schnittstellen

    Kuhnke, Rico / von Meißner, Wolfgang C.G.

    retten!

    2022  Volume 11, Issue 04, Page(s) 250–255

    Language German
    Publishing date 2022-09-01
    Publisher Georg Thieme Verlag KG
    Publishing place Stuttgart ; New York
    Document type Article
    ISSN 2193-2395 ; 2193-2387
    ISSN (online) 2193-2395
    ISSN 2193-2387
    DOI 10.1055/a-1737-9171
    Database Thieme publisher's database

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  5. Article ; Online: The use of routine data from primary care practices in Germany to analyze the impact of the outbreak of SARS-CoV-2 on the utilization of primary care services for patients with type 2 diabetes mellitus.

    Strumann, Christoph / Blickle, Paul-Georg / von Meißner, Wolfgang C G / Steinhäuser, Jost

    BMC primary care

    2022  Volume 23, Issue 1, Page(s) 327

    Abstract: Background: Routinely collected health data from ambulatory care providers offer a wide range of research opportunities. However, the access is often (e.g., technically) hindered, particularly in Germany. In the following, we describe the development of ...

    Abstract Background: Routinely collected health data from ambulatory care providers offer a wide range of research opportunities. However, the access is often (e.g., technically) hindered, particularly in Germany. In the following, we describe the development of an infrastructure for the analysis of pseudonymized routine data extracted from primary care practices in Germany. Further, we analyze the impact of the outbreak of SARS-CoV-2 on the utilization of primary care services for patients with type 2 diabetes mellitus (DM type 2).
    Methods: In this retrospective cohort study, routine data were extracted from nine private primary care practices before and since the outbreak of SARS-CoV-2 in Germany. The sample consisted of patients who were treated between 2016 and 2022 in one of the participating practices. The effects of the outbreak on the frequency of practice visits and the disease course of DM type 2 patients were analyzed by means of bivariate and multivariate analyses.
    Results: The developed infrastructure offers an analysis of routine data from outpatient care within 24 h. In total, routine data of 30,734 patients could be processed for the analyses with 4182 (13.6%) patients having a diagnosed DM type 2 and 59.0% of these patients were enrolled in a disease management program (DMP). In the multivariate analysis, there was a significant negative effect of the SARS-CoV-2 outbreak on utilization of outpatient services of patients with DM type 2 disease. This decrease was less pronounced among DMP patients. The glycated haemoglobin level (HbA1c) has not changed significantly.
    Conclusions: The study showed that the analysis of routine data from outpatient care in Germany is possible in a timely manner using a special developed electronic health record system and corresponding software. The significantly negative effect of the SARS-CoV-2 outbreak on utilization of outpatient services of patients with DM type 2 disease was less pronounced among DMP patients. Two years after the start of the Covid pandemic a significantly worsened course of illness cannot be observed. However, it must be taken into account that the observation period for clinically relevant outcomes is still relatively short.
    Language English
    Publishing date 2022-12-16
    Publishing country England
    Document type Journal Article
    ISSN 2731-4553
    ISSN (online) 2731-4553
    DOI 10.1186/s12875-022-01945-y
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Dokumentation in der Hausarztpraxis

    Chenot, Jean-François / von Meißner, Wolfgang C.G.

    Allgemeinmedizin up2date

    2021  Volume 02, Issue 04, Page(s) 359–371

    Language German
    Publishing date 2021-11-01
    Publisher Georg Thieme Verlag KG
    Publishing place Stuttgart ; New York
    Document type Article
    ISSN 2699-870X ; 2699-8696
    ISSN (online) 2699-870X
    ISSN 2699-8696
    DOI 10.1055/a-1386-9237
    Database Thieme publisher's database

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  7. Article ; Online: Sex differences in symptoms following the administration of BNT162b2 mRNA Covid-19 Vaccine in Children below 5 Years of age in Germany (CoVacU5): a retrospective cohort study

    Moor, Jeanne / Toepfner, Nicole / von Meißner, Wolfgang C G / Berner, Reinhard / Moor, Matthias B. / Kublickiene, Karolina / Strumann, Christoph / Chao, Cho-Ming

    medRxiv

    Abstract: Background Sex differences exist not only in the efficacy but also in adverse event rates of many vaccines. Here we compared the safety of BNT162b2 vaccine administered off-label in female and male children younger than 5 years in Germany. Methods This ... ...

    Abstract Background Sex differences exist not only in the efficacy but also in adverse event rates of many vaccines. Here we compared the safety of BNT162b2 vaccine administered off-label in female and male children younger than 5 years in Germany. Methods This is a retrospective cohort study, in which we performed a post-hoc analysis of a dataset collected through an authentication-based survey of individuals having registered children aged 0-<5 years for vaccination against SARS-CoV-2 in six private practices and/or two lay person-initiated vaccination campaigns. We analyzed the safety profiles of the first 3 doses of 3-10μg BNT162b2. Primary outcome was comparison in frequencies of 4 common post-vaccination symptom categories such as local, general, musculoskeletal symptoms and fever. Data were analyzed according to sex in bivariate analyses and regression models adjusting for age, weight, and dosage. Interaction between sex and BNT162b2 dosage was assessed. An active-comparator analysis was applied to compare post-vaccination symptoms after BNT162b2 versus non-SARS-CoV-2 vaccines. Results The dataset for the present analysis consisted of 7801 participants including 3842 females (49%) and 3977 males (51%) with an age of 3 years (median, interquartile: 2 years). Among individuals receiving 3μg BNT162b2, no sex differences were noted, but after a first dose of 5 or 10μg BNT162b2, local injection-site symptoms were more prevalent in girls compared to boys. In logistic regression, female sex was associated with higher odds of local symptoms, odds ratio (OR) of 1.33 (95% confidence interval [CI]: 1.15-1.55, p<0.05) and general symptoms with OR 1.21 (95% CI: 1.01-1.44, p<0.05). Following non-BNT162b2 childhood vaccinations, female sex was associated with a lower odds of post-vaccination musculoskeletal symptoms (OR: 0.29, 95% CI: 0.11-0.82, p<0.05). An active comparator analysis between BNT162b2 and non-SARS-CoV-2 vaccinations revealed that female sex positively influenced the association between BNT162b2 vaccine type and musculoskeletal symptoms. Conclusions Sex differences exist in post-vaccination symptoms after BNT162b2 administration even in young children. These are of importance for the conception of approval studies, for post-vaccination monitoring and for future vaccination strategies. (German Clinical Trials Register ID: DRKS00028759).
    Keywords covid19
    Language English
    Publishing date 2024-03-13
    Publisher Cold Spring Harbor Laboratory Press
    Document type Article ; Online
    DOI 10.1101/2024.03.08.24303999
    Database COVID19

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  8. Article ; Online: Sex differences in symptoms following the administration of BNT162b2 mRNA Covid-19 Vaccine in Children below 5 Years of age in Germany (CoVacU5): a retrospective cohort study

    Moor, Jeanne / Toepfner, Nicole / von Meissner, Wolfgang C. G. / Berner, Reinhard / Moor, Matthias B. / Kublickiene, Karolina / Strumann, Christoph / Chao, Cho-Ming

    medRxiv

    Abstract: Background Sex differences exist not only in the efficacy but also in adverse event rates of many vaccines. Here we compared the safety of BNT162b2 vaccine administered off-label in female and male children younger than 5 years in Germany. Methods This ... ...

    Abstract Background Sex differences exist not only in the efficacy but also in adverse event rates of many vaccines. Here we compared the safety of BNT162b2 vaccine administered off-label in female and male children younger than 5 years in Germany. Methods This is a retrospective cohort study, in which we performed a post-hoc analysis of a dataset collected through an authentication-based survey of individuals having registered children aged 0-<5 years for vaccination against SARS-CoV-2 in six private practices and/or two lay person-initiated vaccination campaigns. We analyzed the safety profiles of the first 3 doses of 3-10μg BNT162b2. Primary outcome was comparison in frequencies of 4 common post-vaccination symptom categories such as local, general, musculoskeletal symptoms and fever. Data were analyzed according to sex in bivariate analyses and regression models adjusting for age, weight, and dosage. Interaction between sex and BNT162b2 dosage was assessed. An active-comparator analysis was applied to compare post-vaccination symptoms after BNT162b2 versus non-SARS-CoV-2 vaccines. Results The dataset for the present analysis consisted of 7801 participants including 3842 females (49%) and 3977 males (51%) with an age of 3 years (median, interquartile: 2 years). Among individuals receiving 3μg BNT162b2, no sex differences were noted, but after a first dose of 5 or 10μg BNT162b2, local injection-site symptoms were more prevalent in girls compared to boys. In logistic regression, female sex was associated with higher odds of local symptoms, odds ratio (OR) of 1.33 (95% confidence interval [CI]: 1.15-1.55, p<0.05) and general symptoms with OR 1.21 (95% CI: 1.01-1.44, p<0.05). Following non-BNT162b2 childhood vaccinations, female sex was associated with a lower odds of post-vaccination musculoskeletal symptoms (OR: 0.29, 95% CI: 0.11-0.82, p<0.05). An active comparator analysis between BNT162b2 and non-SARS-CoV-2 vaccinations revealed that female sex positively influenced the association between BNT162b2 vaccine type and musculoskeletal symptoms. Conclusions Sex differences exist in post-vaccination symptoms after BNT162b2 administration even in young children. These are of importance for the conception of approval studies, for post-vaccination monitoring and for future vaccination strategies. (German Clinical Trials Register ID: DRKS00028759).
    Keywords covid19
    Language English
    Publishing date 2024-03-13
    Publisher Cold Spring Harbor Laboratory Press
    Document type Article ; Online
    DOI 10.1101/2024.03.08.24303999
    Database COVID19

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  9. Article ; Online: Experiences made by family physicians managing patients with SARS-CoV-2 infection during spring 2020 - a cross-sectional analysis.

    Strumann, Christoph / von Meißner, Wolfgang C G / Blickle, Paul-Georg / Held, Linda / Steinhäuser, Jost

    Zeitschrift fur Evidenz, Fortbildung und Qualitat im Gesundheitswesen

    2021  Volume 165, Page(s) 35–42

    Abstract: Background: In Germany, family physicians care for about 85% of the patients infected with SARS-CoV-2. The geographic distribution of the first wave in 2020 was heterogeneous, and each federal state experienced different percentages of patients that ... ...

    Abstract Background: In Germany, family physicians care for about 85% of the patients infected with SARS-CoV-2. The geographic distribution of the first wave in 2020 was heterogeneous, and each federal state experienced different percentages of patients that died from COVID-19. Each of the 16 federal states implemented its own regulation about medical care for SARS-CoV-2 infected patients. Against this background, the objective of this analysis was to gather experiences made by primary care physicians managing SARS-CoV-2 infected patients during the first wave in March 2020 and to clinically characterize these patients.
    Methods: In total, 5,632 physicians were invited to participate in an online questionnaire surveying routine data regarding the general care situation at the physician practice level and the care for patients infected with SARS-CoV-2. Bivariate and multivariate analyses were applied to characterize treatment experiences and to identify patient characteristics predicting the course of disease.
    Results: 132 family physicians from all German federal states (except from Berlin) participated in this analysis (response rate 2.3%) and provided routine care data for 1,085 patients. Information from 373 of these patients were provided in greater detail. On average, each physician treated 8.5 patients infected with SARS-CoV-2. About 15% of the physicians used video consultations to communicate with their infected patients. More than 82% made positive experiences with the exceptional regulation to provide a certificate of incapacity to work by telephone. Half of the physicians faced equipment insufficiencies due to a lack of protective gear, and in 10% of the practices, the staff themselves acquired SARS-CoV-2 infection. Greater numbers of SARS-CoV-2 cases treated in a practice translated into higher odds for members of the practice to get infected (odds ratio (OR) 1.03, 95% CI [1.01;1.06]). Older persons, males and patients in rural areas had higher odds of a severe course of disease.
    Conclusions: Our results show that a large percentage of primary care physicians additionally managed their COVID-19 patients remotely by telephone or video during the outbreak, while also being at a higher risk for SARS-CoV-2 infection. Further, the increased severity in rural areas underlines the importance of strong primary health care in order to enable hospitals to concentrate on critically ill patients.
    MeSH term(s) Aged ; Aged, 80 and over ; COVID-19 ; Cross-Sectional Studies ; Germany ; Humans ; Male ; Physicians, Family ; SARS-CoV-2
    Language English
    Publishing date 2021-08-30
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 2412512-X
    ISSN 2212-0289 ; 1865-9217
    ISSN (online) 2212-0289
    ISSN 1865-9217
    DOI 10.1016/j.zefq.2021.07.005
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Notfallmanagement: Reanimation in der Arztpraxis.

    von Meißner, Wolfgang C G / von Meißner, Birte

    Deutsche medizinische Wochenschrift (1946)

    2017  Volume 142, Issue 1, Page(s) 58–61

    Title translation Resuscitation at a Doctor's Office.
    MeSH term(s) Emergency Medical Services/methods ; Emergency Medical Services/standards ; Europe ; Heart Arrest/therapy ; Humans ; Practice Guidelines as Topic ; Resuscitation/instrumentation ; Resuscitation/methods ; Resuscitation/standards
    Language German
    Publishing date 2017-01
    Publishing country Germany
    Document type Journal Article ; Review
    ZDB-ID 200446-x
    ISSN 1439-4413 ; 0012-0472
    ISSN (online) 1439-4413
    ISSN 0012-0472
    DOI 10.1055/s-0042-114421
    Database MEDical Literature Analysis and Retrieval System OnLINE

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