Bedeutung der Zweitmeinung bei Prostatabiopsien

Helpap, B.; Oehler, U

doi:10.1007/s00292-011-1462-y

Cited by 10 publications

(2 citation statements)

References 32 publications

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“…SOs can be used to strengthen the decisionmaking ability of patients [2,3]. SOs can also help patients better understand their diagnoses, and consider diagnoses and treatment recommendations [4][5][6]. At the system level SO can also counteract overprescription of surgeries [7].…”

Section: Introductionmentioning

confidence: 99%

Does the Second Opinion Directive in Germany reach the patient? A parallel-convergent mixed- methods study

May

Könsgen

Glatt

et al. 2022

Preprint

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Background: A Second Opinion Directive (SOD) was introduced in Germany in December 2018 for elective surgeries such as hysterectomy, tonsillotomy, tonsillectomy, and shoulder arthroscopy. The aim of the SOD is to avoid surgeries which are not medically induced and to support patients in their decision-making process. A physician who indicates an SOD-relevant procedure must inform the patient about the SOD and its specifications. At this time, it is not clear whether physicians provide information about the SOD to patients and whether and how the SOD is implemented in daily practice. Furthermore, nothing is known about how patients react when they are told that they have the right to seek a second opinion according to the SOD. Methods: To assess this, we undertook a parallel-convergent mixed-methods study with a qualitative and quantitative phase. Qualitative data were analysed by structured qualitative content analysis and survey data were analysed descriptively. Results: 26 interviews were conducted with patients for whom one of the above-mentioned surgeries was indicated. In parallel, a questionnaire survey with 102 patients was conducted. The results show that the SOD is not implemented in Germany for the selected indications because patients were not informed as intended. At the same time, when the right to obtain a second opinion was explained, it seemed to have a positive effect on the physician-patient relationship from patients` perspective. Conclusions: It is possible that there is a lack of information for physicians, which in turn leads to an information deficit for patients. Better information for physicians might be part of the solution, but a negative attitude towards the SOD might also result in the low education rate. Therefore, in addition, potential patients or even the general population should be better informed about the possibility of obtaining a second opinion.

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Section: Introductionmentioning

confidence: 99%

Does the Second Opinion Directive in Germany reach the patient? A parallel-convergent mixed- methods study

May

Könsgen

Glatt

et al. 2022

Preprint

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“…Second medical opinions (SOs) can help patients better understand their diagnoses and gain more con dence when deciding between different treatment options [1,2]. Furthermore, SOs are used to validate diagnosis and treatment recommendations [3,4] and decrease the number of surgeries [4][5][6][7][8]. The rst SO program was introduced in the USA in the 1970s [5].…”

Section: Introductionmentioning

confidence: 99%

Telemedical Second Opinions in Germany – a Customer Survey of an Online Portal

Könsgen

Prediger

Schlimbach

et al. 2021

Preprint

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BackgroundSecond medical opinions (SOs) can strengthen patients’ certainty in decision-making. Since 2019, statutory health insured German residents have the right to obtain an SO for selected indications according to the SO Directive. Additionally, several health insurers offer SO programs often in cooperation with telemedical SO providers. Telemedical SO programs are mostly based on documents only. Our aim was to analyze the characteristics of people who obtained telemedical SOs, their experiences made during the SO process, and their assessment of SOs in general and of the different routes of SO delivery (personally/by phone/documents only).MethodsGerman residents who obtained an SO via an online portal between January 2016 and February 2019 (n=1247) were contacted by post between August and November 2019 up to three times. The results were analyzed descriptively.ResultsThe 368 participants (response rate 30%) were 54% male, 95% statutory health insured and 61 years old (median; interquartile range 51-72). Most participants reported having an orthopedic condition (87%) or had been recommended surgery (78%). The most common reason for seeking an SO in general was the need for more information on further treatment recommendations (64%). A telemedical SO was mainly chosen because it was offered by the health insurer (82%). Disagreements between first opinions and SOs occurred in 55% of the participants. Approximately 60% of the participants with disagreements followed the treatment recommendation of the SO. For 67% of the participants, the SO (rather) enhanced the certainty in decision-making. Approximately 75% were (rather) satisfied with obtaining the SO via the online portal, and 95% would seek another SO (irrespective of the online portal). The most preferred route of SO delivery was a personally delivered SO, which 80% would (rather) consider, followed by 70% (rather) considering SOs based on documents only and 48% (rather) considering SOs by phone.ConclusionSOs were generally appreciated. Although our results show that SOs (based on documents only) support patients and that patient satisfaction was high, personally delivered SOs were still preferred. Future research on the use of SOs based on documents only (in which patient population and in what situations) is needed.

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