Versorgungsqualität im medikamentösen und präventiven Bereich bei Patienten mit und ohne koronare Herzkrankheit

Baberg, Henning T.; Yazar, Aydan; Brechmann, Thorsten; Grewe, Peter; Kügler, Joachim; Zeeuw, Justus de; Bojara, Waldemar; Lawo, Thomas; Mügge, Andreas

doi:10.1007/s00063-004-1004-y

Cited by 3 publications

(2 citation statements)

References 16 publications

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“…For example, the German follow-up of the Hypertension Evaluation Project clearly demonstrated inadequate knowledge of the diagnosis and treatment of arterial hypertension 30. Further, there is evidence that deficiencies in treatment quality appear to be the result of inadequate implementation of existing cardiologic treatment recommendations (among other factors) 21,31. On the other hand, the results of a recent survey indicated that there is essentially no difference in the treatment provided by physicians knowledgeable in the guidelines and those who were less familiar 11…”

Section: Discussionmentioning

confidence: 99%

Barriers to cardiovascular risk prevention and management in Germany – an analysis of the EURIKA study

Schmieder¹,

Goebel²,

Bramlage³

2012

VHRM

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Background and purposeDespite the availability of risk engines to determine cardiovascular risk, risk factor control is suboptimal. Using EURIKA data we compared risk factor control in Germany with that of 11 other European countries (rest of Europe [ROE]) to identify differences and opportunities for improvement.MethodsEURIKA was a multinational, cross-sectional study in 12 European countries including Germany from May 2009 to January 2010. Physicians’ attitudes to risk factor control based on the 2007 European guidelines on cardiovascular disease (CVD) prevention in a representative cohort of 7641 primary care outpatients aged ≥50 years with no CV disease and at least one major CV risk factor were determined.ResultsCompared to the ROE, German physicians were more frequently male (72.7% vs 62.6%), had a higher mean age (51.7 ± 8.4 vs 47.0 ± 9.7 years), faced higher patient loads (37.9% vs 16.5% had >199 patients/week), and involved other health sector professionals (dieticians, psychologists) less (31.8% vs 41.0% in the ROE). The European Society of Cardiology (ESC) guidelines on CVD prevention were more important for German physicians (60.6% vs 55.9%), while those who didn’t use them gave reasons for nonuse as too many (62.5% vs 46.2%), too confusing, unrealistic, or not applicable to their patients. Risk engines were used less (54.5% vs 70.7%), with perceived lack of time (65.5% vs 60.2%) a frequent reason for nonuse. Risk factor control in German patients was inadequate (control rates: hypertension 36.3%, dyslipidemia 30.4%, type 2 diabetes 40.6%, obesity 28.8%) but largely comparable to other ROE countries; however, physicians tended to overestimate control rates.ConclusionEURIKA provides comprehensive data on the status of primary prevention of CVD in clinical practice in Germany and reveals considerable potential for improving the primary prevention of CVD.

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Section: Discussionmentioning

confidence: 99%

Barriers to cardiovascular risk prevention and management in Germany – an analysis of the EURIKA study

Schmieder¹,

Goebel²,

Bramlage³

2012

VHRM

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“…A German analysis evaluated that 47% of men and 59% of women received prescriptions for at least three of the four recommended drugs (antiplatelet drugs, β-blockers, ACE inhibitors, lipid-lowering agents) during the time between the initial myocardial infarction and a secondary event [10]. Another German study revealed that 83.6% of patients with a CHD history received antiplatelet drugs and 70.9% used β-blockers one year after the index event [11]. …”

Section: Introductionmentioning

confidence: 99%

Healthcare Utilization of Patients With Acute Coronary Syndrome in Germany

et al. 2013

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BackgroundThe aim of this study was to determine the health care utilization of patients with acute coronary syndrome (ACS) of one German statutory health insurance. The utilization of ambulatory services as well as of inpatient rehabilitation should be regarded. Moreover, the study should reveal the prescription of drugs for secondary prevention. Here, patients showing guideline corresponding prescriptions should be compared with patients without such prescriptions.MethodsA retrospective claims data analysis of one German statutory health insurance was conducted. Health care utilization was considered in the first year after an index hospitalization due to ACS. Beneficiaries for whom an ICD-10 discharge diagnosis of ACS was reported between January 1st 2007 and December 31st 2009 were included. In order to reveal differences in health care utilization depending on the type of ACS (STEMI versus NSTEMI/UA) stratified analyses were performed. Another stratification was done for patients with and without defined drug prescriptions.ResultsFrom 45,188 patients with ACS almost three quarters were assigned to the group of NSTEMI/UA. For 8.9% of all ACS patients (18.74% STEMI, 8.89% NSTEMI/UA), inpatient post-hospital rehabilitation related to ACS was recorded. Ambulatory care related to CHD diagnosis was utilized by 77.6% of patients, more often by STEMI than by NSTEMI/UA patients. For 36.7% and 45.7% of ACS patients, a prescription of aspirin or clopidogrel was recorded, respectively, 79.4% of STEMI patients received at least one prescription for antiplatelet drugs, the corresponding proportion of NSTEMI/UA was 59.8%. A considerable part of patients without prescription dropped out within the first 90 days after the index event.ConclusionsA claims data analysis of one German statutory health insurance fund showed that health care utilization of ACS patients varied depending on the ACS type. It is necessary to distinguish between STEMI and NSTEMI/UA patients when discussing the ambulatory drug utilization.

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Physicians’ Knowledge of and Compliance With Guidelines

Karbach¹,

Schubert²,

Hagemeister³

et al. 2011

Deutsches Ärzteblatt International

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Versorgungsqualität im medikamentösen und präventiven Bereich bei Patienten mit und ohne koronare Herzkrankheit

Cited by 3 publications

References 16 publications

Barriers to cardiovascular risk prevention and management in Germany – an analysis of the EURIKA study

Barriers to cardiovascular risk prevention and management in Germany – an analysis of the EURIKA study

Healthcare Utilization of Patients With Acute Coronary Syndrome in Germany

Physicians’ Knowledge of and Compliance With Guidelines

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Versorgungsqualität im medikamentösen und präventiven Bereich bei Patienten mit und ohne koronare Herzkrankheit

Cited by 3 publications

References 16 publications

Barriers to cardiovascular risk prevention and management in Germany &ndash; an analysis of the EURIKA study

Barriers to cardiovascular risk prevention and management in Germany &ndash; an analysis of the EURIKA study

Healthcare Utilization of Patients With Acute Coronary Syndrome in Germany

Physicians’ Knowledge of and Compliance With Guidelines

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Product

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Barriers to cardiovascular risk prevention and management in Germany – an analysis of the EURIKA study

Barriers to cardiovascular risk prevention and management in Germany – an analysis of the EURIKA study