Die wahrgenommene Effektivität der Disease Management Programme für Diabetes mellitus Typ 2 und Koronare Herzkrankheit aus Sicht von Hausärzt*innen – Ergebnisse einer Fokusgruppenstudie

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Accounts of Chemical Research Pub Date : 2024-04-01 DOI:10.1016/j.zefq.2023.12.003

Larisa Pilic , Kira Molkentin , Lion Lehmann , Alina Herrmann , Christian Funke , Beate Sigrid Müller , August-Wilhelm Bödecker , Marcus Redaèlli , Stefan Wilm

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Abstract

Background

The majority of patients in disease management programs (DMPs) for type 2 diabetes (T2DM) and coronary heart disease (CHD) in Germany are enrolled by their general practitioner (GP). The aim of this study was, in the context of upcoming DMP expansions, to elicit GPs' current experiences and opinions regarding the perceived effectiveness and acceptance of the DMPs T2DM and CHD, as well as to determine beneficial and hindering aspects of the implementation of these programs from a GP's perspective.

Methods

In August and September 2020, 20 GPs of teaching practices of the University Hospital Cologne with experiences in DMPs were interviewed in semi-structured focus group discussions. Their expectations, attitudes and opinions regarding the DMPs T2DM and CHD were evaluated and analyzed according to the content-structuring qualitative content analysis by Kuckartz.

Results

The DMP T2DM was rated as generally positive by the respondents due to the structured treatment including regular foot and eye examinations, close patient contacts and perceptions of improved health outcomes. The DMP CHD was rated more negatively by the respondents because of a high and partly unnecessary documentation workload and limited therapeutic freedom, leading to a perceived ineffectiveness for patients’ health outcomes. Thus, there was a discrepancy in the perceived effectiveness of the examined DMPs, causing a lower acceptance of the DMP CHD. Therefore, some of the respondents tended to enroll fewer patients into the DMP CHD or to drop out of the DMP CHD.

Discussion

In order to increase the acceptance and sustainability of DMPs some elements of the DMP CHD as well as the remuneration and the documentation need to be reconsidered. Additionally, future studies on the acceptance of DMPs should differentiate between different DMPs in order to generate valid results.

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[全科医生对 2 型糖尿病和冠心病疾病管理计划有效性的看法：焦点小组研究结果]。

背景：在德国，大多数 2 型糖尿病（T2DM）和冠心病（CHD）患者都是由全科医生（GP）登记加入疾病管理计划（DMP）的。本研究的目的是在即将扩大疾病管理计划的背景下，了解全科医生目前的经验和对 T2DM 和 CHD 疾病管理计划有效性和接受度的看法，并从全科医生的角度确定实施这些计划的有利和不利方面：2020 年 8 月和 9 月，科隆大学医院教学实践部的 20 名全科医生在半结构化焦点小组讨论中接受了采访。根据库卡茨（Kuckartz）的内容结构定性内容分析法，对他们对 T2DM 和冠心病 DMP 的期望、态度和观点进行了评估和分析：受访者对 T2DM 的评价总体上是积极的，因为它提供了结构化的治疗，包括定期的足部和眼部检查、与病人的密切接触以及对改善健康结果的看法。受访者对 DMP CHD 的评价则较为负面，原因是文件工作量大且部分是不必要的，治疗自由度有限，导致患者认为治疗效果不佳。因此，受访者对 DMP 的有效性认识存在差异，导致对 DMP CHD 的接受度较低。因此，部分受访者倾向于减少 DMP CHD 的患者人数或退出 DMP CHD：为了提高 DMP 的接受度和可持续性，需要重新考虑 DMP CHD 的一些要素以及报酬和文件。此外，今后关于 DMP 接受度的研究应区分不同的 DMP，以便得出有效的结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.