Pfingsten, Michael

[["dc.bibliographiccitation.firstpage","578"],["dc.bibliographiccitation.issue","7"],["dc.bibliographiccitation.journal","Clinical Journal of Pain"],["dc.bibliographiccitation.lastpage","584"],["dc.bibliographiccitation.volume","24"],["dc.contributor.author","Chenot, Jean-Francois"],["dc.contributor.author","Becker, Annette"],["dc.contributor.author","Leonhardt, Corinna"],["dc.contributor.author","Keller, Stefan"],["dc.contributor.author","Donner-Banzhoff, Norbert"],["dc.contributor.author","Hildebrandt, Jan"],["dc.contributor.author","Basler, Heinz-Dieter"],["dc.contributor.author","Baum, Erika"],["dc.contributor.author","Kochen, Michael M."],["dc.contributor.author","Pfingsten, Michael"],["dc.date.accessioned","2018-11-07T11:11:09Z"],["dc.date.available","2018-11-07T11:11:09Z"],["dc.date.issued","2008"],["dc.description.abstract","Objective: Epidemiologic surveys frequently show that women more often and are more affected by low back pain (LBP). The aim of this secondary analysis of a randomized controlled study was to explore whether presentation and course of LBP of women is different from men, and if sex affects the use of healthcare services for LBP. Methods: Data from 1342 [778 (58%) women] patients presenting with LBP in 116 general practices were collected. Patients completed standardized questionnaires before and after consultation and were contacted by phone 4 weeks, 6 months, and 12 months later for standardized interviews by study nurses. Functional capacity was assessed with Hannover Functional Ability Questionnaire (HFAQ). Logistic regression models-adjusting for sociodemographic and disease-related data-were conducted to investigate the effect of sex for the use of healthcare services. Results: Women had on average a lower functional capacity at baseline and after 12 months. They were more likely to have recurrent or chronic LBP and to have a positive depression score. Being female was associated with a low functional capacity after 12 months (odds ratio: 1.7, 95% confidence interval: 1.2-2.3), but baseline functional capacity, chronicity, and depression were stronger predictors. In univariate analysis, women had a tendency of higher use of healthcare services. Those differences disappeared after adjustment. Discussion: Our findings confirm that women are more severely affected by LBP and have a worse prognosis. Utilization of healthcare services cannot be fully explained by female sex, but . rather by a higher impairment by back pain and pain in other parts of the body characteristic of the female population."],["dc.description.sponsorship","German Ministry for Education and Research (BMBF) [01EM0113]"],["dc.identifier.doi","10.1097/AJP.0b013e31816ed948"],["dc.identifier.isi","000259662200004"],["dc.identifier.pmid","18716496"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/53367"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.relation.issn","0749-8047"],["dc.relation.orgunit","Institut für Allgemeinmedizin"],["dc.title","Sex differences in presentation, course, and management of low back pain in primary care"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.subtype","original_ja"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","701"],["dc.bibliographiccitation.issue","8"],["dc.bibliographiccitation.journal","Spine"],["dc.bibliographiccitation.lastpage","710"],["dc.bibliographiccitation.volume","37"],["dc.contributor.author","Becker, Annette"],["dc.contributor.author","Held, Heiko"],["dc.contributor.author","Redaelli, Marcus"],["dc.contributor.author","Chenot, Jean F."],["dc.contributor.author","Leonhardt, Corinna"],["dc.contributor.author","Keller, Stefan"],["dc.contributor.author","Baum, Erika"],["dc.contributor.author","Pfingsten, Michael"],["dc.contributor.author","Hildebrandt, Jan"],["dc.contributor.author","Basler, Heinz-Dieter"],["dc.contributor.author","Kochen, Michael M."],["dc.contributor.author","Donner-Banzhoff, Norbert"],["dc.contributor.author","Strauch, Konstantin"],["dc.date.accessioned","2018-11-07T09:11:08Z"],["dc.date.available","2018-11-07T09:11:08Z"],["dc.date.issued","2012"],["dc.description.abstract","Study Design. Cost-effectiveness analysis alongside a cluster randomized controlled trial. Objective. To study the cost-effectiveness of 2 low back pain guideline implementation (GI) strategies. Summary of Background Data. Several evidence-based guidelines on management of low back pain have been published. However, there is still no consensus on the effective implementation strategy. Especially studies on the economic impact of different implementation strategies are lacking. Methods. This analysis was performed alongside a cluster randomized controlled trial on the effectiveness of 2 GI strategies (physician education alone [GI] or physician education in combination with motivational counseling [MC] by practice nurses)-both compared with the postal dissemination of the guideline (control group, C). Sociodemographic data, pain characteristics, and cost data were collected by interview at baseline and after 6 and 12 months. low back pain-related health care costs were valued for 2004 from the societal perspective. Results. For the cost analysis, 1322 patients from 126 general practices were included. Both interventions showed lower direct and indirect costs as well as better patient outcomes during follow-up compared with controls. In addition, both intervention arms showed superiority of cost-effectiveness to C. The effects attenuated when adjusting for differences of health care utilization prior to patient recruitment and for clustering of data. Conclusion. Trends in cost-effectiveness are visible but need to be confirmed in future studies. Researchers performing cost-evaluation studies should test for baseline imbalances of health care utilization data instead of judging on the randomization success by reviewing non-cost parameters like clinical data alone."],["dc.description.sponsorship","German Ministry for Education and Research (BMBF) [FKZ 01 EM 0113]"],["dc.identifier.doi","10.1097/BRS.0b013e31822b01bd"],["dc.identifier.isi","000302870700021"],["dc.identifier.pmid","21738095"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/26658"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.relation.issn","0362-2436"],["dc.relation.orgunit","Institut für Allgemeinmedizin"],["dc.title","Implementation of a Guideline for Low Back Pain Management in Primary Care"],["dc.title.subtitle","A Cost-Effectiveness Analysis"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.subtype","original_ja"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","2218"],["dc.bibliographiccitation.issue","12"],["dc.bibliographiccitation.journal","Pain Medicine"],["dc.bibliographiccitation.lastpage","2229"],["dc.bibliographiccitation.volume","17"],["dc.contributor.author","Kuss, Katrin"],["dc.contributor.author","Leonhardt, Corinna"],["dc.contributor.author","Quint, Sabine"],["dc.contributor.author","Seeger, Dagmar"],["dc.contributor.author","Pfingsten, Michael"],["dc.contributor.author","Wolf, Udo"],["dc.contributor.author","Basler, Heinz-Dieter"],["dc.contributor.author","Becker, Annette"],["dc.date.accessioned","2018-11-07T10:04:41Z"],["dc.date.available","2018-11-07T10:04:41Z"],["dc.date.issued","2016"],["dc.description.abstract","Background. Persistent pain is highly prevalent in older adults and can lead to functional limitations in activities of daily living, and to psychosocial distress. There is a lack of established active therapy programs, especially for older adults with chronic pain. Objectives. To develop a graded activity program and to evaluate its feasibility within a pilot study. Design. Phase I/phase II trial of a complex intervention. A mixed methods design was chosen to evaluate the feasibility, acceptability, and preliminary evidence of effectiveness. Subjects and Setting. Several experts participated in the program development. Sixteen community-dwelling older adults (73.9 +/- 5.9 years on average) with chronic low back pain and three primary care physical therapists attempted the program. Methods. Guided semi-structured interviews were conducted with all patients and therapists and used a content-analytic approach. Measurements of self-rated functional status (HFAQ), average pain (NRS), falls self-efficacy (FES-I), and catastrophizing and avoidance beliefs (CAS-D 651) were applied at baseline and after the intervention. Results. The interviews revealed high acceptance, satisfaction, and practicality. Besides improvements in function and pain, patients mentioned more positive attitudes towards pain, activity, and self-confidence. There was a clinically relevant increase in physical function by 20.3%, a decrease in pain intensity, and a reduction in catastrophizing and avoidance behavior. Conclusion. This graded activity program demonstrated feasibility and high acceptance in aged individuals and therapists. Future studies with larger samples must confirm effectiveness. The principles also appear applicable to other chronic pain conditions. The program could easily be implemented in routine primary care."],["dc.description.sponsorship","German Research Foundation (DFG) [BE 3996/2-1]"],["dc.identifier.doi","10.1093/pm/pnw062"],["dc.identifier.isi","000398748500007"],["dc.identifier.pmid","28025356"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/38748"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Oxford Univ Press"],["dc.relation.issn","1526-4637"],["dc.relation.issn","1526-2375"],["dc.title","Graded Activity for Older Adults with Chronic Low Back Pain: Program Development and Mixed Methods Feasibility Cohort Study"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","1023"],["dc.bibliographiccitation.issue","12"],["dc.bibliographiccitation.journal","Clinical Journal of Pain"],["dc.bibliographiccitation.lastpage","1032"],["dc.bibliographiccitation.volume","30"],["dc.contributor.author","Hirsch, Oliver"],["dc.contributor.author","Strauch, Konstantin"],["dc.contributor.author","Held, Heiko"],["dc.contributor.author","Redaelli, Marcus"],["dc.contributor.author","Chenot, Jean-Francois"],["dc.contributor.author","Leonhardt, Corinna"],["dc.contributor.author","Keller, Stefan"],["dc.contributor.author","Baum, Erika"],["dc.contributor.author","Pfingsten, Michael"],["dc.contributor.author","Hildebrandt, Jan"],["dc.contributor.author","Basler, Heinz-Dieter"],["dc.contributor.author","Kochen, Michael M."],["dc.contributor.author","Donner-Banzhoff, Norbert"],["dc.contributor.author","Becker, Annette"],["dc.date.accessioned","2018-11-07T09:32:14Z"],["dc.date.available","2018-11-07T09:32:14Z"],["dc.date.issued","2014"],["dc.description.abstract","Objectives: In industrialized countries, low back pain (LBP) is one of the leading causes for prolonged sick leave, early retirement, and high health care costs. Providing the same treatments to all patients is neither effective nor feasible, and may impede patients' recovery. Recent studies have outlined the need for subgroup-specific treatment allocation. Methods: This is a cross-sectional study that used baseline data from consecutively recruited patients participating in a guideline implementation trial regarding LBP in primary care. Classification variables were employment status, age, pain intensity, functional capacity (HFAQ), depression (CES-D), belief that activity causes pain (FABQ subscale), 2 scales of the SF-36 (general health, vitality), and days in pain per year. We performed k-means cluster analyses and split-half cross-validation. Subsequently, we investigated whether the resulting groups incurred different direct and indirect costs during a 6-month period before the index consultation. Results: A 4-cluster solution showed good statistical quality criteria, even after split-half cross-validation. \"Elderly patients adapted to pain\" (cluster 1) and \"younger patients with acute pain\" (cluster 4) accounted for 55% of all patients. Cluster validation showed the lowest direct and indirect costs in these groups. About 72% of total costs per patient referred to clusters 2 and 3 (\"patients with chronic severe pain with comorbid depression\" and \"younger patients with subacute pain and emotional distress\"). Discussion: Our study adds substantially to the knowledge of LBP-related case-mix in primary care. Information on differential health care needs may be inferred from our study, enabling decision makers to allocate resources more appropriately and to reduce costs."],["dc.identifier.doi","10.1097/AJP.0000000000000080"],["dc.identifier.isi","000345158300002"],["dc.identifier.pmid","24480909"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/31705"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Lippincott Williams & Wilkins"],["dc.relation.issn","1536-5409"],["dc.relation.issn","0749-8047"],["dc.title","Low Back Pain Patient Subgroups in Primary Care Pain Characteristics, Psychosocial Determinants, and Health Care Utilization"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","50"],["dc.bibliographiccitation.issue","1"],["dc.bibliographiccitation.journal","Patient Education and Counseling"],["dc.bibliographiccitation.lastpage","60"],["dc.bibliographiccitation.volume","70"],["dc.contributor.author","Leonhardt, Corinna"],["dc.contributor.author","Keller, Stefan"],["dc.contributor.author","Chenot, Jean-Francois"],["dc.contributor.author","Luckmann, Judith"],["dc.contributor.author","Basler, Heinz-Dieter"],["dc.contributor.author","Wegscheider, Karl"],["dc.contributor.author","Baum, Erika"],["dc.contributor.author","Donner-Banzhoff, Norbert"],["dc.contributor.author","Pfingsten, Michael"],["dc.contributor.author","Hildebrandt, Jan"],["dc.contributor.author","Kochen, Michael M."],["dc.contributor.author","Becker, Annette"],["dc.date.accessioned","2018-11-07T11:20:33Z"],["dc.date.available","2018-11-07T11:20:33Z"],["dc.date.issued","2008"],["dc.description.abstract","Objective: To investigate the effectiveness of a TTM-based motivational counselling approach by trained practice nurses to promote physical activity of low back pain patients in a German primary care setting. Methods: Data were collected in a cluster-randomized controlled trial with three study arms via questionnaires and patient interviews at baseline and after 6 and 12 months. We analysed total physical activity and self-efficacy by using random effect models to allow for clustering. Results: A total of 1378 low back pain patients, many with acute symptoms, were included in the study. Nearly 40% of all patients reported sufficient physical activity at baseline. While there were significant improvements in patients' physical activity behaviour in all study arms, there was no evidence for an intervention effect. Conclusion: The outcome may be explained by insufficient performance of the practice nurses, implementation barriers caused by the German health care system and the heterogenous sample. Practice implications: Given the objective to incorporate practice nurses into patient education, there is a need for a better basic training of the nurses and for a change towards an organizational structure that facilitates patient-nurse communication. Counselling for low back pain patients has to consider more specificated aims for different subgroups. (C) 2007 Elsevier Ireland Ltd. All rights reserved."],["dc.identifier.doi","10.1016/j.pec.2007.09.018"],["dc.identifier.isi","000253081200007"],["dc.identifier.pmid","18023130"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/55562"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.relation.issn","0738-3991"],["dc.relation.orgunit","Institut für Allgemeinmedizin"],["dc.title","TTM-based motivational counselling does not increase physical activity of low back pain patients in a primary care setting - A cluster-randomized controlled trial"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.subtype","original_ja"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","1714"],["dc.bibliographiccitation.issue","18"],["dc.bibliographiccitation.journal","Spine"],["dc.bibliographiccitation.lastpage","1720"],["dc.bibliographiccitation.volume","35"],["dc.contributor.author","Becker, Annette"],["dc.contributor.author","Held, Heiko"],["dc.contributor.author","Redaelli, Marcus"],["dc.contributor.author","Strauch, Konstantin"],["dc.contributor.author","Chenot, Jean F."],["dc.contributor.author","Leonhardt, Corinna"],["dc.contributor.author","Keller, Stefan"],["dc.contributor.author","Baum, Erika"],["dc.contributor.author","Pfingsten, Michael"],["dc.contributor.author","Hildebrandt, Jan"],["dc.contributor.author","Basler, Heinz-Dieter"],["dc.contributor.author","Kochen, Michael M."],["dc.contributor.author","Donner-Banzhoff, Norbert"],["dc.date.accessioned","2018-11-07T08:40:22Z"],["dc.date.available","2018-11-07T08:40:22Z"],["dc.date.issued","2010"],["dc.description.abstract","Study Design. Cost of illness study alongside a randomized controlled trial. Objective. To describe the costs of care for patients with low back pain (1) and to identify patient characteristics as predictors for high health care cost during a 1-year follow-up (2). Summary of Background Data. Low back pain (LBP) is one of the leading causes of high health care costs in industrialized countries (Life time prevalence, 70%). A lot of research has been done to improve primary health care and patients' prognosis. However, the cost of health care does not necessarily follow changes in patient outcomes. Methods. General practitioners (n = 126) recruited 1378 patients consulting for LBP. Sociodemographic data, pain characteristics, and LBP-related cost data were collected by interview at baseline and after 6 and 12 months. Costs were evaluated from the societal perspective. Predictors of high cost during the subsequent year were studied using logistic regression analysis. Results. Mean direct and indirect costs for LBP care are about twice as high for patients with chronic LBP compared to acutely ill patients. Indirect costs account for more than 52% to 54% of total costs. About 25% of direct costs refer to therapeutic procedures and hospital or rehabilitational care. Patients with high disability and limitations in daily living show a 2- to 5-fold change for subsequent high health care costs. Depression seems to be highly relevant for direct health care utilization. Conclusion. Interventions designed to reduce high health care costs for LBP should focus on patients with severe LBP and depressive comorbidity. Our results add to the economic understanding of LBP care and may give guidance for future actions on health care improvement and cost reduction."],["dc.description.sponsorship","German Ministry for Education and Research (BMBF) [FKZ 01 EM 0113]"],["dc.identifier.doi","10.1097/BRS.0b013e3181cd656f"],["dc.identifier.isi","000281277700008"],["dc.identifier.pmid","21374895"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/19219"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.relation.issn","0362-2436"],["dc.relation.orgunit","Institut für Allgemeinmedizin"],["dc.title","Low Back Pain in Primary Care Costs of Care and Prediction of Future Health Care Utilization"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.subtype","original_ja"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","29"],["dc.bibliographiccitation.issue","1"],["dc.bibliographiccitation.journal","Zeitschrift für Sportpsychologie"],["dc.bibliographiccitation.lastpage","43"],["dc.bibliographiccitation.volume","14"],["dc.contributor.author","Leonhardt, Corinna"],["dc.contributor.author","Keller, Stefan"],["dc.contributor.author","Becker, Annette"],["dc.contributor.author","Luckmann, Judith"],["dc.contributor.author","Baum, Erika"],["dc.contributor.author","Donner-Banzhoff, Norbert"],["dc.contributor.author","Pfingsten, Michael"],["dc.contributor.author","Hildebrandt, Jan"],["dc.contributor.author","Chenot, Jean Francois"],["dc.contributor.author","Kochen, Michael M."],["dc.contributor.author","Basler, Heinz Dieter"],["dc.date.accessioned","2018-11-07T11:07:48Z"],["dc.date.available","2018-11-07T11:07:48Z"],["dc.date.issued","2007"],["dc.description.abstract","The goal of this Study was to evaluate the impact of depression and fear-avoidance beliefs on the willingness to commence and continue physical activity in patients with low back pain. Data from a controlled, randomized intervention study of 1,378 German patients in primary care settings (58% female, mean age 49 years) suffering predominantly from acute back pain were subjected to a secondary analysis. Results showed that patients with high scores on both depression and fear-avoidance beliefs reported the lowest physical activity (kcal/week). The most important predictors for physical activity after 6 and 12 months were baseline activity and expected self-efficacy. Important predictors for relapse into inactivity were low self-efficacy and low perceived benefits of physical activity. Neither depression nor fear-avoidance beliefs were significant predictors of physical activity or relapse after 6 or 12 months. It is concluded that relatively stable constructs such as depression or fear-avoidance beliefs do not seem to be suitable for explaining either actual or intended physical activity in low back pain patients. Future research should focus more strongly on the impact of cognitive and affective aspects of situational decision-making processes on physical activity in everyday situations."],["dc.identifier.doi","10.1026/1612-5010.14.1.29"],["dc.identifier.isi","000258701900004"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/52662"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Hogrefe & Huber Publishers"],["dc.relation.issn","1612-5010"],["dc.title","Depression, fear-avoidance beliefs, and physical activity in patients with low back pain"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","275"],["dc.bibliographiccitation.issue","3"],["dc.bibliographiccitation.journal","European Journal of Pain"],["dc.bibliographiccitation.lastpage","283"],["dc.bibliographiccitation.volume","12"],["dc.contributor.author","Chenot, Jean-Francois"],["dc.contributor.author","Leonhardt, Corinna"],["dc.contributor.author","Keller, Stefan"],["dc.contributor.author","Scherer, Martin"],["dc.contributor.author","Donner-Banzhoff, Norbert"],["dc.contributor.author","Pfingsten, Michael"],["dc.contributor.author","Basler, Heinz-Dieter"],["dc.contributor.author","Baum, Erika"],["dc.contributor.author","Kochen, Michael M."],["dc.contributor.author","Becker, Annette"],["dc.date.accessioned","2018-11-07T11:16:29Z"],["dc.date.available","2018-11-07T11:16:29Z"],["dc.date.issued","2008"],["dc.description.abstract","Guidelines portray low back pain (LBP) as a benign self-limiting disease which should be managed mainly by primary care physicians. For the German health care system we analyze which factors are associated with receiving specialist care and how this affects treatment. This is a longitudinal prospective cohort study. General practitioners recruited consecutive adult patients presenting with LBP. Data on physical function, on depression, and on utilization of health services were collected at the first consultation and at follow-up telephone interviews for a period of 12 months. Logistic regression models were calculated to investigate predictors for specialist consultations and use of specific health care services. Large proportions (57%) of the 1342 patients were seeking additional specialist care. Although patients receiving specialist care had more often chronic LBP and a positive depression score, the association was weak. A total of 623 (46%) patients received some form of imaging, 654 (49%) physiotherapy and 417 (31%) massage. Consulting a specialist remained the strongest predictor for imaging and therapeutic interventions while disease-related and socio-demographic factors were less important. Our results suggest that the high use of specialist care in Germany is due to the absence of a functioning primary care gate keeping system for patient selection. The high dependence of health care service utilization on providers rather than clinical factors indicates an unsystematic and probably inadequate management of LBP. (C) 2007 European Federation of Chapters of the International Association for the Study of Pain. Published by Elsevier Ltd. All rights reserved."],["dc.identifier.doi","10.1016/j.ejpain.2007.06.004"],["dc.identifier.isi","000253771000004"],["dc.identifier.pmid","17681811"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/54600"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.relation.issn","1532-2149"],["dc.relation.issn","1090-3801"],["dc.relation.orgunit","Institut für Allgemeinmedizin"],["dc.title","The impact of specialist care for low back pain on health service utilization in primary care patients: A prospective cohort study"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.subtype","original_ja"],["dspace.entity.type","Publication"]]