Himmel, Wolfgang

[["dc.bibliographiccitation.artnumber","w14590"],["dc.bibliographiccitation.issue","56"],["dc.bibliographiccitation.journal","Swiss Medical Weekly"],["dc.bibliographiccitation.volume","148"],["dc.contributor.author","Grimmsmann, Thomas"],["dc.contributor.author","Harden, Markus"],["dc.contributor.author","Fiß, Thomas"],["dc.contributor.author","Himmel, Wolfgang"],["dc.date.accessioned","2021-08-26T14:46:01Z"],["dc.date.available","2021-08-26T14:46:01Z"],["dc.date.issued","2018"],["dc.description.abstract","Hospitalisation influences drug therapy in ambulatory care and this influence is generally negatively perceived. The few studies that have explored changes in benzodiazepine or sleep medication use as a function of hospitalisation failed to precisely determine the hospital's role in initiating, continuing and discontinuing these drugs on a valid basis. The aim of the study was to ascertain the overall influence of hospitalisation on the prescription of benzodiazepines and Z-drugs in outpatient care with a special focus on the role of different hospital departments and drug classes."],["dc.identifier.doi","10.4414/smw.2018.14590"],["dc.identifier.pmid","29442341"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/88876"],["dc.language.iso","en"],["dc.relation.eissn","1424-3997"],["dc.relation.issn","1424-7860"],["dc.relation.orgunit","Institut für Allgemeinmedizin"],["dc.title","The influence of hospitalisation on the initiation, continuation and discontinuation of benzodiazepines and Z-drugs - an observational study"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.subtype","original_ja"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","107"],["dc.bibliographiccitation.issue","1"],["dc.bibliographiccitation.journal","European Journal of Clinical Pharmacology"],["dc.bibliographiccitation.lastpage","115"],["dc.bibliographiccitation.volume","77"],["dc.contributor.author","Grimmsmann, Thomas"],["dc.contributor.author","Himmel, Wolfgang"],["dc.date.accessioned","2021-04-14T08:24:49Z"],["dc.date.available","2021-04-14T08:24:49Z"],["dc.date.issued","2020"],["dc.identifier.doi","10.1007/s00228-020-02948-3"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/81432"],["dc.language.iso","en"],["dc.notes.intern","DOI Import GROB-399"],["dc.relatedmaterial.material","https://www.sueddeutsche.de/wissen/adhs-medikamente-kinder-ritalin-1.5132811!amp"],["dc.relation.eissn","1432-1041"],["dc.relation.issn","0031-6970"],["dc.relation.orgunit","Institut für Allgemeinmedizin"],["dc.rights","CC BY 4.0"],["dc.title","The 10-year trend in drug prescriptions for attention-deficit/hyperactivity disorder (ADHD) in Germany"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.subtype","original_ja"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","847"],["dc.bibliographiccitation.issue","8"],["dc.bibliographiccitation.journal","European Journal of Clinical Pharmacology"],["dc.bibliographiccitation.lastpage","854"],["dc.bibliographiccitation.volume","67"],["dc.contributor.author","Grimmsmann, Thomas"],["dc.contributor.author","Himmel, Wolfgang"],["dc.date.accessioned","2018-11-07T08:53:40Z"],["dc.date.available","2018-11-07T08:53:40Z"],["dc.date.issued","2011"],["dc.description.abstract","Purpose Defined daily doses (DDD) are used for the measurement of drug utilisation. The aim of the study was to analyse whether differences between DDD and prescribed daily doses (PDD) exist for relevant drug classes such as antihypertensive drugs and, if so, whether they primarily depend on drug classes or patient-related factors. Methods Using the data of a large German statutory health insurance scheme, we analysed continuous prescriptions for the following antihypertensive drug classes: thiazide diuretics, beta-blockers, dihydropyridine calcium channel blockers (CCBs), angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin-II receptor blockers (ARBs). We summed the doses of all dispensed drugs per person during a defined time frame. We calculated the PDD (= total dose divided by the number of days) and expressed them as the PDD: DDD ratio (= amount of DDD per day and person). Results During the study period, 149,704 patients continuously received an antihypertensive medication. The average PDD: DDD ratio ranged from 0.84 (beta-blockers) to 1.88 (ARBs) and 2.17 (ACEIs). The average prescribed dosage of each drug class remained unchanged, even if the patients had previously received another antihypertensive drug with another PDD: DDD ratio. For example, if patients were switched from a beta-blocker to an ACEI, the PDD:DDD ratio increased, on average, from 0.79 to 2.17. Vice versa, the ratio decreased for patients with a drug change from an ACEI to a beta-blocker from 2.06 to 0.75. Conclusions Even large differences between DDD and PDD seem to be a matter of drug classes and not primarily of patient characteristics."],["dc.identifier.doi","10.1007/s00228-011-1014-7"],["dc.identifier.isi","000293789800011"],["dc.identifier.pmid","21544512"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/7522"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/22475"],["dc.notes.intern","Merged from goescholar"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.relation.issn","0031-6970"],["dc.relation.orgunit","Institut für Allgemeinmedizin"],["dc.rights","Goescholar"],["dc.rights.uri","https://goescholar.uni-goettingen.de/licenses"],["dc.title","Discrepancies between prescribed and defined daily doses: a matter of patients or drug classes?"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.subtype","original_ja"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.artnumber","e011650"],["dc.bibliographiccitation.issue","11"],["dc.bibliographiccitation.journal","BMJ Open"],["dc.bibliographiccitation.volume","6"],["dc.contributor.author","Grimmsmann, Thomas"],["dc.contributor.author","Himmel, Wolfgang"],["dc.date.accessioned","2018-11-07T10:19:39Z"],["dc.date.available","2018-11-07T10:19:39Z"],["dc.date.issued","2016"],["dc.description.abstract","Objectives: The aim of the study was to compare therapy persistence among patients who started with one of three drug regimens: a monotherapy, or combination therapy either as a fixed combination (ie, 'single pill') or as a free combination (ie, two separate antihypertensive agents). Design: In a secondary data analysis, we used descriptive statistics and multivariate logistic regression to measure the effect of the three therapy regimens on therapy persistence over 4 years. Setting: Prescription data from a large German statutory health insurance provider. Participants: All patients who started with a new antihypertensive therapy in 2007 or 2008 (n=8032) were included and followed for 4 years. Primary outcome measure: Therapy persistence, defined as receiving a refill prescription no later than within 180 days. Results: The persistence rates after 4 years were nearly identical among patients who started with a monotherapy (40.3%) or a fixed combination of two drugs (39.8%). However, significantly more patients who started with free-drug combinations remained therapy persistent (56.4%), resulting in an OR of 2.00 (95% CI 1.6 to 2.5; p<0.0001) for free combinations versus fixed combinations. This trend was observed in all age groups and for men and women. At the end of the study period, the number of different antihypertensive agents was still similar between patients who started with a fixed combination (2.41) and patients who started with a free combination (2.28). Conclusions: While single-pill combinations make it easier to take different drugs at once, the risk is high that these several substances are stopped at once. Therapy persistence was significantly better for patients who started with a free-drug combination without taking much fewer different antihypertensive drugs as those with a fixed combination."],["dc.identifier.doi","10.1136/bmjopen-2016-011650"],["dc.identifier.isi","000391303400065"],["dc.identifier.pmid","27881519"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/14236"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/41707"],["dc.notes.intern","Merged from goescholar"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.relation.issn","2044-6055"],["dc.relation.orgunit","Institut für Allgemeinmedizin"],["dc.rights","CC BY-NC 4.0"],["dc.rights.uri","https://creativecommons.org/licenses/by-nc/4.0"],["dc.title","Comparison of therapy persistence for fixed versus free combination antihypertensives: a retrospective cohort study"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.subtype","original_ja"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.artnumber","e011908"],["dc.bibliographiccitation.issue","8"],["dc.bibliographiccitation.journal","BMJ Open"],["dc.bibliographiccitation.volume","6"],["dc.contributor.author","Heinemann, Stephanie"],["dc.contributor.author","Weiss, Vivien"],["dc.contributor.author","Straube, Kati"],["dc.contributor.author","Nau, Roland"],["dc.contributor.author","Grimmsmann, Thomas"],["dc.contributor.author","Himmel, Wolfgang"],["dc.contributor.author","Hummers-Pradier, Eva"],["dc.date.accessioned","2018-11-07T10:20:03Z"],["dc.date.available","2018-11-07T10:20:03Z"],["dc.date.issued","2016"],["dc.description.abstract","Introduction: Hypnotics and sedatives, especially benzodiazepines and Z-drugs, are frequently prescribed for longer periods than recommended-in spite of potential risks for patients. Any intervention to improve this situation has to take into account the interplay between different actors, interests and needs. The ultimate goal of this study is to develop-together with the professionals involved-ideas for reducing the use of hypnotics and sedatives and then to implement and evaluate adequate interventions in the hospital and at the primary and secondary care interface. Methods and analysis: The study will take place in a regional hospital in northern Germany and in some general practices in this region. We will collect data from doctors, nurses, patients and a major social health insurer to define the problem from multiple perspectives. These data will be explored and discussed with relevant stakeholders to develop interventions. The interventions will be implemented and, in a final step, evaluated. Both quantitative and qualitative data, including surveys, interviews, chart reviews and secondary analysis of social health insurance data, will be collected to obtain a full understanding of the frequency and the reasons for using hypnotics and sedatives. Ethics and dissemination: Approval has been granted from the ethics review committee of the University Medical Center Gottingen, Germany. Results will be disseminated to researchers, clinicians and policy makers in peer-reviewed journal articles and conference publications. One or more dissemination events will be held locally during continuous professional development events for local professionals, including (but not confined to) the study participants."],["dc.description.sponsorship","German Federal Ministry of Health; [FKZ-IIA5-2513DSM228]"],["dc.identifier.doi","10.1136/bmjopen-2016-011908"],["dc.identifier.isi","000382336700064"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/13757"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/41801"],["dc.notes.intern","Merged from goescholar"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.relation.issn","2044-6055"],["dc.relation.orgunit","Institut für Allgemeinmedizin"],["dc.rights","CC BY-NC 4.0"],["dc.rights.uri","https://creativecommons.org/licenses/by-nc/4.0"],["dc.title","Understanding and reducing the prescription of hypnotics and sedatives at the interface of hospital care and general practice: a protocol for a mixed-methods study"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.subtype","original_ja"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","380"],["dc.bibliographiccitation.issue","21"],["dc.bibliographiccitation.journal","Deutsches Ärzteblatt international"],["dc.bibliographiccitation.lastpage","381"],["dc.bibliographiccitation.volume","119"],["dc.contributor.author","Grimmsmann, Thomas"],["dc.contributor.author","Kostev, Karel"],["dc.contributor.author","Himmel, Wolfgang"],["dc.creator.author","Grimmsmann T"],["dc.creator.author","Kostev K"],["dc.creator.author","Himmel W"],["dc.date.accessioned","2022-11-01T10:17:15Z"],["dc.date.available","2022-11-01T10:17:15Z"],["dc.date.issued","2022"],["dc.identifier.doi","10.3238/arztebl.m2022.0151"],["dc.identifier.pmid","36045552"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/116768"],["dc.identifier.url","https://publications.goettingen-research-online.de/handle/2/117160"],["dc.language.iso","en"],["dc.notes.intern","DOI-Import GROB-605"],["dc.relatedmaterial.fulltext","https://www.aerzteblatt.de/int/archive/article/225274"],["dc.relation.doi","10.3238/arztebl.m2022.0151"],["dc.relation.eissn","1866-0452"],["dc.relation.issn","1866-0452"],["dc.relation.orgunit","Institut für Allgemeinmedizin"],["dc.subject.gro","Benzodiazepines, Z-drugs, Drug Prescriptions"],["dc.title","The role of private prescriptions in benzodiazepine and Z-drug use—a secondary analysis of office-based prescription data"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.artnumber","pds.5536"],["dc.bibliographiccitation.journal","Pharmacoepidemiology and Drug Safety"],["dc.contributor.author","Grimmsmann, Thomas"],["dc.contributor.author","Himmel, Wolfgang"],["dc.creator.author","Thomas Grimmsmann"],["dc.creator.author","Wolfgang Himmel"],["dc.date.accessioned","2022-11-29T10:11:01Z"],["dc.date.available","2022-11-29T10:11:01Z"],["dc.date.issued","2022"],["dc.description.abstract","Purpose: To analyse (1) how often patients insured under the statutory health insurance (SHI) scheme received repeated prescriptions for benzodiazepines or Z-drugs as private prescriptions and (2) how often doctors switched from SHI prescriptions to private prescriptions and vice versa when issuing repeat prescriptions.\r\n\r\nMethods: On basis of anonymized prescriptions from 874 ambulatory practices in Germany, we analysed the percentage of private prescriptions for Z-drugs, benzodiazepines/anxiolytics, and benzodiazepines/hypnotics and sedatives over 6 years (2014 to 2020).\r\n\r\nResults: Of 2 200 446 prescriptions for a benzodiazepine or Z-drug, 38% were private prescriptions. In case of Z-drugs, the rate of private prescriptions was 44.1% for single prescriptions and 48.9% for refills. The difference was smaller for anxiolytics (23.3% vs. 26.0%) and, for benzodiazepine/hypnotics and sedatives, the proportion of private prescriptions for refills was even lower than for single prescriptions. In case of Z-drugs, the proportion of private prescriptions was, on average, 42.7% for the first prescription of a series of repeat prescriptions and 49.6% for the tenth prescription. The increase was smaller for anxiolytics and negligible for benzodiazepine/hypnotics and sedatives. Doctors stayed with their initial decision in more than three quarters of repeat prescriptions, be it a SHI or private prescription.\r\n\r\nConclusion: While we observed a large number of private prescriptions for benzodiazepines and Z-drugs, the proportion was only slightly higher for refills than for single prescriptions. Doctors do not seem to issue private prescriptions as a strategy to mask especially long-term use of these substances.\r\n\r\nKeywords: ambulatory care; cohort studies; drug prescriptions; hypnotics and sedatives; physicians' practice patterns."],["dc.identifier.doi","10.1002/pds.5536"],["dc.identifier.pmid","36039726"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/117863"],["dc.identifier.url","https://publications.goettingen-research-online.de/handle/2/113690"],["dc.language.iso","en"],["dc.notes.intern","DOI-Import GROB-597"],["dc.relation.doi","10.1002/pds.5536"],["dc.relation.eissn","1099-1557"],["dc.relation.issn","1053-8569"],["dc.relation.issn","1099-1557"],["dc.relation.orgunit","Institut für Allgemeinmedizin"],["dc.rights.uri","http://onlinelibrary.wiley.com/termsAndConditions#vor"],["dc.title","Role of private prescriptions in the long‐term use of benzodiazepines and Z‐drugs: a patient‐related follow‐up study"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.subtype","original_ja"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]