Kochen, Michael M.

[["dc.bibliographiccitation.firstpage","1"],["dc.bibliographiccitation.issue","69"],["dc.bibliographiccitation.journal","BioMed Central family practice"],["dc.bibliographiccitation.lastpage","6"],["dc.bibliographiccitation.volume","7"],["dc.contributor.author","Scherer, Martin"],["dc.contributor.author","Sobek, Cordula"],["dc.contributor.author","Wetzel, Dirk"],["dc.contributor.author","Koschack, Janka"],["dc.contributor.author","Kochen, Michael M."],["dc.date.accessioned","2019-07-09T11:41:54Z"],["dc.date.available","2019-07-09T11:41:54Z"],["dc.date.issued","2006"],["dc.description.abstract","Background: To date, evidence-based recommendations help doctors to manage patients with heart failure (HF). However, the implementation of these recommendations in primary care is still problematic as beneficial drugs are infrequently prescribed. The aim of the study was to determine whether admission to hospital increases usage of beneficial HF medication and if this usage is maintained directly after discharge. Methods: The study was conducted from November 2002 until January 2004. In 77 patients hospitalised with heart failure (HF), the medication prescribed by the referring general practitioner (GP) and drug treatment directed by the hospital physicians was documented. Information regarding the post-discharge (14 d) therapy by the GP was evaluated via a telephone interview. Ejection fraction values, comorbidity and specifics regarding diagnostic or therapeutic intervention were collected by chart review. Results: When compared to the referring GPs, hospital physicians prescribed more ACEinhibitors (58.4% vs. 76.6%; p = 0.001) and beta-blockers of proven efficacy in HF (metoprolol, bisoprolol, carvedilol; 58.4% vs. 81.8%). Aldosterone antagonists were also administered more frequently in the hospital setting compared to general practice (14.3% vs. 37.7%). The New York Heart Association classification for heart failure did not influence whether aldosterone antagonists were administered either in primary or secondary care. Fourteen days after discharge, there was no significant discontinuity in discharge medication."],["dc.identifier.doi","10.1186/1471-2296-7-69"],["dc.identifier.fs","53189"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?goescholar/1256"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/58544"],["dc.language.iso","en"],["dc.notes.intern","Merged from goescholar"],["dc.relation.orgunit","Institut für Allgemeinmedizin"],["dc.rights","CC BY 2.0"],["dc.rights.uri","https://goescholar.uni-goettingen.de/licenses"],["dc.subject.ddc","610"],["dc.subject.ddc","616"],["dc.subject.ddc","616.1"],["dc.title","Changes in heart failure medications in patients hospitalised and discharged"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.subtype","original_ja"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","1"],["dc.bibliographiccitation.issue","6"],["dc.bibliographiccitation.journal","BMC Family Practice"],["dc.bibliographiccitation.lastpage","7"],["dc.bibliographiccitation.volume","6"],["dc.contributor.author","Fischer, Thomas"],["dc.contributor.author","Fischer, Susanne"],["dc.contributor.author","Kochen, Michael M."],["dc.contributor.author","Hummers-Pradier, Eva"],["dc.date.accessioned","2019-07-09T11:42:40Z"],["dc.date.available","2019-07-09T11:42:40Z"],["dc.date.issued","2005"],["dc.description.abstract","Background: The high rate of antibiotic prescriptions general practitioners (GPs) make for respiratory tract infections (RTI) are often explained by non-medical reasons e.g. an effort to meet patient expectations. Additionally, it is known that GPs to some extent believe in the necessity of antibiotic treatment in patients with assumed bacterial infections and therefore attempt to distinguish between viral and bacterial infections by history taking and physical examination. The influence of patient complaints and physical examination findings on GPs' prescribing behaviour was mostly investigated by indirect methods such as questionnaires.Methods: Direct, structured observation during a winter \"cough an cold period\" in 30 (single handed) general practices. All 273 patients with symptoms of RTI (age above 14, median 37 years, 51% female) were included. Results: The most frequent diagnoses were 'uncomplicated upper RTI/common cold' (43%) followed by 'bronchitis' (26%). On average, 1.8 (95%-confidence interval (CI): 1.72.0) medicines per patient were prescribed (cough-and-cold preparations in 88% of the patients, antibiotics in 49%). Medical predictors of antibiotic prescribing were pathological findings in physical examination such as coated tonsils (odds ratio (OR) 15.4, 95%-CI: 3.666.2) and unspecific symptoms like fatigue (OR 3.1, 95%-CI 1.46.7), fever (OR 2.2, 95%-CI: 1.14.5) and yellow sputum (OR 2.1, 95%-CI: 1.14.1). Analysed predictors explained 70% of the variance of antibiotic prescribing (R2 = 0,696). Efforts to reduce antibiotic prescribing, e.g. recommendations for self-medication, counselling on home remedies or delayed antibiotic prescribing were rare."],["dc.identifier.doi","10.1186/1471-2296-6-6"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?goescholar/1363"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/58719"],["dc.language.iso","en"],["dc.notes.intern","Merged from goescholar"],["dc.relation.orgunit","Institut für Allgemeinmedizin"],["dc.rights","CC BY 2.0"],["dc.rights.uri","https://goescholar.uni-goettingen.de/licenses"],["dc.subject.ddc","610"],["dc.subject.ddc","616"],["dc.subject.ddc","616.2"],["dc.title","Influence of patient symptoms and physical findings on general practitioners' treatment of respiratory tract infections: a direct observation study"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.subtype","original_ja"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]