Research
Research
Resistance testing for outpatient urinary tract infections
Current status:
Ongoing
Description:
Background:
Urinary tract infections are among the most common bacterial infectious diseases and are a frequent reason for antibiotic prescriptions in the outpatient setting. Previous studies indicate a high variability in the diagnosis and treatment of outpatient urinary tract infections.
Project objective:
The primary aim of the project is to survey the current practice of antibiotic resistance testing in outpatient urinary tract infections.
Method:
This is a cross-sectional survey to record the diagnostic standards for resistance testing in laboratories in northern Germany. The survey is carried out by means of a standardised questionnaire by fax; if there is no response, personal contact is made by telephone.
CHARE-GD I Subproject 4: The Influence of Primary Care Provision on Health Care in Nursing Homes
Current status: ongoing
Study director:
- Falk Hoffmann (study director)
- Sytse Zuidema (University Medical Centre Groningen, partial study management)
Responsible scientists (Oldenburg)
- Alexander Fassmer
Funding
- Ministry of Science and Culture of Lower Saxony (March 2021 - October 2024)
Links:
Project description:
- Although the residents of nursing homes in Germany and the Netherlands hardly differ from each other, there are major discrepancies with regard to their medical care. Subproject 4 of the CHARE-GD I study therefore aims to identify differences and similarities in health care between German and Dutch nursing home residents. The consequences of these differences will also be assessed. The study is being conducted in co-operation with the University Medical Center Groningen. Three work packages will be carried out: 1st: The existing evidence on hospitalisation of German and Dutch nursing home residents will be compared by means of a systematic review. 2: Randomly selected 600 German and 600 Dutch nursing homes will be surveyed by post on the topics of medical care, hospital transport and end-of-life care. 3: In Germany and the Netherlands, a total of 24 individual interviews will be conducted with nursing staff and general practitioners or elder care physicians, focussing on the actual medical care in nursing homes and on the strengths and weaknesses of both countries.
CoMpsyKids: Effects of COVID-19-related measures on the mental health of children and adolescents in Lower Saxony
Current status: ongoing
Study director:
- Falk Hoffmann (study director)
- Luise Poustka (Heidelberg University Hospital, Department of Child and Adolescent Psychiatry, sub-study leader)
Responsible scientists (Oldenburg)
- Michael Dörks
- Alexander Fassmer
- Kathrin Jobski
Sponsorship
- COVID-19 Research Network Lower Saxony (COFONI), funded by the Ministry of Science and Culture of Lower Saxony (July 2023 - December 2025)
Links:
Project description:
- There is still a great need for research on how the COVID-19-related measures have affected the mental health of children and adolescents. The aims of this project are to investigate the development of mental illness in children and adolescents in Lower Saxony and their treatment during the course of the pandemic, to place these results in an international context and to develop recommendations to promote the mental health of this group. Based on routine data from the AOK Lower Saxony from 2018-2022, trends in the prevalence of depressive disorders, attention deficit and hyperactivity disorder, anorexia and anxiety disorders, as well as psychotropic drug prescriptions such as antidepressants, will be analysed for 0-17 year olds. The influence of socioeconomic differences will be analysed using the deprivation index. Furthermore, the literature on the effects of COVID-19-related measures on the mental health of children and adolescents will be analysed using systematic reviews in order to place the results of the routine data analysis in a national and international context. Based on this, recommendations will be developed to identify particularly vulnerable groups and the transferability of international instruments, e.g. to reduce potential barriers to the utilisation of health services, will be examined. The innovative and interdisciplinary co-operation between the two locations brings together the methodological and clinical expertise required for this research project.
StrokeCompass - Decision coaching and adherence support for the prevention of stroke recurrence
Current status: ongoing
Project participants:
- Anne C. Rahn (University of Lübeck, head of the junior research group)
Scientists responsible (Oldenburg):
- Falk Hoffmann
- Jasmin Helbach
Co-operation partners
- University of Lübeck
- UKE Hamburg
Funding: Federal Ministry of Education and Research (BMBF)
Project duration: 01.12.2022- 30.08.2027
Aim:
The aim of the project is to develop and pilot a coaching intervention to support people who have suffered a stroke in their decision to take medication to prevent a recurrent stroke and subsequently to promote adherence, i.e. compliance with the jointly set therapy goals
Methodology
Following the Medical Research Council (MRC) guidelines for the development and evaluation of complex interventions, a mixed method study is planned that addresses the "intervention development" and "feasibility" phases.
The development of the intervention is based on a comprehensive evidence synthesis. For this purpose, various reviews, a guideline synthesis and a case study will be conducted and supplemented by a survey of those affected. The intervention itself will consist of several components and includes a web-based decision aid, decision coaching by carers, a medical decision discussion and adherence coaching. The decision coaching will be based on the interprofessional model of shared decision-making and the adherence coaching will include motivational interviewing.
After development, the intervention will be evaluated and revised in two pretests before being piloted in a stepped-wedge design study with around 440 participants over approximately three years at six locations in Germany. The pilot study will be accompanied by a process and health economic evaluation.
Good life
Health care planning for the last phase of life (according to § 132g SGB V) in nursing homes: Implementation to date, barriers and recommendations for further development
Scientific sub-project leaders
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Research assistants
- Hannes Jacobs (University of Oldenburg, Department of Health Services Research, Division of Outpatient Care and Pharmacoepidemiology)
- Tanja Schleef (MHH, Institute for General Medicine and Palliative Medicine)
- Anna Völkel (University of Oldenburg, Department of Health Services Research, Division of Rehabilitation Research)
Project duration
- 07/2022 - 06/2025
Project description
The health care of the approximately 800,000 people currently living in nursing homes in their last phase of life is considered to be problematic. With the introduction of § 132g SGB V - health care planning (GVP) for the last phase of life - nursing homes can offer appropriate counselling services and charge them to the statutory public health insurance.
As it has not yet been investigated whether the change in the law has had an impact on care practice in the meantime, the Gut-Leben project aims to determine the implementation to date of the options for GVP for the last phase of life created by law in 2018 in the nursing home setting and to develop proposals for further practical development.
In five different work packages, relevant stakeholders in care facilities will be asked about barriers and support factors for the implementation of these legal requirements. In addition, characteristics of counselling sessions and care pathways at the end of life will be evaluated and the extent to which the course certificates prescribed for settlement can be used scientifically will be investigated. Furthermore, routine data from people newly admitted to a nursing home will provide information on which characteristics may be relevant for future care planning. The knowledge gained from this and from focus groups, individual interviews and meetings of a practice advisory board will be incorporated into recommendations for the further development of care.
If successful, the Gut-Leben project will make it possible to improve the health care of people in their final phase of life in a nursing home by recognising deficits and developing recommendations for further development. Furthermore, it is possible to transfer the results of the project to nursing homes throughout Germany.
Consortium partners and co-operation partners
- Hannover Medical School (MHH), Institute for General Medicine and Palliative Medicine
- AOK Lower Saxony (Dr PH Jona Stahmeyer)
Evidence syntheses and their methodology
Systematic reviews identify all studies relevant to a research question, evaluate their results and quality, summarise them and make them accessible to a wide audience. Although extensive literature including reporting standards exist for systematic reviews, these often focus very strongly on questions of efficacy. Particularly in the area of systematic reviews on the frequency of diseases or the utilisation of healthcare services, which is important for healthcare research, special methodological challenges must be taken into account. On the one hand, more systematic reviews have been published in recent years overall and also on questions of health services research, but on the other hand these often have methodological weaknesses. On the one hand, our department conducts its own systematic reviews with a focus on health services research. At the same time, we analyse various aspects of the methodological quality of systematic reviews and their abstracts, particularly with regard to reporting, in an attempt to identify potential for improvement. For example, we have analysed trends in the reporting of systematic reviews over the last 20 years.
STADPLAN - Advance Care Planning for older people in need of care and living in their own home environment in Germany: a cluster-randomised study
Current status: completed
Project participants:
- Falk Hoffmann
- Gabriele Meyer (Institute for Health and Nursing Science, Martin-Luther-
University Halle-Wittenberg)
- Sascha Köpke (Institute for Social Medicine and Epidemiology, University of Lübeck)
- Juliane Köberlein-Neu (University of Wuppertal)
Responsible scientists (Oldenburg):
- Falk Hoffmann
- Rieke Schnakenberg
Funding: Federal Ministry of Education and Research (BMBF)
Duration: August 2017 - January 2021
Description
Background:
Older people are in favour of being able to define their wishes for future care and in the event of incapacity to give consent. The concept of "Advance Care Planning (ACP)" provides for a process of dialogue about future medical and care wishes with the people involved in their care.
Project objective:
The primary project objective is the development and evaluation of an ACP concept adapted to the care provided by German care services, in which the carers lead the discussion process.
Method:
This is a cluster-randomised controlled study that will be conducted over 12 months at the 3 study sites Oldenburg, Lübeck and Halle. The intervention and control groups will each be randomly assigned to 16 care services, each of which will include an average of 30 patients in the study (n=960). The nursing counsellors will be familiarised with the concept in a 2-day training course and prepared for the home counselling sessions (intervention). The primary endpoint is patient activation, measured using the PAM-13-D (Patient Activation Measure). Secondary endpoints include hospitalisation, quality of life, advance directives and anxiety. In addition, a comprehensive economic evaluation and process evaluation will take place.
Utilisation potential:
For the first time, this study enables statements to be made about the benefits and efficiency of carers as discussion facilitators in anticipatory care planning and their adoption in standard care.
Oral health for people in need of care (MundPflege)
Current status: terminated
Consortium partner:
Prof. Dr Heinz Rothgang
Prof. Dr Werner Brannath
Prof Dr Falk Hoffmann
Project partner:
BKK Dachverband e.V.
Funding:
Innovation Fund of the Federal Joint Committee (G-BA) (September 2017 - August 2020)
Project description:
Background:
Current studies show that people in need of care make significantly less use of dental services than those who are not in need of care. At the same time, there is an increased need for support with daily oral care, even among those in need of care with lower care levels or care grades.
Project objective:
The project Oral Health in People in Need of Care (MundPflege) is trialling a new form of care (nVF) for people in need of outpatient care with the aim of intensifying dental care for this group of people and improving their oral health. The oral health-related quality of life, which is determined, among other things, by freedom from pain, the ability to adequately grind and swallow food, to speak and thus to participate in social life, is improved.
Method:
The nVF is provided by practising dentists and dental assistants (ZFA). A key feature of the nVF is the outreach and low-threshold approach. Those in need of care are contacted by the BKK and informed about the nVF. They are also relieved of the burden of making an appointment with a dentist. After a dentist has carried out an individual risk analysis for each person in need of care as part of the nVF, advanced and specially trained dental assistants (ZFA) instruct the people in need of care and their informal carers on individual oral care. This means that those in need of care can receive outreach care in their own homes.
The evaluation of the nVF is based on a two-arm randomised controlled trial (RCT) with a case number of 500 subjects each in the intervention and control group. In addition, a BKK routine data analysis will be carried out in which the primary data of the RCT will be linked with the available routine data at the level of the insured persons by means of record linkage. In addition, a health economic evaluation and a potential analysis will be carried out.
Utilisation potential:
If the evaluation is successful, the aim is to transfer the nVF to standard care and thus contribute to the further development of the corresponding guideline according to § 22a SGB V of the Federal Joint Committee (G-BA).
HOMERN - Hospitalisation and emergency department visits of nursing home residents: frequency, causes and development of an intervention to improve care
Current status: finished
Study director:
- Falk Hoffmann (Study Director)
- Michael Freitag (partial study director)
- Guido Schmiemann (IPP, University of Bremen, sub-study director)
www.ipp.uni-bremen.de/mitglieder/guido-schmiemann/
Responsible scientists and researchers:
- Alexander Fassmer
- Ove Spreckelsen
- Alexandra Pulst (IPP, University of Bremen)
www.public-health.uni-bremen.de/mitglieder/alexandra-pulst/
Funding:
Innovation Fund of the Federal Joint Committee (G-BA) (May 2017 - April 2020)
Current status:
Ongoing
Links:
Project summary
All projects funded under the call for proposals
innovationsfonds.g-ba.de/projects/care-research/
Description:
Background:
There are currently around 800,000 people living in care homes in Germany. This population is characterised by a high level of chronic illnesses, often accompanied by polypharmacy, as well as physical and cognitive limitations. Nursing home residents are also frequently treated in emergency departments and hospitals, with the majority of these visits considered inappropriate or avoidable according to international literature. Data from Germany on hospitalisations and emergency room visits by nursing home residents is largely lacking. Furthermore, the specific system of on-call services for SHI-accredited doctors in Germany must also be taken into account.
Project objective:
The aim is to obtain a comprehensive picture of emergency room visits and hospitalisations of nursing home residents as well as the underlying care processes and possible deficits. Based on this, an intervention to improve care is to be developed and piloted.
Method:
Mixed methods approach with 4 consecutive work packages (WP). WP 1: Routine data from the AOK Bremen/Bremerhaven will be used to analyse the frequency and diagnoses of NHH in nursing home residents (n=4,200). WP 2: Using a questionnaire developed from this, the causes and care processes that led to NH are prospectively analysed for residents over a 12-month period (n=1,000 events). WP 3: Using a survey of general practitioners in Bremen and Lower Saxony, case vignettes are created based on frequently occurring scenarios from WP 2 and assessments of avoidability and alternatives are collected (gross sample n=1,121). WP 4: A suitable intervention to improve care is developed in focus groups with all relevant groups of people based on the findings to date. This will then be piloted and its feasibility and acceptance will be analysed.
Utilisation potential:
In nursing home residents, NH is common but highly preventable. This project is the first to comprehensively analyse the current situation, possible care deficits and their causes, and develop a targeted intervention based on this.
Project partners:
- University of Bremen, Institute for Public Health and Nursing Research (IPP), Department 1: Health Services Research
www.ipp.uni-bremen.de/forschung/abteilung-1--versorgungsforschung/
AOK Bremen/Bremerhaven bremen.aok.de
ProFem - Care, functionality and quality of life after proximal femur fracture
Current status: terminated
Consortium partner:
- Andrea Icks(Institute for Health Services Research and Health Economics,
Heinrich Heine University Düsseldorf, consortium leader)
- Gabriele Meyer (Institute for Health and Nursing Science, Martin-Luther-
University Halle-Wittenberg)
- Falk Hoffmann
- Joachim Windolf (Clinic for Trauma and Hand Surgery, Heinrich Heine University
Düsseldorf)
- Christoph Rupprecht (Health Policy/Health Economics Department, AOK Rheinland-Hamburg)
Rhineland-Hamburg)
Responsible scientists (Oldenburg):
- Kathrin Jobski
- Alexander Fassmer
Funding:
Innovation Fund of the Federal Joint Committee (G-BA) (May 2017 - April 2020)
Current status:
Ongoing
Links:
Project summary
All projects funded as part of the call for proposals
innovationsfonds.g-ba.de/projekte/versorgungsforschung/
Description:
Background:
Falls often lead to so-called proximal femur fractures (PFF) in older people. Many patients retain limitations in their ability to function after such an event. Special aftercare programmes must be designed to help older people regain the best possible independence after PFF. However, there are gaps in care here, as more than half of those affected do not receive any further treatment.
Project objective:
The aim of the project is, on the one hand, to take stock of the care situation (use of healthcare services and their costs) and to describe clinical events such as hospitalisation or the onset of care dependency. On the other hand, the information reported by those affected on quality of life, functional ability and social participation is analysed over the course of their lives. The aim is to identify people who potentially require more intensive care.
Method:
This is a population-based prospective observational study based on health insurance data and collected primary data, which are linked individually. Insured persons with PFF are consecutively included in the study over a period of 12 months. Primary data surveys (by interview and by post) are planned at several points in time after the event. In addition, 12-month retrospective and prospective health insurance data of the participating insured persons will be linked with the self-reported data.
Utilisation potential:
The project results should help to recognise possible care deficits in people with PFF and identify people with special care needs. Measures will then be formulated to help further develop target group-specific aftercare services for elderly people with PFF.
Project partners:
- University of Düsseldorf
- University of Halle-Wittenberg
- AOK Rhineland/Hamburg
ASD-Net - Care and costs of autism spectrum disorders in our healthcare system
Current status: finished
Study director:
Falk Hoffmann
Christian Bachmann (King's College London, Institute of Psychiatry, Psychology & Neuroscience)
Inge Kamp-Becker (University Hospital Marburg, Child and Adolescent Psychiatry)
Researchers responsible:
Juliana Höfer
Funding:
BMBF (February 2015 to July 2020)
Current status:
The survey has been completed. The data is currently being analysed and the results published.
Links:
Homepage of the ASD-Net
AG Care research in child and adolescent psychiatry
Description:
Background:
Autism spectrum disorder (ASD) is a complex and lifelong disorder that masks a wide range of symptoms, a broad spectrum of clinical manifestations and a wide variation in severity. It begins in childhood, can have a variety of effects and requires a high or complex level of care. Autism spectrum disorders can be associated with considerable restrictions in many areas of life for those affected. At the same time, these disorders also cause high costs for the healthcare system, which increase with age. In addition, current data suggests that the prevalence of ASD has increased in recent years. To date, studies on the care and costs of this disorder have mainly been conducted abroad. However, these are only transferable to the German situation to a limited extent due to different healthcare systems and framework conditions.
Project objective:
The ASD-Net is a large research network funded by the BMBF, which is dedicated to the topic of autism spectrum disorders, from the molecular basis, diagnostics and therapy to care and its costs.
Our sub-project (SP 5) is concerned with creating a realistic picture of the care processes, utilisation and resource consumption of autism spectrum disorders. The aim is to use the findings to identify opportunities for more efficient care.
Method:
The data basis is formed by the patients treated in the study centres in Marburg, Dresden, Berlin and Mannheim. These include children and adolescents as well as adults. Specific questionnaires will be developed for the study.
In addition to our own data collection, systematic literature research will be conducted to determine which studies are already available internationally on the research questions and how they correspond to the results we have found.
Project partners:
Marburg University Hospital, Department of Child and Adolescent Psychiatry
www.uni-marburg.de/fb20/kjp/forschung/aut
University Hospital Carl Gustav Carus Dresden, Clinic and Polyclinic for Child and Adolescent Psychiatry and Psychotherapy
ZI Mannheim, Department of Clinical Psychology
Max Planck Institute for Human Cognitive and Brain Sciences Leipzig, Department of Social Neuroscience
Charité - Universitätsmedizin Berlin, Benjamin Franklin campus, Department of Psychiatry and Psychotherapy
University of Bremen, Centre for Social Policy (ZeS), Department of Health Economics, Health Policy and Health Services Research
www.zes.uni-bremen.de/abteilungen/gesundheitsoekonomie-gesundheitspolitik-und-versorgungsforschung/
PROCLAIR - Merging patient surveys with health insurance data for health services research in rheumatology
Current status: finished
Study management:
Angela Zink (DRFZ, Berlin)
Falk Hoffmann
Responsible scientists:
Sabrina Hense
Johanna Callhoff (DRFZ, Berlin)
Funding:
BMBF (February 2015 to July 2019)
Current status:
The project has started and the first survey is currently underway.
Description:
Background:
Chronic musculoskeletal disorders are among the most important causes of disability and reduced quality of life. They cause high social costs through treatment, incapacity to work and early retirement. For rheumatoid arthritis, a disease that often progresses gradually but is also characterised by sudden onset of pain in the small finger or toe joints, sufferers are often only seen by internal rheumatologists at a very late stage, despite effective treatment strategies and high-quality guidelines. It is not known how patients who are not treated by rheumatologists are cared for, what disease burden and disease consequences they have to bear, and what differences in care exist. We also know little about the general care situation for ankylosing spondylitis (Bechterew's disease), a chronic inflammatory rheumatic disease with pain and stiffening of joints, as well as osteoarthritis of the hip and knee joints.
Project objective:
The aim of the network is therefore to gain new and fundamental insights into the care situation, the burden of disease and the costs of treating people with three important musculoskeletal diseases. These are the two inflammatory rheumatic diseases rheumatoid arthritis (RA) and ankylosing spondylitis (AS) as well as osteoarthritis of the hip or knee joints caused by degenerative changes. While we have good knowledge of the care situation of patients treated by rheumatologists thanks to various registers and cohort studies, we know very little about how patients who are only treated by GPs or who do not receive specialised care are treated today. Of particular interest is whether there are differences in care depending on age, gender, region of residence or social status.
Method:
The data is based on routine data from BARMER GEK, one of the largest health insurance funds in Germany with around 9 million insured persons. A sample of 4,000 to 6,000 insured persons is drawn from this data for each of the three disease groups and surveyed by post.
The information generated from the questionnaires is merged with the routine data of the insured persons, so that the combination of these two survey methods provides a large amount of data on the individual assessment of those affected as well as on utilisation and the resulting costs.
Project partners:
German Rheumatism Research Centre (DRFZ): An Institute of the Leibniz Association
BARMER GEK
Charité Universitätsmedizin Berlin, Rheumatology, Benjamin Franklin Klinikum site
Carl Gustav Carus University Dresden, Clinic and Polyclinic for Orthopaedics
www.uniklinikum-dresden.de/ouc
Carl Gustav Carus University Dresden, Centre for Evidence-Based Healthcare
www.uniklinikum-dresden.de/zegv
University of Bremen, Centre for Social Policy (ZeS), Department of Health Economics, Health Policy and Health Services Research
www.zes.uni-bremen.de/abteilungen/gesundheitsoekonomie-gesundheitspolitik-und-versorgungsforschung/
Painkillers in the outpatient care of elderly patients
Current status: finished
Study director:
Falk Hoffmann
Gerd Glaeske (ZeS, University of Bremen)
www.zes.uni-bremen.de/das-zentrum/organisation/mitglieder/gerd-glaeske/
Researchers responsible:
Jana Schulze (ZeS, University of Bremen)
www.zes.uni-bremen.de/das-zentrum/organisation/mitglieder/jana-schulze/
Funding:
Dr Werner Jackstädt Foundation (April 2014 to March 2016)
Current status:
The project is in the evaluation phase.
Description:
Background:
Pain is a significant and common health problem in older people and has a significant impact on their quality of life. In the treatment of tumour-related and non-tumour-related pain, the World Health Organization (WHO) stepwise plan provides for a gradual escalation in the intensity of treatment with analgesics if necessary. However, age-related changes in pharmacokinetics and dynamics, frequently existing polymedication, the age-specific spectrum of side effects and possible drug interactions must be taken into account. Guidelines on pain management in older people exist mainly for the Anglo-Saxon world, but these do not take German market conditions into account (e.g. the active ingredient metamizole is not authorised in many countries).
Project objective:
The aim of this project is to provide a comprehensive overview of the supply of painkillers for older people. To this end, the prescription of individual active ingredients or active ingredient groups of the WHO schedule will be analysed for age- and gender-specific as well as regional differences. Furthermore, it will be determined how often and which painkillers are used by newly admitted nursing home residents with and without cancer.
Method:
The data basis is the routine data of the Gmünder ErsatzKasse (GEK) and the BARMER GEK. GEK was a statutory public health insurance company with 1.8 million insured persons, which merged with BARMER Ersatzkasse in 2010 to form BARMER GEK (approx. 9 million insured persons). This database offers the opportunity to gain a comprehensive insight into healthcare provision.
Diagnosis and drug prescription data from outpatient care as well as data from social long-term care insurance are used for the analyses.
Project partners:
University of Bremen, Centre for Social Policy (ZeS), Department of Health Economics, Health Policy and Health Services Research
www.zes.uni-bremen.de/abteilungen/gesundheitsoekonomie-gesundheitspolitik-und-versorgungsforschung/
University of Bremen, Institute for Public Health and Nursing Research (IPP), Department of Health Services Research
www.ipp.uni-bremen.de/forschung/abteilung-1--versorgungsforschung/
Department of General Medicine
IMREN - Improving the safety of drug therapy for nursing home residents
Current status: finished
Study director:
Falk Hoffmann
Guido Schmiemann (IPP, University of Bremen)
Responsible scientists and researchers:
Jana Schulze (ZeS, University of Bremen)
www.zes.uni-bremen.de/das-zentrum/organisation/mitglieder/jana-schulze/
Anne Dehlfing (IPP, University of Bremen)
www.ipp.uni-bremen.de/homepages/dehlfing/index.php
Michael Dörks
Funding:
KfH Foundation for Preventive Medicine (April 2014 to September 2015)
Current status:
Completed
Links:
Project summary
www.kfh-stiftung-praeventivmedizin.de/content/foerderprogramm
All projects funded as part of the call for proposals
www.kfh-stiftung-praeventivmedizin.de/content/view/download/symposiumsband.pdf
Description:
Background:
Older age, concomitant diseases and existing (poly)medication are known risk factors for chronic renal insufficiency and the associated problems in the area of drug therapy safety. Adverse drug reactions can be reduced and hospital admissions prevented by adapting medication to renal function. Nursing home residents are characterised by a particularly high level of chronic illnesses as well as physical and cognitive limitations. According to international literature, the proportion of people with chronic renal insufficiency in this group is also significantly higher than in the general population (of the same age). However, data on the frequency of impaired renal function in nursing home residents and on how often medication is not adapted to renal function in this group is still lacking in Germany.
Project objective:
On the one hand, the aim is to determine how often nursing home residents have impaired kidney function and how often they receive medication that is not or not sufficiently adapted to their kidney function. A further aim is to develop measures to prevent adverse drug reactions in nursing home residents resulting from a dosage that is not adapted to renal function.
Method:
In a cross-sectional study, data on diagnoses, laboratory values and medication for a total of almost 900 residents are being collected in around 20 care homes in Bremen and the surrounding area of Lower Saxony.
The data is collected by the nursing staff on site and passed on to the researchers in anonymised form.
The analysis of the collected data forms the basis for the development of measures to improve drug therapy safety. To this end, focus groups are conducted together with all professional groups involved in care (nursing staff, GPs, nephrologists and pharmacists).
Project partners:
University of Bremen, Centre for Social Policy (ZeS), Department of Health Economics, Health Policy and Health Services Research
www.zes.uni-bremen.de/abteilungen/gesundheitsoekonomie-gesundheitspolitik-und-versorgungsforschung/
University of Bremen, Institute for Public Health and Nursing Research (IPP), Department of Health Services Research
www.ipp.uni-bremen.de/forschung/abteilung-1--versorgungsforschung/
Red Cross Hospital Bremen, Medical Clinic
Hannover Medical School (MHH), Institute of General Medicine, Medical Statistics and IT Infrastructure Working Group
Other projects carried out with own funds
Medical and nursing care for dementia patients
Current status: completed
Description:
This is a project funded until 2011 by the Federal Ministry of Education and Research (BMBF) as part of the Degenerative Dementia Competence Network (KNDD) (funding codes: O1GI0710, 01GI0716, 01GI0717) and subsequently until 2014 by the Jackstädt Foundation.
The data basis was the routine data of the Gmünder ErsatzKasse (GEK) from 2004 to 2010. In 2006, more than 1.6 million people were insured with GEK throughout Germany, of which around 150,000 were over the age of 65. From this database, a cohort of 1,848 people with incident dementia and 7,392 age- and gender-matched controls as well as patients with prevalent dementia (e.g. 8,042 people in 2009) were analysed. Previous studies have focussed, among other things, on the medication and outpatient medical care of dementia patients, but also on questions relating to typical geriatric multimorbidity and need for care, mortality after dementia diagnosis and duration until admission to a nursing home, as well as the frequency of dementia in nursing home residents.
Further analyses are currently being carried out using the available data.