gms | German Medical Science

10. Deutscher Kongress für Versorgungsforschung, 18. GAA-Jahrestagung

Deutsches Netzwerk Versorgungsforschung e. V.
Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie e. V.

20.-22.10.2011, Köln

Implementation of the German PIM list in a large-scale quality circle program in Baden-Wuerttemberg

Meeting Abstract

  • corresponding author presenting/speaker Petra Kaufmann-Kolle - AQUA-Institut für angewandte Qualitätsförderung und Forschung im Gesundheitswesen GmbH, Göttingen, Germany
  • author Tonia Kazmaier - AQUA-Institut für angewandte Qualitätsförderung und Forschung im Gesundheitswesen GmbH, Göttingen, Germany
  • author Kirstin Neidhart - AQUA-Institut für angewandte Qualitätsförderung und Forschung im Gesundheitswesen GmbH, Göttingen, Germany
  • author Petra Bludau-Mysegades - AQUA-Institut für angewandte Qualitätsförderung und Forschung im Gesundheitswesen GmbH, Göttingen, Germany
  • author Erik Bauer - AQUA-Institut für angewandte Qualitätsförderung und Forschung im Gesundheitswesen GmbH, Göttingen, Germany
  • author Joachim Szecsenyi - AQUA-Institut für angewandte Qualitätsförderung und Forschung im Gesundheitswesen GmbH, Göttingen, Germany; Universitätsklinikum Heidelberg, Abteilung Allgemeinmedizin und Versorgungsforschung, Heidelberg, Germany

10. Deutscher Kongress für Versorgungsforschung. 18. GAA-Jahrestagung. Köln, 20.-22.10.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc11dkvf121

DOI: 10.3205/11dkvf121, URN: urn:nbn:de:0183-11dkvf1212

Veröffentlicht: 12. Oktober 2011

© 2011 Kaufmann-Kolle et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

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Background: In cooperation with the Hausärztliche Vertragsgemeinschaft eG (HÄVG), the MEDIVERBUND and the participating general practitioners (GPs) the AOK Baden-Wuerttemberg offers as a sickness fund in line with its statutory obligation on the basis of § 73 b SGB V the insured persons the opportunity to participate in the doctor-centered care. Such a consistent and continuous management by the general practitioner is supposed to guarantee a high quality and efficient care of the insured. Participating in data-based quality circles managed by the AQUA-Institute GPs are supported in meeting their personal quality requirements.

Materials and methods: The intervention comprises 315 quality circles with about 3,500 GPs including feedback on prescribing patterns and a series of quarterly sessions in which the feedback reports, guidelines on appropriate prescribing were discussed as well as best practices exchanged in order to reflect prescription routines and improve patient care. Each feedback and each quality circle session, respectively, focuses on a different category of drugs (antibiotics, antidiabetic or antihypertensive drugs etc.) Drugs considered to have an increased risk of adverse drug events are classified as potentially inappropriate medication (PIM). The department of P. Thuermann developed a PIM list for elderly especially for use in Germany. Immediately after the publication one quality circle session dealt with the PIM list.

Results: There were mixed reactions to the first German PIM list in the quality circles. While the recommendations were considered by some GPs to be very helpful, others found them difficult to implement in daily practice. Main criticism was the currently missing validation of the German PIM list. At present time, the effect of the intervention cannot be conclusively assessed but will be subject of later evaluation.

Conclusions: The implementation of the current best available evidence in the daily routine of general practice is a major challenge. A number of approaches with varying degrees of success has been described in literature. Particularly promising are multifaceted interventions. Quality circles with structured feedback improve demonstrably the prescription behavior. However, it is expected that a single session can serve to raise awareness of the subject, but cannot initiate a sustainable change. It is therefore important to focus again on this theme after some time and after validation of the German PIM list.