Akzeptanz von Patienteninformations-Broschüren zur kardiovaskulären Präventionin Hausarztpraxen

Kardiovaskuläre Krankheiten sind die Ursache für den größten Teil der Todesfälle in Deutschland. Zugleich handelt es sich bei diesem Krankheits-Spektrum um einen der am besten im Sinn evidenzbasierter Medizin erforschten Bereiche der Medizin. Neben der geforderten Evidenzbasierung sind im Sinn ei...

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Bibliographic Details
Main Author: Egidi, Günther
Contributors: Baum, Erika (Prof. Dr) (Thesis advisor)
Format: Doctoral Thesis
Published: Philipps-Universität Marburg 2008
Online Access:PDF Full Text
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Cardiovascular diseases are one of the main reasons for mortality in Germany. At the same time this is one of the most researched areas in sense of evidence based medicine. Elements of shared decision making are of growing importance for the improvement of the therapeutic relation in General Practice. The aim should be to inform the patients in an understandable and acceptable way to enable them to decide commonly with their family doctor in an informed consent. The aim of this study was to evaluate whether DEGAM patient informations concerning cardiovascular prevention are understood by the patients and accepted. Which barriers are there to the implementation of indipendent patient informations? Are they whished by the patients? There were 6 leaflets evaluated covering the themes hypertension, aspirine, movement, nutrition, anticoagulation and diabetes. Aditionally there were two leaflets to metformin and smoking the GP surgeries could give out for evaluation. Each of the patient information was given out in Bavarian rural GP offices to 10 consecutive patientes with the correspondent conditions. For the quantitative judgement we used a German translation of the DISCERN questionnaire short form –and there was an opportunity to give free commentaries. As cut-off-point fort he acceptance of a leaflet we choose a median of at least “rather yes”in each of the 14 DISCERN items. The results of the quantitative evaluations between the praxises and between doctors and patients were set in relation to each other. In addition we evaluated the qualitative commentaries of doctors and patients. The results were set into relation to sentences of the leaflets using a synopsis. The realisation of the evaluation differed in a considerable way between the GP surgeries: while one surgery was able to test all 8 different patient leaflets within 3 months, other practices hadn’t the capacity to test more than one information. 2 practices didn’t answer at all. As main reasons were declared stress in the every day work in the practice, but also difficulties of patients to understand the context of this investigation.376 questionnaires could be evaluated. The mean value of the medians about all different items was an accepting “rather yes”. The medians of answers about the question 13 (overall quality of the information) were “rather yes”. The medians of answers to the single items showed a need to improvement of the leaflets regarding the topics nutrition, smoking and metformin. The evaluation of the mean values to the different items showed partly worse results and leeds to a further correction of the informations to hypertension, aspirine and movement. The 11 doctor’s questionnaires sent back were partly quite more critical. The qualitative evaluation showed additionaly many interesting and detailed critical points and correction proposals for the improvement of the leaflets. Conclusion: the DEGAM patient information leaflets regarding cardiovascular prevention were well accepted. The evaluation regarding single aspects showed potentials for a revision of the leaflets that led to an improvement of the informations before the correspondent guideline will be produced and implemented. With 376 questionnaries this is one of the largest studies concerning the topic of acceptance of written patient information at least in Germany.