Saxon Epidemiological Study in General Practice-6 (SESAM-6): protocol of a cross-sectional study.

INTRODUCTION: General practitioners (GPs) are mostly the first point of contact for patients with health problems in Germany. There is only a limited epidemiological overview data that describe the GP consultation hours based on other than billing data. Therefore, the aim of Saxon Epidemiological Study in General Practice-6 (SESAM-6) is to examine the frequency of reasons for encounter, prevalence of long-term diagnosed diseases and diagnostic and therapeutic decisions in general practice. This knowledge is fundamental to identify the healthcare needs and to develop strategies to improve the GP care. The results of the study will be incorporated into the undergraduate, postgraduate and continuing medical education for GP. METHODS AND ANALYSIS: This cross-sectional study SESAM-6 is conducted in general practices in the state of Saxony, Germany. The study design is based on previous SESAM studies. Participating physicians are assigned to 1 week per quarter (over a survey period of 12 months) in which every fifth doctor-patient contact is recorded for one-half of the day (morning or afternoon). To facilitate valid statements, a minimum of 50 GP is required to document a total of at least 2500 doctor-patient contacts. Univariable, multivariable and subgroup analyses as well as comparisons to the previous SESAM data sets will be conducted. ETHICS AND DISSEMINATION: The study was approved by the Ethics Committee of the Technical University of Dresden in March 2023 (SR-EK-7502023). Participation in the study is voluntary and will not be remunerated. The study results will be published in peer-reviewed scientific journals, preferably with open access. They will also be disseminated at scientific and public symposia, congresses and conferences. A final report will be published to summarise the central results and provided to all study participants and the public.

Associations of an Easy-to-Understand Patient Letter on the Health Literacy of Patients after Discharge from Hospital: Results of a Randomized Controlled Intervention Study. / Assoziationen eines leicht verständlichen Patientenbriefs zur Gesundheitskompetenz nachstationärer Patienten. Ergebnisse einer randomisiert kontrollierten Interventionsstudie.

BACKGROUND: 54% of the German population has limited health literacy, which is associated with poorer health outcomes and higher utilization of the healthcare system. AIM OF THE STUDY: The aim of this pilot study was to examine the effects of an easy-to-understand patient letter on patients' health literacy after discharge from a Clinic for Internal Medicine and to analyze patients' need for written, easy-to-understand information. METHOD: In a randomized controlled trial (2016-2018), the effects of the patient letter on health literacy were examined by means of the HLS-EU-Q47 questionnaire. The intervention group (IG, n=242) received an easy-to-understand patient letter 3 days after discharge, the control group (KG, n=175) received only the usual medical discharge letter. RESULTS: 60% of post-discharge patients were found to have limited health literacy. The study could not show any effect of patient letters on overall health literacy. The analysis of single items of health literacy showed positive effects of these letters on patients' comprehension of medical advice as well as their understanding and implementation of medication instructions (Cohens d≥0.20). Furthermore, patients expressed their wish for information after discharge from hospital (99%) and rated the patient letter as informative, understandable and helpful. CONCLUSIONS: Patients wish to receive and are empowered by an easy-to-understand letter after discharge from hospital with medical information and medical instructions that they can implement at home.