[Individual risk screening and visualization as a central element of health days through the interactive electronic GloRiA program]. / Individuelles Risikoscreening und Visualisierung als zentrales Element von Gesundheitstagen. Einsatz des interaktiven elektronischen GloRiA-programms.

BACKGROUND: Health days are an established forum for prevention and health promotion for different groups in the general population. Through the use of modular questionnaires "Global Risk Assessment" (GloRiA) on computers (handheld and desktop), the recording of patient data and presentation of the results can be optimized. Possible applications include identification of risk factors, early detection of patients at risk, epidemiology and health services research, promotion of patient adherence by visualizations (e.g. risk scores). Up to 12 different question modules are available (e.g. risk for the occurrence of cardiovascularevents by Framingham score, forfuture riskof diabetes mellitus using FindRisk score, smoking, COPD, pain, comorbidities). METHODS AND RESULTS: During 57 health days in 2010 and 2011, data were collected from 3451 persons (53% women, mean age 59.6 +/- 15.4 years) using GloRiA. The percentage of former smokers was 32.7%, while that of current smokers was 14.7%. The average 10-year risk based on the Framingham score (calculated with 1739 persons) in 53.7% of respondents was at <10%, in 37.0% at 10-20%, and in 9.3% at > 20%. In men risk was higher than in women. Smoking cessation would theoretically reduce the mean 10-year risk from 10.9 +/- 9.2% to 7.4 +/- 6.6%. In 50.5% of participants blood pressure measurement revealed elevated values, and in 10% or 2%, respectively, a moderately high or high 10-year riskof incident diabetes mellitus according to FindRisk. CONCLUSION: The use of GloRiA for the consolidation of health data under the framework of health days provides new and sustained possibilities in early detection of cardiovascular disease. The calculation and visualization of risks and the impact of treatment decisions, e.g. reduction of cardiovascular risk by smoking cessation, were communicated directly to the participants. The individual health report facilitates the diagnostic procedures bya physician.

[Patient classification and analysis of risk profiles for type 2 diabetics as the main focus point in practice. Results of the TEMPO study]. / Patientenklassifikation und Risikoprofilanalysen bei Typ-2-Diabetikern in der Schwerpunktpraxis. Ergebnisse der TEMPO-Studie.

BACKGROUND AND OBJECTIVE: Disease management programs (DMP) e. g. for diabetes mellitus, should be the clinical and economic basis for a structured treatment. This article shows results of specialized outpatient treatment using a risk factor depending patient classification. PATIENTS AND METHODS: Diabetes associated co-morbidities, micro- and macrovascular complications, the results and findings of blood pressure and metabolism of glucose and lipids, as well as all treatment-associated costs of 5245 type 2 diabetics were collected for a period of 12 months, accompanied by different measures of quality control. For documentation in the centres, all available original data were used as local data sources. RESULTS: The patient classification system, on which diabetic risk profiles are based, covered 74.3 % of all type 2 diabetic patients. Daily direct costs for all treatment measures ranged between EUR 4.79 (primary prevention) and EUR 8.96 for patients suffering from advanced diabetic foot syndrome. Most of the treatment costs arose from prescriptions of pharmaceuticals, other remedies and aids. Specific strategies of therapy were both related to the severity of co-morbidities and the time since manifestation of diabetes (r = 0.486; p < 0.01, two-sided). The share of patients receiving diet and exercise only decreased from 22.8 % (primary prevention) to below 10 % of patients suffering from microvascular complications. Simultaneously, the share of patients receiving insulin increased up to 81.8 % of patients suffering from advanced diabetic retinopathy. CONCLUSION: The risk profile specific variation in the results clearly shows the need of a risk factor depending classification system for type 2 diabetes, which could be useful to reform and focus the system of compensating payments between health insurance companies more and more on morbidity, or on risk profiles.