Family doctors' attitudes toward peer support programs for type 2 diabetes and/or coronary artery disease: an exploratory survey among German practitioners.

BACKGROUND: Type 2 diabetes (T2D) and coronary artery disease (CAD) are chronic illnesses where adherence to a healthy lifestyle is crucial. If organisational and cultural factors are well managed, Peer support programs (PSP) can improve self-management, quality of life, and health outcomes. In preparation for launching a PSP, we surveyed family doctors (FD) about their attitudes toward such a program and about potential barriers, and facilitators. METHODS: In March 2020 we surveyed 896 FDs from five university teaching practice networks in North-Rhine Westphalia, Germany, via an anonymous web-based survey. The questionnaire addressed details of PSPs, including suitable patients and FDs'role. Data were analysed using descriptive and inferential statistics; qualitative material underwent content analysis by two researchers. RESULTS: A total of 165 FDs responded (response rate: 18.4%), 97% were practice owners. Respondents viewed PSPs positively (T2D: 92.0%, CAD 89.9%), especially for patients with poor self-structuring (82.7%), low motivation (76.3%) and few social contacts (67.6%). On average, FDs were able to identify 4.0 ± 3.2 patients as potential group leaders. Major facilitators reported included motivation by peers (92.5%), exercise (79.1%), and social contacts (70.1%). Waning interest over time (73.1%) and poor motivation (70.9%) were considered barriers. The majority of FDs would recommend PSPs to their patients (89.5%). They considered such a program a valuable addition to current care (79.7%). The percentage of FDs' who expected long-term benefits for their workload was relatively low (37.6%). CONCLUSIONS: In an exploratory survey among German FDs on PSPs, respondents viewed PSPs as a valuable add-on for T2D and CAD patients, while not expecting a positive impact on their workload. Communication with FDs on PSPs may need to highlight anticipated implementation outcomes such as benefits of PSPs to the practice.

[Vaccine Refrigerator and Vaccine Management in General Practices: A Representative, Web-Based Survey among General Practitioners (Keep Cool I)]. / Impfkühlschrank- und Impfstoffmanagement in Hausarztpraxen: Eine repräsentative, Web-basierte Umfrage unter Hausärzten (Keep Cool I).

Aim: The purpose of this study was to analyse vaccine refrigerator and vaccine management in primary care and to identify physician- and practice-related influencing factors. Background: Adequate cooling of vaccines in a temperature range of 2-8°C is essential to assure vaccine effectiveness. Studies from various countries have demonstrated cooling chain problems. We surveyed general practitioners about the quality of their vaccine refrigerator and vaccine management and aimed at identifying physician- and practice-related influencing factors. Methods: A cross-sectional, web-based questionnaire survey was performed among 3 physician populations in primary care: a 10% random sample of general practitioners (n=954), all teaching physicians of the Universities Duisburg-Essen (n=221) and Halle-Wittenberg (n=92). Surveyed were items on the following 6 aspects: (1) responsibilities within practice teams, (2) vaccine ordering and storing, (3) criteria for the vaccine pre-selection, (4) stocking system inside the refrigerator, (5) wrapping, and use of stocking boxes, (6) refrigerator and temperature control. The quality indicator "comprehensive refrigerator management" was defined to include 4 aspects: (1) separate refrigerator, (2) written temperature documentation (temperature-logbook), (3) regular storage control (wrapping, temperature and expiration date), and (4) storage in original wrappings. Results: A total of 278 physicians participated in the survey (22%). Of these, 80% had a separate refrigerator, 52% reported written temperature documentation, 93% documented regular storage control addressing vaccine wrappings, temperature and expiration dates, and 95% reported vaccine storage in original card box wrappings. A "comprehensive refrigerator management" was realised by 42% of the practices. This indicator was reached more frequently by practices with 3 or more physicians (p=0.01) and those with an additional qualification in travel medicine (p=0.036). Conclusion: Our survey showed good results for most aspects of the refrigerator and vaccine management but room for improvement with regard to temperature documentation.

[How do you explain vaccine effects to patients? A representative, web-based survey among primary care physicians from North-Rhine Westphalia]. / Wie erklären Sie Ihren Patienten die Impfwirkung?

BACKGROUND: This study investigates how frequent general practitioners (GP) explain the immunological vaccine response to patients and which stylistic means they use. METHOD: Data from a cross-sectional, web-based survey were analyzed. The study population included a representative random sample of 10 % of GPs from North Rhine-Westphalia and all teaching physicians from two universities. The data was evaluated using a multi-method approach with a statistical analysis and a content analysis according to Mayring. RESULTS: The analysis included 187 GPs (69 % males, 56 % ≤50 years). 18.3 % of GPs routinely informed about the vaccine response. In a clinical vignette, 48.7 % used a layperson-oriented language, supported by figures of speech in 11.8 %. The key content categories were: protection against disease (63.6 %), antibody formation (64.2 %), vaccine concept (47.6 %), and potential adverse reactions (4.3 %). CONCLUSION: To improve patients' health literacy, physicians are asked to routinely explain the immunological effects of vaccines.