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Giebel GD, Abels C, Plescher F, Speckemeier C, Schrader NF, Börchers K, Wasem J, Neusser S, Blase N. Problems and Barriers Related to the Use of mHealth Apps From the Perspective of Patients: Focus Group and Interview Study. J Med Internet Res 2024; 26:e49982. [PMID: 38652508 DOI: 10.2196/49982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 10/24/2023] [Accepted: 01/31/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Since fall 2020, mobile health (mHealth) apps have become an integral part of the German health care system. The belief that mHealth apps have the potential to make the health care system more efficient, close gaps in care, and improve the economic outcomes related to health is unwavering and already partially confirmed. Nevertheless, problems and barriers in the context of mHealth apps usually remain unconsidered. OBJECTIVE The focus groups and interviews conducted in this study aim to shed light on problems and barriers in the context of mHealth apps from the perspective of patients. METHODS Guided focus groups and individual interviews were conducted with patients with a disease for which an approved mHealth app was available at the time of the interviews. Participants were recruited via self-help groups. The interviews were recorded, transcribed, and subjected to a qualitative content analysis. The content analysis was based on 10 problem categories ("validity," "usability," "technology," "use and adherence," "data privacy and security," "patient-physician relationship," "knowledge and skills," "individuality," "implementation," and "costs") identified in a previously conducted scoping review. Participants were asked to fill out an additional questionnaire about their sociodemographic data and about their use of technology. RESULTS A total of 38 patients were interviewed in 5 focus groups (3 onsite and 2 web-based) and 5 individual web-based interviews. The additional questionnaire was completed by 32 of the participants. Patients presented with a variety of different diseases, such as arthrosis, tinnitus, depression, or lung cancer. Overall, 16% (5/32) of the participants had already been prescribed an app. During the interviews, all 10 problem categories were discussed and considered important by patients. A myriad of problem manifestations could be identified for each category. This study shows that there are relevant problems and barriers in the context of mHealth apps from the perspective of patients, which warrant further attention. CONCLUSIONS There are essentially 3 different areas of problems in the context of mHealth apps that could be addressed to improve care: quality of the respective mHealth app, its integration into health care, and the expandable digital literacy of patients.
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Affiliation(s)
- Godwin Denk Giebel
- Institute for Health Care Management and Research, Universität Duisburg-Essen, Essen, Germany
| | - Carina Abels
- Institute for Health Care Management and Research, Universität Duisburg-Essen, Essen, Germany
| | - Felix Plescher
- Institute for Health Care Management and Research, Universität Duisburg-Essen, Essen, Germany
| | - Christian Speckemeier
- Institute for Health Care Management and Research, Universität Duisburg-Essen, Essen, Germany
| | - Nils Frederik Schrader
- Institute for Health Care Management and Research, Universität Duisburg-Essen, Essen, Germany
| | | | - Jürgen Wasem
- Institute for Health Care Management and Research, Universität Duisburg-Essen, Essen, Germany
| | - Silke Neusser
- Institute for Health Care Management and Research, Universität Duisburg-Essen, Essen, Germany
| | - Nikola Blase
- Institute for Health Care Management and Research, Universität Duisburg-Essen, Essen, Germany
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Speckemeier C, Abels C, Höfer K, Walendzik A, Wasem J, Neusser S. A Best-Worst Scaling Study of the General Population's Preferences for Activities in Living Arrangements for Persons With Dementia. Patient 2024; 17:121-131. [PMID: 38063993 PMCID: PMC10894109 DOI: 10.1007/s40271-023-00661-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/16/2023] [Indexed: 02/25/2024]
Abstract
BACKGROUND Activity involvement is a central element of dementia care. However, few studies have examined preferences for types of activities for persons who may be in need of care in the future. In this study, a best-worst scaling (BWS) was conducted to gather insights on preferred activities in small-scale living arrangements for dementia in the general population aged 50-65 years from rural and urban regions. METHODS BWS tasks were developed based on literature searches and focus groups. The final BWS contains ten activities, namely 'interaction with animals', 'gardening', 'painting, handicrafts, manual activities', 'household activities (e.g., folding laundry, cooking)', 'watching television', 'practicing religion', 'listening to music and singing familiar songs', 'conversations about the past', 'walks and excursions', 'sport activities (e.g., gymnastics)'. Each participant had to fill out subsets of four objects each and identify them as best and worst. A postal survey was sent to a total of 4390 persons from rural and urban regions aged between 50 and 65 years. Results were analyzed by count analysis and logit models. It was examined if preferences differ with respect to gender, religiousness, and informal caregiving experience. RESULTS A total of 840 questionnaires were returned, and 627 surveys were included in the analysis. In the rural sample, the highest relative importance (RI) was assigned to 'walks and excursions' (RI: 100%), 'sport activities (e.g., gymnastics)' (RI: 56%), 'gardening' (RI: 28%), and 'interaction with animals' (26%). In the urban sample, 'walks and excursions' (RI: 100%), 'sport activities (e.g., gymnastics)' (RI: 37%), 'interaction with animals' (25%) and 'gardening' (RI: 22%) were perceived as most important. In both groups, household activities and practicing religion were of lowest importance. Importance ranks differed between subgroups. Results of the logit models with random effects showed the same order as results from the count analyses. DISCUSSION Our findings show that respondents generally favored activities with an outdoor component, while the household activities that are part of many concepts were of low importance to respondents. Thus, our study can inform the design of a preference-based specific range of activities in small-scale living arrangements for dementia.
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Affiliation(s)
- Christian Speckemeier
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Thea-Leymann-Str. 9, 45127, Essen, Germany.
| | - Carina Abels
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Thea-Leymann-Str. 9, 45127, Essen, Germany
| | - Klemens Höfer
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Thea-Leymann-Str. 9, 45127, Essen, Germany
| | - Anke Walendzik
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Thea-Leymann-Str. 9, 45127, Essen, Germany
| | - Jürgen Wasem
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Thea-Leymann-Str. 9, 45127, Essen, Germany
| | - Silke Neusser
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Thea-Leymann-Str. 9, 45127, Essen, Germany
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Niemann A, Schrader NF, Speckemeier C, Abels C, Blase N, Weitzel M, Neumann A, Riederer C, Nadstawek J, Straßmeir W, Wasem J, Neusser S. Prescription of Opioid Analgesics for Chronic Non-Cancer Pain in Germany despite Contraindications: Administrative Claims Data Analysis. Int J Environ Res Public Health 2024; 21:180. [PMID: 38397671 PMCID: PMC10888146 DOI: 10.3390/ijerph21020180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 01/26/2024] [Accepted: 01/30/2024] [Indexed: 02/25/2024]
Abstract
In Germany, long-term opioid treatment (L-TOT) for chronic non-tumor pain (CNTP) is discussed as not being performed according to the German guideline on L-TOT for CNTP. In the present analysis, the occurrence and predictors of inappropriate care/overuse in a cohort of German insureds with L-TOT for CNTP by the presence of a contraindication with concurrent opioid analgesic (OA) therapy were investigated. We also analyzed whether prescribing physicians themselves diagnosed a contraindication. The retrospective cohort study was based on administrative claims data from a German statutory health insurance. Eight contraindication groups were defined based on the German guideline. Logistic regressions were performed in order to identify predictors for OA prescriptions despite contraindications. The possible knowledge of the prescribing physician about the contraindication was approximated by analyzing concordant unique physician identification numbers of OA prescriptions and contraindication diagnoses. A total of 113,476 individuals (75% female) with a mean age of 72 years were included. The most common documented contraindications were primary headaches (8.7%), severe mood disorders (7.7%) and pain in somatoform disorders (4.5%). The logistic regressions identified a younger age, longer history of OA therapy, opioid related psychological problems, and outpatient psychosomatic primary care as positive predictors for all contraindication groups.
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Affiliation(s)
- Anja Niemann
- Institute for Health Care Management and Research, University Duisburg-Essen, Thea-Leymann-Str. 9, 45127 Essen, Germany
| | - Nils F. Schrader
- Institute for Health Care Management and Research, University Duisburg-Essen, Thea-Leymann-Str. 9, 45127 Essen, Germany
| | - Christian Speckemeier
- Institute for Health Care Management and Research, University Duisburg-Essen, Thea-Leymann-Str. 9, 45127 Essen, Germany
| | - Carina Abels
- Institute for Health Care Management and Research, University Duisburg-Essen, Thea-Leymann-Str. 9, 45127 Essen, Germany
| | - Nikola Blase
- Institute for Health Care Management and Research, University Duisburg-Essen, Thea-Leymann-Str. 9, 45127 Essen, Germany
| | - Milena Weitzel
- Institute for Health Care Management and Research, University Duisburg-Essen, Thea-Leymann-Str. 9, 45127 Essen, Germany
| | - Anja Neumann
- Institute for Health Care Management and Research, University Duisburg-Essen, Thea-Leymann-Str. 9, 45127 Essen, Germany
| | | | - Joachim Nadstawek
- Association of German Doctors and Psychotherapists Practicing in Pain Medicine and Palliative Care (BVSD e.V.), Katharinenstraße 8, 10711 Berlin, Germany
| | - Wolfgang Straßmeir
- Association of German Doctors and Psychotherapists Practicing in Pain Medicine and Palliative Care (BVSD e.V.), Katharinenstraße 8, 10711 Berlin, Germany
| | - Jürgen Wasem
- Institute for Health Care Management and Research, University Duisburg-Essen, Thea-Leymann-Str. 9, 45127 Essen, Germany
| | - Silke Neusser
- Institute for Health Care Management and Research, University Duisburg-Essen, Thea-Leymann-Str. 9, 45127 Essen, Germany
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Speckemeier C, Abels C, Höfer K, Niemann A, Wasem J, Walendzik A, Neusser S. Preferences for Living Arrangements in Dementia: A Discrete Choice Experiment. Pharmacoecon Open 2024; 8:65-78. [PMID: 37995011 PMCID: PMC10781908 DOI: 10.1007/s41669-023-00452-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/02/2023] [Indexed: 11/24/2023]
Abstract
BACKGROUND Dementia affects about 55 million people worldwide. Demographic change and shifting lifestyles challenge the organization of dementia care. A discrete choice experiment (DCE) was conducted to elicit preferences for living arrangements in dementia in urban and rural regions of Germany. METHODS Preliminary work included review of previous literature and focus groups. The DCE consists of seven attributes (group size, staff qualifications, organization of care, activities offered, support of religious practice, access to garden, consideration of food preferences) with three levels each. Individuals from the general population between the ages of 50 and 65 years were identified through population registration offices in three rural municipalities and one urban area, and 4390 individuals were approached via postal survey. A hierarchical Bayesian mixed logit model was estimated and interactions with sociodemographic characteristics were investigated. RESULTS A total of 428 and 412 questionnaires were returned by rural and urban respondents, respectively. Access to a garden was perceived as the most important attribute (average importance 36.0% in the rural sample and 33.4% in the urban sample), followed by consideration of food preferences (15.8%, 17.8%), staff qualification (14.6%, 15.3%), care organization (11.4%, 12.3%), group size (12.2%, 11.1%), and range of activities (8.0%, 10.1%). The attribute relating to religious practice was given the least importance (2.1%, 0%). Preferences vary according to gender, age, religious beliefs, experience as an informal caregiver, and migrant background. CONCLUSION Heterogeneous preferences for living arrangements for people with dementia were identified. The expansion of concepts with access to natural environments for persons with dementia might be a viable option for the formal care market in Germany. Further research is needed to meet the challenges of setting up and designing innovative living arrangements for people with dementia. Preferences vary by gender, age, religious beliefs, experience as an informal caregiver, and migrant background.
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Affiliation(s)
- Christian Speckemeier
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Thea-Leymann-Str. 9, 45127, Essen, Germany.
| | - Carina Abels
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Thea-Leymann-Str. 9, 45127, Essen, Germany
| | - Klemens Höfer
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Thea-Leymann-Str. 9, 45127, Essen, Germany
| | - Anja Niemann
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Thea-Leymann-Str. 9, 45127, Essen, Germany
| | - Jürgen Wasem
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Thea-Leymann-Str. 9, 45127, Essen, Germany
| | - Anke Walendzik
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Thea-Leymann-Str. 9, 45127, Essen, Germany
| | - Silke Neusser
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Thea-Leymann-Str. 9, 45127, Essen, Germany
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Diekmann S, Schlierenkamp S, Walendzik A, Abels C, Zur Nieden P, Best D, Schaff C, Timmermann H, Klipker K, Marschall U, Wasem J, Neusser S. [Evaluating the reform of the psychotherapy guideline using a mixed-methods approach: a study protocol]. Gesundheitswesen 2023; 85:1066-1071. [PMID: 37473768 DOI: 10.1055/a-2011-6129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
INTRODUCTION In Germany, psychotherapy in outpatient statutory health care is regulated by the Psychotherapy Guideline (PT-GL). A discussion on waiting times and inadequate care for patients resulted in a structural reform of the PT-GL in 2017. The reform aims to improve access to psychotherapy and the entire course of care and treatment. The purpose of the present study was the evaluation of the new elements and identification of obstacles and barriers in their implementation. METHODS Quantitative and qualitative methods were used to evaluate the reform of the PT-GL. In a retrospective cohort-based analysis of anonymized administrative claim data from the statutory health insurances BARMER and AOK, the health care situation before and after the reform were compared. In addition, a cross-sectional questionnaire survey evaluated the implementation of the new care elements from the perspective of psychotherapists, general practitioners and patients. The questionnaires were developed based on focus groups with stakeholders and a literature search. The survey results provided the data basis for the cross-sectional analysis together with the routine data on the care situation after the reform of the PT-GL as well as aggregated, anonymized data from the National Association of Statutory Health Insurance Physicians on statutory health insurance care and on the use of the appointment service centers. CONCLUSION By combining quantitative and qualitative data, the effects of the structural reform of the PT-GL of 2016 can be analyzed at the individual and structural level as well as in relation to the entire care and treatment process. Based on this, proposals for a needs-oriented further development of the PT-GL will be prepared, considering the perspectives of various interest groups.
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Affiliation(s)
- Sandra Diekmann
- EsFoMed, Essener Forschungsinstitut für Medizinmanagement GmbH, Essen, Germany
| | - Sarah Schlierenkamp
- EsFoMed, Essener Forschungsinstitut für Medizinmanagement GmbH, Essen, Germany
| | - Anke Walendzik
- Lehrstuhl für Medizinmanagement, Universität Duisburg-Essen, Essen, Germany
| | - Carina Abels
- Lehrstuhl für Medizinmanagement, Universität Duisburg-Essen, Essen, Germany
| | - Pauline Zur Nieden
- EsFoMed, Essener Forschungsinstitut für Medizinmanagement GmbH, Essen, Germany
| | - Dieter Best
- Deutsche Psychotherapeuten Vereinigung (DPtV), Berlin, Germany
| | - Christa Schaff
- Berufsverband für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie in Deutschland e. V. (bkjpp), Mainz, Germany
| | - Helene Timmermann
- Vereinigung für analytische und tiefenpsychologisch fundierte Kinder- und Jugendlichen-Psychotherapie in Deutschland e.V. (VAKJP), Berlin, Germany
| | | | | | - Jürgen Wasem
- Lehrstuhl für Medizinmanagement, Universität Duisburg-Essen, Essen, Germany
| | - Silke Neusser
- EsFoMed, Essener Forschungsinstitut für Medizinmanagement GmbH, Essen, Germany
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Diekmann S, Schlierenkamp S, Walendzik A, Abels C, Zur Nieden P, Best D, Schaff C, Timmermann H, Klipker K, Marschall U, Wasem J, Neusser S. [Correction: Evaluating the reform of the psychotherapy guideline using a mixed-methods approach: a study protocol]. Gesundheitswesen 2023; 85:e48. [PMID: 37972584 DOI: 10.1055/a-2167-0010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Affiliation(s)
- Sandra Diekmann
- EsFoMed, Essener Forschungsinstitut für Medizinmanagement GmbH, Essen, Germany
| | - Sarah Schlierenkamp
- EsFoMed, Essener Forschungsinstitut für Medizinmanagement GmbH, Essen, Germany
| | - Anke Walendzik
- Lehrstuhl für Medizinmanagement, Universität Duisburg-Essen, Essen, Germany
| | - Carina Abels
- Lehrstuhl für Medizinmanagement, Universität Duisburg-Essen, Essen, Germany
| | - Pauline Zur Nieden
- EsFoMed, Essener Forschungsinstitut für Medizinmanagement GmbH, Essen, Germany
| | - Dieter Best
- Deutsche Psychotherapeuten Vereinigung (DPtV), Berlin, Germany
| | - Christa Schaff
- Berufsverband für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie in Deutschland e. V. (bkjpp), Mainz, Germany
| | - Helene Timmermann
- Vereinigung für analytische und tiefenpsychologisch fundierte Kinder- und Jugendlichen-Psychotherapie in Deutschland e.V. (VAKJP), Berlin, Germany
| | | | | | - Jürgen Wasem
- Lehrstuhl für Medizinmanagement, Universität Duisburg-Essen, Essen, Germany
| | - Silke Neusser
- EsFoMed, Essener Forschungsinstitut für Medizinmanagement GmbH, Essen, Germany
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Speckemeier C, Niemann A, Weitzel M, Abels C, Höfer K, Walendzik A, Wasem J, Neusser S. Assessment of innovative living and care arrangements for persons with dementia: a systematic review. BMC Geriatr 2023; 23:464. [PMID: 37525120 PMCID: PMC10391868 DOI: 10.1186/s12877-023-04187-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 07/20/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Alternative forms of housing for persons with dementia have been developed in recent decades. These concepts offer small groups of residents familiar settings combined with efforts to provide normal daily life. The aim of this systematic review is to collate and analyze these more innovative forms of housing regarding residents' quality of life, behavioral aspects, as well as functional, cognitive and emotional aspects. METHODS Searches were conducted in PubMed, EMBASE and PsycInfo in November 2020. Studies comparing traditional and more innovative living environments for persons with dementia were eligible. Concepts are described based on the results of additional searches. Risk of bias of included studies was assessed using checklists from the Joanna Briggs Institute. RESULTS A total of 21 studies corresponding to 11 different concepts were included, namely Green Houses (USA), Group Living (Sweden), Cantou (France), Group Homes (Japan), Small-scale Group Living (Austria), Special Care Facilities (Canada), Shared-housing Arrangements (Germany), Residential Groups (Germany), Residential Care Centers / Woodside Places (USA/Canada), Small-scale Living (Netherlands/ Belgium), and Green Care Farms (Netherlands). The concepts are broadly similar in terms of care concepts, but partly differ in group sizes, staff qualifications and responsibilities. Several studies indicate that innovative forms of housing may encourage social behavior, preserve activity performance and/or positively influence emotional status compared to more traditional settings, while other studies fail to demonstrate these effects. Some studies also show increased behavioral and psychological symptoms of dementia (BPSD) in residents who live in more innovative housing concepts. The effect on cognition remains indistinct. DISCUSSION The positive effects may be attributable to the inherent characteristics, including small group sizes, a stimulating design, and altered staff roles and responsibilities. Arguably, some of these characteristics might also be the reason for increased BPSD. Studies had variable methodological quality and results have to be considered with caution. Future research should examine these effects more closely and should investigate populations' preferences with regards to housing in the event of dementia.
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Affiliation(s)
- C Speckemeier
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Thea-Leymann-Str. 9, 45127, Essen, Germany.
| | - A Niemann
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Thea-Leymann-Str. 9, 45127, Essen, Germany
| | - M Weitzel
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Thea-Leymann-Str. 9, 45127, Essen, Germany
| | - C Abels
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Thea-Leymann-Str. 9, 45127, Essen, Germany
| | - K Höfer
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Thea-Leymann-Str. 9, 45127, Essen, Germany
| | - A Walendzik
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Thea-Leymann-Str. 9, 45127, Essen, Germany
| | - J Wasem
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Thea-Leymann-Str. 9, 45127, Essen, Germany
| | - S Neusser
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Thea-Leymann-Str. 9, 45127, Essen, Germany
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Abels C, Diekmann S, Neusser S, Schlierenkamp S, Wasem J, Walendzik A. [Reform Implementation of the Psychotherapy Guideline 2017: Results from Focus Groups Within the Framework of the Innovation Fund Project EVA PT-RL]. Gesundheitswesen 2023. [PMID: 37044118 DOI: 10.1055/a-1976-1856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Abstract
BACKGROUND Mental illnesses cause both individual and social burdens. The main goal of the structural reform of the Psychotherapy Guideline of 2017 was to improve access to psychotherapeutic care. The focus groups, which were conducted as part of the research project "Evaluation of the Psychotherapy Guideline (Eva PT-RL)" funded by the Innovation Fund, address the implementation of the goals of the reform and the individual newly introduced care elements as well as hurdles to implementation from the perspective of service providers, patients and insurers. METHODS Six focus groups and five individual interviews were conducted with people from the three stakeholder groups mentioned above. The basis was a semistructured interview guide adapted to the respective group of people based on a structured literature research. The interviews were conducted by a team of moderators via video conference, recorded and transcribed. The analysis was carried out via a qualitative content analysis based on Mayring. RESULTS The initial psychotherapeutic consultation received a generally positive assessment particularly with regard to timely initial access to psychotherapeutic care. At the same time a delayed transition to subsequent guideline psychotherapy due to a lack of capacity was criticized by all participant groups. Beneficial effects of telephone accessibility as well as increased networking of psychotherapeutic care also with other psychosocial services were mentioned. However the implementation of acute treatment and relapse prophylaxis was found to be inadequate. The central finding was that the impulse for a paradigm shift aimed at by the reform was perceived and implemented differently by the psychotherapists - from a focus on individual therapy processes to a public mental health perspective with a commitment to care coordination. CONCLUSION Some elements of the reform were criticized by stakeholders, the transition from initial appointments to continuous treatment was considered as not timely enough, and the design of other elements (acute treatment and relapse prevention regulations) was assessed as improvable. There is a need for further research. The results of the focus groups serve as a basis for following project steps including a survey of psychotherapists, patients and GPs.
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Affiliation(s)
- Carina Abels
- Lehrstuhl für Medizinmanagement, Universität Duisburg Essen Lehrstuhl für Medizinmanagement, Essen, Germany
| | - Sandra Diekmann
- EsFoMed, Essener Forschungsinstitut für Medizinmanagement GmbH, Essen, Germany
| | - Silke Neusser
- EsFoMed, Essener Forschungsinstitut für Medizinmanagement GmbH, Essen, Germany
| | - Sarah Schlierenkamp
- EsFoMed, Essener Forschungsinstitut für Medizinmanagement GmbH, Essen, Germany
| | - Jürgen Wasem
- Lehrstuhl für Medizinmanagement, Universität Duisburg Essen Lehrstuhl für Medizinmanagement, Essen, Germany
| | - Anke Walendzik
- Lehrstuhl für Medizinmanagement, Universität Duisburg Essen Lehrstuhl für Medizinmanagement, Essen, Germany
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Stegemann A, Soeberdt M, Abels C, Steinbrink K, Böhm M. 622 Fibroblast function in vitro modulated by the melanocortin tripeptide derivatives KdPT and WOL074-029. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Giebel GD, Speckemeier C, Abels C, Plescher F, Börchers K, Wasem J, Blase N, Neusser S. Problems and Barriers related to the Use of Digital Health Applications: A scoping review (Preprint). J Med Internet Res 2022; 25:e43808. [PMID: 37171838 DOI: 10.2196/43808] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 01/26/2023] [Accepted: 02/27/2023] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND The digitization of health care led to a steady increase in the adoption and use of mobile health (mHealth) apps. Germany is the first country in the world to cover the costs of mHealth apps through statutory health insurance. Although the benefits of mHealth apps are discussed in detail, aspects of problems and barriers are rarely studied. OBJECTIVE This scoping review aimed to map and categorize the evidence on problems and barriers related to the use of mHealth apps. METHODS Systematic searches were conducted in the MEDLINE, Embase, and PsycINFO databases. Additional searches were conducted on JMIR Publications and on websites of relevant international organizations. The inclusion criteria were publications dealing with apps similar to those approved in the German health care system, publications addressing problems and barriers related to the use of mHealth apps, and articles published between January 1, 2015, and June 8, 2021. Study selection was performed by 2 reviewers. The manuscript was drafted according to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist. The analysis of the included publications and categorization of problems and hurdles were performed using MAXQDA (VERBI Software GmbH). RESULTS The database search identified 1479 publications. Of the 1479 publications, 21 (1.42%) met the inclusion criteria. A further 8 publications were included from citation searching and searching in JMIR Publications. The identified publications were analyzed for problems and barriers. Problems and barriers were classified into 10 categories ("validity," "usability," "technology," "use and adherence," "data privacy and security," "patient-physician relationship," "knowledge and skills," "individuality," "implementation," and "costs"). The most frequently mentioned categories were use and adherence (eg, incorporating the app into daily life or dropouts from use; n=22) and usability (eg, ease of use and design; n=19). CONCLUSIONS The search identified various problems and barriers in the context of mHealth apps. Although problems at the app level (such as usability) are studied frequently, problems at the system level are addressed rather vaguely. To ensure optimal use of and care with mHealth apps, it is essential to consider all types of problems and barriers. Therefore, researchers and policy makers should have a special focus on this issue to identify the needs for quality assurance. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/32702.
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Schrader NF, Niemann A, Speckemeier C, Abels C, Blase N, Giebel GD, Riederer C, Nadstawek J, Straßmeir W, Wasem J, Neusser S. Prescription of opioid analgesics for non-cancer pain in Germany: study protocol for a mixed methods analysis. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-022-01748-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Abstract
Aim
Long-term therapy with opioid analgesics bears the risk of complications, such as misuse, abuse, and dependence. An evidence-based guideline addresses the long-term use of opioid analgesics for non-cancer pain. Recent studies observed an increase in opioid prescriptions over the past two decades in Germany. However, the exact circumstances of this increase and if long-term therapy adheres to these guidelines in practice remains unknown. Therefore, this study aimed to evaluate the provision of opioid analgesics for adults with non-cancer pain from patients’ and physicians’ perspectives. Based on the results, recommendations for care strategies for the patient groups at risk of misuse, abuse, and dependence were developed.
Methods
Built on a mixed methods approach, this evaluation combines (i) interviews with primary care physicians and specialists, (ii) surveys of patients and physicians, (iii) analyses based on administrative claims data from a German statutory health insurance provider. Proceeding from the analysis of the evaluation results, the development of care strategies included (iv) semi-structured interviews with stakeholders and (v) expert workshops.
Conclusion
To our knowledge, this is the first attempt to analyze opioid prescriptions from the combined perspectives of patients and practitioners in Germany. The results are intended to facilitate the development of target group-specific care strategies and recommendations to establish a general framework for the implementation of care strategies.
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Niemann A, Schrader NF, Speckemeier C, Abels C, Blase N, Giebel G, Riederer C, Nadstawek J, Straßmeir W, Wasem J, Neusser S. Verschreibung opioidhaltiger Analgetika trotz Kontraindikationen bei
nicht-tumorbedingten Schmerzen in Deutschland? Das Gesundheitswesen 2022. [DOI: 10.1055/s-0042-1753658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- A Niemann
- Universität Duisburg-Essen, Lehrstuhl für
Medizinmanagement, Essen, Deutschland
| | - NF Schrader
- Universität Duisburg-Essen, Lehrstuhl für
Medizinmanagement, Essen, Deutschland
| | - C Speckemeier
- Universität Duisburg-Essen, Lehrstuhl für
Medizinmanagement, Essen, Deutschland
| | - C Abels
- Universität Duisburg-Essen, Lehrstuhl für
Medizinmanagement, Essen, Deutschland
| | - N Blase
- Universität Duisburg-Essen, Lehrstuhl für
Medizinmanagement, Essen, Deutschland
| | - G Giebel
- Universität Duisburg-Essen, Lehrstuhl für
Medizinmanagement, Essen, Deutschland
| | - C Riederer
- DAK-Gesundheit, Versorgungsforschung und Innovation, Hamburg,
Deutschland
| | - J Nadstawek
- Berufsverband der Ärzte und Psychologischen Psychotherapeuten
in der Schmerz- und Palliativmedizin in Deutschland – BVSD e.V., Berlin,
Deutschland
| | - W Straßmeir
- Berufsverband der Ärzte und Psychologischen Psychotherapeuten
in der Schmerz- und Palliativmedizin in Deutschland – BVSD e.V., Berlin,
Deutschland
| | - J Wasem
- Universität Duisburg-Essen, Lehrstuhl für
Medizinmanagement, Essen, Deutschland
| | - S Neusser
- Universität Duisburg-Essen, Lehrstuhl für
Medizinmanagement, Essen, Deutschland
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Schlierenkamp S, Diekmann S, zur Nieden P, Lux G, Walendzik A, Abels C, Wasem J, Best D, Klipker K, Marschall U, Schaff C, Timmermann H, Neusser S. Arztkontakte vor und nach der Strukturreform der
Psychotherapie-Richtlinie: eine Analyse von Routinedaten der gesetzlichen
Krankenversicherung im Projekt Eva PT-RL (Evaluation der
Psychotherapie-Richtlinie). Das Gesundheitswesen 2022. [DOI: 10.1055/s-0042-1753660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- S Schlierenkamp
- Essener Forschungsinstitut für Medizinmanagement GmbH, Essen,
Deutschland
| | - S Diekmann
- Essener Forschungsinstitut für Medizinmanagement GmbH, Essen,
Deutschland
| | - P zur Nieden
- Essener Forschungsinstitut für Medizinmanagement GmbH, Essen,
Deutschland
| | - G Lux
- Essener Forschungsinstitut für Medizinmanagement GmbH, Essen,
Deutschland
| | - A Walendzik
- Universität Duisburg-Essen, Lehrstuhl für
Medizinmanagement, Essen, Deutschland
| | - C Abels
- Universität Duisburg-Essen, Lehrstuhl für
Medizinmanagement, Essen, Deutschland
| | - J Wasem
- Universität Duisburg-Essen, Lehrstuhl für
Medizinmanagement, Essen, Deutschland
| | - D Best
- Deutsche Psychotherapeuten Vereinigung, Berlin,
Deutschland
| | - K Klipker
- AOK-Bundesverband GbR, Berlin, Deutschland
| | | | - C Schaff
- Berufsverband für Kinder- und Jugendpsychiarie, Psychosomatik
und Psychotherapie in Deutschland e.V. (BKJPP), Mainz, Deutschland
| | - H Timmermann
- Vereinigung Analytischer Kinder- und Jugendlichen-Psychotherapeuten in
Deutschland e.V. (VAKJP), Berlin, Deutschland
| | - S Neusser
- Essener Forschungsinstitut für Medizinmanagement GmbH, Essen,
Deutschland
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Schrader NF, Niemann A, Speckemeier C, Abels C, Blase N, Giebel G, Riederer C, Nadstawek J, Straßmeir W, Wasem J, Neusser S. Routinedaten zur Verschreibung opioidhaltiger Analgetika bei
nicht-tumorbedingten Schmerzen in Deutschland: Überversorgung durch
hochdosierte Langzeittherapie? Das Gesundheitswesen 2022. [DOI: 10.1055/s-0042-1753662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- NF Schrader
- Universität Duisburg-Essen, Lehrstuhl für
Medizinmanagement, Essen, Deutschland
| | - A Niemann
- Universität Duisburg-Essen, Lehrstuhl für
Medizinmanagement, Essen, Deutschland
| | - C Speckemeier
- Universität Duisburg-Essen, Lehrstuhl für
Medizinmanagement, Essen, Deutschland
| | - C Abels
- Universität Duisburg-Essen, Lehrstuhl für
Medizinmanagement, Essen, Deutschland
| | - N Blase
- Universität Duisburg-Essen, Lehrstuhl für
Medizinmanagement, Essen, Deutschland
| | - G Giebel
- Universität Duisburg-Essen, Lehrstuhl für
Medizinmanagement, Essen, Deutschland
| | - C Riederer
- DAK-Gesundheit, Versorgungsforschung und Innovation, Hamburg,
Deutschland
| | - J Nadstawek
- Berufsverband der Ärzte und Psychologischen Psychotherapeuten
in der Schmerz- und Palliativmedizin in Deutschland – BVSD e.V., Berlin,
Deutschland
| | - W Straßmeir
- Berufsverband der Ärzte und Psychologischen Psychotherapeuten
in der Schmerz- und Palliativmedizin in Deutschland – BVSD e.V., Berlin,
Deutschland
| | - J Wasem
- Universität Duisburg-Essen, Lehrstuhl für
Medizinmanagement, Essen, Deutschland
| | - S Neusser
- Universität Duisburg-Essen, Lehrstuhl für
Medizinmanagement, Essen, Deutschland
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Walendzik A, Abels C, Wasem J. [Reimbursement for New Examination and Treatment Methods of Outpatients: Comparison of Statutory Health and Private Medical Insurance]. Gesundheitswesen 2022; 85:462-470. [PMID: 35255514 DOI: 10.1055/a-1749-5591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AIM OF THE STUDY The aim of the study was to compare the timeliness of reimbursement for new examination and treatment methods in outpatient care in the social (SHI) and private insurance system (PHI) in Germany. METHODOLOGY For the reimbursement in the SHI system, the decisions and further documentation of the Joint Federal Committee and the evaluation committee could be used. For the reimbursement in the PHI system, for example, the resolutions of the Central Consultation Committee for Fee Schedule Questions and those of the Fee Schedule Committee, but also evaluations of the North Rhine Medical Association and a working group of the German Association of PHI were used. Included were medical methods finally assessed for use in outpatient medical care by the Joint Federal Committee between 2010 and 2019. RESULTS A total of 17 individual resolutions, two series of resolutions consisting of several individual resolutions, and regulations concerning companion diagnostics were included. The time intervals between the start of the procedure and the introduction of the new method into the SHI system varied widely (14 to 216 months). At the same time, the study showed that for the majority of the methods, reimbursement in PHI was possible earlier than in SHI. Furthermore, five methods showed a potential limitation of reimbursement in PHI dependent on individual insurance contracts, but in two cases also reimbursement by PHI for services later assessed as without benefit by SHI. CONCLUSION Medical procedures based on the included new methods in most cases were reimbursed in the PHI earlier than in the SHI system. However, this also implies a risk of reimbursing services that are subsequently assessed by the Joint Federal Committee as having no medical benefit. If the joint federal committee assessment is used as a benchmark, this could lead to a reduction in the cost-effectiveness of care and, in individual cases, to patient harm due to overuse or misuse of care. Thus, there is a conflict between early access to new examination and treatment methods (especially in the case of very long Joint Federal Committee procedures) and (cost) effectiveness and assurance of the quality of care.
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Affiliation(s)
- Anke Walendzik
- Gesundheitspolitik, EsFoMed - Essener Forschungsinstitut für Medizinmanagement GmbH, Essen, Germany
| | - Carina Abels
- Lehrstuhl für Medizinmanagement, Universitat Duisburg-Essen - Campus Essen, Essen, Germany
| | - Jürgen Wasem
- Lehrstuhl für Medizinmanagement, Universitat Duisburg-Essen - Campus Essen, Essen, Germany
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Giebel GD, Schrader NF, Speckemeier C, Abels C, Börchers K, Wasem J, Blase N, Neusser S. Quality Assessment of Digital Health Applications: A Scoping Review Protocol (Preprint). JMIR Res Protoc 2022; 11:e36974. [PMID: 35857359 PMCID: PMC9350825 DOI: 10.2196/36974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 05/09/2022] [Accepted: 05/09/2022] [Indexed: 11/13/2022] Open
Abstract
Background All over the world, development and usage of mobile health (mHealth) apps is increasing. While apps offer numerous opportunities to improve health care, there are associated problems that differ significantly from those of traditional health care services. Further investigations on the quality of mHealth apps are needed to address these problems. Objective This study aims to identify and map research on quality assessment and quality assurance of mHealth apps and their transferability to continuous quality assurance of mHealth apps. Methods The scoping review will follow published methodological frameworks for scoping studies as well as Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews criteria. Electronic databases (Medline, EMBASE, and PsycINFO), reference lists of relevant articles, and websites of relevant institutions will be searched. Two reviewers will independently assess eligibility of articles. Therefore, a 2-stage (title and abstract, followed by full text) screening process was conducted. Quality management systems and quality assessment tools will be analyzed and included in our review. Particular focus is placed on quality dimensions. Results This scoping review provides an overview of the available evidence and identifies research gaps regarding continuous quality assessment of mHealth apps. Thereby, relevant quality dimensions and criteria can be identified and their eligibility and relevance for the development of a continuous quality assurance system of mHealth apps can be determined. Our results are planned to be submitted to an indexed, peer-reviewed journal in the second half of 2022. Conclusions This is the first review in the context of continuous quality assurance of mHealth apps. Our results will be used within the research “Continuous quality assurance of Digital Health Applications” (“QuaSiApps”) project funded by the German Federal Joint Committee. International Registered Report Identifier (IRRID) DERR1-10.2196/36974
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Affiliation(s)
- Godwin Denk Giebel
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Essen, Germany
| | - Nils Frederik Schrader
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Essen, Germany
| | - Christian Speckemeier
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Essen, Germany
| | - Carina Abels
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Essen, Germany
| | | | - Jürgen Wasem
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Essen, Germany
| | - Nikola Blase
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Essen, Germany
| | - Silke Neusser
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Essen, Germany
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Giebel GD, Speckemeier C, Abels C, Börchers K, Wasem J, Blase N, Neusser S. Problems and Barriers related to the Use of Digital Health Applications: A Scoping Review Protocol (Preprint). JMIR Res Protoc 2021; 11:e32702. [PMID: 35451979 PMCID: PMC9073601 DOI: 10.2196/32702] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 11/19/2021] [Accepted: 01/19/2022] [Indexed: 11/17/2022] Open
Abstract
Background The use of mobile health (mHealth) apps is increasing rapidly worldwide. More and more institutions and organizations develop regulations and guidelines to enable an evidence-based and safe use. In Germany, mHealth apps fulfilling predefined criteria (Digitale Gesundheitsanwendungen [DiGA]) can be prescribed and are reimbursable by the German statutory health insurance scheme. Due to the increasing distribution of DiGA, problems and barriers should receive special attention. Objective This study aims to identify the relevant problems and barriers related to the use of mHealth apps fulfilling the criteria of DiGA. Methods This scoping review will follow published methodological frameworks and the PRISMA-Scr (Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews) criteria. Electronic databases (MEDLINE, EMBASE, PsycINFO, and JMIR), reference lists of relevant articles, and grey literature sources will be searched. Two reviewers will assess the eligibility of the articles by a two-stage (title and abstract as well as full text) screening process. Only problems and barriers related to mHealth apps fulfilling the criteria of DiGA are included for this research. The identified studies will be categorized and analyzed with MAXQDA. Results This scoping review gives an overview of the available evidence and identifies research gaps regarding problems and barriers related to DiGA. The results are planned to be submitted to an indexed, peer-reviewed journal in the first quarter of 2022. Conclusions This is the first review to identify the problems and barriers related to the use of mHealth apps fulfilling the German definition of DiGA. Nevertheless, the findings can be applied to other contexts and health care systems as well. International Registered Report Identifier (IRRID) DERR1-10.2196/32702
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Affiliation(s)
- Godwin Denk Giebel
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Essen, Germany
| | - Christian Speckemeier
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Essen, Germany
| | - Carina Abels
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Essen, Germany
| | | | - Jürgen Wasem
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Essen, Germany
| | - Nikola Blase
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Essen, Germany
| | - Silke Neusser
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Essen, Germany
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Abels C, Soeberdt M, Kilic A, Reich H, Knie U, Jourdan C, Schramm K, Heimstaedt‐Muskett S, Masur C, Szeimies R. A glycopyrronium bromide 1% cream for topical treatment of primary axillary hyperhidrosis: efficacy and safety results from a phase IIIa randomized controlled trial. Br J Dermatol 2021; 185:315-322. [PMID: 33445205 PMCID: PMC8451866 DOI: 10.1111/bjd.19810] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Effective topical treatment options for patients with primary axillary hyperhidrosis (PAHH) are limited. A phase I trial showed promising results regarding the efficacy and safety of a topical cream containing glycopyrronium bromide (GPB). OBJECTIVES To assess the efficacy, safety and tolerability of a 4-week topical treatment of GPB 1% cream in patients with PAHH vs. placebo. METHODS In total, 171 patients (84 receiving placebo; 87 receiving GPB 1%) with PAHH were included in the 4-week, multicentre, randomized, double-blind, placebo-controlled phase IIIa part of the pivotal study. Sweat production was measured by gravimetry. Patients rated the impact of disease with the Hyperhidrosis Disease Severity Scale (HDSS) and Hyperhidrosis Quality of Life Index (HidroQoL© ). RESULTS Absolute change in sweat production from baseline to day 29 in logarithmic values was significantly larger in the GPB 1% group compared with the placebo group (P = 0·004). The improvement in HidroQoL exceeded the minimal clinically important difference of 4. The proportion of responders was twofold higher for sweat reduction (-197·08 mg GPB 1% vs. -83·49 mg placebo), HDSS (23% GPB 1% vs. 12% placebo) and HidroQoL (60% GPB 1% vs. 26% placebo). Treatment was safe: most treatment-emergent adverse effects were mild or moderate, and transient. Local tolerability was very good, with 9% of patients having only mild or moderate application-site reactions. The most reported adverse drug reaction was dry mouth (16%), an expected anticholinergic effect of the treatment. CONCLUSIONS GPB 1% cream may provide an effective new treatment option exhibiting a good safety profile for patients with PAHH. The long-term open-label part (phase IIIb) is ongoing.
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Affiliation(s)
- C. Abels
- Dr. August Wolff GmbH & Co. KG Arzneimittel33611BielefeldGermany
| | - M. Soeberdt
- Dr. August Wolff GmbH & Co. KG Arzneimittel33611BielefeldGermany
| | - A. Kilic
- Dr. August Wolff GmbH & Co. KG Arzneimittel33611BielefeldGermany
| | - H. Reich
- Dr. August Wolff GmbH & Co. KG Arzneimittel33611BielefeldGermany
| | - U. Knie
- Dr. August Wolff GmbH & Co. KG Arzneimittel33611BielefeldGermany
| | | | | | | | - C. Masur
- Dr. August Wolff GmbH & Co. KG Arzneimittel33611BielefeldGermany
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Abels C, Soeberdt M, Kilic A, Reich H, Knie U, Masur C, Szeimies RM. Pharmacokinetic profile data of glycopyrronium bromide 1% cream beyond 2 weeks are important: reply from the authors. Br J Dermatol 2021; 185:468-469. [PMID: 33792915 DOI: 10.1111/bjd.20095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- C Abels
- Dr. August Wolff GmbH & Co. KG Arzneimittel, Bielefeld, Germany
| | - M Soeberdt
- Dr. August Wolff GmbH & Co. KG Arzneimittel, Bielefeld, Germany
| | - A Kilic
- Dr. August Wolff GmbH & Co. KG Arzneimittel, Bielefeld, Germany
| | - H Reich
- Dr. August Wolff GmbH & Co. KG Arzneimittel, Bielefeld, Germany
| | - U Knie
- Dr. August Wolff GmbH & Co. KG Arzneimittel, Bielefeld, Germany
| | - C Masur
- Dr. August Wolff GmbH & Co. KG Arzneimittel, Bielefeld, Germany
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Huang D, Sun Z, Shen X, Gu Q, Soeberdt M, Abels C, Xu J. 562 Biological evaluation of litchi derived products as dermatological agents. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Gabes M, Jourdan C, Schramm K, Masur C, Abels C, Kamudoni P, Salek S, Apfelbacher C. Hyperhidrosis Quality of Life Index (HidroQoL©): further validation and clinical application in patients with axillary hyperhidrosis using data from a phase III randomized controlled trial. Br J Dermatol 2020; 184:473-481. [PMID: 32510573 DOI: 10.1111/bjd.19300] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND The Hyperhidrosis Quality of Life Index (HidroQoL©) is a validated patient-reported outcome measure capturing the quality of life of people affected by hyperhidrosis. OBJECTIVES We aimed to extend the validity evidence to physician-confirmed diagnosis of primary axillary hyperhidrosis. METHODS Data from a phase III randomized placebo-controlled clinical trial were used (n = 171). Confirmatory factor analysis was carried out to confirm the a priori two-factor structure of the HidroQoL. Internal consistency was assessed using Cronbach's α. Intraclass correlation coefficients (ICCs) were calculated to evaluate test-retest reliability after days -7 to -4. Convergent validity was assessed using correlations with the Dermatology Life Quality Index (DLQI), the Hyperhidrosis Disease Severity Scale (HDSS) and gravimetric sweat production. Known groups were analysed to evaluate discriminative validity. Responsiveness after 29 days was assessed and minimal important difference (MID) values were calculated using both anchor- and distribution-based approaches. All analyses were carried out for total HidroQoL and its two domains. RESULTS The two-factor structure of the HidroQoL was confirmed. Internal consistency and test-retest reliability were strong (Cronbach's α 0·81-0·90; ICCs 0·89-0·93). Correlations with other outcome measures were in line with a priori hypotheses. The HidroQoL discriminated between different severity groups (P ≤ 0·001) and showed sensitivity to change towards improvement (P < 0·001). An MID value of 4 is proposed for the total scale. CONCLUSIONS This study supports excellent measurement properties including clinical applicability of the HidroQoL in primary axillary hyperhidrosis and suggests a MID of 4 be applied to clinical trial data.
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Affiliation(s)
- M Gabes
- Institute of Social Medicine and Health Economics, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany.,Medical Sociology, Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - C Jourdan
- FGK Clinical Research GmbH, Munich, Germany
| | - K Schramm
- FGK Clinical Research GmbH, Munich, Germany
| | - C Masur
- Dr. August Wolff GmbH & Co. KG Arzneimittel, Bielefeld, Germany
| | - C Abels
- Dr. August Wolff GmbH & Co. KG Arzneimittel, Bielefeld, Germany
| | | | - S Salek
- School of Life and Medical Sciences, University of Hertfordshire, UK.,Institute of Medicines Development, Cardiff, UK
| | - C Apfelbacher
- Institute of Social Medicine and Health Economics, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
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Samadi A, Ahmad Nasrollahi S, Maghsoudi Ashtiani M, Abels C, Firooz A. Changes in skin barrier function following single and repeated applications of 4 types of moisturizers: a randomized controlled trial. J Eur Acad Dermatol Venereol 2020; 34:e288-e290. [PMID: 32043630 DOI: 10.1111/jdv.16288] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- A Samadi
- Center for Research & Training in Skin Diseases & Leprosy, Tehran University of Medical Sciences, Tehran, Iran
| | - S Ahmad Nasrollahi
- Center for Research & Training in Skin Diseases & Leprosy, Tehran University of Medical Sciences, Tehran, Iran
| | | | - C Abels
- Dr. August Wolff GmbH & Co. KG Arzneimittel, Bielefeld, Germany
| | - A Firooz
- Center for Research & Training in Skin Diseases & Leprosy, Tehran University of Medical Sciences, Tehran, Iran
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Marsella R, Ahrens K, Sanford R, Trujillo A, Massre D, Soeberdt M, Abels C. Double blinded, vehicle controlled, crossover study on the efficacy of a topical endocannabinoid membrane transporter inhibitor in atopic Beagles. Arch Dermatol Res 2019; 311:795-800. [PMID: 31446453 DOI: 10.1007/s00403-019-01963-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 04/26/2019] [Accepted: 06/15/2019] [Indexed: 01/05/2023]
Abstract
The endocannabinoid system is important for skin homeostasis and alterations are linked to inflammatory diseases like atopic dermatitis (AD). Importantly, activation of cannabinoid receptor CB2 decreases pruritus and inflammation in mouse models. Reduction of inactivation of endogenous cannabinoids could, therefore, be a therapeutic option for AD. Dogs spontaneously develop AD, which closely mimics the human disease making them suitable to test new therapies. Our study aimed to test the effects of a topical endocannabinoid membrane transporter inhibitor (WOL067-531, 1% gel) on pruritus and dermatitis in a canine model of AD. Nineteen Beagles allergic to dust mites (DM) were randomized to receive either active ingredient or vehicle on inguinal area while challenged epicutaneously with DM twice weekly for 28 days. Treatment was administered twice daily and started after three challenges (day 8). Dermatitis and pruritus were scored weekly by personnel blinded to treatment allocation. Dermatitis was scored using a validated scoring system and pruritus was scored using camera recordings. After a 4-week washout, dogs were crossed over and the study was repeated. On days 15 and 22, dermatitis scores were significantly increased after DM challenge in the vehicle group (16.34, p = 0.0089 and 7.42, p = 0.04845, respectively) but not in the active ingredient group (p = 0.3177 and p = 0.3190, respectively). Significant decrease on pruritus both on inguinal area and overall (p = 0.048 and p = 0.032, respectively) occurred in the active ingredient group. No adverse effects were noted. In conclusion, the newly developed topical endocannabinoid membrane transporter inhibitor (WOL067-531) minimized allergic flares and pruritus in a canine model of AD.
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Affiliation(s)
- Rosanna Marsella
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, 2015 SW 16th Avenue, Gainesville, FL, 32610, USA.
| | - K Ahrens
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, 2015 SW 16th Avenue, Gainesville, FL, 32610, USA
| | - R Sanford
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, 2015 SW 16th Avenue, Gainesville, FL, 32610, USA
| | - A Trujillo
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, 2015 SW 16th Avenue, Gainesville, FL, 32610, USA
| | - D Massre
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, 2015 SW 16th Avenue, Gainesville, FL, 32610, USA
| | - M Soeberdt
- Dr. August Wolff GmbH & Co. KG Arzneimittel, Sudbrackstrasse 56, 33605, Bielefeld, Germany
| | - C Abels
- Dr. August Wolff GmbH & Co. KG Arzneimittel, Sudbrackstrasse 56, 33605, Bielefeld, Germany
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Proksch E, Merker S, Müller-Röhr S, Neumann C, Masur C, Kilic A, Abels C. 237 Skin barrier integrity is enhanced after topical application of emulsions with an acidic pH. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.07.238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Masur C, Soeberdt M, Kilic A, Knie U, Abels C. Safety and efficacy of topical formulations containing 0·5, 1 and 2% glycopyrronium bromide in patients with primary axillary hyperhidrosis: a randomized, double-blind, placebo-controlled study. Br J Dermatol 2019; 182:229-231. [PMID: 31218668 DOI: 10.1111/bjd.18234] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- C Masur
- Dr. August Wolff GmbH & Co. KG Arzneimittel, Bielefeld, Germany
| | - M Soeberdt
- Dr. August Wolff GmbH & Co. KG Arzneimittel, Bielefeld, Germany
| | - A Kilic
- Dr. August Wolff GmbH & Co. KG Arzneimittel, Bielefeld, Germany
| | - U Knie
- Dr. August Wolff GmbH & Co. KG Arzneimittel, Bielefeld, Germany
| | - C Abels
- Dr. August Wolff GmbH & Co. KG Arzneimittel, Bielefeld, Germany
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Proksch E, Merker S, Müller-Röhr S, Neumann C, Reich H, Masur C, Kilic A, Abels C. 316 Skin barrier function and integrity changes after topical application of emulsions with different pH. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Soeberdt M, Kilic A, Abels C. 696 A straightforward preclinical efficacy assessment approach to identify promising drug candidates for development of novel topical anti-inflammatory drugs. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Stute P, Schmidts-Winkler I, Panz M, Masur C, Abels C. Multinational multicenter open-label randomized controlled parallel trial comparing non-hormonal vaginal moisturizing cream to vaginal estriol cream in postmenopausal women with vaginal dryness. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- P Stute
- Inselspital, Bern University Hospital, Frauenheilkunde und Geburtshilfe, Bern, Schweiz
| | | | - M Panz
- Dr. August Wolff GmbH & Co. KG Arzneimittel, Bielefeld, Deutschland
| | - C Masur
- Dr. August Wolff GmbH & Co. KG Arzneimittel, Bielefeld, Deutschland
| | - C Abels
- Dr. August Wolff GmbH & Co. KG Arzneimittel, Bielefeld, Deutschland
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Angelova-Fischer I, Fischer TW, Abels C, Zillikens D. Accelerated barrier recovery and enhancement of the barrier integrity and properties by topical application of a pH 4 vs. a pH 5·8 water-in-oil emulsion in aged skin. Br J Dermatol 2018; 179:471-477. [PMID: 29577247 DOI: 10.1111/bjd.16591] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Increased skin-surface pH is an important host-related factor for deteriorated barrier function in aged skin. OBJECTIVES We investigated whether restoration of skin pH through topical application of a water-in-oil emulsion with pH 4 improved the barrier homeostasis in aged skin, and compared the effects with an identical galenic formulation with pH 5·8. METHODS The effects of the test formulations on barrier recovery were investigated by repeated measurements of transepidermal water loss (TEWL) and skin pH 3 h, 6 h and 24 h after acetone-induced impairment of barrier function in aged skin. The long-term effects of the pH 4 and pH 5·8 emulsions were analysed by investigation of the barrier integrity and cohesion, the skin-surface pH and the skin roughness and scaliness before and after a 4-week, controlled application of the formulations. RESULTS The application of the pH 4 emulsion accelerated barrier recovery in aged skin: 3 h and 6 h after acetone-induced barrier disruption the differences in the TEWL recovery between the pH 4 treated and acetone control fields were significant. Furthermore, long-term application of the pH 4 formulation resulted in significantly decreased skin pH, enhanced barrier integrity and reduced skin-surface roughness and scaliness. At the same time points, the pH 5·8 formulation exerted only minor effects on the barrier function parameters. CONCLUSIONS Exogenous acidification through topical application of a water-in-oil emulsion with pH 4 leads to improvement of the skin barrier function and maintenance of the barrier homeostasis in aged skin.
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Affiliation(s)
- I Angelova-Fischer
- Department of Dermatology, University of Lübeck, Lübeck, Germany.,Department of Dermatology, Kepler University Hospital, Linz, Austria
| | - T W Fischer
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - C Abels
- Dr August Wolff GmbH & Co. KG Arzneimittel, Sudbrackstraße 56, D-33611, Bielefeld, Germany
| | - D Zillikens
- Department of Dermatology, University of Lübeck, Lübeck, Germany
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Soeberdt M, Masur C, Knie U, Metze D, Abels C. 388 A phase Ib trial in AD patients evaluating safety, tolerability, pharmacokinetics and efficacy of topical formulations containing the kappa-opioid receptor agonist WOL071-007. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.395] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Masur C, Knie U, Kilic A, Daehnhardt D, Daehnhardt-Pfeiffer S, Abels C. 616 A water-in-oil emulsion with pH 4 improves structure of lipid lamellae and restores disrupted epidermal barrier in the elderly. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Proksch E, Soeberdt M, Neumann C, Reich H, Abels C. 670 Topically applied buffers of different pH and composition influence skin pH, barrier repair, epidermal differentiation, and inflammation. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Tóth K, Szabó-Papp J, Kilic A, Soeberdt M, Abels C, Bíró T, Oláh A. 126 The selective serotonin reuptake inhibitor fluoxetine exerts anti-inflammatory actions on human epidermal keratinocytes. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.436] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Abels C, Masur C, Daehnhardt-Pfeiffer S, Daehnhardt D, Knie U. 413 Formulation with low pH decreases skin pH, restores disrupted epidermal barrier and improves lipid lamellae structure. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.02.432] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Mihály J, Angyal Á, Bánhalminé Szilágyi S, Tubak V, Soeberdt M, Abels C, Oláh A, Bíró T. 303 Establishment and optimization of pro-inflammatory model systems in human keratinocytes. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.06.323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abels C, Qualtieri A, De Vittorio M, Megill WM, Rizzi F. A bio-inspired real-time capable artificial lateral line system for freestream flow measurements. Bioinspir Biomim 2016; 11:035006. [PMID: 27257144 DOI: 10.1088/1748-3190/11/3/035006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
To enhance today's artificial flow sensing capabilities in aerial and underwater robotics, future robots could be equipped with a large number of miniaturized sensors distributed over the surface to provide high resolution measurement of the surrounding fluid flow. In this work we show a linear array of closely separated bio-inspired micro-electro-mechanical flow sensors whose sensing mechanism is based on a piezoresistive strain-gauge along a stress-driven cantilever beam, mimicking the biological superficial neuromasts found in the lateral line organ of fishes. Aiming to improve state-of-the-art flow sensing capability in autonomously flying and swimming robots, our artificial lateral line system was designed and developed to feature multi-parameter freestream flow measurements which provide information about (1) local flow velocities as measured by the signal amplitudes from the individual cantilevers as well as (2) propagation velocity, (3) linear forward/backward direction along the cantilever beam orientation and (4) periodicity of pulses or pulse trains determined by cross-correlating sensor signals. A real-time capable cross-correlation procedure was developed which makes it possible to extract freestream flow direction and velocity information from flow fluctuations. The computed flow velocities deviate from a commercial system by 0.09 m s(-1) at 0.5 m s(-1) and 0.15 m s(-1) at 1.0 m s(-1) flow velocity for a sampling rate of 240 Hz and a sensor distance of 38 mm. Although experiments were performed in air, the presented flow sensing system can be applied to underwater vehicles as well, once the sensors are embedded in a waterproof micro-electro-mechanical systems package.
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Affiliation(s)
- C Abels
- Center for Biomolecular Nanotechnologies @UNILE, Istituto Italiano di Tecnologia, Arnesano (LE), I-73010, Italy. Rhine-Waal University of Applied Sciences, Faculty of Technology and Bionics, Kleve, D-47533, Germany. Università del Salento, Dipartimento di Ingegneria dell'Innovazione, Lecce (LE), I-73100, Italy
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Schreml S, Meier R, Albert M, Seidl U, Zeller V, Behm B, Landthaler M, Abels C, Babilas P. The Impact of 10% α-Hydroxy Acid Emulsion on Skin pH. Skin Pharmacol Physiol 2012; 25:34-8. [DOI: 10.1159/000331204] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2011] [Accepted: 07/19/2011] [Indexed: 01/23/2023]
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Goertz O, Abels C, Knie U, May T, Hirsch T, Daigeler A, Steinau HU, Langer S. Clinical safety and efficacy of a novel thermoreversible polyhexanide-preserved wound covering gel. ACTA ACUST UNITED AC 2010; 44:96-101. [PMID: 20090348 DOI: 10.1159/000276303] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2009] [Accepted: 11/16/2009] [Indexed: 11/19/2022]
Abstract
BACKGROUND An ideal topical formulation for wound therapy does not exist. The aim of this study was to develop a novel improved therapeutic option for the treatment of acute and chronic wounds. METHODS A transparent wound gel which is in a liquid state below and in a gel state at or above room temperature was developed. Forty-four patients were included in this open randomized controlled single-center study. Flammazine served as control in the treatment of skin graft donor sites. Wounds were assessed for time of dressing change and overall satisfaction of patients and health care providers. The data were analyzed using the nonparametric Mann-Whitney test. RESULTS The wound gel proved to be superior in comparison with Flammazine with respect to wound assessment (p = 0.002), staining (p = 0.007), leaking (p = 0.032) and smell (p = 0.034). Flammazine showed favorable results regarding the parameters dehydration of the dressings (p = 0.012) and wound adherence (p = 0.005). The evaluation of the overall dressing change process showed no significant differences. CONCLUSION The thermoreversible wound gel containing polyhexanide allows for good handling and wound assessment. This study demonstrated a high satisfaction level of patient and health care providers, and the wound gel proved an effective alternative to commonly used treatments.
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Affiliation(s)
- O Goertz
- Department of Plastic and Hand Surgery, Burn Center, BG University Hospital Bergmannsheil, Ruhr University Bochum, Buerkle-de-la-Camp Platz 1, Bochum, Germany.
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Goertz O, Ring A, Knie U, Abels C, Daigeler A, Steinau HU, Steinstraesser L, Langer S. Evaluation of a Novel Polihexanide-Preserved Wound Covering Gel on Dermal Wound Healing. Eur Surg Res 2010; 44:23-9. [DOI: 10.1159/000260040] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2009] [Accepted: 08/14/2009] [Indexed: 11/19/2022]
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Meyer K, Bodó E, Brzoska T, Abels C, Paus R. Immunomodulatory effects of the α-melanocyte-stimulating hormone-related tripeptide K(D)PT on human scalp hair follicles under proinflammatory conditions. Br J Dermatol 2009; 161:1400-3. [DOI: 10.1111/j.1365-2133.2009.09427.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Meyer K, Brzoska T, Abels C, Paus R. The α-melanocyte stimulating hormone-related tripeptide K(D)PT stimulates human hair follicle pigmentationin situunder proinflammatory conditions. Br J Dermatol 2009; 160:433-7. [DOI: 10.1111/j.1365-2133.2008.08872.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Brandt M, Abels C, May T, Lohmann K, Schmidts-Winkler I, Hoyme U. Intravaginally applied metronidazole is as effective as orally applied in the treatment of bacterial vaginosis, but exhibits significantly less side effects. Eur J Obstet Gynecol Reprod Biol 2008; 141:158-62. [DOI: 10.1016/j.ejogrb.2008.07.022] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2008] [Revised: 06/09/2008] [Accepted: 07/11/2008] [Indexed: 11/25/2022]
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Bodó E, van Beek N, Naumann V, Ohnemus U, Brzoska T, Abels C, Paus R. 17-beta estradiol and prednisolone as potential stimulators of hair re-growth in chemotherapy-induced human hair follicle damage via ‘dystrophic catagen’ promotion? Exp Dermatol 2008. [DOI: 10.1111/j.1600-0625.2008.00742_15.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Proksch E, Abels C. Wirkung von Linola®-Emulsion im Vergleich zu einer Hydrokortison-Emulsion im Testmodell einer irritativen Kontaktdermatitis. Akt Dermatol 2007. [DOI: 10.1055/s-2007-966637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Maisch T, Bosl C, Szeimies RM, Love B, Abels C. Determination of the antibacterial efficacy of a new porphyrin-based photosensitizer against MRSA ex vivo. Photochem Photobiol Sci 2007; 6:545-51. [PMID: 17487307 DOI: 10.1039/b614770d] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Following extensive in vitro screening of new photosensitizers the purpose of the present study was to examine penetration as well as antibacterial efficacy of a lead photosensitizer against MRSA using an ex vivo porcine skin model. Two different applications were performed: (i) preincubation of bacteria in solution with a porphyrin-based photosensitizer XF73 and subsequent application on the ex vivo porcine skin; (ii) application of pure bacteria on the explants followed by an incubation with XF73 in a water-ethanol formulation for up to 60 min under occlusion. The localisation of XF73 was restricted to the stratum corneum. Different concentrations (0-10 microM) of XF73 and different incubation times (5-60 min) were used to determine phototoxicity against methicillin-resistant and methicillin-sensitive S. aureus, which was applied on the explants. Preincubation of S. aureus with 0.1 microM XF73 in solution prior to the application of these XF73-incubated bacteria on the skin demonstrates a higher efficacy (>3 log10) after irradiation. Antibacterial photodynamic inactivation resulted in a approximately 1 log10 (0.1 microM)-3.64+/-0.035 (10 microM) log10 growth reduction independently of the antibiotic resistance pattern of used S. aureus strains. Irradiation of applied bacteria without photosensitizer incubation did not show any marked decrease (<1 log10) of bacteria cell number, indicating a significant phototoxicity of the XF73. Histological evaluations of untreated and treated skin areas upon irradiation within 24 h showed no significant degree of necrosis or apoptosis determined by TUNEL-assay indicating that the porcine skin is still vital. This study demonstrates that this XF73 porphyrin-based photosensitizer had concentration-dependent differences in killing efficacy of MRSA in comparison to skin cells using an ex vivo porcine skin model. The results described here imply that topical delivery of XF73 may be considered as a possible treatment in patients with superficial infections of the skin.
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Affiliation(s)
- T Maisch
- Department of Dermatology, University of Regensburg, Klinik und Poliklinik für Dermatologie, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany.
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Abstract
Atopic eczema is one of the most common diseases in dermatology. Patients suffer from both the chronic relapsing skin disease and the associated emotional stress. Itching and visible lesions on the face and hands are the most unpleasant features for many often young patients, seriously reducing their quality of life. New therapeutic approaches have changed the management of atopic eczema in recent years. Relatively potent new drugs with fewer side effects than corticosteroids help to control the disease. This review focuses on the basic principles of modern atopic eczema treatment, emphasizing basic emollient therapy and topical therapy with calcineurin inhibitors.
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Affiliation(s)
- C Abels
- Dr. August Wolff GmbH & Co. KG Arzneimittel, Sudbrackstrasse 56, 33611 , Bielefeld.
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Abstract
The basis of "antibacterial photodynamic therapy" involves the killing of bacteria by reactive oxygen species in the presence of a photosensitizer and light. Possible dermatologic indications include inactivation of bacteria in skin and wound infections and reduction in density of nosocomial multi-resistant infections. The chief advantage of antibacterial photodynamic therapy is that regardless of the resistance pattern of a bacteria, inactivation can be achieved, analogous to the use of antiseptics. The aim of the present review is to describe the physicochemical and biological mechanisms of antibacterial photodynamic therapy as well as possible clinical indications in dermatology.
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Affiliation(s)
- T Maisch
- Klinik und Poliklinik für Dermatologie, Klinikum der Universität Regensburg.
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Maisch T, Bosl C, Szeimies RM, Lehn N, Abels C. Photodynamic effects of novel XF porphyrin derivatives on prokaryotic and eukaryotic cells. Antimicrob Agents Chemother 2005; 49:1542-52. [PMID: 15793136 PMCID: PMC1068608 DOI: 10.1128/aac.49.4.1542-1552.2005] [Citation(s) in RCA: 183] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The worldwide rise in the rates of antibiotic resistance of bacteria underlines the need for alternative antibacterial agents. A promising approach to the killing of gram-positive antibiotic-resistant bacteria of the skin uses light in combination with a photosensitizer to induce a phototoxic reaction. Different concentrations (0 to 100 microM) of porphyrin-based photosensitizers (CTP1, XF70, and XF73) and different incubation times (5 min, 1 h, and 4 h) were used to determine phototoxicity against two methicillin-resistant Staphylococcus aureus strains, one methicillin-sensitive S. aureus strain, one methicillin-resistant Staphylococcus epidermidis strain, one Escherichia coli strain, and human keratinocytes and fibroblasts. Incubation with 0.005 microM XF70 or XF73, followed by illumination, yielded a 3-log10 (> or = 99.9%) decrease in the viable cell numbers of all staphylococcal strains, indicating that the XF drugs have high degrees of potency against gram-positive bacteria and also that the activities of these novel drugs are independent of the antibiotic resistance pattern of the staphylococci examined. CTP1 was less potent against the staphylococci under the same conditions. At 0.005 microM, XF70 and XF73 demonstrated no toxicity toward fibroblasts or keratinocytes. No inactivation of E. coli was detected at this concentration. XF73 was confirmed to act via a reactive oxygen species from the results of studies with sodium azide (a quencher of singlet oxygen), which reduced the killing of both eukaryotic and prokaryotic cells. When a quencher of superoxide anion and the hydroxyl radical was used, cell killing was not inhibited. These results demonstrate that the porphyrin-based photosensitizers had concentration-dependent differences in their efficacies of killing of methicillin-resistant staphylococcal strains via reactive oxygen species without harming eukaryotic cells at the same concentrations.
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Affiliation(s)
- T Maisch
- Department of Dermatology, University of Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany.
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Scherer K, Abels C, Bäumler W, Ackermann G, Szeimies RM. Structure-activity relationships of three differently substituted 2,7,12,17-tetrakis-(�-methoxyethyl) porphycene derivatives in vitro. Arch Dermatol Res 2004; 295:535-41. [PMID: 15034722 DOI: 10.1007/s00403-004-0458-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2003] [Revised: 01/26/2004] [Accepted: 02/01/2004] [Indexed: 11/26/2022]
Abstract
The subcellular localization, efficacy and photooxidative mechanism of three new photosensitizing porphycenes (HexoTMPn, PeloTMPn, CpoTMPn) for photodynamic therapy with different substituents at position 9 of the tetrapyrrole macrocycle were investigated in vitro using different human skin-derived cell lines (HaCaT, SCL I, SCL II) with the aim of customizing the side-chain chemistry to accelerate cellular uptake and so enhance photodynamic activity. Cells were incubated with a porphycene and costained with organelle-specific markers. Subcellular localization was determined by fluorescence microscopy. Also, cells were incubated with different sensitizer concentrations (0-1000 nmol/l) and irradiated by an incoherent light source (lambda(em) = 600-750 nm, 40 mW/cm(2), 24 J/cm(2)) with/without quenchers or enhancers (NaN(3), histidine, mannitol or D(2)O). Cell viability was assessed. All porphycenes were localized in perinuclear lysosomes and induced a decrease in mitochondrial activity following irradiation. HexoTMPn was the most efficient in all three cell lines (EC(50) in HaCaT cells: HexoTMPn 14 nmol/l, CpoTMPn 62 nmol/l, PeloTMPn 89 nmol/l). Addition of either NaN(3) or histidine reduced the phototoxicity significantly. Due to the short lifetime of singlet oxygen, the sites of sensitizer localization are the initial subcellular targets. The cytotoxicity of each sensitizer varied depending on singlet oxygen quantum yield and cell line. Despite the different chemical structures, the biological effects were not very distinct, since they seemed to be mostly determined by the tetrapyrrole ring and only slightly modified by the substituent at position 9. Also, there was only a narrow margin between biological compatibility and efficacy.
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Affiliation(s)
- Kathrin Scherer
- Department of Dermatology, University of Regensburg, 93042 Regensburg, Germany
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Babilas P, Schacht V, Liebsch G, Wolfbeis OS, Landthaler M, Szeimies RM, Abels C. Effects of light fractionation and different fluence rates on photodynamic therapy with 5-aminolaevulinic acid in vivo. Br J Cancer 2003; 88:1462-9. [PMID: 12778078 PMCID: PMC2741044 DOI: 10.1038/sj.bjc.6600910] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
To improve efficacy of photodynamic therapy (PDT) with intravenously administered 5-aminolaevulinic acid (ALA) fractionating the light dose or reducing the light intensity may be a possibility. Therefore, Syrian Golden hamsters were fitted with dorsal skinfold chambers containing an amelanotic melanoma (n=26). PDT was performed (100 mW cm(-2), 100 J cm(-2), continuously or fractionated, and 25 mW cm(-2), 100 J cm(-2); continuously or fractionated) using an incoherent light source following i.v. application of ALA. Following fractionated irradiation, the light was paused after 20 J cm(-2) for 15 min. Prior to and up to 24 h after PDT tissue, pO(2) was measured using luminescence lifetime imaging. The efficacy was evaluated by measuring the tumour volume of amelanotic melanoma cells grown subcutaneously in the back of Syrian Golden hamsters (n=36). Only high-dose PDT resulted in a significant decrease of pO(2). Irrespective of the mode of irradiation only high-dose PDT induced complete remission of all tumours (13 out of 13). It could be shown that low-dose PDT failed to induce a significant decrease of pO(2). No significant effect of fractionated irradiation was shown regarding the therapeutic efficacy 28 days after PDT. Thus performing a fractionated PDT with ALA or reducing the light intensity seems not to be successful in clinical PDT according to the present data.
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Affiliation(s)
- P Babilas
- Department of Dermatology, University of Regensburg, Franz-Josef-Strauss-Allee 11, 93042 Regensburg, Germany
| | - V Schacht
- Department of Dermatology, University of Regensburg, Franz-Josef-Strauss-Allee 11, 93042 Regensburg, Germany
| | - G Liebsch
- Institute of Analytical Chemistry, Chemo- and Biosensors, University of Regensburg, Franz-Josef-Strauss-Allee 11, 93042 Regensburg, Germany
| | - O S Wolfbeis
- Institute of Analytical Chemistry, Chemo- and Biosensors, University of Regensburg, Franz-Josef-Strauss-Allee 11, 93042 Regensburg, Germany
| | - M Landthaler
- Department of Dermatology, University of Regensburg, Franz-Josef-Strauss-Allee 11, 93042 Regensburg, Germany
| | - R-M Szeimies
- Department of Dermatology, University of Regensburg, Franz-Josef-Strauss-Allee 11, 93042 Regensburg, Germany
| | - C Abels
- Department of Dermatology, University of Regensburg, Franz-Josef-Strauss-Allee 11, 93042 Regensburg, Germany
- Department of Dermatology, University of Regensburg, Franz-Josef-Strauss-Allee 11, 93042 Regensburg, Germany. E-mail:
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