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Niederer D, Schiller J, Groneberg DA, Behringer M, Wolfarth B, Gabrys L. Machine learning-based identification of determinants for rehabilitation success and future healthcare use prevention in patients with high-grade, chronic, nonspecific low back pain: an individual data 7-year follow-up analysis on 154,167 individuals. Pain 2024; 165:772-784. [PMID: 37856652 DOI: 10.1097/j.pain.0000000000003087] [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] [Received: 01/20/2023] [Accepted: 08/22/2023] [Indexed: 10/21/2023]
Abstract
ABSTRACT To individually prescribe rehabilitation contents, it is of importance to know and quantify factors for rehabilitation success and the risk for a future healthcare use. The objective of our multivariable prediction model was to determine factors of rehabilitation success and the risk for a future healthcare use in patients with high-grade, chronic low back pain. We included members of the German pension fund who participated from 2012 to 2019 in multimodal medical rehabilitation with physical and psychological treatment strategies because of low back pain (ICD10:M54.5). Candidate prognostic factors for rehabilitation success and for a future healthcare use were identified using Gradient Boosting Machines and Random Forest algorithms in the R-package caret on a 70% training and a 30% test set. We analysed data from 154,167 patients; 8015 with a second medical rehabilitation measure and 5161 who retired because of low back pain within the study period. The root-mean-square errors ranged between 494 (recurrent rehabilitation) and 523 (retirement) days ( R2 = 0.183-0.229), whereas the prediction accuracy ranged between 81.9% for the prediction of the rehabilitation outcome, and 94.8% for the future healthcare use prediction model. Many modifiable prognostic factors (such as duration of the rehabilitation [inverted u-shaped], type of the rehabilitation, and aftercare measure), nonmodifiable prognostic factors (such as sex and age), and disease-specific factors (such as sick leave days before the rehabilitation [linear positive] together with the pain grades) for rehabilitation success were identified. Inpatient medical rehabilitation programmes (3 weeks) may be more effective in preventing a second rehabilitation measure and/or early retirement because of low back pain compared with outpatient rehabilitation programs. Subsequent implementation of additional exercise programmes, cognitive behavioural aftercare treatment, and following scheduled aftercare are likely to be beneficial.
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Affiliation(s)
- Daniel Niederer
- Department of Sports Medicine and Exercise Physiology, Institute of Occupational, Social and Environmental Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Joerg Schiller
- Department of Rehabilitation Medicine, Hannover Medical School, Hannover, Germany
| | - David A Groneberg
- Institute of Occupational, Social and Environmental Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Michael Behringer
- Department of Sports Sciences, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Bernd Wolfarth
- Department of Sports Medicine, Humboldt University and Charité University School of Medicine, Berlin, Germany
| | - Lars Gabrys
- University of Applied Sciences for Sports and Management, Potsdam, Germany
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Tilgner N, Nehls D, Lichtmess C, Kober A, Küsel C, Radloff L, Gabrys L. Adherence to exercise and fitness following exercise-based outpatient cardiac rehabilitation: a cross-sectional survey for Germany. BMC Sports Sci Med Rehabil 2022; 14:191. [DOI: 10.1186/s13102-022-00585-0] [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] [Received: 06/22/2021] [Accepted: 10/26/2022] [Indexed: 11/09/2022]
Abstract
Abstract
Background
Exercise-based cardiac rehabilitation is safe and effective, evidence-based and implemented in national and international cardiac rehabilitation guidelines. Recent data show a decrease in cardiovascular mortality, reduced hospital admissions and an overall improvement in quality of life. To maintain positive effects and to prevent further cardiovascular events a major goal of cardiac rehabilitation is to induce a long-term health behaviour change and the integration of regular physical activity and exercise training in everyday life. The aim of this study is to evaluate the adherence of cardiac patients to exercise-based programs following rehabilitation phase III.
Methods
A nationwide online cross-sectional survey was conducted. All outpatient aftercare providers who offer sports rehabilitation programs (heart groups) for cardiac patients in Germany were contacted. The questionnaire comprised 15 questions in five subcategories (general information regarding the outpatient aftercare provider, structure of rehabilitation sport programs, membership structure, content of heart groups, adherence to exercise-based programs).
Results
560 of 2447 outpatient aftercare providers participated in the survey (response rate: 23%). On average, rehabilitation sport facilities hosted 2 (IQR 2) heart groups per week, and 23 patients (IQR 30) (61% males; 31% females) per facility completed rehabilitation sport prescription in 2018. Almost all providers offer follow-up programs on a self-payer basis after rehabilitation sport prescription ends. Adherence to follow-up programs was at 54% (IQR 65; 55% males and 50% females). With 60% (IQR 71), patients with a statutory health insurance (mainly pensioners) adhere slightly more often to a follow-up program compared to privately insured persons (mainly population with a high income or civil servants) with 50% and significantly more often compared to persons who were insured by the German pension fund (covering working population) with only 9% (IQR 89) adherence.
Conclusion
Almost all outpatient aftercare providers offer follow-up programs for cardiac rehabilitation patients but only half of them actually participate. Younger people (working population) do not adhere sufficiently to sport and exercise programs following rehabilitation phase III. This seems critical to address in terms of achieving long-term rehabilitation goals.
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Neugebauer E, Piwernetz K, Bramesfeld A, Deckert S, Falkai P, Gabrys L, Hollederer A, Riedel-Heller SG, Schaller A, Scheibe M, Bierbaum T, Schmitt J, Dreinhöfer KE. [Correction: Necessity and Ways to Develop Care Goals for the Health System in Germany - a Position Paper of the DNVF]. Gesundheitswesen 2022; 84:e44. [PMID: 36170866 DOI: 10.1055/a-1941-9010] [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: 10/14/2022]
Affiliation(s)
- Edmund Neugebauer
- Medizinische Hochschule Brandenburg (MHB), Theodor Fontane Neuruppin, Germany
| | - Klaus Piwernetz
- Public Health, Medimaxx Health Management GmbH, München, Germany
| | - Anke Bramesfeld
- Hannover Medical School, Medizinische Hochschule Hannover Institut fur Epidemiologie Sozialmedizin und Gesundheitssystemforschung, Hannover, Germany
| | - Stefanie Deckert
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany
| | - Peter Falkai
- Klinik für Psychiatrie und Psychotherapie, Klinikum der Universität München, Munchen, Germany
| | - Lars Gabrys
- Gesundheitssport und Prävention, ESAB Fachhochschule für Sport und Management Potsdam, Potsdam, Germany
| | - Alfons Hollederer
- Fachbereich 01 Humanwissenschaften, Universität Kassel, Kassel, Germany
| | - Steffi G Riedel-Heller
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health, Universität Leipzig, Leipzig, Germany
| | - Andrea Schaller
- Institut für Bewegungstherapie un bewegungsorientierte Prävention und Rehabilitation, Deutsche Sporthochschule Köln, Köln, Germany
| | - Madlen Scheibe
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
| | - Thomas Bierbaum
- Geschäftsstelle, Deutsches Netzwerk Versorgungsforschung, Berlin, Germany
| | - Jochen Schmitt
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany
| | - Karsten E Dreinhöfer
- Centrum für Muskuloskeletale Chirurgie (CMSC), Charité Universitätsmedizin Berlin und Medical Park Berlin Humboldtmühle
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Wenz B, Graf J, Du Y, Teti A, Gabrys L. Physical Activity Treatment in Adults with Type 2 Diabetes Mellitus per National Treatment Guidelines for Germany: A Telephone-Survey-Based Analysis. Healthcare (Basel) 2022; 10:healthcare10101857. [PMID: 36292304 PMCID: PMC9601844 DOI: 10.3390/healthcare10101857] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/16/2022] [Accepted: 09/19/2022] [Indexed: 11/29/2022] Open
Abstract
Physical activity (PA) is effective in the prevention of type 2 diabetes mellitus (T2DM). According to the German national treatment guidelines for T2DM, PA is recommended at all stages of the treatment process. Adults with T2DM were recruited within the cross-sectional telephone survey ‘Disease knowledge and information needs–Diabetes mellitus (2017)’. Self-reported data on socio-demographic characteristics, previous and current T2DM treatment, and PA behavior were collected. Using multivariable logistic regression models, the correlation between PA treatment (referrals and recommendations) and PA was investigated. Overall, 1149 adults diagnosed with T2DM are included in the analysis. Of the participants, 66.7% reported having ever received PA as part of their T2DM treatment with 61% of the participants reporting PA treatment at the time of the initial T2DM diagnosis and 54% at the time of the interview. Women, older participants, and those with a lower educational level were less likely to have ever been treated with PA. Currently being treated with PA as part of the T2DM treatment was associated with higher rates of achieving the World Health Organization’s PA recommendations (≥150 min per week) (OR = 1.95, 95% CI: 1.42–2.68), as well as ever being treated with PA (OR = 1.74, 95% CI: 1.20–2.38). The analyses showed that PA treatment plays a role in the treatment process of T2DM, but not all patient subgroups benefit in the same way. Efforts to increase PA treatment as part of T2DM treatment are needed, especially for those who are currently not treated with PA. Further research is needed to better understand the type of PA (e.g., structured or unstructured) undertaken by adults with T2DM to develop tailored PA interventions for adults with T2DM and for those in vulnerable subgroups.
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Affiliation(s)
- Benjamin Wenz
- University of Applied Sciences for Sport and Management Potsdam, Am Luftschiffhafen 1, 14471 Potsdam, Germany
- Institute of Gerontology, Faculty I, Vechta University, Driverstraße 22, 49377 Vechta, Germany
| | - Jonathan Graf
- Institute of Gerontology, Faculty I, Vechta University, Driverstraße 22, 49377 Vechta, Germany
| | - Yong Du
- Robert Koch Institute, Department of Epidemiology and Health Monitoring, General-Pape-Str. 62-66, 12101 Berlin, Germany
| | - Andrea Teti
- Institute of Gerontology, Faculty I, Vechta University, Driverstraße 22, 49377 Vechta, Germany
| | - Lars Gabrys
- University of Applied Sciences for Sport and Management Potsdam, Am Luftschiffhafen 1, 14471 Potsdam, Germany
- Correspondence: ; Tel.: +49-331-9075-7110
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Neugebauer E, Piwernetz K, Bramesfeld A, Deckert S, Falkai P, Gabrys L, Hollederer A, Riedel-Heller SG, Schaller A, Scheibe M, Bierbaum T, Schmitt J, Dreinhöfer KE. [Necessity and Ways to Develop Care Goals for the Health System in Germany - a Position Paper of the DNVF]. Gesundheitswesen 2022; 84:971-978. [PMID: 36067778 PMCID: PMC9525141 DOI: 10.1055/a-1911-8605] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Gesundheits- und Versorgungsziele sind eine unverzichtbare Grundvoraussetzung
für ein funktionierendes Gesundheitssystem. Das Dilemma des deutschen
Gesundheitssystems ist, dass es nicht planvoll weiter entwickelt wurde, sondern
dass es historisch gewachsen ist. In den letzten Jahren hat es sich im freien
Spiel der Kräfte zu dem entwickelt, was es heute ist. Den aktuellen
Zustand beschreibt die OECD so: Die Kosten des deutschen Gesundheitssystems
entsprechen nicht den oft nur durchschnittlichen Gesundheitsergebnissen
für die Bevölkerung. Zur Erfüllung der gesetzlichen
Anforderungen (vor allem SGB V §§ 12, 27 und 70) braucht die
Gesundheitsversorgung/das Gesundheitssystem in Deutschland konkrete
Ziele. Eine Orientierung an Versorgungszielen zieht Maßnahmen auf allen
Ebenen der Versorgung nach sich: auf der Makroebene
(Gesamtsystem/gesamte Bevölkerung), auf der Mesoebene
(unterteilt nach Regionen, spezifischen Bevölkerungsgruppen etc.) sowie
auf der Mikroebene ( Patient:innen und Leistungserbringer) Ausgehend von
nationalen und internationalen Erfahrungen zeigt das vorliegende Positionspapier
des DNVF e.V. (Deutsches Netzwerk Versorgungsforschung) das Potenzial, wie
operationalisierte Versorgungsziele eine effektive, finanzierbare und qualitativ
hochwertige Gesundheitsversorgung gewährleisten können. Der
Koalitionsvertrag der Ampelregierung propagiert eine Neuausrichtung mit
Patient:innen bezogenen Versorgungszielen. Jetzt gilt es, aus dieser
Absichtserklärung konkrete und umsetzbare Ziele abzuleiten und dabei
alle wesentlichen Gruppen zu beteiligen. Ergänzend werden in diesem
Prozess Werte und ethische Normen für die Umsetzung vereinbart. Das BMG
(Bundesministerium für Gesundheit) sollte den Prozess der
gesellschaftlichen Willensbildung zur Definition von Nationalen
Versorgungszielen ermöglichen und fördern. Dazu bedarf es einer
klaren politischen Willensbildung. Als Ergebnis liegen am Ende des Prozesses die
Nationalen Versorgungsziele vor, die zusammen mit evidenzbasierten Fakten sowie
mit validen und belastbaren Daten in einem Handbuch „Nationale
Versorgungsziele“ veröffentlicht und gepflegt werden. Die
operative Verantwortung für die Umsetzung könnte bei dem neu zu
gründenden Bundesinstitut für öffentliche Gesundheit
liegen, wie es bereits im Koalitionsvertrag der Ampelkoalition
angekündigt wurde. Das DNVF ist bereit, an der Entwicklung von
Versorgungszielen aktiv mitzuwirken.
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Affiliation(s)
- Edmund Neugebauer
- Medizinische Hochschule Brandenburg (MHB), Theodor Fontane Neuruppin, Germany
| | - Klaus Piwernetz
- Public Health, Medimaxx Health Management GmbH, München, Germany
| | - Anke Bramesfeld
- Hannover Medical School, Medizinische Hochschule Hannover Institut fur Epidemiologie Sozialmedizin und Gesundheitssystemforschung, Hannover, Germany
| | - Stefanie Deckert
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany
| | - Peter Falkai
- Klinik für Psychiatrie und Psychotherapie, Klinikum der Universität München, Munchen, Germany
| | - Lars Gabrys
- Gesundheitssport und Prävention, ESAB Fachhochschule für Sport und Management Potsdam, Potsdam, Germany
| | - Alfons Hollederer
- Fachbereich 01 Humanwissenschaften, Universität Kassel, Kassel, Germany
| | - Steffi G Riedel-Heller
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health, Universität Leipzig, Leipzig, Germany
| | - Andrea Schaller
- Institut für Bewegungstherapie un bewegungsorientierte Prävention und Rehabilitation, Deutsche Sporthochschule Köln, Köln, Germany
| | - Madlen Scheibe
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
| | - Thomas Bierbaum
- Geschäftsstelle, Deutsches Netzwerk Versorgungsforschung, Berlin, Germany
| | - Jochen Schmitt
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany
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Mähs M, Pithan JS, Bergmann I, Gabrys L, Graf J, Hölzemann A, Van Laerhoven K, Otto-Hagemann S, Popescu ML, Schwermann L, Wenz B, Pahmeier I, Teti A. Activity tracker-based intervention to increase physical activity in patients with type 2 diabetes and healthy individuals: study protocol for a randomized controlled trial. Trials 2022; 23:617. [PMID: 35907864 PMCID: PMC9338482 DOI: 10.1186/s13063-022-06550-z] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 07/15/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND One relevant strategy to prevent the onset and progression of type 2 diabetes mellitus (T2DM) focuses on increasing physical activity. The use of activity trackers by patients could enable objective measurement of their regular physical activity in daily life and promote physical activity through the use of a tracker-based intervention. This trial aims to answer three research questions: (1) Is the use of activity trackers suitable for longitudinal assessment of physical activity in everyday life? (2) Does the use of a tracker-based intervention lead to sustainable improvements in the physical activity of healthy individuals and in people with T2DM? (3) Does the accompanying digital motivational intervention lead to sustainable improvements in physical activity for participants using the tracker-based device? METHODS The planned study is a randomized controlled trial focused on 1642 participants with and without T2DM for 9 months with regard to their physical activity behavior. Subjects allocated to an intervention group will wear an activity tracker. Half of the subjects in the intervention group will also receive an additional digital motivational intervention. Subjects allocated to the control group will not receive any intervention. The primary outcome is the amount of moderate and vigorous physical activity in minutes and the number of steps per week measured continuously with the activity tracker and assessed by questionnaires at four time points. Secondary endpoints are medical parameters measured at the same four time points. The collected data will be analyzed using inferential statistics and explorative data-mining techniques. DISCUSSION The trial uses an interdisciplinary approach with a team including sports psychologists, sports scientists, health scientists, health care professionals, physicians, and computer scientists. It also involves the processing and analysis of large amounts of data collected with activity trackers. These factors represent particular strengths as well as challenges in the study. TRIAL REGISTRATION The trial is registered at the World Health Organization International Clinical Trials Registry Platform via the German Clinical Studies Trial Register (DRKS), DRKS00027064 . Registered on 11 November 2021.
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Affiliation(s)
- M Mähs
- Institute of Gerontology, Vechta University, Vechta, Germany.
| | - J S Pithan
- Sport Science, Vechta University, Vechta, Germany
| | - I Bergmann
- Institute of Gerontology, Vechta University, Vechta, Germany
| | - L Gabrys
- University of Applied Sciences for Sport and Management Potsdam, Potsdam, Germany
| | - J Graf
- Institute of Gerontology, Vechta University, Vechta, Germany
| | - A Hölzemann
- Research group Ubiquitous Computing, University of Siegen, Siegen, Germany
| | - K Van Laerhoven
- Research group Ubiquitous Computing, University of Siegen, Siegen, Germany
| | - S Otto-Hagemann
- Diabetologische Schwerpunktpraxis Dr. Silke Otto-Hagemann (diabetes center) Vechta, Vechta, Germany
| | - M L Popescu
- Diabetologische Schwerpunktpraxis Dr. Silke Otto-Hagemann (diabetes center) Vechta, Vechta, Germany
| | - L Schwermann
- Diabetologische Schwerpunktpraxis Dr. Silke Otto-Hagemann (diabetes center) Vechta, Vechta, Germany
| | - B Wenz
- Institute of Gerontology, Vechta University, Vechta, Germany
| | - I Pahmeier
- Sport Science, Vechta University, Vechta, Germany
| | - A Teti
- Institute of Gerontology, Vechta University, Vechta, Germany
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Gabrys L, Soff J, Thiel C, Schmidt C, Swart E, Peschke D. Exercise-Based Cardiac Rehabilitation: Secondary Data Analyses of Mortality and Working Capacity in Germany, 2010-2017. Sports Med Open 2021; 7:88. [PMID: 34862956 PMCID: PMC8642745 DOI: 10.1186/s40798-021-00381-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 11/14/2021] [Indexed: 01/14/2023]
Abstract
BACKGROUND Exercise-based cardiac rehabilitation is safe and implemented in international cardiac rehabilitation guidelines. Evidence for long-term health effects is scarce and rare for health care service research. OBJECTIVE The aim of this study is to evaluate the effectiveness of exercise-based phase III cardiac rehabilitation programs in improving mortality and working capacity outcomes. METHODS The present analyses used claims data of the German pension fund from 2010 to 2017. Overall, 54,163 patients with coronary heart disease (ICD10 I20.-I25.) were included and followed up for exercise-based cardiac rehabilitation participation (mean 4.3 ± 1.9 years). All patients were categorized according to participation duration (long: ≥ 90 days, short: < 90 days, no). The effectiveness of exercise-based rehabilitation was analyzed by calculating adjusted hazard ratios for mortality and reduced working capacity in relation to program participation. RESULTS Of all the cardiac patients, 57.6% received medical recommendations for exercise-based phase III rehabilitation, and 16.8% participated in this rehabilitation. In total, 1776 (3.3%) patients died during the study period, and 3050 (5.5%) received reduced earning capacity pensions. Mortality risk was nearly doubled for those who did not participate in exercise-based cardiac rehabilitation compared to those who participated for a long duration (HR 1.97, 95% CI 1.60-2.43) and 44% higher compared to a short participation (HR 1.44, 95% CI 1.03-2.01). Furthermore, the risk of reduced working capacity was higher for those who did not participate compared to those who participated for a short duration (HR 1.24, 95% CI 1.00-1.54). CONCLUSION Exercise-based phase III cardiac rehabilitation is independently associated with reduced mortality and reduced loss in working capacity. Strong efforts should be made to increase participation rates to improve cardiac patients care.
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Affiliation(s)
- Lars Gabrys
- Department of Sport and Prevention, University of Applied Sciences for Sport and Management Potsdam, Am Luftschiffhafen 1, 14471, Potsdam, Germany.
| | - Johannes Soff
- Department of Applied Health Sciences, University of Applied Sciences for Health, Bochum, Germany
| | - Christian Thiel
- Department of Applied Health Sciences, University of Applied Sciences for Health, Bochum, Germany
| | - Christian Schmidt
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Enno Swart
- Institute for Social Medicine and Health System Research, Otto Von Guericke University Magdeburg, Magdeburg, Germany
| | - Dirk Peschke
- Department of Applied Health Sciences, University of Applied Sciences for Health, Bochum, Germany
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Gabrys L, Baumert J, Heidemann C, Busch M, Finger JD. Sports activity patterns and cardio-metabolic health over time among adults in Germany: Results of a nationwide 12-year follow-up study. J Sport Health Sci 2021; 10:439-446. [PMID: 32738519 PMCID: PMC8343057 DOI: 10.1016/j.jshs.2020.07.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 06/27/2020] [Accepted: 06/29/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Physical activity is favorable for health, and vigorous sports activity is particularly beneficial. This study investigates the association between changes in sports participation patterns over time and cardio-metabolic and self-perceived health outcomes. METHODS Data from 3752 adults (18-79 years of age) who participated in 2 national health interview and examination surveys in 1997-1999 and 2008-2011 were included, with a mean follow-up time of about 12 years. A change in self-reported sports activity was analyzed with respect to the incidence of type 2 diabetes, coronary heart disease (CHD), hypertension, obesity, dyslipidemia, metabolic syndrome, and poor self-perceived health. Participants with pre-existing disease or risk factor of interest at baseline were excluded from the analysis. Being sufficiently active in sports was specified as doing sports for at least 1-2 h per week, and 4 activity categories were defined: 1) inactive at both time points (inactive-inactive), 2) inactive at baseline and active at follow-up (inactive-active), 3) active at baseline and inactive at follow-up (active-inactive), and 4) active at both time points (active-active). Associations between sports activity engagement and health outcomes were estimated by logistic regression models with different stages of adjustments. RESULTS Not engaging in any regular sports activity at both time points (inactive-inactive) was associated with higher rates of type 2 diabetes (odds ratio (OR) = 1.82, 95% confidence interval (95%CI): 1.08-3.08), CHD (OR = 1.82, 95%CI: 1.16-2.84), hypertension (OR = 1.36, 95%CI: 1.03-1.81), metabolic syndrome (OR = 1.58, 95%CI: 1.08-2.32), and poor self-perceived health (OR = 2.54, 95%CI: 1.83-3.53) compared to doing regular sports for a minimum of 1-2 h per week over time (active-active). In case of change from inactivity to any regular sports activity (inactive-active), the rate of risk factor occurrence was not statistically different from the active-active reference group except for poor self-perceived health, but it was higher for type 2 diabetes (OR = 2.15, 95%CI: 1.12-4.14) and CHD (OR = 1.77, 95%CI: 1.03-3.03). Being active at baseline but inactive at follow-up (active-inactive) was not associated with higher disease incidence of type 2 diabetes (OR = 0.70, 95%CI: 0.25-1.97) or CHD (OR = 1.20, 95%CI: 0.49-2.99), but was associated with higher rates of hypertension (OR = 1.61, 95%CI: 1.11-2.34), obesity (OR = 2.34, 95%CI: 1.53-3.57), metabolic syndrome (OR = 1.70, 95%CI: 1.11-2.63), and poor self-perceived health (OR = 2.16, 95%CI: 1.53-3.07) at follow-up. CONCLUSION Even a low weekly quantity (1-2 h) of regular sports activity is partly associated with health benefits. Being formerly but not currently active was not associated with an increased disease incidence, but was associated with a higher risk-factor development compared to the reference group (active-active). Becoming active was preventive for risk-factor development but was not preventive for disease incidence, which probably means that the health benefits from sports activity are not sustainable and disease incidence is only shifted to a later period in life. For this reason, the promotion of and commitment to regular sports activity should be addressed as early as possible over the lifespan to achieve the best health benefits.
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Affiliation(s)
- Lars Gabrys
- University of Applied Sciences of Sport and Management, 14471 Potsdam, Germany; Robert Koch Institute, Department of Epidemiology and Health Monitoring, 12101 Berlin, Germany.
| | - Jens Baumert
- Robert Koch Institute, Department of Epidemiology and Health Monitoring, 12101 Berlin, Germany
| | - Christin Heidemann
- Robert Koch Institute, Department of Epidemiology and Health Monitoring, 12101 Berlin, Germany
| | - Markus Busch
- Robert Koch Institute, Department of Epidemiology and Health Monitoring, 12101 Berlin, Germany
| | - Jonas David Finger
- Robert Koch Institute, Department of Epidemiology and Health Monitoring, 12101 Berlin, Germany
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Carmienke S, Baumert J, Gabrys L, Heise M, Frese T, Heidemann C, Fink A. Participation in structured diabetes mellitus self-management education program and association with lifestyle behavior: results from a population-based study. BMJ Open Diabetes Res Care 2020; 8:e001066. [PMID: 32205327 PMCID: PMC7206925 DOI: 10.1136/bmjdrc-2019-001066] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 02/12/2020] [Accepted: 02/26/2020] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE Whether participation in structured diabetes self-management education programs (DSME) for participants with diabetes mellitus is associated with a healthy lifestyle in routine care apart from randomized-controlled studies remains unclear and is this studies' research question. RESEARCH DESIGN AND METHODS We identified 1300 persons with diabetes mellitus drawn from the cross-sectional population-based analysis German Health Update 2014/2015 (GEDA 2014/2015), which integrated the modules of the European Health Interview Survey (EHIS) wave 2. Of those, 816 were ever-DSME participants and 484 never-participants. We conducted multivariable weighted logistic regression analyses for lifestyle differences comparing ever-DSME and never-DSME participants. Lifestyle was defined by physical activity (PA), current smoking, fruit/vegetable consumption and body mass index (BMI). Age, sex, socioeconomic status, living together, limitation due to health problems for at least for 6 months, self-efficacy and attention to one's health were included as confounders in the regression models. RESULTS Ever-DSME participants engaged significantly more often in cycling at least 1 day per week (OR 1.62, 95% CI: 1.15-2.30) and performed significantly more often aerobic endurance training of 150 min per week (including walking: OR 1.42, 95% CI: 1.03-1.94, without walking: OR 1.48, 95% CI: 1.08-2.03) compared with never-DSME participants. Ever-DSME participants were significantly more often ex-smoker compared with never-DSME participants (OR 1.39, 95% CI: 1.03-1.88). DSME attendance was not significantly associated with current smoking, BMI and fruit or vegetable consumption. CONCLUSION DSME participation is associated with a moderately healthier lifestyle particularly for PA even in routine healthcare. Study results emphasize the importance of a broadly dissemination of DSME access for nationwide diabetes healthcare. Future studies should adjust for DSME participation when investigating lifestyle in persons with diabetes.
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Affiliation(s)
- Solveig Carmienke
- Institute for General Practice and Family Medicine, Medical Faculty of Martin-Luther-Universitat Halle-Wittenberg, Halle, Germany
| | - Jens Baumert
- Department of Epidemiology and Health Monitoring, Robert Koch-Institute, Berlin, Germany
| | - Lars Gabrys
- Department of Epidemiology and Health Monitoring, Robert Koch-Institute, Berlin, Germany
- Fachhochschule für Sport und Management Potsdam, Potsdam, Germany
| | - Marcus Heise
- Institute for General Practice and Family Medicine, Medical Faculty of Martin-Luther-Universitat Halle-Wittenberg, Halle, Germany
| | - Thomas Frese
- Institute for General Practice and Family Medicine, Medical Faculty of Martin-Luther-Universitat Halle-Wittenberg, Halle, Germany
| | - Christin Heidemann
- Department of Epidemiology and Health Monitoring, Robert Koch-Institute, Berlin, Germany
| | - Astrid Fink
- Institute of Medical Sociology, Martin-Luther-Universitat Halle-Wittenberg, Halle, Germany
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10
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Finger JD, Banzer W, Baumeister SE, Brandes M, Bös K, Gabrys L, Gößwald A, Härtel S, Kluttig A, Kuhnert R, Leitzmann M, Löllgen HH, Manz K, Mensink GM, Niessner C, Rosario AS, Kurth BM. [Reference Values for Cardiorespiratory Fitness of the General Population: The German National Health Interview and Examination Survey for Adults (DEGS1) 2008-2011]. Gesundheitswesen 2019; 83:114-121. [PMID: 31746446 DOI: 10.1055/a-1026-6220] [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: 10/25/2022]
Abstract
AIM OF STUDY This study aims to provide population-based reference values for heart rate-based indicators of cardiorespiratory fitness for adults with physical activity readiness aged 18 to 64 years living in Germany. METHODS Based on data on 2,826 individuals who participated in a submaximal cycle ergometer exercise test as part of the German National Health Interview and Examination Survey for Adults (DEGS1) between 2008 and 2011, we calculated the following indicators: physical working capacity at 150 and 130 beats/min and at 75% of estimated maximum heart rate (PWC150, PWC130 and PWC75%) as well as heart rate-based estimated maximum oxygen uptake (VO2max). We used the LMS method by Cole & Green 1992 to calculate reference values. RESULTS 25th, 50th and 75th percentiles of PWC150 were 1.5, 1.77 and 2.08 watts/kg among men and 1.18, 1.44 and 1.69 among women. 25th, 50th and 75th percentiles of PWC130 were 1.16, 1.41 and 1.68 watts/kg among men and 0.81, 1.05 and 1.29 among women. Age-dependent median PWC75% values among men and women were 1.87 - age in years× 0.01 and 1.31 - (age in years/100)2× 0.98, respectively, and VO2max among men is 41.7 - age× 0.15. CONCLUSIONS The references values presented can be used for individual rating of cardiorespiratory fitness among adults living in Germany. Furthermore, they can serve as a basis for regular monitoring purposes.
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Affiliation(s)
- Jonas David Finger
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, Berlin
| | - WinfriedE Banzer
- Institut für Sportwissenschaften, Goethe-Universität Frankfurt am Main, Frankfurt am Main
| | | | - Mirko Brandes
- Abteilung für Prävention und Evaluation, Leibniz-Institut für Präventionsforschung und Epidemiologie - BIPS GmbH, Bremen
| | - Klaus Bös
- Karlsruher Institut für Technologie (KIT), Institut für Sport und Sportwissenschaft, Karlsruhe
| | - Lars Gabrys
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, Berlin.,Abteilung für Gesundheitssport und Prävention, Fachhochschule für Sport und Management Potsdam, Potsdam
| | - Antje Gößwald
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, Berlin
| | - Sascha Härtel
- Karlsruher Institut für Technologie (KIT), Institut für Sport und Sportwissenschaft, Karlsruhe
| | - Alexander Kluttig
- Institut für Medizinische Epidemiologie, Biometrie und Informatik, Martin-Luther-Universität Halle-Wittenberg, Halle
| | - Ronny Kuhnert
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, Berlin
| | - MichaelF Leitzmann
- Institut für Epidemiologie und Präventivmedizin, Universität Regensburg, Regensburg
| | - Herbert H Löllgen
- European Federation of Sports Medicine Associations (EFSMA), S&E Commission, Remscheid
| | - Kristin Manz
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, Berlin
| | - GertB M Mensink
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, Berlin
| | - Claudia Niessner
- Karlsruher Institut für Technologie (KIT), Institut für Sport und Sportwissenschaft, Karlsruhe
| | | | - Bärbel-Maria Kurth
- Leiterin der Abt. für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Insitut, Berlin
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11
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Finger JD, Varnaccia G, Gabrys L, Hoebel J, Kroll LE, Krug S, Manz K, Baumeister SE, Mensink GBM, Lange C, Leitzmann MF. Area-level and individual correlates of active transportation among adults in Germany: A population-based multilevel study. Sci Rep 2019; 9:16361. [PMID: 31705025 PMCID: PMC6841943 DOI: 10.1038/s41598-019-52888-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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] [Received: 06/18/2019] [Accepted: 10/21/2019] [Indexed: 11/20/2022] Open
Abstract
This study aimed at estimating the prevalence in adults of complying with the aerobic physical activity (PA) recommendation through transportation-related walking and cycling. Furthermore, potential determinants of transportation-related PA recommendation compliance were investigated. 10,872 men and 13,144 women aged 18 years or older participated in the cross-sectional 'German Health Update 2014/15 - EHIS' in Germany. Transportation-related walking and cycling were assessed using the European Health Interview Survey-Physical Activity Questionnaire. Three outcome indicators were constructed: walking, cycling, and total active transportation (≥600 metabolic equivalent, MET-min/week). Associations were analyzed using multilevel regression analysis. Forty-two percent of men and 39% of women achieved ≥600 MET-min/week with total active transportation. The corresponding percentages for walking were 27% and 28% and for cycling 17% and 13%, respectively. Higher population density, older age, lower income, higher work-related and leisure-time PA, not being obese, and better self-perceived health were positively associated with transportation-related walking and cycling and total active transportation among both men and women. The promotion of walking and cycling among inactive people has great potential to increase PA in the general adult population and to comply with PA recommendations. Several correlates of active transportation were identified which should be considered when planning public health policies and interventions.
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Affiliation(s)
- J D Finger
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany.
| | - G Varnaccia
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - L Gabrys
- Department of Sport and Prevention, University of Applied Sciences for Sport and Management Potsdam, Potsdam, Germany
| | - J Hoebel
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - L E Kroll
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - S Krug
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - K Manz
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - S E Baumeister
- Chair of Epidemiology, Ludwig-Maximilian-University Munich at University Medicine Augsburg, Augsburg, Germany
- Independent Research Group Clinical Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - G B M Mensink
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - C Lange
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - M F Leitzmann
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
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12
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Abstract
PURPOSE Physical exercise interventions are well accepted and widely used in cardiac rehabilitation programs. To ensure long-lasting effects on physical fitness and the maintenance of work ability a subsequent transfer to rehabilitation sport programs following cardiac rehabilitation is intended in a timely manner. The aim of the present study is to evaluate prescription and utilization rates of rehabilitation sport programs following cardiac rehabilitation. METHODS The present paper analyzes referral rates and the actual utilization of those programs in patients who had a cardiac rehabilitation in the years 2006-2013 using insurance data of the German pension fund. RESULTS Overall, reductions in the prescription of rehabilitation sport programs can be observed. In 2013 55.7% (m) and 62.6% (w) of patients received a prescription for rehabilitation sport programs following cardiac rehabilitation. In contrast to declining prescription rates from 64.2 to 55.7% (m) and 68.0 to 62.6% (w) an increase in sports participation between 3-7% can be observed. CONCLUSION Overall, participation rates between 9.7% and 22.5% (2012) seem not sufficient to promote long-term physical activity behavior change. Next to our evaluation, determinants and barriers for program participation should be investigated.
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Affiliation(s)
- Lars Gabrys
- Fachhochschule für Sport und Management Potsdam (FHSMP)
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13
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Vogt L, Hoppe I, Thoma R, Gabrys L, Friedrich G, Coester E, Füzéki E, Banzer W. [Exercise on Prescription - Patients' Perceptions on Effectiveness and Change in Physical Activity Behavior]. Dtsch Med Wochenschr 2019; 144:e64-e69. [PMID: 31083730 DOI: 10.1055/a-0820-9425] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND So far physical activity counseling and exercise referral in primary health care are not well established Germany. The exercise referral scheme "Rezept für Bewegung" ("exercise on prescription", "EoP") represents an appropriate tool. The initiative aims to reinforce the physicians' verbal advice via the written prescription. The aim of this study was to assess patients' perceptions of the counseling and their self-reported intention to increase their level of physical activity. METHODS 3.9 ± 1.0 months after physical activity counseling and referral 173 patients were invited to fill out a 17-item self-administered questionnaire regarding counseling satisfaction and the impact on physical activity behavior. Study participants were recruited through 12 medical offices in 8 areas of the sports association in Hessen. RESULTS Data of 51 patients (aged 56.1 ± 13.3; 35 female) were included in the evaluation. Almost 2/3 of patients reported ≤ 60 min/week physical activity prior to counseling. 63 % of the interviewees rated the counseling good to very good. Following the counseling more than 1/2 of the respondents attended a course at a sports club and 51 % increased their physical activity in daily life. Overall satisfaction with counseling was associated with higher rates of sports participation OR 3.16 (95 % CI 1.07 - 9.33). 49 % of the respondents wished more support from their health insurance to find an appropriate course. DISCUSSION "EoP" may be effective in raising patients' awareness for exercise and health and in increasing participation in physical activity.
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Affiliation(s)
- Lutz Vogt
- Goethe-Universität Frankfurt/Main, Abteilung Sportmedizin
| | | | - Rebekka Thoma
- Provadis School of International Management and Technology AG
| | - Lars Gabrys
- Fachhochschule für Sport und Management Potsdam
| | | | | | - Eszter Füzéki
- Goethe-Universität Frankfurt/Main, Institut für Arbeits-, Sozial- und Umweltmedizin, Abteilung Präventiv- und Sportmedizin
| | - Winfried Banzer
- Goethe-Universität Frankfurt/Main, Institut für Arbeits-, Sozial- und Umweltmedizin, Abteilung Präventiv- und Sportmedizin
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14
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Wanke EM, Gabrys L, Leslie-Spinks J, Ohlendorf D, Groneberg DA. Functional muscle asymmetries and laterality in Latin American formation dancers. J Back Musculoskelet Rehabil 2019; 31:931-938. [PMID: 29945337 DOI: 10.3233/bmr-160633] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Despite the high popularity of Latin American dance and the specific movement patterns characteristic of this dance discipline, studies on the physical effects of these dance style specific movement patterns are still lacking. OBJECTIVE The purpose of the present study is to analyze strength level differences and shortening of relevant muscle groups resulting from formation dance, taking performance standard and gender into consideration. Furthermore, the correlation between the findings of muscle function tests (MFT) and the occurrence of lumbar spine complaints is evaluated. METHODS A total of 66 participants (m: n= 31, f: n= 35) volunteered for this cross-sectional study (examination group, n= 39, m: n= 19, f: n= 20). The control group consisted of n= 27 participants (m: n= 12, f: n= 15). Besides isometric maximal strength tests (Digi Max system, mechaTronic), relevant muscle groups were examined for shortenings (hip flexors, hamstrings). RESULTS The male participants in dance sport reached a significantly higher strength level in the muscles of the spine region (p= 0.011) than the participants of the control group. The female elite dance athletes developed a significantly higher strength level in the knee flexors on the right side than the dancers of the advanced group (NL) (p= 0.021). At that, muscle shortening were observed that seem to be specific to dance sport. In addition, gender specific differences were observed both in strength levels and in tendency to shortenings. CONCLUSION The specific requirements profile of Latin American formation dance seems to produce affects in the form of muscular imbalance on both sides of the body. These differences of muscular status were mainly observed between dance sport competitors and non-dancers rather than between performance levels. Future investigations with higher numbers of participants would be necessary here.
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Affiliation(s)
- Eileen M Wanke
- Goethe-University, Institute of Environmental, Social and Occupational Medicine, 60590 Frankfurt/Main, Germany
| | - Lars Gabrys
- University of Applied Sciences for Sports and Management, 14471 Potsdam, Germany
| | | | - Daniela Ohlendorf
- Goethe-University, Institute of Environmental, Social and Occupational Medicine, 60590 Frankfurt/Main, Germany
| | - David A Groneberg
- Goethe-University, Institute of Environmental, Social and Occupational Medicine, 60590 Frankfurt/Main, Germany
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15
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Schmidt C, Baumert J, Gabrys L, Ziese T. [Diabetes Mellitus in the Medical Rehabilitation - Use of Rehabilitation Services During 2006-2013]. REHABILITATION 2018; 58:253-259. [PMID: 30049000 DOI: 10.1055/a-0645-9060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND AND AIMS Over the last years the prevalence of diabetes mellitus (DM) has risen. Due to the disease pattern an increasing importance of rehabilitation services is assumed as well. This article contributs to the debate by analyising the use of medical rehabilitations from 2006 to 2013. METHODS The secondary data analysis is based on a scientific use file. DM is defined according to ICD-10 (E10-E14). The trends stratified by age and gender are displayed crude and standardized per 100.000. The use will be correlated with the population-based prevalence on the level of federal states. RESULTS The standardized use rose from 2006 to 2013 in men from 170 to 204.4 and woman from 99 to 123.6 per 100.000. While it declined for people under 60 years old, it rose by about 80% in the age group of the 60-64 year-olds. The use correlated positively (r=0.64) with the population-based prevalence. CONCLUSION As a result of increasingly late retierment, the importance of rehabilitation services in people with DM incesases.
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Affiliation(s)
- Christian Schmidt
- Abteilung für Epidemiologie und Gesundheitsberichterstattung, Robert Koch-Institut, Berlin
| | - Jens Baumert
- Abteilung für Epidemiologie und Gesundheitsberichterstattung, Robert Koch-Institut, Berlin
| | - Lars Gabrys
- Abteilung für Epidemiologie und Gesundheitsberichterstattung, Robert Koch-Institut, Berlin
| | - Thomas Ziese
- Abteilung für Epidemiologie und Gesundheitsberichterstattung, Robert Koch-Institut, Berlin
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16
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Paprott R, Heidemann C, Stühmann LM, Baumert J, Du Y, Hansen S, Zeisler ML, Lemcke J, Beyhl S, Kuhnert R, Schmidt C, Gabrys L, Teti A, Ziese T, Schmich P, Gellert P, Zahn D, Scheidt-Nave C. First results from the study 'Disease knowledge and information needs - Diabetes mellitus (2017)'. J Health Monit 2018; 3:22-60. [PMID: 35586544 PMCID: PMC8852783 DOI: 10.17886/rki-gbe-2018-064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Very little research has been undertaken into what people in Germany know about diabetes, the information they may require about the condition, where they look for such information and how they rate the information currently available. In 2017, the Robert Koch Institute (RKI) carried out a nationwide telephone survey aimed at answering these questions. The study entitled 'Disease knowledge and information needs - Diabetes mellitus (2017)' focused on people aged at least 18 years. A total of 2,327 people without diabetes and 1,479 people with diagnosed diabetes were interviewed for the study. First results show that 56.7% of people without diabetes and 92.8% of those with diabetes rate their knowledge about the condition as 'very good' or 'good'. People without diabetes were found to have the strongest need for information in terms of 'lifestyle changes, health promotion and disease prevention', whereas respondents with diabetes stressed the strongest need for information about 'treatment and therapy'. Almost a third of respondents without diabetes have actively sought information about diabetes at least once, mostly via print media. Patients with diabetes stated that their general practitioner was their most frequent source of information about the condition. In both groups, about half of respondents reported that they found it difficult to judge the trustworthiness of the information published in the media about diabetes. The results of the study form part of the German National Diabetes Surveillance, which is coordinated by the RKI. The data are also intended to be used by the Federal Centre for Health Education to develop a strategy to improve the information provided about diabetes.
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Affiliation(s)
- Rebecca Paprott
- Robert Koch Institute, Berlin, Department of Epidemiology and Health Monitoring
| | - Christin Heidemann
- Robert Koch Institute, Berlin, Department of Epidemiology and Health Monitoring
| | - Lena M. Stühmann
- Charité - UniversitätsmedizinBerlin, Institute for Medical Sociology
| | - Jens Baumert
- Robert Koch Institute, Berlin, Department of Epidemiology and Health Monitoring
| | - Yong Du
- Robert Koch Institute, Berlin, Department of Epidemiology and Health Monitoring
| | - Sylvia Hansen
- Federal Centre for Health Education, Cologne Office for National Education and Communication on Diabetes Mellitus
| | - Marie-Luise Zeisler
- Robert Koch Institute, Berlin, Department of Epidemiology and Health Monitoring
| | - Johannes Lemcke
- Robert Koch Institute, Berlin, Department of Epidemiology and Health Monitoring
| | - Silke Beyhl
- Robert Koch Institute, Berlin, Department of Epidemiology and Health Monitoring
| | - Ronny Kuhnert
- Robert Koch Institute, Berlin, Department of Epidemiology and Health Monitoring
| | - Christian Schmidt
- Robert Koch Institute, Berlin, Department of Epidemiology and Health Monitoring
| | - Lars Gabrys
- Robert Koch Institute, Berlin, Department of Epidemiology and Health Monitoring,University of Applied Sciences for Sport and Management, Potsdam
| | - Andrea Teti
- University of Vechta Institute for Gerontology
| | - Thomas Ziese
- Robert Koch Institute, Berlin, Department of Epidemiology and Health Monitoring
| | - Patrick Schmich
- Robert Koch Institute, Berlin, Department of Epidemiology and Health Monitoring
| | - Paul Gellert
- Charité - UniversitätsmedizinBerlin, Institute for Medical Sociology
| | - Daniela Zahn
- Federal Centre for Health Education, Cologne Office for National Education and Communication on Diabetes Mellitus
| | - Christa Scheidt-Nave
- Robert Koch Institute, Berlin, Department of Epidemiology and Health Monitoring,Corresponding author Dr Christa Scheidt-Nave, Robert Koch Institute, Department of Epidemiology and Health Monitoring, General-Pape-Str. 62–66, D-12101 Berlin, Germany, E-mail:
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17
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Gabrys L, Heidemann C, Schmidt C, Baumert J, Teti A, Du Y, Paprott R, Ziese T, Banzer W, Böhme M, Borrmann B, Busse R, Freitag M, Hagen B, Holl R, Icks A, Kaltheuner M, Koch K, Kümmel S, Kuhn J, Kuß O, Laux G, Schubert I, Szecsenyi J, Uebel T, Zahn D, Scheidt-Nave C. Selecting and defining indicators for diabetes surveillance in Germany. J Health Monit 2018; 3:3-21. [PMID: 35586543 PMCID: PMC8852787 DOI: 10.17886/rki-gbe-2018-063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Mainly because of the large number of people affected and associated significant health policy implications, the Robert Koch Institute (RKI) is developing a public health surveillance system using diabetes as an example. In a first step to ensure long-term and comparable data collection and establish efficient surveillance structures, the RKI has defined a set of relevant indicators for diabetes surveillance. An extensive review of the available literature followed by a structured process of consensus provided the basis for a harmonised set of 30 core and 10 supplementary indicators. They correspond to the following four fields of activity: (1) reducing diabetes risk, (2) improving diabetes early detection and treatment, (3) reducing diabetes complications, (4) reducing the disease burden and overall costs of the disease. In future, in addition to the primary data provided by RKI health monitoring diabetes surveillance needs to also consider the results from secondary data sources. Currently, barriers to accessing this data remain, which will have to be overcome, and gaps in the data closed. The RKI intentends to continuously update this set of indicators and at some point apply it also to further chronic diseases with high public health relevance.
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Affiliation(s)
| | | | | | | | | | - Yong Du
- Robert Koch Institute, Berlin
| | | | | | | | | | | | | | | | - Bernd Hagen
- Central Research Institute of Ambulatory Health Care in Germany, Cologne
| | | | - Andrea Icks
- Heinrich Heine University Düsseldorf.,German Diabetes Center Düsseldorf.,German Center for Diabetes Research, Neuherberg
| | | | - Klaus Koch
- Institute of Quality and Efficiency in Health Care, Cologne
| | - Stefanie Kümmel
- Institute for Applied Quality Improvement and Research in Health Care, Göttingen
| | - Joseph Kuhn
- Bavarian Health and Food Safety Authority, Oberschleißheim
| | - Oliver Kuß
- Institute for Biometrics and Epidemiology at the German Diabetes Center, Düsseldorf
| | | | | | | | - Til Uebel
- German College of General Practitioners and Family Physicians, Berlin
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18
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Schmidt C, Heidemann C, Paprott R, Baumert J, Du Y, Gabrys L, Ziese T, Scheidt-Nave C. Diabetes surveillance - status and perspectives. J Health Monit 2018; 3:10. [PMID: 35586465 PMCID: PMC8852794 DOI: 10.17886/rki-gbe-2018-055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Christian Schmidt
- Correspondence address Dr Christian Schmidt, Robert Koch Institute, Department of Epidemiology and Health Monitoring, General-Pape-Straße 62-66, 12101 Berlin, E-mail:
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Schmidt C, Bätzing-Feigenbaum J, Bestmann A, Brinks R, Dreß J, Goffrier B, Hagen B, Laux G, Pollmanns J, Schröder H, Stahl T, Baumert J, Du Y, Gabrys L, Heidemann C, Paprott R, Scheidt-Nave C, Teti A, Ziese T. [Integration of secondary data into national diabetes surveillance : Background, aims and results of the secondary data workshop at the Robert Koch Institute]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2018; 60:656-661. [PMID: 28466131 DOI: 10.1007/s00103-017-2552-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Epidemiological data provide evidence that diabetes mellitus is a highly relevant public health issue in Germany as in many other countries. The Robert Koch Institute (RKI) is in the process of building a national diabetes surveillance system that is aimed at establishing indicator-based public health monitoring of diabetes population dynamics using primary and secondary data. The purpose of the workshop was to conduct an inventory of available secondary data sources and to discuss data contents, data access, data analysis examples in addition to the options for ongoing data use for diabetes surveillance.
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Affiliation(s)
- Christian Schmidt
- Abteilung für Epidemiologie und Gesundheitsberichterstattung, Robert Koch-Institut (RKI), General-Pape-Str. 62-66, 12101, Berlin, Deutschland.
| | | | - Anja Bestmann
- Deutsche Rentenversicherung Bund (DRV), Berlin, Deutschland
| | - Ralph Brinks
- Institut für Biometrie und Epidemiologie, Deutsches Diabetes-Zentrum (DDZ), Düsseldorf, Deutschland
| | - Jochen Dreß
- Deutsches Institut für Medizinische Dokumentation und Information (DIMDI), Köln, Deutschland
| | - Benjamin Goffrier
- Zentralinstitut für die kassenärztliche Versorgung in Deutschland (Zi), Berlin, Deutschland
| | - Bernd Hagen
- Zentralinstitut für die kassenärztliche Versorgung in Deutschland (Zi), Berlin, Deutschland
| | - Gunter Laux
- Abteilung Allgemeinmedizin und Versorgungsforschung, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - Johannes Pollmanns
- Fachbereich Gesundheitswissenschaften, Hochschule Niederrhein, Krefeld, Deutschland
| | - Helmut Schröder
- Wissenschaftliches Institut der AOK (WIdO), Berlin, Deutschland
| | - Teresa Stahl
- Statistisches Bundesamt (DESTATIS), Wiesbaden, Deutschland
| | - Jens Baumert
- Abteilung für Epidemiologie und Gesundheitsberichterstattung, Robert Koch-Institut (RKI), General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Yong Du
- Abteilung für Epidemiologie und Gesundheitsberichterstattung, Robert Koch-Institut (RKI), General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Lars Gabrys
- Abteilung für Epidemiologie und Gesundheitsberichterstattung, Robert Koch-Institut (RKI), General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Christin Heidemann
- Abteilung für Epidemiologie und Gesundheitsberichterstattung, Robert Koch-Institut (RKI), General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Rebecca Paprott
- Abteilung für Epidemiologie und Gesundheitsberichterstattung, Robert Koch-Institut (RKI), General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Christa Scheidt-Nave
- Abteilung für Epidemiologie und Gesundheitsberichterstattung, Robert Koch-Institut (RKI), General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Andrea Teti
- Abteilung für Epidemiologie und Gesundheitsberichterstattung, Robert Koch-Institut (RKI), General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Thomas Ziese
- Abteilung für Epidemiologie und Gesundheitsberichterstattung, Robert Koch-Institut (RKI), General-Pape-Str. 62-66, 12101, Berlin, Deutschland
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Gabrys L, Heidemann C, Teti A, Borrmann B, Gawrich S, Maulbecker-Armstrong C, Fertmann R, Schubert U, Schmidt C, Baumert J, Paprott R, Du Y, Scheidt-Nave C, Ziese T. [Regionalization of federal health reporting using the example of diabetes surveillance : Aims and results of the discussion between the Robert Koch Institute and the federal states]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2017; 60:1147-1152. [PMID: 28871413 DOI: 10.1007/s00103-017-2616-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Insufficiently treated diabetes mellitus can lead to severe comorbidities. National and international analyses show a continuous increase in diabetes prevalence over the last decades. Currently, an indicator-based national diabetes surveillance system is implemented at the Robert Koch Institute (RKI) to monitor and report on diabetes development on the basis of available primary and secondary data. The aim of the meeting was to go into deeper discussions and to integrate expectations and expertise of the federal states into the design of the national surveillance system. A close collaboration between the RKI and the federal states is intended.
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Affiliation(s)
- Lars Gabrys
- Abteilung für Epidemiologie und Gesundheitsberichterstattung, Robert Koch-Institut (RKI), General-Pape-Str. 62-66, 12101, Berlin, Deutschland.
| | - Christin Heidemann
- Abteilung für Epidemiologie und Gesundheitsberichterstattung, Robert Koch-Institut (RKI), General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Andrea Teti
- Abteilung für Epidemiologie und Gesundheitsberichterstattung, Robert Koch-Institut (RKI), General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Brigitte Borrmann
- Landeszentrum Gesundheit Nordrhein-Westfalen, Bielefeld, Deutschland
| | - Stefan Gawrich
- Hessisches Landesprüfungs- und Untersuchungsamt im Gesundheitswesen, Dillenburg, Deutschland
| | - Catharina Maulbecker-Armstrong
- Referat Prävention und Gesundheitsberichterstattung, Hessisches Ministerium für Soziales und Integration, Wiesbaden, Deutschland
| | - Regina Fertmann
- Fachabteilung Gesundheitsdaten und Gesundheitsförderung, Behörde für Gesundheit und Verbraucherschutz, Hamburg, Deutschland
| | - Ulrike Schubert
- Ministerium für Soziales, Gesundheit, Jugend, Familie und Senioren des Landes Schleswig-Holstein, Kiel, Deutschland
| | - Christian Schmidt
- Abteilung für Epidemiologie und Gesundheitsberichterstattung, Robert Koch-Institut (RKI), General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Jens Baumert
- Abteilung für Epidemiologie und Gesundheitsberichterstattung, Robert Koch-Institut (RKI), General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Rebecca Paprott
- Abteilung für Epidemiologie und Gesundheitsberichterstattung, Robert Koch-Institut (RKI), General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Yong Du
- Abteilung für Epidemiologie und Gesundheitsberichterstattung, Robert Koch-Institut (RKI), General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Christa Scheidt-Nave
- Abteilung für Epidemiologie und Gesundheitsberichterstattung, Robert Koch-Institut (RKI), General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Thomas Ziese
- Abteilung für Epidemiologie und Gesundheitsberichterstattung, Robert Koch-Institut (RKI), General-Pape-Str. 62-66, 12101, Berlin, Deutschland
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Schmidt C, Baumert J, Gabrys L, Ziese T. Diabetes mellitus in der Rehabilitation: Inanspruchnahme, regionale Aspekte und EM-Berentung im Zeitverlauf der Reha-Kohorten 2006 – 2013. Das Gesundheitswesen 2017. [DOI: 10.1055/s-0037-1605688] [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: 10/18/2022]
Affiliation(s)
- C Schmidt
- Robert Koch-Institut, Epidemiologie und Gesundheitsberichtserstattung, Berlin
| | - J Baumert
- Robert Koch-Institut, Epidemiologie und Gesundheitsberichtserstattung, Berlin
| | - L Gabrys
- Robert Koch-Institut, Epidemiologie und Gesundheitsberichtserstattung, Berlin
| | - T Ziese
- Robert Koch-Institut, Epidemiologie und Gesundheitsberichtserstattung, Berlin
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Schmidt C, Bätzing-Feigenbaum J, Bestmann A, Brinks R, Dreß J, Goffrier B, Hagen B, Laux G, Pollmanns J, Schröder H, Stahl T, Baumert J, Du Y, Gabrys L, Heidemann C, Paprott R, Scheidt-Nave C, Teti A, Ziese T. [Integration of secondary data into national diabetes surveillance : Background, aims and results of the secondary data workshop at the Robert Koch Institute]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2017. [PMID: 28466131 DOI: 10.20364/va-17.07] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Epidemiological data provide evidence that diabetes mellitus is a highly relevant public health issue in Germany as in many other countries. The Robert Koch Institute (RKI) is in the process of building a national diabetes surveillance system that is aimed at establishing indicator-based public health monitoring of diabetes population dynamics using primary and secondary data. The purpose of the workshop was to conduct an inventory of available secondary data sources and to discuss data contents, data access, data analysis examples in addition to the options for ongoing data use for diabetes surveillance.
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Affiliation(s)
- Christian Schmidt
- Abteilung für Epidemiologie und Gesundheitsberichterstattung, Robert Koch-Institut (RKI), General-Pape-Str. 62-66, 12101, Berlin, Deutschland.
| | | | - Anja Bestmann
- Deutsche Rentenversicherung Bund (DRV), Berlin, Deutschland
| | - Ralph Brinks
- Institut für Biometrie und Epidemiologie, Deutsches Diabetes-Zentrum (DDZ), Düsseldorf, Deutschland
| | - Jochen Dreß
- Deutsches Institut für Medizinische Dokumentation und Information (DIMDI), Köln, Deutschland
| | - Benjamin Goffrier
- Zentralinstitut für die kassenärztliche Versorgung in Deutschland (Zi), Berlin, Deutschland
| | - Bernd Hagen
- Zentralinstitut für die kassenärztliche Versorgung in Deutschland (Zi), Berlin, Deutschland
| | - Gunter Laux
- Abteilung Allgemeinmedizin und Versorgungsforschung, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - Johannes Pollmanns
- Fachbereich Gesundheitswissenschaften, Hochschule Niederrhein, Krefeld, Deutschland
| | - Helmut Schröder
- Wissenschaftliches Institut der AOK (WIdO), Berlin, Deutschland
| | - Teresa Stahl
- Statistisches Bundesamt (DESTATIS), Wiesbaden, Deutschland
| | - Jens Baumert
- Abteilung für Epidemiologie und Gesundheitsberichterstattung, Robert Koch-Institut (RKI), General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Yong Du
- Abteilung für Epidemiologie und Gesundheitsberichterstattung, Robert Koch-Institut (RKI), General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Lars Gabrys
- Abteilung für Epidemiologie und Gesundheitsberichterstattung, Robert Koch-Institut (RKI), General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Christin Heidemann
- Abteilung für Epidemiologie und Gesundheitsberichterstattung, Robert Koch-Institut (RKI), General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Rebecca Paprott
- Abteilung für Epidemiologie und Gesundheitsberichterstattung, Robert Koch-Institut (RKI), General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Christa Scheidt-Nave
- Abteilung für Epidemiologie und Gesundheitsberichterstattung, Robert Koch-Institut (RKI), General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Andrea Teti
- Abteilung für Epidemiologie und Gesundheitsberichterstattung, Robert Koch-Institut (RKI), General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Thomas Ziese
- Abteilung für Epidemiologie und Gesundheitsberichterstattung, Robert Koch-Institut (RKI), General-Pape-Str. 62-66, 12101, Berlin, Deutschland
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Gabrys L, Schmidt C, Heidemann C, Baumert J, Du Y, Paprott R, Teti A, Wolf IK, Ziese T, Scheidt-Nave C. Diabetes Surveillance in Germany - Background, concept and prospects. J Health Monit 2017; 2:83-95. [PMID: 37168685 PMCID: PMC10165556 DOI: 10.17886/rki-gbe-2017-022] [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] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Diabetes mellitus is a chronic disease that is associated with serious health problems and high costs. According to estimates gained from nationally representative health surveys conducted by the Robert Koch Institute (RKI), 4.6 million adults aged 18 to 79 suffer from diabetes in Germany. In addition, around 1.3 million adults have undetected diabetes. A surveillance system is currently being established at the RKI in order to gather the data sources available on diabetes in Germany and to provide reliable and comparable findings on time trends covering the frequency, progress of treatment, prevention and care of the disease. Next to identifying trends, diabetes surveillance also needs to detect differences in epidemiology that are related to social status or geographic region. Diabetes surveillance at the RKI is being undertaken in close cooperation with stakeholders involved in science, health-care provision, health policy and health-system self-governance. Furthermore, its progress is accompanied by an interdisciplinary scientific advisory board. Diabetes surveillance involves the following key elements: 1) the development of a research-based conceptual framework that uses indicators to appropriately measure developments in the disease; 2) the establishment of standards for the use of existing data sources and the identification of barriers to data usage and gaps in the data; and 3) the implementation of focused health reporting that is geared towards the target group. In addition to policy consultations, diabetes surveillance must guarantee the provision of timely and continuous information to the public together with the Federal Agency for Health Education. The implementation of a diabetes surveillance in Germany should act as a model and serve as a basis with which to establish the surveillance of other non-communicable diseases. In principle, indicator-based diabetes monitoring at the population level can be viewed as providing the body for evidence-based policy consultation and focused health policy. In turn, this should enable the implementation of effective disease prevention measures and high-quality care for all groups within the population.
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Affiliation(s)
- Lars Gabrys
- Corresponding author Dr. Lars Gabrys Robert Koch Institute, Department for Epidemiology and Health Monitoring, General-Pape-Str. 62–66, D-12101 Berlin, Germany, E-mail:
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Teti A, Gabrys L, Ziese T, Scheidt-Nave C, Heidemann C, Gabrys L, Schmidt C, Teti A, Wolf IK, Du Y, Paprott R, Baumert J, Ziese T, Scheidt-Nave C, Gregg EW, Geiss L, Mainz J, Jørgensen M, Johnson J, Carinci F, Wild S. Proceedings of the International Workshop ‘Development of a National Diabetes Surveillance System in Germany – Core Indicators and Conceptual Framework’. BMC Proc 2017. [PMCID: PMC5356042 DOI: 10.1186/s12919-016-0070-5] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Gabrys L, Sperzel S, Bernhoerster M, Banzer W, Vogt L. Real-time visual activity feedback for physical activity improvement in breast and colon cancer patients. Res Sports Med 2016; 25:1-10. [DOI: 10.1080/15438627.2016.1258639] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Lars Gabrys
- Department of Sports Medicine, Goethe-University, Frankfurt, Germany
| | - Stefan Sperzel
- Department of Sports Medicine, Goethe-University, Frankfurt, Germany
| | | | - Winfried Banzer
- Department of Sports Medicine, Goethe-University, Frankfurt, Germany
| | - Lutz Vogt
- Department of Sports Medicine, Goethe-University, Frankfurt, Germany
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Gabrys L, Jordan S, Schlaud M. Prevalence and temporal trends of physical activity counselling in primary health care in Germany from 1997-1999 to 2008-2011. Int J Behav Nutr Phys Act 2015; 12:136. [PMID: 26503585 PMCID: PMC4624583 DOI: 10.1186/s12966-015-0299-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [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] [Received: 08/06/2015] [Accepted: 10/22/2015] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND For patients, usually the first and most preferred contact person on health issues is still the doctor and most persons see their doctor at least once a year. Therefore, physical activity counselling strategies delivered by a physician seem to be a promising approach for physical activity improvement. The aim of this work is to show prevalence and time trends in physical activity counselling by primary health care physicians from 1997-1999 to 2008-2011 in Germany. METHODS Data from two representative cross-sectional health interview and examination surveys of the Robert Koch Institute were used. Prevalence proportions of physicians' physical activity counselling and patients' utilisation of health promotion programmes in relation to physical activity counselling were analysed. Strengths of associations were calculated by using binary logistic regression models. Overall, 11,907 persons aged 18-64 years were included in the analyses. RESULTS Physical activity counselling prevalence decreased from 11.1 to 9.4% in men and from 9.3 to 7.7% in women over ten years. Only persons with accumulated health risks (OR 5.33; 95% CI 1.89-15.00) and persons with diagnosed diabetes mellitus (OR 3.42; 95% CI 1.68-6.69) showed significantly higher counselling proportions in 2008-2011 compared to 1997-1999. Men were more often counselled on physical activity than women, but women showed significantly higher participation rates in physical activity promotion programmes in both surveys. In both sexes significantly higher participation rates could be observed in persons who had received some activity counselling by a physician. CONCLUSION Although, evidence underlines the positive health effects of regular physical activity; overall, physicians counselling behaviour on physical activity decreased over time. However, it is positive to note that a trend towards a disease-specific counselling behaviour in terms of a tailored intervention could be observed.
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Affiliation(s)
- Lars Gabrys
- Robert Koch Institute - Department of Epidemiology and Health Monitoring, General Pape Str. 62-66, 12101, Berlin, Germany.
| | - Susanne Jordan
- Robert Koch Institute - Department of Epidemiology and Health Monitoring, General Pape Str. 62-66, 12101, Berlin, Germany.
| | - Martin Schlaud
- Robert Koch Institute - Department of Epidemiology and Health Monitoring, General Pape Str. 62-66, 12101, Berlin, Germany.
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Santarossa C, Niederer D, Gabrys L, Vogt L, Banzer W. Sustainability Of Sports Medical Counselling For Long-term Unemployed Persons. Med Sci Sports Exerc 2015. [DOI: 10.1249/01.mss.0000477504.22275.e4] [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: 11/21/2022]
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Gabrys L, Michallik L, Thiel C, Vogt L, Banzer W. Effects of a structured physical-activity counseling and referral scheme in long-term unemployed individuals: a pilot accelerometer study. Behav Med 2013; 39:44-50. [PMID: 23668911 DOI: 10.1080/08964289.2013.782852] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Unemployment is associated with health risks. Physical activity produces health benefits. This study examined the effects of a physical activity counseling and exercise referral scheme on physical-activity behavior in long-term unemployed individuals. In this study, 51 long-term unemployed persons received physical-activity counseling and exercise referral. Further, 21 unemployed and 17 employed persons with no intervention were included. Physical activity was measured over 7 consecutive days prior to and 12 weeks after counseling by accelerometer. Participants who started exercising increased their amount of moderate physical activity from 26 ± 14 to 35 ± 25 minutes/day and total physical activity from 207 ± 86 to 288 ± 126 counts/minute. Generally, unemployed persons were less active and less healthy compared to employed persons. Persons who are willing and motivated benefit from structured physical activity counseling and exercise referral and increase physical activity to a health promoting level. Physical activity inequalities could be reduced.
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Affiliation(s)
- Lars Gabrys
- Department of Sports Medicine, Goethe University Frankfurt am Main, 60487 Frankfurt a. M., Germany.
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Gabrys L, Thiel C, Saborowski G, Vogt L, Banzer W. Bewegungsberatung durch Experten aus der Sportwissenschaft. Eine Public Health Strategie zur Erhöhung körperlicher Aktivität bei speziellen Zielgruppen. ACTA ACUST UNITED AC 2012. [DOI: 10.1007/s12662-012-0271-7] [Citation(s) in RCA: 3] [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: 10/27/2022]
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Gabrys L, Thiel C, Minakawa S, Saborowski G, Vogt L, Banzer W. Sportmedizinische Bewegungsberatung bei Arbeitslosen. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2011; 55:82-7. [DOI: 10.1007/s00103-011-1394-y] [Citation(s) in RCA: 2] [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: 10/14/2022]
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