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  • 1
    Online Resource
    Online Resource
    Health Care Use and Costs in Individuals With Diabetes With and Without Comorbid Depression in Germany: Results of the Cross-sectional DiaDec Study
    American Diabetes Association ; 2021
    In:  Diabetes Care Vol. 44, No. 2 ( 2021-02-01), p. 407-415
    Details
    In: Diabetes Care, American Diabetes Association, Vol. 44, No. 2 ( 2021-02-01), p. 407-415
    Abstract: Increased health care use and costs have been reported in individuals with diabetes with comorbid depression. Knowledge regarding cost differences between individuals with diabetes alone and those with diabetes and diagnosed/undiagnosed depression is, however, scarce. We therefore compared use and costs for patients with diabetes and no depression and patients with diabetes and documented depression diagnosis or self-reported depression symptoms for several cost components, including mental health care costs. RESEARCH DESIGN AND METHODS Data from a 2013 cross-sectional survey of randomly sampled members of a nationwide German statutory health insurance (SHI) provider with diabetes (n = 1,634) were linked individually with SHI data covering four quarters before and after the survey. Self-reported depression symptoms were assessed with the Patient Health Questionnaire-9, with depression diagnosis taken from SHI data. We analyzed health care use and costs, using regression analysis to calculate cost ratios (CRs) with adjustment for sociodemographic/socioeconomic factors and comorbidities for two groups: 1) those with no symptoms and no diagnosis and 2) those with symptoms or diagnosis. In our explorative subanalysis we analyzed subgroups with either symptoms or diagnosis separately. RESULTS Annual mean total health care costs were higher for patients with comorbid depression (EUR 5,629 [95% CI 4,987–6,407]) than without (EUR 3,252 [2,976–3,675] , the CR being 1.25 [1.14–1.36]). Regression analysis showed that excess costs were highly associated with comorbidities. Mental health care costs were very low for patients without depression (psychotherapy EUR 2; antidepressants EUR 4) and still relatively low for those with depression (psychotherapy EUR 111; antidepressants EUR 76). CONCLUSIONS Costs were significantly higher when comorbid depression was present either as symptoms or diagnosed. Excess costs for mental health services were rather low.
    Type of Medium: Online Resource
    ISSN: 0149-5992 , 1935-5548
    URL: Article
    DOI: 10.2337/dc19-2487
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2021
    detail.hit.zdb_id: 1490520-6
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  • 2
    Online Resource
    Online Resource
    Gedanken an Gesundheit bei Diabetes: Ergebnisse der DiaDec-Studie
    Walter de Gruyter GmbH ; 2022
    In:  Public Health Forum Vol. 30, No. 3 ( 2022-09-27), p. 207-210
    Details
    In: Public Health Forum, Walter de Gruyter GmbH, Vol. 30, No. 3 ( 2022-09-27), p. 207-210
    Abstract: Bei Menschen mit chronischen Erkrankungen können häufige negative Gedanken einerseits mit ungünstigen Gesundheitsoutcomes, andererseits mit positiven Outcomes wie gesundheitsförderndem Verhalten in Verbindung stehen. Wir berichten die Ergebnisse einer Studie, die sich mit Gedanken an Gesundheit bei Menschen mit Diabetes befasst. Wir untersuchten Häufigkeit, Valenz und Zusammenhang solcher Gedanken mit gesundheitsbezogener Lebensqualität, diabetesbezogenen Belastungen und depressiven Symptomen.
    Type of Medium: Online Resource
    ISSN: 1876-4851 , 0944-5587
    URL: Article
    DOI: 10.1515/pubhef-2022-0055
    Language: English
    Publisher: Walter de Gruyter GmbH
    Publication Date: 2022
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  • 3
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    Online Resource
    Thoughts about health and patient-reported outcomes among people with diabetes mellitus: results from the DiaDec-study
    Springer Science and Business Media LLC ; 2021
    In:  BMC Public Health Vol. 21, No. 1 ( 2021-01-26)
    Details
    In: BMC Public Health, Springer Science and Business Media LLC, Vol. 21, No. 1 ( 2021-01-26)
    Abstract: There is considerable evidence that repetitive negative thoughts are often associated with adverse health outcomes. The study aims are (i) to identify the frequency and valence of thoughts about health in people with diabetes mellitus using questions based on the day reconstruction method (DRM) and (ii) to analyse associations between thoughts about health and health-related quality of life (HRQoL), diabetes-related distress and depressive symptoms. Methods Cross-sectional study of a random sample of a German statutory health insurance population with diabetes aged between 18 and 80 linking questionnaire and claims data. Associations between frequency and valence of thoughts about health on a previous day and HRQoL assessed by a 12-Item Short-Form Health Survey, diabetes-related distress assessed using the Problem Areas in Diabetes scale and depressive symptoms assessed by Patient Health Questionnaire-9 were analysed using linear and logistic regression analysis, adjusting for sociodemographic and clinical characteristics. Results Thoughts about health were analysed in 726 participants (86% type 2 diabetes, 62% male, mean age 67.6 ± 9.7 years). A total of 46% had not thought about their health the day before, 17.1% reported low frequency and negative thoughts, 21.4% low frequency and positive thoughts, 12.1% high frequency and negative thoughts and 3.4% high frequency and positive thoughts. The presence of thoughts about health irrespective of their frequency and valence is associated with a lower physical and mental component summary score of the 12-Item Short-Form Health Survey. Negative thoughts are associated with high diabetes-related distress. Frequent or negative thoughts are associated with depressive symptoms. Conclusions Thoughts about health are a part of everyday life for a substantial number of people with diabetes. Surprisingly, even positive thoughts are associated with poorer HRQoL in our study. Further research within the DRM paradigm is needed to understand how thoughts about health may affect people’s (assessment of) state of health. Thoughts about health should be considered in diabetes education and patient counselling with a view to preventing and treating emotional disorders. More attention should be paid to the outcomes of interventions that may themselves lead to an increase in the frequency of thoughts about health.
    Type of Medium: Online Resource
    ISSN: 1471-2458
    URL: Article
    DOI: 10.1186/s12889-021-10231-y
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2041338-5
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  • 4
    Online Resource
    Online Resource
    Self-care time and rating of health state in persons with diabetes: results from the population-based KORA survey in Germany
    Springer Science and Business Media LLC ; 2022
    In:  Health and Quality of Life Outcomes Vol. 20, No. 1 ( 2022-12-14)
    Details
    In: Health and Quality of Life Outcomes, Springer Science and Business Media LLC, Vol. 20, No. 1 ( 2022-12-14)
    Abstract: The amount of empirical research on whether people in fact include health-related changes in leisure time into health state valuations is limited and the results are inconclusive. In this exploratory study, we analyse whether time aspects of diabetes self-care might explain the ratings of the health state (HSR) in addition to the effects of physical and mental health-related quality of life. Methods Using the data from participants with diagnosed type 2 diabetes in the population-based KORA FF4 study ( n  = 190, 60% Male, mean age 69 ± 10 years), multiple logistic regression models were fitted to explain HSR (good vs. poor) in terms of the SF-12 physical and mental component summary (PCS and MCS) scores, time spent on diabetes self-care and a number of background variables. Results There was no significant association between time spent on diabetes self-care and HSR in models without interaction. Significant interaction term was found between the SF-12 PCS score and time spent on self-care. In models with interaction self-care time has a small, but significant impact on the HSR. In particular, for a PCS score under 40, more time increases the chance to rate the health state as “good”, while for a PCS score above 40 there is a reverse effect. Conclusions The additional impact of self-care time on HSR in our sample is small and seems to interact with physical health-related quality of life. More research is needed on whether inclusion of health-related leisure time changes in the denominator of cost-effectiveness analysis is sufficient.
    Type of Medium: Online Resource
    ISSN: 1477-7525
    URL: Article
    DOI: 10.1186/s12955-022-02068-9
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2098765-1
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  • 5
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    Online Resource
    Clinical efficacy and safety outcomes of bempedoic acid for LDL-C lowering therapy in patients at high cardiovascular risk: a systematic review and meta-analysis
    BMJ ; 2022
    In:  BMJ Open Vol. 12, No. 2 ( 2022-02), p. e048893-
    Details
    In: BMJ Open, BMJ, Vol. 12, No. 2 ( 2022-02), p. e048893-
    Abstract: Bempedoic acid (BA) is a novel oral low-density lipoprotein cholesterol lowering drug. This systematic review and meta-analysis aims to assess efficacy and safety for clinical outcomes in high cardiovascular (CV) risk patients. Data sources MEDLINE, Cochrane Central Register of Controlled Trials, Google Scholar, Embase, ClinicalTrials.gov, Clinical Trial Results and the American College of Cardiology web site were searched. Study selection Randomised controlled trials (RCTs) of BA versus placebo in high CV risk patients reporting clinical outcomes were included. Main outcomes and measures Primary efficacy outcomes were major adverse cardiovascular events (MACE), all-cause mortality, CV mortality and non-fatal myocardial infarction (MI). Safety outcomes included new onset or worsening of diabetes mellitus (DM), muscular disorders, gout and worsening of renal function. Results Six RCTs with a total of 3956 patients and follow-ups of four to 52 weeks were identified. Heterogeneity mainly derived from differing follow-up duration and baseline CV risk. No difference in MACE (OR 0.84; 95% CI 0.61 to 1.15), all-cause mortality (OR 2.37; CI 0.80 to 6.99) and CV mortality (OR 1.66; CI 0.45 to 6.04) for BA versus placebo was observed. BA showed beneficial trends for non-fatal MI (OR 0.57; CI 0.32 to 1.00) and was associated with a lower risk of new-onset or worsening of DM (OR 0.68; CI 0.49 to 0.94), but higher risk of gout (OR 3.29; CI 1.28 to 8.46) and a trend for muscular disorders (OR 2.60; CI 1.15 to 5.91) and worsening of renal function (OR 4.24; CI 0.98 to 18.39). Conclusion BA in high CV risk patients showed no significant effects on major CV outcomes in short-term follow-up. Unfavourable effects on muscular disorders, renal function and gout sound a note of caution. Hence, further studies with longer term follow-up in carefully selected populations are needed to clarify the risk/benefit ratio of this novel therapy.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    DOI: 10.1136/bmjopen-2021-048893
    Language: English
    Publisher: BMJ
    Publication Date: 2022
    detail.hit.zdb_id: 2599832-8
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  • 6
    Online Resource
    Online Resource
    How Far is Germany From Value-Based Pricing 10 Years After the Introduction of AMNOG?
    Springer Science and Business Media LLC ; 2022
    In:  Applied Health Economics and Health Policy Vol. 20, No. 3 ( 2022-05), p. 287-290
    Details
    In: Applied Health Economics and Health Policy, Springer Science and Business Media LLC, Vol. 20, No. 3 ( 2022-05), p. 287-290
    Type of Medium: Online Resource
    ISSN: 1175-5652 , 1179-1896
    URL: Article
    DOI: 10.1007/s40258-021-00712-x
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2180637-8
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  • 7
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    Online Resource
    Knowledge of HbA1c and LDL‐C treatment goals, subjective level of disease‐related information and information needs in patients with atherosclerotic cardiovascular disease
    Wiley ; 2023
    In:  Clinical Cardiology Vol. 46, No. 2 ( 2023-02), p. 223-231
    Details
    In: Clinical Cardiology, Wiley, Vol. 46, No. 2 ( 2023-02), p. 223-231
    Abstract: Risk factor control of diabetes mellitus (DM) and especially dyslipidemia remains unsatisfactory in patients with atherosclerotic cardiovascular disease (ASCVD). We aimed to analyze the knowledge of low‐density lipoprotein cholesterol (LDL‐C) and glycated hemoglobin (HbA1c) treatment goals, subjective level of information, and information needs in very high‐risk patients with ASCVD. Methods ASCVD patients ( n  = 210; 75 ± 9 years; 71.4% male; 89.5% coronary disease) with DM (96.7% type 2) completed a questionnaire assessing knowledge of HbA1c and LDL‐C treatment goals and subjective level of information and information needs on disease‐related topics of DM and ASCVD. Serum LDL‐C and HbA1c were measured. Results HbA1c goal ( 〈 7.0% in 60.6%) was attained more frequently than LDL‐C goal ( 〈 70 mg/dl in 39.9%; p   〈  .01). Significantly more participants named the correct goal for HbA1c compared to LDL‐C (52.9% vs. 2.4%; p   〈  .01). Subjective levels of information were higher and information needs were lower for DM than for ASCVD ( p   〈  .01 for all topics). No associations of knowledge of treatment goals and level of information with the attainment of treatment goals for HbA1c and LDL‐C were found. However, in multivariate regression, higher levels of education were associated with knowledge of treatment goals (HbA1c: odds ratio [OR] 1.32, 95% confidence interval [CI] 1.01–1.72, p  = .04; LDL‐C: OR 2.32, 95% CI 1.07–5.03; p  = .03). Conclusion In very high‐risk patients with ASCVD, a deficit of knowledge of treatment goals to control dyslipidemia exists when compared to DM, patients felt significantly better informed for topics of DM than for ASCVD and display higher information needs for topics of ASCVD.
    Type of Medium: Online Resource
    ISSN: 0160-9289 , 1932-8737
    URL: Issue
    URL: Article
    DOI: 10.1002/clc.v46.2
    DOI: 10.1002/clc.23948
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2048223-1
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