Projects at the Institute of General Practice
The Institute of General Practice is active in a number of projects, primarily in healthcare research aiming at the best possible treatment for ambulatory patients.
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Post-COVID-19: Survey of family physicians and pediatricians
Dr. med. Lorena Dini
Project team members
The COVID-19 pandemic has posed major challenges to the health care system. Due to the persistence of the pandemic and the emergence of new SARS-CoV-2 variants, it is expected that more and more people will become infected and thus the number of patients with long-term health consequences (long-COVID) will increase. Family physicians and outpatient pediatricians are the primary contacts for the care of persons with long-COVID.
An anonymous nationwide survey will provide first-hand information from primary care physicians and pediatricians on the extent to which they see patients with long/post-COVID in their daily practice, the challenges they face, the sources of information they rely on, and the information and support needs they see for their work with post-COVID patients.The results are to be used to design information offers according to needs. Through cooperation with various actors, solutions are to be developed and expanded.
This survey is part of the research project "Post-acute health consequences of COVID-19" (Post-COVID-19) funded by the German Federal Ministry of Health (BMG). Further information on the overall project can be found on the RKI website. All results, including this survey, will also be presented here as the project progresses.
The ethics vote (EA2/088/22) and the approval of the data protection concept including the use of Soscisurvey as an online survey instrument are available. Planned survey period: Q3 2022 and Q2 2023
National Association of Statutory Health Insurance Physicians (KBV)
German Society for General Medicine
German Society for Pediatric and Adolescent Medicine
German Society for Pediatric Infectiology
Professional association of pediatricians and adolescent physicians e.V.
01.12.2021 - 31.12.2023
COMPASS II - Coordination of Medical Professions Aiming at Sustainable Support II
Prof. Dr. med. Christoph Heintze
Dr. Susanne Döpfmer
Dr. Lisa Peter
Federal Ministry for Education and Research
COMPASS II is a sub-project of the NAVICARE network for patient-oriented health care research, which aims to reduce barriers and inequalities in the care of patients with age-associated diseases. COMPASS II lays a focus on multimorbid patients in primary care.
The results of the first funding phase from 2017 to 2020 showed that, in the context of demographic development, general practitioners (GP) are increasingly challenged to address the complex care needs of multimorbid patients. It becomes clear that the coordination of care for multimorbid patients that is typically provided by a large number of health care providers, requires considerable time and personnel resources. It also shows that multimorbid patients often turn to GP practices for advice for social and legal aspects of their care. General practitioners would like to see relief in this area by counselling services or other qualified staff. There were indications that existing institutions, such as community care points, are not well known to both GPs and patients and could be more involved in the care of multimorbid patients.
Therefore, COMPASS II is intended to test possibilities for cooperation between general practitioners and community care points. Following a survey of Berlin general practitioners about their experience with community care points, we will conduct an intervention study to examine the feasibility of an intensified cooperation between general practitioners and community care points based on the dimensions of acceptance, demand and feasibility. In addition, we will record the utilization of community care points and investigate whether the cooperation leads to an improvement in care based on patient-related outcomes.
01.04.2020 – 31.03.2023
RESPoNsE - Research Practice Network Berlin-Brandenburg-Thüringen
Dr. med. Susanne Döpfmer
Lisa Kümpel, M.Sc.
Doreen Kuschick, M.Sc.
Institute of General Practice, Universitätsklinikum Jena
Federal Ministry of Education and Research
Due to demographic aging, clinical primary health care as well as health care research will gain importance over the next few decades. The assessment of the quality of the actual care situation as well as the development, implementation and evaluation of relevant diagnostic or therapeutic interventions are of equal importance. Conditions differ significantly from research in hospital care as a result of spatial decentralization, limited personal and time resources, different epidemiology, the unselected patient population and a broad range of mild to severe and acute to chronic and multiple diseases. These factors result in distinct challenges to research. The planned network aims at facilitating clinical research in general practices to generate evidence about day-to-day healthcare in the regions of Berlin, Brandenburg and Thuringia.
Subsidiary aims are consolidation and extension of existing networks in the area, provision of central infrastructure, transfer of research competence and the adoption of methods for the participation of doctors, medical assistants and patients / members of the public.
Two pilot studies are planned. An accompanying process evaluation focuses on the feasibility of the project.
01.02.2020 - 31.01.2025
EMAPrepare - Emergency and Acute Medicine - Primary Care demands in patients resorting to emergency departments (emergency and acute medicine - GP treatment requirements for emergency department patients)
Prof. Dr. Christoph Heintze
Dr. Felix Holzinger
Investigation of the decision-making process and care patterns of emergency department patients in outpatient care. Two different populations (patients without a family doctor connection and emergency department patients) are investigated regarding the possibility of alternative care in primary care. The study methodology includes quantitative and qualitative components (mixed methods).
01.02.2020 – 31.01.2023
REDARES - Reduction of antibiotic resistance through guideline-based treatment of patients with uncomplicated urinary tract infections in outpatient care
Prof. Dr. med. Ildikó Gágyor
Institut für Allgemeinmedizin, Universitätsklinikum Würzburg
Project coordination Berlin
Dr. med. Angela Schuster
Institute of General Practice, Charité - Universitätsmedizin Berlin
Project staff Berlin
Judith Kraft, M.Sc.
Institute of General Practice, Charité - Universitätsmedizin Berlin
Innovationsfond des gemeinsamen Bundesausschusses
Urinary tract infections are among the most common bacterial infections in outpatient care and are usually treated with antibiotics. The treatment of urinary tract infections is not always easy since antibiotic prescriptions should be reduced and on the other hand serious complications are to be avoided.
The aim of the REDARES study is to optimize the prescription behaviour for uncomplicated urinary tract infections (UTI) in GP practices. For this purpose, the participating practices are randomized into two groups. The practices will transmit anonymous prescription data at different times and receive individual feedback.
Several university departments of general practice of epidemiology and public health as well as the Robert Koch Institute are involved in the project. The Institute of General Practice Würzburg is the project leader.
01.09.2019 - 31.08.2022
PICTURE – PTSD after ICU Survival, Caring for Patients with Traumatic Stress Sequelae following Intensive Medical Care
Prof. Dr. Jochen Gensichen – LMU München
Dr. Susanne Schultz- LMU München
Dr. Sabine Gehrke-Beck
Dr. Konrad Schmidt
Thuy Minh Tri Le
PICTURE is a randomized, controlled trial troughout Germany with study centers in Munich, Hamburg, Dresden, Berlin and Tübingen - led by the Institute of General Practice of the Ludwig-Maximilians-Universität, Munich.
An increasing number of patients in Germany are treated in intensive care units (ICU) surviving life-threatenig conditions. Being discharged, a considerable number of theses patients suffers from psychological problems.
Intensive care treatment possibly leaves fearful memories as the experience of violence or other traumatizing events. Some patients suffer for months and years from sleeping disorders, overexitation, nightmares or emotional withdrawal.
Usually, the general practitioner (GP) cares for these patients in the long term. However, patients with mild post-traumatic stress-disorders often are not recognized in everyday GP practice.
These patients are not willing or able to talk about their memories. This is why they are often misunderstood as “difficult” patients.
So far, therapeutic concepts and treatments for patients with such post-traumatic stress disorders are missing in general practice.
At the same time, long waiting time is common to be referred to psychotherapy.
Narration Exposure therapy is a prooved talking treatment for trauma-spectrum disorders.
Within this study, a short version of narration therapy has been developed for GPs to close this gap.
GPs are trained to use this short version of narration therapy to talk with their patients about their threatening experiences in a specific way to reconsolidate their memory.
GPs and intensive care specialists from the different locations work together to identify patients who might benefit from this therapy already at the ICU.
If this therapy proves to be successful, effective and safe, GPs may use it for patients with mild post-traumatic stress disorders to enable both an early and low-threshold care and to bridge long waiting times of specialist care.
01.01.2018 - 31.12.2019
Women 5.0 Model Program for patient-centered cross-pratice and cross-professional cooperative primary care of women 50+ (MP Women 5.0)
Dr. Lorena Dini, MScI
Innovationfonds / Gemeinsamer Bundesausschuss (Federal Joint Committee)
Conception of a new form of care based on the results of the previous project Women 5.0 and formation of a consortium.
15.01.2021 - 15.07.2021
SPI_RE - Social prescribing: systematic review on the effectiveness of preventive community-based psychosocial referral interventions
Dr. med. Felix Holzinger
Prof. Wolfram Herrmann
Dr. med. Karen Krüger
Dr. med Hendrik Napierala
Bundesministerium für Bildung und Forschung
Psychosocial problems play an important role in family practice, for example problems at work, limited social participation and family problems. Studies show that almost all patients with psychosocial problems see their family doctor at least once a year. Patients with poorer health opportunities due to social factors are particularly likely to see their GP. At the same time, we know that patients who are in particular need of preventive services use them the least.
To cope with psychosocial problems, there are numerous offers in many regions that belong to the so-called non-medical sector. They range from crisis counseling to sports and leisure activities and club activities.
Social prescribing is a new concept from the United Kingdom for closing the gap between medical and non-medical services in the outpatient healthcare system.
The need for a preventive service due to psychosocial stress is determined together with the patient during the normal GP consultation or health check-up. Patients in need of help or prevention are "referred" to a community-based facilitator by their family doctor, who issues a so-called "social prescription". The facilitator makes an appointment with the patient for a detailed discussion to specify the prevention needs. Difficulties and challenges are assessed, as well as vulnerability, the social situation and previous experiences. With knowledge of the services available close to home, the mediator discusses the possibilities in the community with the patient in order to be able to select the most suitable services. In the further course, the mediator ideally ensures that the patient actually uses the corresponding offer and reports to the family doctor about this mediation activity.
There are a number of studies on corresponding intervention models, mainly from Great Britain, in which social prescribing was tested and evaluated. Some intervention projects have shown improvements in relevant endpoints such as mental illness, physical health, outpatient and inpatient utilization. Overall, however, the evidence base is heterogeneous and confusing, and previous reviews have focused only on the implementation of social prescribing in the United Kingdom.
The aim of the SPI_RE project is to examine intervention studies on "social prescribing" with regard to effectiveness on health and/or quality of life by means of a systematic literature review of the current state of studies. The planned literature review is very broad and is described in detail in the draft study protocol.
Corona life: the Situation of People in Germany during the Corona Pandemic
Prof. Dr. med. Wolfram Herrmann
Dr. Pichit Buspavanich, Charité – Universitätsmedizin Berlin und Medizinische Hochschule Brandenburg Theodor Fontane
Maximilian Berger, Charité – Universitätsmedizin Berlin und Medizinische Hochschule Brandenburg Theodor Fontane
Prof. Dr. Paul Gellert, Charité – Universitätsmedizin Berlin
The current Corona (Covid-19) pandemic leads to severe restrictions in everyday life; for many people this is stressful. Therefore, the aim of this study is to assess the current situation and well-being of people in Germany during the Corona pandemic. This is to enable better offers for coping with the social restrictions. One focus of the study is whether lesbian, gay, bisexual, asexual, trans and inter people (LGBTIA+) experience particular challenges in the current situation. However, the study explicitly addresses all people living in Germany.
On 04.03.2021 preliminary results were published in the form of a policy briefing (only available in German).
KARDIO-Study – Left cardiac catheter in case of chest pain and coronary heart disease
Department of General Practice/ Family Medicine at the University of Marburg
(Prof. Norbert Donner-Banzhoff)
• Institute of General Practice, Charité – Universitätsmedizin Berlin, Germany
• Institute of General Practice and Family Medicine, Faculty of Medicine, Ruhr University Bochum, Germany
• Department of General Practice, University Medical Centre Göttingen/Georg-August-University Göttingen, Germany
• Department of General Practice, University Medical Centre Würzburg/Julius-Maximilian-University Würzburg, Germany
• Philipps-Universität Marburg (Department of General Practice/ Family Medicine)
• Universitätsklinikum Hamburg-Eppendorf (Department of Health Economics and Health Services Research)
• Department of Health Services Management, Ludwig-Maximilians-University München, Germany
• Ostbayerische Technische Hochschule Regensburg (Faculty of Social and Health Care Sciences)
Healthcare institutes and organisations
• DGK German Cardiac Society (Deutsche Gesellschaft für Kardiologie Herz und Kreislaufforschung e. V.), Düsseldorf, Germany
• Stiftung Institut für Herzinfarktforschung (Foundation Institute for Research into Myocardial Infarction)
• ÄZQ German Agency for Quality in Medicine (Ärztliches Zentrum für Qualität, ÄZQ), Berlin, Germany
• Standing Guideline Commission of the Association of Scientific Medical Societies in Germany (AWMF); Institute for Medical Knowledge Management, Marburg, Germany
Health insurance companies
• Federal Association of the Local Health Care Funds (AOK), Berlin, Germany, Research Institute of the Local Health Care Funds (WIdO), Berlin, Germany
• BARMER (Health Care Insurance), Wuppertal, Germany
• Techniker Krankenkasse (Health Care Insurance), Germany
Project staff at the Institute of General Practice
Dipl.-Psych. Sandra Fahrenkrog
Martha Koppelow / Judith Kraft
Federal Joint Committee (G-BA) (Aktenzeichen: 01VSF16048)
In Germany, the frequency of cardiac catheter examinations varies strongly from region to region. The KARDIO-study examines if these differences are due to dissimilar morbidity structures or rather due to differences in healthcare and treatment routines.
Regional varieties and influencing factors
In two sub-projects, we analyze the frequency of left cardiac catheter examinations based on routine data of several health insurance companies. Based on these findings, we interview patients and doctors in regions with high coverage of medical services and low coverage of medical services in order to identify possible influencing factors.
Development of local clinical pathways
In another sub-project, doctors develop local clinical pathways for patients with symptoms indicating a coronary heart disease (chest pain) in four selected regions. The project aims to improve the medical care of these patients. A specific feature of this project is that the participating actors (general practitioner, cardiologists, representatives from hospitals, radiologists, nuclear medicine specialists) actively shape the regional and inter-sectoral cooperation (bottom-up approach). The Charité Institute of General Practice is responsible for conducting the study in the region Frankfurt/Oder.
Family doctors, cardiologist, emergency rooms in the Frankfurt/Oder region are very welcome to participate in this project.
For further information, please contact Sandra Fahrenkrog: 030 / 450 514 115 or sandra.fahrenkrog(at)charite.de.
01.04.2018 - 31.03.2020
COMPASS - Coordination of Medical Professions Aiming at Sustainable Support
Prof. Dr. Christoph Heintze
Dr. Susanne Döpfmer
Judith Stumm, MScMPH
Dr. Lisa Peter
Federal Ministry of Education and Research (BMBF)
COMPASS is a partial project of the NAVICARE project which is conducted in cooperation with the Institute for Public Health, the Institute of Medical Sociology and Rehabilitation Science, the Charité Comprehensive Cancer Center and the Center for Stroke Research Berlin. (CSB).
The projects aims to analyze and to reduce barriers and inequalities in the care of patients with age-associated diseases. For this purpose “optimal care” is regarded from the patients’ perspective and from the perspective of medical and non-medical providers. Different research groups examine the barriers and resources of optimal care from a variety of perspectives. They identify vulnerable patient groups as well as exiting resources that help patients to navigate through the care system. COMPASS puts a special focus on multi-morbid patients in primary care. Additionally, the projects enables the establishment of an active, sustainable cooperation network for patient-oriented care.
01.02.2017 - 31.03.2020
WOMEN 5.0 Regional Health Care Service Provision by Gynecologists and General Practitioners for Women 49 Years of Age and older
Dr. Lorena Dini
Barbara Trusch, M.Sc. Psychology
Cornelia Thierbach, Dipl.-Soz.
Innovationsausschuss beim G-BA
Due to consequences of the demographic change and the reduced access to medical specialists for gynecology and obstetrics (Gyn), women of middle age and beyond living in rural areas will be affected by a decreased availability and consequently be underserved with gynecological care.
The main aim of this project is to explore and describe the current provision of health care service by Gyn and general practitioners (GPs) and to identify innovative potentials based on inter-disciplinary medical care, i.e. the redistribution of tasks attributed and delivered by specialists (task-shifting) and other possible approaches to properly face the imminent undersupply.
Secondary data from the stock of the Robert-Koch Institute will be analyzed (nationwide representative random sample including 2.300 women aged 49 years or older). Furthermore, a regional randomized survey of primary health care providers from Brandenburg, Mecklenburg-Vorpommern and Berlin (around 1.000 GPs and 500 Gyn) will be conducted. Finally, women of middle age and beyond living in these regions will be interviewed (semi-structured telephone based interviews).
Based on the development of a service tasks catalogue a proposal for developing an inter-disciplinary patient-centered care model will be elaborated.
The evaluation of this previously unexplored interface between ambulatory services in general practice and gynecology allows the identification and analysis of relevant indicators for improving the health care service delivery to women 49 years and older that are necessary to formulate interventions in order to improve the access and fairness in the provision of services to the elderly female population.
01.07.2017 - 29.02.2020
ERIM: Emergency support for primary care clinicians
Robert Koch Institut (RKI)
Contact at the Institute of General Practice
Dr. Lorena Dini, Institut für Allgemeinmedizin, Charité - Universitätsmedizin Berlin
Bundesministerium für Gesundheit
The aim of the study is to devise supporting information materials, which provide primary care clinicians with specific and evidence-based advice regarding unusual biological incidents. They will serve as templates for new material to be developed in the future as required.
Up-to-date, timely, practice-oriented and user-friendly information is crucial for the successful management of unusual biological incidents caused by special pathogens. To be able to respond quickly, relevant information materials should be developed and tested in preparation to meet the high demand for information in case of an incident.
Different actors, such primary care clinicians, clinical staff and health authorities, have varied information needs and preferences in crisis situations. In the course of the project, information materials tailored specifically to primary care clinicians will be develop to supplement existing, comprehensive reference documents (e.g. RKI Ebola framework concept).
01.08.18 bis 30.06.2020
EMACross - Emergency and Acute Care for Respiratory Diseases beyond Sectoral Separation
Prof. Dr. Christoph Heintze
Dr. Felix Holzinger
Federal Ministry of Education and Research (BMBF)
EMACross is part of the Berlin emergency room research network EMANet which has been developed since 2016
In emergency rooms, patients with very different disease patterns are treated. Quite often it is necessary for the emergency patients to be admitted to hospital for further diagnostic workup and therapy. Other patients, however, can be discharged home after examination or treatment in the emergency room. This frequently occurs with respiratory diseases (infections of the respiratory tract).
Aim of the study EMACROSS is to improve not only outpatient care in emergency rooms, but also the cooperation with general practitioners and other ambulatory care providers. In the study, we focus on patients with respiratory diseases. We want to find out, how and why patients decide to seek help in emergency rooms. Furthermore, we would like to find out how medical care was before the treatment in the emergency rooms and what comes after the emergency consultation. The study is financed by the Federal Ministry of Research and Education (BMBF) and is conducted in 8 emergency rooms in the district of Berlin-Mitte.
01.12.2016 - 30.11.2019