Zusammenfassung
Hintergrund
Untersuchung der Patientensicht auf Case-Management bei einer verhaltenstherapeutisch-orientierten, psychoedukativen Intervention („Patient Activation foR Anxiety DIsordErS/Para-dies“) für Menschen mit Panikstörung mit/ohne Agoraphobie in der Hausarztpraxis.
Methoden
16 Patientinnen und Patienten der Interventionsgruppe (87,5 % weiblich, Durchschnittsalter: 44,3 Jahre) aus zwölf Praxen mit Panikstörung mit/ohne Agoraphobie (ICD-10: F41.0, F40.01) wurden mittels semistrukturiertem Interviewleitfaden befragt. Die Interviews wurden transkribiert und inhaltsanalytisch nach Mayring qualitativ analysiert.
Ergebnisse
Das lokale Angebot zur Behandlung der Panikstörung durch das vertraute Praxisteam wurde von den Patientinnen und Patienten positiv aufgenommen und führte zu einem engeren Verhältnis zwischen Patientinnen und Patienten und Praxisteams. Die strukturierten Monitoringanrufe durch die medizinische Fachangestellte (MFA) als Case-Managerin wurden als kontinuierliche Unterstützung und Motivation zum Selbstmanagement bewertet. Sie halfen Probanden über Phasen der Demotivation hinweg und boten eine Möglichkeit zur Selbstreflexion des Behandlungsstandes.
Schlussfolgerungen
Das durch Case-Manager unterstützte Behandlungsprogramm zu Panikstörung in Hausarztpraxen wird von den Patientinnen und Patienten positiv bewertet. Die Betreuung durch das Praxisteam kann zu einer höheren Patientenzufriedenheit, einer besseren Compliance und einer engeren Bindung an das Hausarztpraxisteam beitragen.
Abstract
Background
To investigate patients’ perspective on case management in a behaviour therapy-oriented, psychoeducational intervention („Patient Activation foR Anxiety DIsordErS /Paradies“) for patients with panic disorder with/without agoraphobia in family practice.
Methods
16 patients of the intervention group (87,5% female, mean age: 44,3 years) from 12 practices with panic disorder with/ without agoraphobia (ICD-10: F41.0, F40.01) were interviewed using a semi-structured interview guide. The interviews were transcribed and analysed qualitatively using content analysis according to Mayring.
Results
The local offer of treatment for panic disorder by the familiar practice team was positively received by the participants and led to a closer relationship between participants and practice teams. The structured monitoring calls of the medical assistant (MFA) as case manager were felt as support and motivation for self-management. They helped patients overcome phases of demotivation and provided an opportunity for self-reflection on the treatment.
Conclusions
This case manager-supported treatment programme for panic disorder in family practices was positively evaluated by the patients. The support by the practice team can contribute to higher patient satisfaction, better compliance and a closer relationship with the practice team.
This is a preview of subscription content, log in via an institution to check access.
Literatur
Lowe B, Grafe K, Zipfel S, et al. Detecting panic disorder in medical and psychosomatic outpatients: comparative validation of the Hospital Anxiety and Depression Scale, the Patient Health Questionnaire, a screening question, and physicians‘ diagnosis. J Psy-chosom Res 2003; 55: 515–9
Bandelow B, Aden I, Alpers GW, et al. Deutsche S3-Leitlinie Behandlung von Angststörungen, Version 2 2021
Gensichen J, Hiller TS, Breitbart J, et al. Panic disorder in primary care. Dtsch Arztebl Int 2019; 116: 159–66
Seekles W, Cuijpers P, Kok R, Beek-man A, van Marwijk H, van Straten A. Psychological treatment of anxiety in primary care: a meta-analysis. Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet]: Centre for Reviews and Dissemination (UK); 2013
Bodenheimer T, Wagner EH, Grum-bach K. Improving primary care for patients with chronic illness: the chronic care model, Part 2. JAMA 2002; 288: 1909–14
Breitbart J, Hiller TS, Schone E, et al. [Panic disorder and agoraphobia in general practice: Advantages and pitfalls of a practice team-supported exposure training from the general practitioner‘s perspective – a qualitative study]. Z Evid Fortbild Qual Ge-sundhwes 2019; 143: 15–20
Blank WA, Lukaschek K, Breitbart J, et al. [Health assistants perspectives on team-led program for patients with panicd in general practice – a qualitative study]. Psychiatr Prax 2021; 48: 258–64
Beck AT, Steer RA: Beck Anxiety Inventory Manual. San Antonio: Har-court Brace and Company, 1993
Teddlie C, Yu F. Mixed methods sampling. J Mixed Meth Res 2007; 1: 77–100
Bellg AJ, Borrelli B, Resnick B, et al. Enhancing treatment fidelity in health behavior change studies: best practices and recommendations from the NIH Behavior Change Consortium. Health Psychol. 2004; 23: 443–51
Kuckartz U. Qualitative Inhaltsanalyse. Methoden, Praxis, Computerunterstützung, 2., durchgesehene Auflage. Weinheim, Basel: Beltz Ju-venta; 2014
Mayring P. Qualitative Inhaltsanalyse. Grundlagen und Techniken, 12., überarb. Auflage. Weinheim: Beltz; 2015
Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Quality Health Care 2007; 19: 349–57
Hudon C, Chouinard M-C, Pluye P, et al. Characteristics of case management in primary care associated with positive outcomes for frequent users of health care: a systematic review. Ann Fam Med 2019; 17: 448–58
Szafran O, Kennett SL, Bell NR, Green L. Patients’ perceptions of team-based care in family practice: access, benefits and team roles. J Prim Health Care 2018; 10: 248–57
Gensichen J, von Korff M, Peitz M, et al. Case management for depression by health care assistants in small primary care practices: a cluster randomized trial. Ann Intern Med 2009; 151: 369–78
Peters-Klimm F, Campbell S, Hermann K, et al. Case management for patients with chronic systolic heart failure in primary care: the HICMan exploratory randomised controlled trial. Trials 2010; 11: 56
Gensichen J, Beyer M, Muth C, Gerlach F, Von Korff M, Ormel J. Case management to improve major depression in primary health care: a systematic review. Psychol Med 2006; 36: 7–14
Elwyn G, Buetow S, Hibbard J, Wen-sing M. Respecting the subjective: quality measurement from the patient‘s perspective. BMJ 2007; 335: 1021–2
Schmidt-Traub S. Panikstörung und Agoraphobie. Ein Therapiemanual. Göttingen: Hogrefe; 2014
Prins M, Verhaak P. van der MK, Pen-ninx BW, Bensing JM. Primary care patients with anxiety and depression: need for care from the patient’s perspective J Affect Dis 2009; 119: 163–71
Fogarty CT, Sharma S, Chetty VK, Culpepper L. Mental health conditions are associated with increased health care utilization among urban family medicine patients. J Am Board Fam Med 2008; 21: 398–407
Author information
Authors and Affiliations
Consortia
Corresponding author
Additional information
Die beiden Autorinnen teilen sich die Erstautorenschaft.
Rights and permissions
About this article
Cite this article
Lukaschek, K., Schöne, E., Hiller, T.S. et al. Case-Management bei Panikstörung in der Hausarztpraxis. Z Allg Med 98, 54–58 (2022). https://doi.org/10.53180/zfa.2022.0054-0058
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.53180/zfa.2022.0054-0058