Dtsch Arztebl Int
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5% to 8% of adults have type 2 diabetes, a disease that is usually asymptomatic at first. The goals of management are timely diagnosis and the prevention of complications. ⋯ Although there are many treatment options, individualized long-term treatment still presents a challenge in many cases.
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Controlled Clinical Trial
Implementing an advance care planning program in German nursing homes: results of an inter-regionally controlled intervention trial.
Advance Care Planning (ACP) is a systematic approach to ensure that effective advance directives (ADs) are developed and respected. We studied the effects of implementing a regional ACP program in Germany. ⋯ The implementation of an ACP program in German nursing homes led, much more frequently than previously reported, to the creation of advance directives with potential relevance to medical decision-making. Future research should assess the effect of such programs on clinical and structural outcomes.
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Meta Analysis
Improving adherence with medication: a selective literature review based on the example of hypertension treatment.
A common problem among patients with chronic diseases is poor adherence with prescribed medication. Studies have shown that certain interventions can improve adherence and clinical outcomes. ⋯ The promotion of adherence to prescribed medication is clearly desirable. Studies on the treatment of hypertension have shown that attempts to improve adherence often fail. In most studies, however, improved adherence led to better clinical outcomes. Simplification of drug regimens (e.g., reducing the number of pills taken per day) is the single most effective way to promote adherence. Moreover, the findings of studies on the treatment of hypertension and other diseases suggest that shared decision-making should be the basis of physicianpatient discussions about medication. Suitable medications can also be chosen in order to maximize safety and efficacy even if adherence is incomplete. It would also be desirable for studies on the promotion of adherence to be carried out in Germany, under the specific conditions that prevail in our national health-care system.