CINDI Highlights • Number 8 - Health Promotion Agency

14
Germany
Professor Egbert Nüssel
Programme Director
This year’s activities included the development of
collaboration between pharmacists and general
practitioners on the primary prevention of
noncommunicable diseases (NCD). Evaluation of
risk factor intervention in general practices was
also undertaken.
The CINDI demonstration areas in Germany are Kreis
Bergstrasse (with approximately 260,000 inhabitants) and
Heidelberg (approximately 140,000 inhabitants).
Primary prevention of NCD
Under the umbrella of the joint CINDI/EuroPharm Forum project on
hypertension management at pharmacies, a pilot project to enhance
collaboration between general practitioners and pharmacists on the primary
prevention of NCD was launched in the CINDI demonstration areas in 2001.
The experience gained through the pilot study involving 16 pharmacies in
CINDI Baden-Württemberg was positive. The results relate to 500 persons
who visited the pharmacies for measurement of cholesterol or blood pressure
levels. The results show that the pattern of cholesterol levels recorded by the
pharmacists was very similar to that of the cholesterol levels recorded for
patients visiting general practitioners.
Participants were requested to complete a standardised health questionnaire
and were advised to consult their GPs if the levels were too high. Advice on
lifestyle modification relating to personal risk factor profile was given. Based
on this experience, in 2002 information about the project was disseminated to
all pharmacies in the CINDI demonstration areas as well as in the south of
Hessen and the north of Baden-Württemberg (500 pharmacies). Many of
those approached have shown an interest in participating.
In parallel to a new pilot study in the CINDI demonstration areas, it is intended
to run a larger study which would include interested pharmacies in areas
outside the CINDI demonstration areas (the north of Hessen and the north of
Baden-Württemberg).
Evaluation of risk factor intervention
In the north of Bavaria, the north of Baden-Württemberg and the south of
Hessen 34 general practices have been participating since 1990 in a project
aimed at the reduction of risk factors for NCD through intervention measures
in general practice. In 2002 a project was launched to evaluate the impact of
this intervention. A neutral team was appointed for this purpose.
The team visited each of the general practitioners involved and random
samples of their patients were drawn. Within a retrospectively established
cohort of 100 men and 100 women, the most recent findings relating to
smoking habits, body mass index, blood pressure and cholesterol were
compared with those documented at least six months previously. It was at the
same time possible to ascertain the rate of the missing information relating to
the risk factors.
The first results from 10 general practices (1,000 men and 1,000 women)
were to be made public by the Mayor of Heidelberg by the end of March
2003. It is expected that a comparison of the results will encourage dialogue
and lead to concrete intervention measures.
Preparatory work was started in 2002 for the same project to be carried out
in the rural demonstration area of Kreis Bergstrasse.
Further information
For more information, please contact Professor Egbert Nüssel, CINDI
Programme Director, Wissenschaftliches Institut der Praxisärzte, Villa Bosch,
Schlosswolfsbrünnenweg 33, 69118 Heidelberg, Germany. Tel: +49 6221
533 119; Fax: +49 6221 533 177; E-mail: egbert.nuessel@wip.villa-bosch.de