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1.
  • Atzendorf, Josefine, et al. (författare)
  • Die Nutzung von E-Zigaretten in der deutschen Bevölkerung – Ergebnisse des Epidemiologischen Suchtsurvey 2015
  • 2019
  • Ingår i: Das Gesundheitswesen. - : Georg Thieme Verlag KG. - 0941-3790 .- 1439-4421. ; 81:02, s. 137-143
  • Tidskriftsartikel (refereegranskat)abstract
    • Hintergrund Schätzungen zum E-Zigarettenkonsum in Deutschland variieren erheblich. Die Nutzung von E-Zigaretten zur Tabakentwöhnung wird kritisch diskutiert. Anhand aktueller Daten soll die Verbreitung des Konsums von E-Zigaretten und deren Nutzung in der erwachsenen Allgemeinbevölkerung Deutschlands dargestellt werden.Methoden Als Datenbasis diente der Epidemiologische Suchtsurvey 2015, eine bundesweite Befragung von 18- bis 64-jährigen in Deutschland (n=9,204; Rücklaufquote: 52,2%).Ergebnisse E-Zigaretten waren einem Großteil der Befragten bekannt (85,3%, 43,5 Mio.), wohingegen lediglich 2,9% (1,5 Mio.) E-Zigaretten in den letzten 30 Tagen genutzt hatten. Jüngere Personen (OR=0,95, 95%-KI=(0,93; 0,97)), Männer (OR=1,45, 95%-KI=(1,02; 2,07)) und Raucher (OR=12,53, 95%-KI=(8,71; 18,03)) zeigten ein signifikant höheres Risiko, E-Zigaretten zu konsumieren. Etwa ein Drittel (36,6%) der Raucher und Ex-Raucher konventioneller Zigaretten nutzte E-Zigaretten zur Tabakentwöhnung, wovon ein Fünftel (21,3%) mit dem Rauchen aufhören konnte.Schlussfolgerungen E-Zigarettennutzer scheinen häufiger männlich, jünger und Raucher konventioneller Zigaretten zu sein. Neben Neugierde ist die Veränderung des Rauchverhaltens ein bedeutendes Konsummotiv. Die Ergebnisse deuten darauf hin, dass der Gebrauch von E-Zigaretten vereinzelt zur Tabakentwöhnung beitragen kann, die Mehrheit der Nutzer aber weiterhin konventionelle und/oder E-Zigaretten konsumiert.
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2.
  • Atzendorf, Josefine, et al. (författare)
  • Do smoking, nutrition, alcohol use, and physical activity vary between regions in Germany?-results of a cross-sectional study
  • 2020
  • Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 20:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Previous studies on lifestyle risk factors mainly focused on age- or gender-specific differences. However, lifestyle risk factors also vary across regions. Aim of the present study was to examine the extent to which prevalence rates of SNAP (smoking, nutrition, alcohol consumption, physical activity) vary between East and West Germany or North and South Germany.Methods: Data came from the population-representative 2015 Epidemiological Survey of Substance Abuse (ESA) comprising 9204 subjects aged 18 to 64 years. To assess an east-west or south-north gradient, two binary logistic regression models were carried out for each SNAP factor.Results: The logistic regression models revealed statistically significant differences with higher rates of at-risk alcohol consumption and lower rates of unhealthy nutrition in East Germany compared to West Germany. Significant differences between North and South Germany were found for at-risk alcohol consumption with higher rates of at-risk alcohol consumption in South Germany. Daily smoking and low physical activity were equally distributed across regions.Conclusions: The implementation of measures reducing at-risk alcohol consumption in Germany should take the identified east-west and south-north gradient into account. Since the prevalence of unhealthy nutrition was generally high, prevention and intervention measures should focus on Germany as a whole instead of specific regions.
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3.
  • Atzendorf, Josefine, et al. (författare)
  • E-Zigaretten : Einschätzung vonGesundheitsgefahren undNutzung zur Tabakentwöhnung
  • 2018
  • Ingår i: Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz. - : Springer Science and Business Media LLC. - 1436-9990 .- 1437-1588. ; 61:11, s. 1415-1421
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundThe perception that e-cigarettes are less harmful than traditional tobacco products can influence the consumption of e-cigarettes.ObjectivesThree questions were examined: (1)How do different population groups perceive health risks of e-cigarettes? (2)Do sociodemographic variables explain differences in the risk assessment of e-cigarettes? (3)Does the perception of health risks predict the use of e-cigarettes for smoking cessation?MethodsData came from the 2015 Epidemiological Survey of Substance Abuse (ESA) with asample size of n=9204 participants, aged 18 to 64years (response rate 52.2%). Data were collected by telephone, online, or by written questionnaires. Assessments of risk perception of e-cigarettes and conventional cigarettes (more harmful, just as harmful, less harmful, do not know) were compared. Descriptive statistics and logistic regressions were performed.ResultsIndividuals with lower education rated e-cigarettes as more harmful. Older people and women perceived e-cigarettes as just as harmful. Smokers considered e-cigarettes to be more harmful than or just as harmful as conventional tobacco products. The likelihood of using e-cigarettes for smoking cessation was higher if people thought they were less harmful than conventional cigarettes.ConclusionsOnly one-third of the population knows that e-cigarettes are less harmful to health than conventional cigarettes. The perception of health risks is related to the usage of e-cigarettes for smoking cessation.
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4.
  • Atzendorf, Josefine, et al. (författare)
  • Patterns of multiple lifestyle risk factors and their link to mental health in the German adult population : a cross-sectional study
  • 2018
  • Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 8:12
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives Lifestyle risk factors, such as drinking or unhealthy diet, can expotentiate detrimental health effects. Therefore, it is important to investigate multiple lifestyle risk factors instead of single ones. The study aims at: (1) identifying patterns of lifestyle risk factors within the adult general population in Germany and (2) examining associations between the extracted patterns and external factors.Design Cross-sectional study.Setting General German adult population (aged 18–64 years).Participants Participants of the 2015 Epidemiological Survey of Substance Abuse (n=9204).Primary outcome measures Lifestyle risk factors (daily smoking, at-risk alcohol consumption, unhealthy diet, low physical activity, weekly use of pharmaceuticals, as well as consumption of cannabis and other illicit drugs).Results A latent class analysis was applied to identify patterns of lifestyle risk factors, and a multinomial logistic regression was carried out to examine associations between the extracted classes and external factors. A total of four classes were extracted which can be described as healthy lifestyle (58.5%), drinking lifestyle (24.4%), smoking lifestyle (15.4%) and a cumulate risk factors lifestyle (1.7%). Individuals who were male, at younger age and single as well as individuals with various mental health problems were more likely to show multiple lifestyle risk factors.Conclusions Healthcare professionals should be aware of correlations between different lifestyle risk factors as well as between lifestyle risk groups and mental health. Health promotion strategies should further focus especially on younger and single men.This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
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5.
  • Bloomfield, Kim, et al. (författare)
  • Drinking patterns at the sub-national level : What do they tell us about drinking cultures in European countries?
  • 2017
  • Ingår i: Nordic Studies on Alcohol and Drugs. - : SAGE Publications. - 1455-0725 .- 1458-6126. ; 34:4, s. 342-352
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim:A drinking pattern is not only a major drinking variable, but is also one indicator of a country's drinking culture. In the present study, we examine drinking patterns within and across the neighbouring countries of Denmark and Germany. The aim of the research is to determine to what extent drinking patterns differ or are shared at the sub-national level in the two countries.Method:Data came from the German 2012 Epidemiological Survey of Substance Use (n = 9084) 18-64 years (response rate 54%), and the Centre for Alcohol and Drug Research's 2011 Danish national survey (n = 5133) 15-79 years (response rate 64%), which was reduced to a common age range, producing a final n = 4016. The drinking pattern variable included abstention, moderate drinking, heavy drinking, risky single occasion drinking (RSOD), and was investigated with bivariate statistics and gender-specific hierarchical cluster analysis.Results:For men three clusters emerged: one highlighting abstention and RSOD, moderate/heavy drinking, RSOD and RSOD + heavy drinking. For women, two clusters appeared: one highlighting abstention and moderate/heavy drinking and the other highlighting RSOD and RSDO + heavy drinking. The clusters revealed different geographical patterning: for men, a west vs. east divide; for women, a north-south gradient.Conclusions:The analysis could identify for each gender clusters representing both separate and shared drinking patterns as well as distinctive geographical placements. This new knowledge can contribute to a new understanding of the dynamics of drinking cultures and could indicate new approaches to prevention efforts and policy initiatives.
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6.
  • Braun, Barbara, et al. (författare)
  • Therapie alkoholbezogener Störungen im Alter : Ergebnisse der deutschen Stichprobe der randomisiert-kontrollierten ELDERLY-Studie bis zum 12-Monats-Follow-up
  • 2019
  • Ingår i: SUCHT. - : Hogrefe Publishing Group. - 0939-5911 .- 1664-2856. ; 65:2, s. 101-114
  • Tidskriftsartikel (refereegranskat)abstract
    • Zielsetzung: Der demographische Wandel lässt eine höhere Anzahl älterer Personen mit Alkoholproblemen erwarten, deren therapeutische Versorgung bislang unzureichend ist. Mit der internationalen, randomisiert-kontrollierten ELDERLY-Studie wurden zwei Varianten einer ambulanten psychotherapeutischen Behandlung für Personen ab 60 Jahren mit einer Alkoholkonsumstörung nach DSM-5 (AS) in drei Ländern erprobt. Methodik: Nach der Baseline-Befragung wurden die zufällig zugeordneten Behandlungsgruppen nach 1, 3, 6 und 12 Monaten erneut untersucht. Erfasst wurden Veränderungen (Zeit und Gruppe) hinsichtlich Trinkmenge, Anzahl abstinenter Tage, Anzahl Tage Rauschtrinken und Tage risikoarmen Konsums sowie Anzahl zutreffender DSM-5-Kriterien für AS. Complete-Case- und Intention-to-treat-Analysen werden für die deutsche Teilstichprobe vorgestellt (n=203). Ergebnisse: Für beide Behandlungsgruppen ergaben sich stabil bis zu 12 Monate nach Baseline ein Anstieg der Abstinenzrate (18 %; t0: 4 %), des Anteils der Personen ohne einen Tag mit riskantem Konsum (45 %, t0: 4 %) sowie ohne Rauschtrinken (68 %, t0: 15 %). Auch zeigte sich eine Verringerung der Trinkmenge (Median bei 27 g Reinalkohol pro Trinktag; t0: 58 g) und Anzahl erfüllter AS-Kriterien (Median bei 2; t0: 5). Schlussfolgerungen:Die Verbesserungen des Trinkverhaltens und der AS-Symptome waren trotz relativ kurzer Behandlungsdauer stabil. Motivierende Interventionen, insbesondere die persönliche Rückmeldung zum Trinkverhalten, bewirken auch bei älteren Personen mit alkoholbezogenen Störungen Verhaltensänderungen. Ein therapeutischer Nihilismus ist unangebracht; vielmehr sollten spezifische Bedürfnisse der Zielgruppe beachtet und in passenden Versorgungsangeboten umgesetzt werden.
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7.
  • Buchholz, Angela, et al. (författare)
  • Patient-Centered Placement Matching of Alcohol-Dependent Patients Based on a Standardized Intake Assessment : Primary Outcomes of an Exploratory Randomized Controlled Trial
  • 2020
  • Ingår i: European Addiction Research. - : S. Karger AG. - 1022-6877 .- 1421-9891. ; 26:3, s. 109-121
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Placement matching guidelines are promising means to optimize patient-centered care and to match patients' treatment needs. Despite considerable research regarding placement matching approaches to optimize alcohol abuse treatment, findings are inconclusive. Objectives: To investigate whether the use of patient-centered placement matching (PCPM) guidelines is more effective in reducing heavy drinking and costs 6 months after discharge from an inpatient alcohol withdrawal treatment compared to usual referral to aftercare. Secondary aims were to investigate whether age, gender, trial site or level of care (LOC) are moderators of efficacy and whether patients who were actually referred to the recommended LOC had better treatment outcomes compared to patients who were treated under- or overmatched. Methods: Design. Exploratory randomized controlled trial with measurements during withdrawal treatment and 6 months after initial assessment. Setting. Four German psychiatric clinics offering a 7-21 day inpatient qualified withdrawal program for patients suffering from alcohol dependence. Participants. From 1,927 patients who had a primary diagnosis of alcohol dependence and did not have organized aftercare when entering withdrawal treatment, 299 were invited to participate. Of those, 250 were randomized to the intervention group (IG, n = 123) or the control group (CG, n = 127). Intervention. The PCPM were applied to patients of the IG by feeding back a recommendation to a LOC for aftercare that was calculated from the Measurements in the Addictions for Triage and Evaluation (MATE) and discussed with the staff of the treatment unit. Patients of the CG received a general feedback regarding their MATE interview on request. Measurements. The MATE, the Client Socio-Demographic and Service Receipt Inventory--European Version and the MATE-Outcomes were administered. Data were analyzed using generalized linear models. Results: In the intention-to-treat analysis, there were no significant differences between IG and CG regarding days of heavy drinking (incident risk ratio [IRR] 1.09; p = 0.640), direct (IRR 1.06; p = 0.779), indirect (IRR 0.77; p = 0.392) and total costs (IRR 0.89; p = 0.496). Furthermore, none of the investigated moderator variables affected statistically significant drinking or cost-related primary outcomes. Regardless of group allocation, patients who received matched aftercare reported significantly fewer days of heavy drinking than undermatched patients (IRR 2.09; p = 0.004). For patients who were overmatched, direct costs were significantly higher (IRR 1.79; p = 0.024), but with no additional effects on alcohol consumption compared to matched patients. Conclusions: While the use of PCPM failed to affect the actual referral to aftercare, our findings suggest that treating patients on the recommended LOC may have the potential to reduce days of heavy drinking compared to undertreatment and costs compared to overtreatment.
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8.
  • Buchholz, Angela, et al. (författare)
  • Patient-centered placement matching of alcohol-dependent patients based on a standardized intake assessment : process evaluation within an exploratory randomized controlled trial
  • 2022
  • Ingår i: BMC Psychiatry. - : Springer Science and Business Media LLC. - 1471-244X. ; 22:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: In the implementation of placement matching guidelines, feasibility has been concerned in previous research. Objectives of this process evaluation were to investigate whether the patient-centered matching guidelines (PCPM) are consistently applied in referral decision-making from an inpatient qualified withdrawal program to a level of care in aftercare, which factors affect whether patients actually receive matched aftercare according to PCPM, and whether its use is feasible and accepted by clinic staff.Methods: The study was conducted as process evaluation within an exploratory randomized controlled trial in four German psychiatric clinics offering a 7-to-21 day qualified withdrawal program for patients suffering from alcohol dependence, and with measurements taken during detoxification treatment and six months after the initial assessment. PCPM were used with patients in the intervention group by feeding back to them a recommendation for a level of care in aftercare that had been calculated from Measurements in the Addictions for Triage and Evaluation (MATE) and discussed with the staff on the treatment unit. As measurements, The MATE, the Client Socio-Demographic and Service Receipt Inventory—European Version, a documentation form, the Control Preference Scale, and the Motivation for Treatment Scale were administered. A workshop for the staff at the participating trial sites was conducted after data collection was finished.Results: Among 250 patients participating in the study, 165 were interviewed at follow-up, and 125 had received aftercare. Although consistency in the application of PCPM was moderate to substantial within the qualified withdrawal program (Cohen’s kappa ≥ .41), it was fair from discharge to follow-up. In multifactorial multinomial regression, the number of foregoing substance abuse treatments predicted whether patients received more likely undermatched (Odds Ratio=1.27; p=.018) or overmatched (Odds Ratio=0.78; p=.054) treatment. While the implementation process during the study was evaluated critically by the staff, they stated a potential of quality assurance, more transparency and patient-centeredness in the use of PCPM.Conclusions: While the use of PCPM has the potential to enhance the quality of referral decision making within treatment, it may not be sufficient to determine referral decisions for aftercare.Trial Registration: German Clinical Trials Register DRKS00005035. Registered 03/06/2013.
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9.
  • Buchholz, Angela, et al. (författare)
  • Placement matching of alcohol-dependent patients based on a standardized intake assessment : rationale and design of a randomized controlled trial
  • 2014
  • Ingår i: BMC Psychiatry. - : Springer Science and Business Media LLC. - 1471-244X. ; 14, s. 286-
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Despite considerable research on substance-abuse placement matching, evidence is still inconclusive. The aims of this exploratory trial are to evaluate (a) the effects of following matching guidelines on health-care costs and heavy drinking, and (b) factors affecting the implementation of matching guidelines in the treatment of alcohol-dependent patients. Methods: A total of 286 alcohol-dependent patients entering one of four participating detoxification units and having no arrangements for further treatment will be recruited. During the first week of treatment, all patients will be administered Measurements in the Addictions for Triage and Evaluation (MATE), European Quality of Life-Five Dimensions health status questionnaire (EQ-5D), and the Client Socio-Demographic and Service Receipt Inventory-European Version (CSSRI-EU). Patients who are randomly allocated to the intervention group will receive feedback regarding their assessment results, including clear recommendations for subsequent treatment. Patients of the control group will receive treatment as usual and, if requested, global feedback regarding their assessment results, but no recommendations for subsequent treatment. At discharge, treatment outcome and referral decisions will be recorded. Six months after discharge, patients will be administered MATE-Outcome, EQ-5D, and CSSRI-EU during a telephone interview. Discussion: This trial will provide evidence on the effects and costs of using placement-matching guidelines based on a standardized assessment with structured feedback in the treatment of alcohol-dependent patients. A process evaluation will be conducted to facilitate better understanding of the relationship between the use of guidelines, outcomes, and potential mediating variables.
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10.
  • Friedrichs, Anke, et al. (författare)
  • Role preferences of patients with alcohol use disorders
  • 2018
  • Ingår i: Addictive Behaviours. - : Elsevier BV. - 0306-4603 .- 1873-6327. ; 84, s. 248-254
  • Tidskriftsartikel (refereegranskat)abstract
    • AimsShared decision making (SDM) is increasingly demanded in medical decision making. SDM acknowledges patients' role preferences in decision making processes. There has been limited research on SDM and role preferences in substance use disorders; results are promising. Aim of this study was to investigate role preferences of patients with alcohol use disorders (AUD), and to identify predictors of these preferences.MethodCross-sectional data collected from June 2013 to May 2014 in four detoxification wards in Germany during a randomised controlled trial (RCT, Registration Code O1GY1114) was analysed. Of the 250 patients with AUD who were included in the RCT, data from 242 patients [65% male; mean age = 45.2 years (sd = 10.3)] were analysed. Participants' role preferences were assessed with the Control Preference Scale. Potential correlates were drawn from instruments used in the RCT; multinomial logistic regression was used.Results90% (n = 217) of the AUD patients preferred an active or shared role in decision-making, 10% (n = 25) preferred a passive role. Patients' desire for help was associated with their role preference (OR = 3.087, p = .05). The model's goodness of fit was Nagelkerke's R-2 = 0.153 [chi(2) (24) = 25.206, p = .395].ConclusionsPatients' preference for an active role in decision-making underscores the importance of involving patients in their treatment planning. Patients' desire for help seems to be an important determinant of paternalistic decision making. However, further research is needed to determine whether patients' role preferences are related to their behavior during their treatment referral and recovery.
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