Disease-Management-Programme: Haben sie die Prävention in der Primärversorgung vorangebracht?

In 2003, disease management programs (DMP) were set up in Germany to improve the care of chronically ill patients in outpatient settings. To date, only a few studies have been carried out with regard to the acceptance, attitudes and experiences of general practitioners towards DMP.

The study sheds light on what positions general practitioners hold with regard to DMP, what experiences they have had in practical care with DMP, how they assess the specific benefits of DMP and what improvements they would like to see in the future.

Between March and September 2023, 44 semi-standardized interviews were conducted with general practitioners in Baden–Württemberg, Hesse, North Rhine–Westphalia, Rhineland–Palatinate, Saarland and Thuringia.

The physicians interviewed use DMP widely. There is a high level of satisfaction with the programs that respondents believe contribute to improved care. The combination of continuous patient care and evidence orientation is considered a great advantage. The benefits for increased awareness and compliance are also highly valued. The interviewees stated that they were able to expand their diagnostic and therapeutic knowledge through participation in DMP. Many interviewees now basically follow the DMP recommendations. However, DMP guidelines are often perceived as too rigid. Extensive documentation requirements and a lack of primary care compatibility sometimes lead to time and resource problems. Cooperation with specialist medical colleagues in the context of DMP is often perceived as needing improvement.

General practitioners see DMP as an integral part of the care of chronic illnesses. At the same time, the programs should be further optimized so that they can be used more easily in primary care. It would be beneficial to give physicians greater scope for action and reduce documentation and administrative efforts. A larger, more differentiated range of compulsory training courses could help to strengthen the delegation component within DMP. Greater involvement of general practitioners in the process of further developing the DMP should also be considered.