Using High Quality Evidence Based Consumer Health Information for Non-therapeutic Patient Advice in Germany.

Article type
Authors
Weingart O, Huth A, Sänger S, Ollenschläger G
Abstract
Objective: Special patient advisory centres outside of hospitals and surgeries are established in Germany since many years. Many of these organisations look for quality of medical care from different point of view. There is a lack of using quality criteria and methods of evidence-based medicine (ebm) in selecting the information. The start of implementation of ebm in the German health care system and the influence of health suppliers by promoting their methods using consumer information, gives rise to the need to use ebm criteria in advising. We plan a study about education of patient-advisers in using evidence based consumer information. This pre-survey gives an overview about the current situation and needs.

Methods: In July 2001 a questionnaire was sent out to 704 non-profit patient advisory centres (self-help groups, patient-associations, public health offices) for selecting and randomising the participating organisations for a study. In these pre-survey we assessed the following data: staff (qualification, further education); content of advice (therapeutic options, prevention, medical errors, social law); criteria for use and selection of given information; use of Internet.

Results: 231 (33.8%) gave a feed back, 204 of them have professional staff of different groups. Out of the total number of 204 organisations we found social workers in 144 organisations; physicians in 132; nurses in 53; educationalists in 45; psychologists in 29; pastoral workers in 4, and other professions in 124. 6 organisations offer no continuing education for the staff. Only 1 offers no advice for therapy, prevention or medical errors. 178 organisations use information of other self-help associations, 167 use self-created information, 156 information from medical associations, 121 commercial information, 95 information from university centres, 79 information from co-operating hospitals/physicians, and 71 other sources for the information were used. In 37 organisations ebm is one of the criteria for selecting information. External methodological criteria are used by 11 organisations, internal quality criteria by 126; in 93 the supplier is the one of the criteria. 76 organisations have no web access, 55 have their own website. The database of the German Clearinghouse for Patient Information GCPI (www.patienten-information.de) is used only by 20 organisations and known by 64.

Conclusions: Missing information about the quality criteria for good consumer information may be one cause for lack of evidence. Sending the questionnaire and additional information material about the GCPI to the patient advisory centres might be the first step. For the further promotion of quality advice the staff should be educated in using methods of ebm. Therefore AQuMed will develop a curriculum for patient-advisers. The effect of education will be evaluated in a study; this evaluation includes a module for assessing the needs of advisers who use the GCPI database in order to improve the database.