Table 1 Clinical vignette of a multimorbid senior for the structured process observations
From: Electronic reminders to facilitate longitudinal care: a mixed-methods study in general practices
Sex | Male |
Age | 76 years |
Health insurance | Statutory health insurancea |
Chronic diseases | - Type 2 diabetes mellitus - Hypertension - Atrial fibrillation - Hashimoto |
Participation in special care contracts | - GP-centered care - DMP type 2 diabetes mellitus |
Prevention & functional testing | - Check-up (bi-yearly) - Skin cancer screening (bi-yearly) - Prostate cancer screening (yearly) - Geriatric assessment (yearly) - Diphtheria booster (every 10 years) - Tetanus booster (every 10 years) - Influenza immunization (yearly) |
Follow-up examinations | - Repeat colonoscopy in 2019 is recommended (colonoscopy 2016: tubular adenoma) - Control of INR - DMP diabetes examinations (twice a year) - Diabetes feet check (yearly) - Referral for diabetic eye check (yearly) - Thyroid control |
Lifestyle characteristics | Smoker |
Characteristics/impairments | - Receives oral anticoagulants - Poor hearing and poor eyesight - Sometimes nagging - The patient’s advance health care directive is deposited in the practice |
Persons involved in care processes | - Mobile nursing service that helps the patient to put on the compression stockings to prevent leg ulcer in venous insufficiency - Next of kin has to be involved in care decisions |