To estimate the prevalence and comorbidity patterns of mental health disorders (MHDs) in persons with vitiligo and compare relative risks (RRs) with dermatological diseases (atopic dermatitis and psoriasis) and non-vitiligo comparator cohorts using claims data.

Retrospective matched cohort study using nationwide statutory health insurance claims data.

German statutory health insurance claims (DAK-Gesundheit), 2016–2020.

A 40% anonymised sample of insured persons (N=2 885 984). In 2020, persons with vitiligo (International Statistical Classification of Diseases, Tenth Revision, German Modification L80) were compared with cohorts with atopic dermatitis (L20), psoriasis (L40) and persons without vitiligo. Cohorts were propensity score matched (1:3) by age and sex.

Prevalence of MHDs and RRs across comparator cohorts.

Internal plausibility of expert-informed claims-based MHD case definitions using diagnosis-only versus diagnosis-plus-care criteria.

In 2020, 4 631 persons were diagnosed with vitiligo. Affective disorders and neurotic, stress-related and somatoform disorders showed the highest prevalence, with depressive episodes ranging from 8.9% to 19.2% and somatoform disorders from 5.3% to 17.9% across definitions. In matched comparisons with atopic dermatitis, only a few and inconsistent differences were observed. In contrast, more pronounced and consistent differences were identified in comparisons with psoriasis. Emotional disorders in childhood showed higher risks under the most sensitive case definition (RR=2.29, 95% CI 1.14 to 4.61), whereas hyperkinetic disorders showed consistent effects across all definitions (RR range=1.58–1.93). Compared with persons without vitiligo, risks were higher for social phobia (RR range=2.10–2.81) and anxiety disorders (RR range=1.64–1.93).

Persons with vitiligo show a substantial burden of affective and stress-related MHDs. The mental health comorbidity profile was largely comparable to that of atopic dermatitis, whereas more pronounced differences were observed in comparisons with psoriasis. Claims-based prevalence estimates were sensitive to case definition, highlighting the importance of transparent operationalisation.

Osteoarthritis (OA) commonly affects the ageing population, particularly the hip joint. Total hip arthroplasty (THA) is a frequent procedure that relieves pain and improves mobility, though some patients experience persistent postoperative pain. With rising numbers of THA, optimising perioperative care and pain management is crucial to address the growing clinical burden and improve patient outcomes. Positive treatment expectations have shown promise in enhancing outcomes, especially in pain management. This study implements two strategies to optimise the patient’s treatment expectations, comprising enhanced physician communication and digital social observational learning. We will examine their separate and combined effects on preoperative expectations, negative emotions, postoperative pain, inflammation and function during recovery up to 12 months postoperatively.

This randomised controlled trial (RCT) investigates the impact of augmented physician communication and observational learning on treatment expectations and recovery. Participants (n=200) will be randomised into four groups: treatment as usual (TAU), augmented doctor conversation (aDOC), observational learning video (Video) and a combination of both (aDOC+Video). The aDOC group receives empathic communication and targeted information to strengthen self-efficacy. The Video group watches a model patient demonstrating successful recovery. The combined group receives both interventions. Outcomes will be assessed at multiple time points (4 days preoperatively; 1 and 4 days, 4 weeks and 3, 6 and 12 months postoperatively), including subjective pain ratings, mobility and objective physical function. The primary analysis will compare changes in pain intensity across groups. Secondary outcomes will include functional status, self-efficacy, recovery and systemic inflammatory markers. Statistical analysis involves repeated measures ANOVA and post hoc tests for between-group and within-group comparisons.

German Clinical Trials Register: DRKS00033212.

Prehospital notification by emergency medical services (EMS) can activate hospital resources before the patient arrives, which has been shown to improve in-hospital care for stroke patients. Optimising prehospital and handover processes in stroke care requires considering end-user perspectives to enhance acceptance and effectiveness of the developed solutions. The aim of this study was to identify current barriers in the preclinical-clinical phase of stroke care.

Within the investigator-initiated CAEHR project (CArdiovascular diseases—Enhancing Healthcare through cross-sectoral Routine data integration), an interface for transferring data from the electronic prenotification system to the hospital information system is implemented. A mixed-methods approach with semi-structured interviews as well as a cross-sectional online survey was used to gather feedback from healthcare professionals at a single stroke centre in Germany as well as from the participating EMS personnel. Data collection for the interviews was conducted between January and August 2023 and for the online survey between May and September 2023.

Interviews were conducted with 10 healthcare professionals, including seven from the neurological clinic and three from EMS. Additionally, 39 EMS employees took part in a cross-sectional online survey.

Challenges identified were educational and training aspects affecting preclinical processes and patient handover procedures, along with the opportunity for establishing more uniform protocols. Participants emphasised the importance of detailed patient information. Electronic prenotification was seen as an important step regarding structured information transmission, reducing the risk of information loss in stroke care.

The study highlights the importance of addressing organisational processes in addition to technical interfaces for implementing effective stroke care processes.

German Clinical Trials Register, DRKS00029103.