SCOPE-D

Project researcher: Prof. Chenot /  Simone Kiel

Project lead: Prof. Dr. Eva Hummers and Dr. Eva Maria Noack, Department of General Practice, University Medical Center Göttingen

Background

Atrial fibrillation (AF) is a very common cardiac arrhythmia, also in its paroxysmal form of repeated short episodes.  AF increases the risk of ischemic stroke. Paroxysmal AF often remains undetected or is an incidental finding. However, if AF is detected, oral anticoagulation treatment can significantly reduce the risk of stroke. To date, there is insufficient evidence for an optimal screening strategy. AF screening requires an approach that identifies patients at increased risk and optimizes the duration and frequency of ECG monitoring. AF prevalence is known to increase with age and presence of hypertension.

Aim

The project Target-AF aims to improve primary care for older adults at increased risk of stroke through evidence-based, systematic early detection of AF. To this, the project will assess the efficacy of a structured screening intervention for people with a high risk for AF as well as approaches to risk stratification in German general practice. 

Methods

Target-AF is a multi-center, open-label 2-armed (intervention vs. control, 1:1) randomized controlled trial (RCT). General practice patients 70 years old or older with diagnosed hypertension, no previous diagnosis of AF, and no anticoagulant treatment are eligible to enroll in our study. Up to 1000 participants will be recruited in 72 general practices of the FoPraNet Nord. In each of the six regions 12 practices recruit 13-14 patients each. All participants will receive one 24-hour Holter ECG to exclude present AF and to assess for supraventricular ectopy, a potential precursor/risk marker. A blood sample will be taken for measurement of biomarkers potentially predicting AF (NTproBNP, CDT, TSH, and creatinine). Participants are randomized 1:1 to either usual care at the treating physicians’ discretion (control group), or to an intervention of 7-day continuous ECG monitoring at inclusion, after 3, 12, 24, and 36 months, or until detection of AF >30 seconds. At inclusion and after 3, 12, 24, and 36 months, all patients will be surveyed for quality of life, general state of health, cardiovascular and bleeding events and health care utilization. The primary endpoint is the detection of AF (>30 sec) within 36 months. Secondary objective is to assess the predictive value of biomarkers and supraventricular ectopy both individually and in combination.

Relevance of the expected outcome

The project will generate data on effect sizes and implementation parameters to inform the design of a future confirmatory powered RCT on stoke prevention through targeted screening for AF.

Funding

The project is funded by the Federal Ministry of Research, Technology, and Space (BMFTR) (grant number 01GK2502A). The project will run for 60 months (May 1, 2026, to April 30, 2031).

Project reseracher: Prof. Chenot / Hannah Siegert

Project lead: Prof Dr Nils Schneider and PD Dr Kambiz Afshar, Institute of General Medicine and Palliative Medicine, Hannover Medical School

Background

Depression is one of the most common mental illnesses worldwide. The individual risk of illness and the population-related burden of disease are high and increasing, especially for people of working age.

GPs play a central role in the care of people with depression. However, guideline-compliant diagnosis and treatment is often inadequately implemented in primary care.

Objectives

The aim of the SCOPE-D project is to improve primary care for patients with depression in Germany by 1) promoting the implementation of the National Care Guideline for Unipolar Depression and 2) strengthening psychosomatic primary care by integrating the online self-help tool deprexis®.

Methods

SCOPE-D is a multi-centre, cluster-randomised intervention study at six locations under the umbrella of the supra-regional research practice network FoPraNet-Nord. By means of interviews with GPs, analyses of routine data and questionnaire surveys of patients, changes in care routines and the effectiveness of the online self-help tool deprexis® in the context of psychosomatic primary care are to be investigated.
Relevance of the expected.

Results

The results are of great practical importance, as they are intended to sustainably promote professional expertise, research competence and the implementation of guideline-based depression care in GP practices. They can contribute to the evidence-based further development of clinical guidelines and curricula for psychosomatic primary care, in particular through the systematic integration of digital self-help tools.

Funding

The project is funded by the Federal Ministry of Research, Technology and Space (BMFTR) (funding reference 01GK2505A). The project duration is 42 months (01.04.2026 to 30.09.2029).

Konsortial- und Kooperationspartner

Consortium management

• Prof Dr Nils Schneider and PD Dr Kambiz Afshar, Institute of General Medicine and Palliative Medicine, Hannover Medical School

Consortium partners

• Prof Dr Martin Scherer, Institute and Polyclinic of General Medicine, University Medical Center Hamburg-Eppendorf
• Prof Dr Eva Hummers, Institute of General Medicine, University Medical Centre Göttingen
• Prof Dr Michael Freitag, Division of General Medicine in the Department of Health Services Research, University of Oldenburg
• Prof Dr Michael Freitag, Department of Health Service Research, Department of General Medicine, University of Oldenburg
• Prof Dr Ralf Jendyk, Institute of General Medicine, Rostock University Medical Centre
• Prof Dr Christian Krauth, Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School
• Prof Dr Antonia Zapf, Institute for Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf

Co-operation partner

• Prof Dr Christian Thies, School of Computing Science, Reutlingen University of Applied Sciences