ADAPT-HEAT
Hitzesensible Medikamentikationsanpassung (Adaptation of drug therapy during hot seasons)
Background
In recent years, an increase in heat and the number of extreme heat events has been observed worldwide and in Germany. This trend is expected to continue as a result of climate change. Extreme heat events are associated with a variety of health risks and can have fatal consequences: In 2018-2020, around 20,000 deaths were linked to heat in Germany, according to the Robert Koch Institute. Medication can increase heat-related health risks and, for example, impair a person's ability to adapt to heat. For example, some medications inhibit sweat production, reduce blood flow to the skin or reduce the feeling of thirst. People with several illnesses (multimorbidity), for example, are affected, as the mode of action of medication can change during periods of heat. Nevertheless, physicians rarely adjust their patients' medication during periods of heat.
Aims
The overall aim of the project is to develop, test in practice and disseminate evidence-based, consensus-based and cross-sectoral recommendations for heat-sensitive medication adjustments in order to prevent heat-related health problems. The project thus makes an important contribution to the development of strategies for adapting healthcare to climate change.
Methods
The consortium lead for the ADAPT-HEAT project is the Institute of General Medicine at the University Hospital of Cologne. The Institutes ofGeneral Medicine and Palliative Medicine and of Clinical Pharmacology at the MHH and the PMV research group Cologne are active as consortium partners.
As part of the ADAPT-HEAT project, a CALOR list (calor = Latin for heat) is being developed that provides an overview of relevant medications and recommendations for adjusting medication in the event of heat. A first draft of the list will be created based on the results of a comprehensive literature search (WP 1.1). The project team will also examine the relevance of the influence of certain medications on health during periods of heat using billing data from statutory health insurance and weather data from previous years (WP 1.2). A panel of experts will draw up the final CALOR list in a Delphi process (WP 1.3). During the warm summer months in 2025, physicians, Nursing staff and pharmacists test the list in practice (WP 2.1). A group of experts will then review the use of the list and revise it based on practical experience (WP 2.2). In order to provide patients with access to this list, the key recommendations are summarized in the form of brochures and video clips (WP 3). Figure 1 shows an overview of the work packages in the ADAPT-HEAT project.
The main focus of the Institute ofGeneral Medicine and Palliative Medicine at the MHH is on the Delphi process (WP 1.3). A Delphi procedure is a multi-stage evaluation procedure that is carried out as an online survey using the SoSciSurvey survey tool. It is based on the CALOR list developed and adapted as part of the evidence synthesis and linked data analysis. In the Delphi survey rounds, a total of 20-30 experts are asked to evaluate the previously identified medicines and adaptation measures in terms of their relevance and feasibility. At the end of this process, consensual recommendations for heat-sensitive medication adaptation with practical relevance will be developed.
Relevance of the expected results
If successful, both healthcare professionals and patients will have an evidence-based overview for heat-sensitive medication adjustment with clear recommendations. In addition, the health literacy of the population will be promoted and the implementation of the CALOR list in care will improve patient safety.
The project is also helping to establish the linking of SHI routine data with climate and weather data in Germany. This can be groundbreaking for future research projects in the context of climate change and health.
Funding
The project is funded by the Innovation Fund at the Joint Federal Committee (funding code 01VSF23016; funding period 01.01.2024 to 31.12.2026).
Consortium management
Prof. Dr. Beate Müller and Dr. Maxie Bunz, Institute of General Medicine, University Hospital Cologne
Consortium partners
Dr. Katharina van Baal and Prof. Dr. Olaf Krause, Institute ofGeneral Medicine and Palliative Medicine, MHH
Ingo Meyer, PMV research group, Cologne
Dr. Johannes Heck, Institute of Clinical Pharmacology, MHH
Cooperation partners
Westphalia-Lippe Association of Statutory Health Insurance Physicians
Contact the ADAPT-HEAT project team at the Institute ofGeneral Medicine and Palliative Medicine
Dr. Katharina van Baal (project management)
Prof. Dr. Dr. Olaf Krause (deputy project manager)
Christina Princk (research assistant)
Svenja Arendt (research assistant)
Phone: +49 511 532-81245
Mail: adapt-heat@mh-hannover.de
Contact address
Hannover Medical School
Institute ofGeneral Medicine and Palliative Medicine
Carl-Neuberg-Strasse 1
30625 Hanover