Department of General Internal Medicine

Inselspital Bern

The Department focuses on caring for patients with multiple diseases (multimorbidity) and complex conditions requiring an interdisciplinary and interprofessional approach. Through its contributions to research and its broad, practical training program, the clinic contributes to the development of the medicine of the future.

To the Inselspital website

Director

Prof. Drahomir Aujesky

Profile

Research groups in the areas of multimorbidity, quality of care, polypharmacy, hospital mobility, thromboembolic disease, lipid disorders, thyroid disorders.

External Partners

Université catholique de Louvain (Belgium), Institute of Psychiatry and Neurology (Warsaw, Poland), Universitat Autònoma de BArecelona (Spain), MAGIC and University of Oslo (Norway), National and Kapodistrian University of Athens (Greece), tp21 GmbH, University of Ottawa and University of Toronto (Canada), Choosing Wisely International, Utrecht University (Netherlands), University College of Cork (Ireland), Leiden University Medical Center and Utrecht University (Netherlands), Centre hospitalier universitaire de Brest (France), Clinique Universitaires Saint-Luc Brussels and CHU de Liège (Belgium)

Grants

  • SNSF Ambizione grant: Impacts of an INtervention TO increase MOBility in older hospitalised medical patients (INTOMOB): a cluster randomised controlled trial (Prof. C.E. Aubert)
  • SNSF project grants: Early exercise-based rehabilitation in high-risk patients hospitalized for acute pulmonary embolism: a pragmatic multicenter randomized partially blinded superiority trial (PD Dr. T. Tritschler and Prof. D. Aujesky); Clinical surveillance vs. anticoagulation for low-risk patients with isolated subsegmental pulmonary embolism: a multicenter randomized placebo-controlled non-inferiority trial (Prof. D. Aujesky); Subclinical thyroid dysfunction: evaluating risks, underlying mechanisms and treatment efficacy using pooled individual data in an international consortium (Prof. N. Rodondi).
  • Horizon Europe grant: Implementing a patient-centred and evidence-based intervention to reduce BEnzodiazepine and sedative-hypnotic use to improve patient SAFEty and quality of care (Prof. C.E. Aubert and Prof. N. Rodondi).
  • Further funding sources: Bangerter Rhyner Foundation, Swiss Society of General Internal Medicine, Insel Gruppe, smarter medicine – Choosing Wisely Switzerland, Kollegium für Hausarztmedizin.

Highlights 2025

Central nervous system-active medications in older multimorbid adults: missing indications and risks

Polypharmacy is an important problem, particularly in older multimorbid adults. In subanalyses of the OPERAM trial, we showed that atypical antipsychotics are frequently prescribed without a clear indication, particularly during an acute hospitalization and that the risk of readmission increased by 7% for each additional central nervous system-active medication prescription. These findings highlight the importance of carefully review prescription indications, particularly in older multimorbid adults.

Schneider et al., BMC Geriatr. 2025

Stuber et al., J Am Geriatr Soc. 2025

Characteristics and prognosis of central pulmonary embolism

Given the unclear impact of central localization of pulmonary embolism, we conducted a retrospective analysis of the SWITCO65+ cohort (2009-2013). Over one third of patients had a central pulmonary embolism, which was associated with more respiratory symptoms and heart dysfunction and injury. However, we found no difference in mortality of quality of life according to embolism localization. The impact of these results on the duration of anticoagulation should be further studied.

Hofstetter et al., J Thromb Haemost. 2025

Mobility during an acute medical hospitalization

In a secondary analysis of our GoMob-In trial, we found that mobility increased in almost two thirds of patients between admission and discharge, primarily at the beginning of hospitalization, while there was a plateau after one week, particularly in older adults. Increased daily activity was associated with a higher likelihood of living at home three months after discharge. These findings suggest a critical window and population for targeted interventions.

Liechti et al., J Am Med Dir Assoc. 2025

Feasibility and acceptability of an intervention to systematize fall risk assessment

To help systematize fall risk assessment and prevention in older hospitalized adults, we developed an intervention targeting physicians and nursing staff. While the intervention was tested in a pre-post intervention study and showed an improvement in assessment, we assessed its feasibility and acceptability in a mixed methods study. Most clinicians found the intervention useful. While everyday clinical workload remains a barrier to systematic assessment, concise and clear reminders can facilitate implementation.

Stuby et al., BMC Geriatr. 2025

Well-being of the Swiss General Internal Medicine workforce

Physician well-being is crucial to ensure productivity and quality of care. In a nationwide survey of general internists, among which three fourths worked in outpatient settings, one third reported reduced well-being and 54% felt burnt out. Lower age, being female, working in outpatient setting, long weekly working hours and dissatisfaction with income were associated with a higher likelihood of reduced well-being. Addressing potential risk factors could help preserve our population of primary care professionals.

Villiger et al., Swiss Med Wkly. 2025