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Lionis C, Anastasaki M, Bertsias A, Angelaki A, Carlsson AC, Gudjonsdottir H, Wändell P, Larrabee Sonderlund A, Thilsing T, Søndergaard J, Seifert B, Kral N, De Wit NJ, Hollander M, Korevaar J, Schellevis F. High Variability in Implementation of Selective-Prevention Services for Cardiometabolic Diseases in Five European Primary Care Settings. Int J Environ Res Public Health 2020; 17:ijerph17239080. [PMID: 33291815 PMCID: PMC7730804 DOI: 10.3390/ijerph17239080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 11/22/2020] [Accepted: 11/30/2020] [Indexed: 11/20/2022]
Abstract
(1) Background: Cardiometabolic diseases are the most common cause of death worldwide. As part of a collaborative European study, this paper aims to explore the implementation of primary care selective-prevention services in five European countries. We assessed the implementation process of the selective-prevention services, participants’ cardiometabolic profile and risk and participants’ evaluation of the services, in terms of feasibility and impact in promoting a healthy lifestyle. (2) Methods: Eligible participants were primary care patients, 40–65 years of age, without any diagnosis of cardiometabolic disease. Two hundred patients were invited to participate per country. The extent to which participants adopted and completed the implementation of selective-prevention services was recorded. Patient demographics, lifestyle-related cardiometabolic risk factors and opinions on the implementation’s feasibility were also collected. (3) Results: Acceptance rates varied from 19.5% (n = 39/200) in Sweden to 100% (n = 200/200) in the Czech Republic. Risk assessment completion rates ranged from 65.4% (n = 70/107) in Greece to 100% (n = 39/39) in Sweden. On a ten-point scale, the median (25–75% quartile) of participant-reported implementation feasibility ranged from 7.4 (6.9–7.8) in Greece to 9.2 (8.2–9.9) in Sweden. Willingness to change lifestyle exceeded 80% in all countries. (4) Conclusions: A substantial variation in the implementation of selective-prevention receptiveness and patient risk profile was observed among countries. Our findings suggest that the design and implementation of behavior change cardiometabolic programmes in each country should be informed by the local context and provide some background evidence towards this direction, which can be even more relevant during the current pandemic period.
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Affiliation(s)
- Christos Lionis
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, 70013 Heraklion, Greece; (M.A.); (A.B.); (A.A.)
- Correspondence:
| | - Marilena Anastasaki
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, 70013 Heraklion, Greece; (M.A.); (A.B.); (A.A.)
| | - Antonios Bertsias
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, 70013 Heraklion, Greece; (M.A.); (A.B.); (A.A.)
| | - Agapi Angelaki
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, 70013 Heraklion, Greece; (M.A.); (A.B.); (A.A.)
| | - Axel C. Carlsson
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 14183 Huddinge, Sweden; (A.C.C.); (P.W.)
- Academic Primary Health Care Centre, Stockholm Region, 11365 Stockholm, Sweden
| | | | - Per Wändell
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 14183 Huddinge, Sweden; (A.C.C.); (P.W.)
| | - Anders Larrabee Sonderlund
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, 5000 Odense C, Denmark; (A.L.S.); (T.T.); (J.S.)
| | - Trine Thilsing
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, 5000 Odense C, Denmark; (A.L.S.); (T.T.); (J.S.)
| | - Jens Søndergaard
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, 5000 Odense C, Denmark; (A.L.S.); (T.T.); (J.S.)
| | - Bohumil Seifert
- Institute of General Practice, First Faculty of Medicine, Charles University, 128 00 Prague 2, Czech Republic; (B.S.); (N.K.)
| | - Norbert Kral
- Institute of General Practice, First Faculty of Medicine, Charles University, 128 00 Prague 2, Czech Republic; (B.S.); (N.K.)
| | - Niek J De Wit
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands; (N.J.D.W.); (M.H.)
| | - Monika Hollander
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands; (N.J.D.W.); (M.H.)
| | - Joke Korevaar
- Nivel Netherlands Institute for Health Services Research, 3513 CR Utrecht, The Netherlands; (J.K.); (F.S.)
| | - François Schellevis
- Nivel Netherlands Institute for Health Services Research, 3513 CR Utrecht, The Netherlands; (J.K.); (F.S.)
- Department of General Practice, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, location VUmc, 1081 HV Amsterdam, The Netherlands
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Goodarzi B, Walker A, Holten L, Schoonmade L, Teunissen P, Schellevis F, de Jonge A. Towards a better understanding of risk selection in maternal and newborn care: A systematic scoping review. PLoS One 2020; 15:e0234252. [PMID: 32511258 PMCID: PMC7279596 DOI: 10.1371/journal.pone.0234252] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 05/21/2020] [Indexed: 01/21/2023] Open
Abstract
Globally, millions of women and their children suffer due to preventable morbidity and mortality, associated with both underuse and overuse of maternal and newborn care. An effective system of risk selection that differentiates between what care should be provided and who should provide it is a global necessity to ensure women and children receive appropriate care, at the right place and the right time. Poor conceptualization of risk selection impedes evaluation and comparison of models of risk selection across various settings, which is necessary to improve maternal and newborn care. We conducted a scoping review to enhance the understanding of risk selection in maternal and newborn care. We included 210 papers, published over the past four decades, originating from 24 countries. Using inductive thematic analysis, we identified three main dimensions of risk selection: (1) risk selection as an organisational measure to optimally align women's and children's needs and resources, (2) risk selection as a practice to detect and assess risk and to make decisions about the delivery of care, and (3) risk selection as a tool to ensure safe care. We found that these three dimensions have three themes in common: risk selection (1) is viewed as both requiring and providing regulation, (2) has a provider centred focus and (3) aims to avoid underuse of care. Due to the methodological challenges of contextual diversity, the concept of risk selection needs clear indicators that capture the complexity of care to make cross-setting evaluation and comparison of risk selection possible. Moreover, a comprehensive understanding of risk selection needs to consider access disparity, women's needs, and unnecessary medicalization.
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Affiliation(s)
- Bahareh Goodarzi
- Department of Midwifery Science, AVAG, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Annika Walker
- Department of Midwifery Science, AVAG, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Lianne Holten
- Department of Midwifery Science, AVAG, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Linda Schoonmade
- Medical Library, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Pim Teunissen
- Department of Obstetrics and Gynaecology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- School of Health Professions Education, Maastricht University, Maastricht, The Netherlands
| | - François Schellevis
- Department of General Practice and Elderly Care Medicine, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- NIVEL (Netherlands Institute for Health Services Research), Utrecht, The Netherlands
| | - Ank de Jonge
- Department of Midwifery Science, AVAG, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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van Puffelen A, Kasteleyn M, de Vries L, Rijken M, Heijmans M, Nijpels G, Schellevis F. Self-care of patients with type 2 diabetes mellitus over the course of illness: implications for tailoring support. J Diabetes Metab Disord 2020; 19:81-89. [PMID: 32550159 DOI: 10.1007/s40200-019-00479-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 12/17/2019] [Indexed: 11/28/2022]
Abstract
Purpose Type 2 diabetes requires patients to make lifestyle changes and perform daily self-care. To determine at what stages patients may need particular self-management support, we examined (1) whether patients' performance of self-care related to their diabetes duration, and (2) whether illness characteristics (treatment and complications) and diabetes-related distress influenced this relationship. Methods Cross-sectional data from 590 type 2 diabetes patients were analysed through linear and logistic regression analysis. Self-care behaviours were assessed by the revised Summary of Diabetes Self-Care Activities (SDSCA) measure. Diabetes duration (model 1), treatment and complications (model 2), and distress, as assessed by the Problem Areas In Diabetes (PAID) scale (model 3), were stepwise included. Sociodemographic characteristics were added to all models to account for confounding. Results Patients with a longer history of diabetes were less physically active, but monitored their blood glucose levels more frequently than more recently diagnosed patients. These relationships were mediated by the presence of complications and the use of insulin, with lower levels of physical activity being found among patients with macrovascular complications and higher frequencies of glucose monitoring among patients on insulin. All predictors together explained maximally 5% of the variance in self-care, except for glucose monitoring (37%) and smoking (11%). Conclusion Type 2 diabetes patients' self-care activity changes over the course of illness. To provide tailored self-management support, diabetes care providers should take into account patients' phase of illness, including their treatment and complications, as well as their personal characteristics and distress level.
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Affiliation(s)
- Anne van Puffelen
- NIVEL (the Netherlands Institute for Health Services Research), PO Box 1568, 3500 BN Utrecht, the Netherlands
| | - Marise Kasteleyn
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Universiteitsweg 100, 3584 CG Utrecht, the Netherlands
| | - Lianne de Vries
- Department of General Practice & Elderly Care Medicine, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, location VUmc, Van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands
| | - Mieke Rijken
- NIVEL (the Netherlands Institute for Health Services Research), PO Box 1568, 3500 BN Utrecht, the Netherlands
- Department of Health and Social Management, University of Eastern Finland, PO Box 1627, FI-70211 Kuopio, Finland
| | - Monique Heijmans
- NIVEL (the Netherlands Institute for Health Services Research), PO Box 1568, 3500 BN Utrecht, the Netherlands
| | - Giel Nijpels
- Department of General Practice & Elderly Care Medicine, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, location VUmc, Van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands
| | - François Schellevis
- NIVEL (the Netherlands Institute for Health Services Research), PO Box 1568, 3500 BN Utrecht, the Netherlands
- Department of General Practice & Elderly Care Medicine, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, location VUmc, Van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands
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El Guerche-Séblain C, Moureau A, Schiffler C, Dupuy M, Pepin S, Samson SI, Vanhems P, Schellevis F. Epidemiology and burden of influenza in healthy children aged 6 to 35 months: analysis of data from the placebo arm of a phase III efficacy trial. BMC Infect Dis 2019; 19:308. [PMID: 30947693 PMCID: PMC6449994 DOI: 10.1186/s12879-019-3920-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 03/19/2019] [Indexed: 11/10/2022] Open
Abstract
Background Despite World Health Organization recommendations, in many countries young children are not targeted for influenza vaccination. To help inform influenza vaccination policy, we examined the occurrence and burden of influenza in healthy children aged 6 to 35 months using data from a recent phase III placebo-controlled influenza vaccine trial conducted in countries in the Northern and Southern Hemispheres. Methods This was an analysis of data from participants included in the placebo arm of a phase III clinical trial in healthy children aged 6 to 35 months (EudraCT no. 2013–001231-51). Included children had never been vaccinated for influenza and were observed for one influenza season. Outcome measures included the occurrence of influenza-like illness (ILI), laboratory-confirmed influenza, virus types/subtypes, severe symptoms and complications of confirmed influenza, and healthcare use associated with confirmed influenza. Results Data from 2210 participants were analysed. ILI was reported for 811 participants (36.7%). Of these, 255 participants (31.4%) had 263 virologically confirmed episodes of influenza. The overall influenza attack rate was 11.5%. The most common influenza virus detected was A(H3N2) (40.7%), followed by B/Yamagata (23.6%), A(H1N1) (18.6%), and B/Victoria (8.0%). Grade 3 fever was reported in 24.3% of confirmed episodes, acute lower respiratory infection in 8.7%, acute otitis media in 6.1%, and pneumonia in 1.9%. In most influenza episodes (93.2%), antipyretics, analgesics, or non-steroidal anti-inflammatory drugs were taken. Antibiotics were prescribed for 41.4% of influenza episodes. More than half of the influenza episodes (57.0%) resulted in outpatient visits. Influenza resulted in overnight hospitalisation in 1.1% of episodes. Conclusions Influenza is associated with a significant burden of disease in healthy children. This analysis also revealed that antibiotics continue to be frequently used for young children with influenza. Trial registration EudraCT no. 2013–001231-51. Electronic supplementary material The online version of this article (10.1186/s12879-019-3920-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Annick Moureau
- Global Clinical Biostatistics Department, Sanofi Pasteur, Marcy l'Étoile, France
| | | | - Martin Dupuy
- Global Biostatistics Department, Sanofi Pasteur, Marcy l'Étoile, France
| | - Stephanie Pepin
- Global Clinical Sciences, Sanofi Pasteur, Marcy l'Étoile, France
| | | | - Philippe Vanhems
- Epidemiology and International Health Team, Emergent Pathogens Laboratory, Fondation Mérieux, International Center for Research in Infectiology, National Institute of Health and Medical Research, U1111, National Center of Scientific Research, Mixed Scientific Unit 5308, École Nationale Supérieure de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - François Schellevis
- Netherlands Institute for Health Services Research, Utrecht, The Netherlands.,Department of General Practice & Elderly Care Medicine, Amsterdam Public Health Research Institute, Amsterdam University Medical Centres, Amsterdam, The Netherlands
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Borlée F, Yzermans CJ, Oostwegel FSM, Schellevis F, Heederik D, Smit LAM. Attitude toward livestock farming does not influence the earlier observed association between proximity to goat farms and self-reported pneumonia. Environ Epidemiol 2019; 3:e041. [PMID: 33778336 PMCID: PMC7952105 DOI: 10.1097/ee9.0000000000000041] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 01/13/2019] [Indexed: 11/26/2022] Open
Abstract
Attitudes toward environmental risks may be a source of bias in environmental health studies because concerns about environmental hazards may influence self-reported outcomes. OBJECTIVE The main aim was to assess whether earlier observed associations between proximity to goat farms and self-reported pneumonia were biased by participants' attitude toward farming. METHODS We developed an attitude-score for 2,457 participants of the Dutch Livestock Farming and Neighbouring Residents' Health Study (veehouderij en gezondheid omwonenden) by factor analysis of 13 questionnaire items related to attitude toward livestock farming. Linear regression analysis was used to assess associations between attitude and potential determinants. The effect of attitude on the association between goat farm proximity and pneumonia was analyzed by evaluating (1) misclassification of the outcome, (2) effect modification by attitude, and (3) exclusion of participants reporting health problems due to farms in their environment. RESULTS In general, the study population had a positive attitude toward farming, especially if participants were more familiar with farming. Older participants, females, ex-smokers, and higher-educated individuals had a more negative attitude. Both self-reported respiratory symptoms and exposure to livestock farms were associated with a more negative attitude. Misclassification of self-reported pneumonia was nondifferential with regard to participants' attitude. Furthermore, no indication was found that the association between proximity to goat farms and pneumonia was modified by attitude. Excluding subjects who attributed their health symptoms to livestock farms did also not change the association. CONCLUSIONS The association between goat farm proximity and pneumonia was not substantially biased by study participants' attitude toward livestock farming.
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Affiliation(s)
- Floor Borlée
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
- Netherlands Institute for Health Services Research, NIVEL, Utrecht, The Netherlands
| | - C. Joris Yzermans
- Netherlands Institute for Health Services Research, NIVEL, Utrecht, The Netherlands
| | - Floor S. M. Oostwegel
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - François Schellevis
- Netherlands Institute for Health Services Research, NIVEL, Utrecht, The Netherlands
- Department of General Practice & Elderly Care Medicine, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Dick Heederik
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Lidwien A. M. Smit
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
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6
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El Guerche-Séblain C, Caini S, Paget J, Vanhems P, Schellevis F. Epidemiology and timing of seasonal influenza epidemics in the Asia-Pacific region, 2010-2017: implications for influenza vaccination programs. BMC Public Health 2019; 19:331. [PMID: 30898100 PMCID: PMC6429768 DOI: 10.1186/s12889-019-6647-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 03/12/2019] [Indexed: 12/17/2022] Open
Abstract
Background Description of the epidemiology of influenza is needed to inform influenza vaccination policy. Here we examined influenza virus circulation in countries in the Asia-Pacific region and compared the timing of seasonal epidemics with the timing of influenza vaccination. Methods Data were obtained from the World Health Organization (WHO) FluNet database for 2010–2017 for countries in the WHO Asia-Pacific region. Data from countries covering ≥5 consecutive seasons and ≥ 100 influenza positive cases per year were included. Median proportions of cases for each influenza virus type were calculated by country and season. The timing and amplitude of the epidemic peaks were determined by Fourier decomposition. Vaccination timing was considered appropriate for each country if it was recommended ≤4 months before the primary peak of influenza circulation. Results Seven hundred eleven thousand seven hundred thirty-four influenza cases were included from 19 countries. Peak circulation coincided with the winter seasons in most countries, although patterns were less clear in some countries in the inter-tropical area due to substantial secondary peaks. Influenza A/H3N2 dominated overall, but proportions of A and B strains varied by year and by country. Influenza B represented 31.4% of all cases. The WHO-recommended timing for influenza vaccination was appropriate in 12 countries. Vaccination timing recommendations were considered inappropriate in Laos, Cambodia, and Thailand, and were inconclusive for India, Sri Lanka, Singapore, and Vietnam due to unclear seasonality of influenza virus circulation. Conclusions Influenza virus circulation varied considerably across the Asia-Pacific region with an unusually high burden of influenza B. The recommended timing for vaccination was appropriate in most countries, except for several countries with unclear seasonality, mainly located in the inter-tropical area. Electronic supplementary material The online version of this article (10.1186/s12889-019-6647-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Saverio Caini
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
| | - John Paget
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
| | - Philippe Vanhems
- Epidemiology and International Health Team, Emergent Pathogens Laboratory, Fondation Mérieux, International Center for Research in Infectiology, National Institute of Health and Medical Research, U1111,National Center of Scientific Research, Mixed Scientific Unit 5308, École Nationale Supérieure de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - François Schellevis
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.,Department of General Practice & Elderly Care Medicine, Amsterdam Public Health Research Institute, Amsterdam University Medical Centres, Amsterdam, The Netherlands
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Caini S, Schellevis F, El-Guerche Séblain C, Paget J. Important changes in the timing of influenza epidemics in the WHO European Region over the past 20 years: virological surveillance 1996 to 2016. ACTA ACUST UNITED AC 2019; 23. [PMID: 29317016 PMCID: PMC5765775 DOI: 10.2807/1560-7917.es.2018.23.1.17-00302] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The global epidemiology of many infectious diseases is changing, but little attention has been paid to whether the timing of seasonal influenza epidemics changed in recent years. This study investigated whether the timing of the peak of influenza epidemics has changed in countries of the World Health Organization (WHO) European Region between 1996 and 2016.
Methods: Surveillance data were obtained from the WHO FluNet database. For each country and season (July to June of the next year), the peak was defined as the week with the highest 3-week moving average for reported cases. Linear regression models were used to test for temporal trends in the timing of the epidemic peak in each country and to determine whether this differed geographically.
Results: More than 600,000 influenza cases were included from 38 countries of the WHO European Region. The timing of the epidemic peak changed according to a longitudinal gradient, occurring progressively later in Western Europe (e.g. by 2.8 days/season in Spain) and progressively earlier in Eastern Europe (e.g. by 3.5 days/season in the Russian Federation).
Discussion: These results were confirmed in several sensitivity analyses. Our findings have implications for influenza control and prevention measures in the WHO European Region, for instance for the implementation of influenza vaccination campaigns.
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Affiliation(s)
- Saverio Caini
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
| | - François Schellevis
- Department of General Practice and Elderly Care Medicine, EMGO Institute for Health and Care research, VU University Medical Center, Amsterdam, The Netherlands.,Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
| | | | - John Paget
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
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8
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Rijken M, Schellevis F. Identifying target groups for person-centred integrated care among multi-morbid populations. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- M Rijken
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, Netherlands
| | - F Schellevis
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, Netherlands
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9
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Holvast F, Wouters H, Hek K, Schellevis F, Oude Voshaar R, van Dijk L, Burger H, Verhaak P. Non-adherence to cardiovascular drugs in older patients with depression: A population-based cohort study. Int J Cardiol 2018; 274:366-371. [PMID: 30249352 DOI: 10.1016/j.ijcard.2018.08.100] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 07/20/2018] [Accepted: 08/31/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Depression is common among patients with cardiovascular disease and has been associated with both drug non-adherence and increased mortality. Non-adherence can occur because of non-initiation, suboptimal implementation, or non-persistence. We aimed to determine if depression increased the risk of any of these components of non-adherence among older patients prescribed cardiovascular drugs in primary care. METHODS A longitudinal analysis of routine primary care data from the Nivel Primary Care Database was performed using data for 2011-2013. A total of 1512 patients aged ≥60 years diagnosed with depression in 2012 were compared with age- and sex-matched groups with either other psychological diagnoses (N = 1457) or mentally healthy controls (N = 1508), resulting in the inclusion of 4477 patients. Non-adherence was classified as non-initiation, suboptimal implementation, or non-persistence. Regression analyses were performed to determine the association between mental health status and non-initiation, suboptimal implementation, and non-persistence. RESULTS Mixed-effects logistic regression analyses showed increased odds for suboptimal implementation of beta-blockers among depressed patients (2.18; 95% CI 1.29-3.69). For non-persistence, a clustered Cox regression analysis demonstrated that, compared with controls, there was an increased hazard ratio for depressed patients to discontinue beta-blockers (2.31; 95% CI 1.58-3.37) and calcium antagonists (1.74; 95% CI 1.23-2.46). CONCLUSIONS It is likely that older patients in primary care diagnosed with depression are at increased risk of non-persistence with cardiovascular drug therapy. Because non-adherence is associated with increased cardiovascular mortality, it is important that physicians ensure that older depressed patients persevere with therapy.
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Affiliation(s)
- Floor Holvast
- University of Groningen, University Medical Center Groningen, Department of General Practice, Groningen, the Netherlands.
| | - Hans Wouters
- University of Groningen, University Medical Center Groningen, Department of General Practice, Groningen, the Netherlands
| | - Karin Hek
- NIVEL, Netherlands Institute for Health Services Research, Utrecht, the Netherlands
| | - François Schellevis
- NIVEL, Netherlands Institute for Health Services Research, Utrecht, the Netherlands; Department of General Practice and Elderly care medicine/Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, the Netherlands
| | - Richard Oude Voshaar
- University of Groningen, University Medical Center Groningen, University Center of Psychiatry, Groningen, the Netherlands
| | - Liset van Dijk
- NIVEL, Netherlands Institute for Health Services Research, Utrecht, the Netherlands
| | - Huibert Burger
- University of Groningen, University Medical Center Groningen, Department of General Practice, Groningen, the Netherlands
| | - Peter Verhaak
- University of Groningen, University Medical Center Groningen, Department of General Practice, Groningen, the Netherlands; NIVEL, Netherlands Institute for Health Services Research, Utrecht, the Netherlands
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Caini S, Spreeuwenberg P, Kusznierz GF, Rudi JM, Owen R, Pennington K, Wangchuk S, Gyeltshen S, Ferreira de Almeida WA, Pessanha Henriques CM, Njouom R, Vernet MA, Fasce RA, Andrade W, Yu H, Feng L, Yang J, Peng Z, Lara J, Bruno A, de Mora D, de Lozano C, Zambon M, Pebody R, Castillo L, Clara AW, Matute ML, Kosasih H, Nurhayati, Puzelli S, Rizzo C, Kadjo HA, Daouda C, Kiyanbekova L, Ospanova A, Mott JA, Emukule GO, Heraud JM, Razanajatovo NH, Barakat A, El Falaki F, Huang SQ, Lopez L, Balmaseda A, Moreno B, Rodrigues AP, Guiomar R, Ang LW, Lee VJM, Venter M, Cohen C, Badur S, Ciblak MA, Mironenko A, Holubka O, Bresee J, Brammer L, Hoang PVM, Le MTQ, Fleming D, Séblain CEG, Schellevis F, Paget J. Distribution of influenza virus types by age using case-based global surveillance data from twenty-nine countries, 1999-2014. BMC Infect Dis 2018; 18:269. [PMID: 29884140 PMCID: PMC5994061 DOI: 10.1186/s12879-018-3181-y] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 05/30/2018] [Indexed: 11/23/2022] Open
Abstract
Background Influenza disease burden varies by age and this has important public health implications. We compared the proportional distribution of different influenza virus types within age strata using surveillance data from twenty-nine countries during 1999-2014 (N=358,796 influenza cases). Methods For each virus, we calculated a Relative Illness Ratio (defined as the ratio of the percentage of cases in an age group to the percentage of the country population in the same age group) for young children (0-4 years), older children (5-17 years), young adults (18-39 years), older adults (40-64 years), and the elderly (65+ years). We used random-effects meta-analysis models to obtain summary relative illness ratios (sRIRs), and conducted meta-regression and sub-group analyses to explore causes of between-estimates heterogeneity. Results The influenza virus with highest sRIR was A(H1N1) for young children, B for older children, A(H1N1)pdm2009 for adults, and (A(H3N2) for the elderly. As expected, considering the diverse nature of the national surveillance datasets included in our analysis, between-estimates heterogeneity was high (I2>90%) for most sRIRs. The variations of countries’ geographic, demographic and economic characteristics and the proportion of outpatients among reported influenza cases explained only part of the heterogeneity, suggesting that multiple factors were at play. Conclusions These results highlight the importance of presenting burden of disease estimates by age group and virus (sub)type. Electronic supplementary material The online version of this article (10.1186/s12879-018-3181-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Saverio Caini
- Netherlands Institute for Health Services Research (NIVEL), Otterstraat 118-124, 3513, CR, Utrecht, The Netherlands.
| | - Peter Spreeuwenberg
- Netherlands Institute for Health Services Research (NIVEL), Otterstraat 118-124, 3513, CR, Utrecht, The Netherlands
| | - Gabriela F Kusznierz
- Instituto Nacional de Enfermedades Respiratorias "Dr. Emilio Coni", Santa Fe, Argentina
| | - Juan Manuel Rudi
- Instituto Nacional de Enfermedades Respiratorias "Dr. Emilio Coni", Santa Fe, Argentina
| | - Rhonda Owen
- Vaccine Preventable Diseases Surveillance Section, Health Policy Protection branch, Office for Health Protection, Department of Health, Woden, Canberra, Australia
| | - Kate Pennington
- Vaccine Preventable Diseases Surveillance Section, Health Policy Protection branch, Office for Health Protection, Department of Health, Woden, Canberra, Australia
| | - Sonam Wangchuk
- Public Health Laboratory, Department of Public Health, Ministry of Health, Thimphu, Bhutan
| | - Sonam Gyeltshen
- Public Health Laboratory, Department of Public Health, Ministry of Health, Thimphu, Bhutan
| | | | | | - Richard Njouom
- Virology Department, Centre Pasteur of Cameroon, Yaoundé, Cameroon
| | | | - Rodrigo A Fasce
- Sección Virus Respiratorios, Instituto de Salud Pública de Chile, Santiago, Chile
| | - Winston Andrade
- Sección Virus Respiratorios, Instituto de Salud Pública de Chile, Santiago, Chile
| | - Hongjie Yu
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Luzhao Feng
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Juan Yang
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhibin Peng
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jenny Lara
- National Influenza Center, Ministry of Health, San José, Costa Rica
| | - Alfredo Bruno
- Instituto Nacional de Investigacion en Salud Publica (INSPI), Centro de Referencia Nacional de Influenza y otros Virus Respiratorios, Guayaquil, Ecuador
| | - Doménica de Mora
- Instituto Nacional de Investigacion en Salud Publica (INSPI), Centro de Referencia Nacional de Influenza y otros Virus Respiratorios, Guayaquil, Ecuador
| | - Celina de Lozano
- National Influenza Center, Ministry of Health, San Salvador, El Salvador
| | - Maria Zambon
- Respiratory Virus Unit, Public Health England, London, Colindale, UK
| | - Richard Pebody
- Respiratory Diseases Department, Public Health England, London, Colindale, UK
| | - Leticia Castillo
- National Influenza Center, Ministry of Health, Guatemala City, Guatemala
| | - Alexey W Clara
- US Centers for Disease Control, Central American Region, Guatemala City, Guatemala
| | | | | | - Nurhayati
- US Naval Medical Research Unit No.2, Jakarta, Indonesia
| | - Simona Puzelli
- National Influenza Center, National Institute of Health, Rome, Italy
| | - Caterina Rizzo
- National Center for Epidemiology, Surveillance and Health Promotion, National Institute of Health, Rome, Italy
| | - Herve A Kadjo
- Department of Epidemic Virus, Institut Pasteur, Abidjan, Côte d'Ivoire
| | - Coulibaly Daouda
- Service of Epidemiological Diseases Surveillance, National Institute of Public Hygiene, Abidjan, Côte d'Ivoire
| | - Lyazzat Kiyanbekova
- National Center of Expertise, Committee of Consumer Right Protection, Astana, Kazakhstan
| | - Akerke Ospanova
- Zonal Virology Laboratory, National Center of Expertise, Committee of Consumer Right Protection, Astana, Kazakhstan
| | - Joshua A Mott
- Centers for Disease Control and Prevention - Kenya Country Office, Nairobi, Kenya.,US Public Health Service, Rockville, Maryland, USA
| | - Gideon O Emukule
- Centers for Disease Control and Prevention - Kenya Country Office, Nairobi, Kenya
| | - Jean-Michel Heraud
- National Influenza Center, Virology Unit, Institut Pasteur of Madagascar, Antananarivo, Madagascar
| | | | - Amal Barakat
- National Influenza Center, Institut National d'Hygiène, Ministry of Health, Rabat, Morocco
| | - Fatima El Falaki
- National Influenza Center, Institut National d'Hygiène, Ministry of Health, Rabat, Morocco
| | - Sue Q Huang
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - Liza Lopez
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - Angel Balmaseda
- National Influenza Center, Ministry of Health, Managua, Nicaragua
| | - Brechla Moreno
- National Influenza Center, IC Gorgas, Panama City, Panama
| | - Ana Paula Rodrigues
- Department of epidemiology, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
| | - Raquel Guiomar
- National Influenza Reference Laboratory, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
| | - Li Wei Ang
- Epidemiology and Disease Control Division, Ministry of Health, Singapore, Singapore
| | | | - Marietjie Venter
- Global Disease Detection, US-CDC, Pretoria, South Africa.,Zoonoses Research Center, Department of Medical Virology, University of Pretoria, Pretoria, South Africa
| | - Cheryl Cohen
- Centre for Respiratory Diseases and Meningitis (CRDM), National Institute for Communicable Diseases, Johannesburg, South Africa.,School of Public Health, Faculty of Health Science, University of the Witwatersrand, Johannesburg, South Africa
| | | | | | - Alla Mironenko
- L.V.Gromashevsky Institute of Epidemiology and Infectious Diseases National Academy of Medical Science of Ukraine, Reiv, Ukraine
| | - Olha Holubka
- L.V.Gromashevsky Institute of Epidemiology and Infectious Diseases National Academy of Medical Science of Ukraine, Reiv, Ukraine
| | - Joseph Bresee
- Epidemiology and Prevention Branch, Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Lynnette Brammer
- Epidemiology and Prevention Branch, Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | | | | | - François Schellevis
- Netherlands Institute for Health Services Research (NIVEL), Otterstraat 118-124, 3513, CR, Utrecht, The Netherlands.,Department of General Practice & Elderly Care Medicine, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, the Netherlands
| | - John Paget
- Netherlands Institute for Health Services Research (NIVEL), Otterstraat 118-124, 3513, CR, Utrecht, The Netherlands
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11
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Seijmonsbergen-Schermers AE, Zondag DC, Nieuwenhuijze M, Van den Akker T, Verhoeven CJ, Geerts C, Schellevis F, De Jonge A. Regional variations in childbirth interventions in the Netherlands: a nationwide explorative study. BMC Pregnancy Childbirth 2018; 18:192. [PMID: 29855270 PMCID: PMC5984340 DOI: 10.1186/s12884-018-1795-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 04/30/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Although interventions in childbirth are important in order to prevent neonatal and maternal morbidity and mortality, non-indicated use may cause avoidable harm. Regional variations in intervention rates, which cannot be explained by maternal characteristics, may indicate over- and underuse. The aim of this study is to explore regional variations in childbirth interventions in the Netherlands and their associations with interventions and adverse outcomes, controlled for maternal characteristics. METHODS Childbirth intervention rates were compared between twelve Dutch regions, using data from the national perinatal birth register for 2010-2013. All single childbirths from 37 weeks' gestation onwards were included. Primary outcomes were induction and augmentation of labour, pain medication, instrumental birth, caesarean section (prelabour, intrapartum) and paediatric involvement. Secondary outcomes were adverse neonatal and maternal outcomes. Multivariable logistic regression analyses were used to adjust for maternal characteristics. Associations were expressed in Spearman's rank correlation coefficients. RESULTS Most variation was found for type of pain medication and paediatric involvement. Epidural analgesia rates varied from between 12 and 38% (nulliparous) and from between 5 and 14% (multiparous women). These rates were negatively correlated with rates of other pharmacological pain relief, which varied from between 15 and 43% (nulliparous) and from between 10 and 27% (multiparous). Rates of paediatric involvement varied from between 37 and 60% (nulliparous) and from between 26 and 43% (multiparous). For instrumental vaginal births, rates varied from between 16 and 19% (nulliparous) and from between 3 and 4% (multiparous). For intrapartum caesarean section, the variation was 13-15% and 5-6%, respectively. A positive correlation was found between intervention rates in midwife-led and obstetrician-led care at the onset of labour within the same region. Adverse neonatal and maternal outcomes were not lower in regions with higher intervention rates. Higher augmentation of labour rates correlated with higher rates of severe postpartum haemorrhage. CONCLUSIONS Most variation was found for type of pain medication and paediatric involvement, and least for instrumental vaginal births and intrapartum caesarean sections. Care providers and policy makers should critically audit remarkable variations, since these may be unwarranted. Limited variation for some interventions may indicate consensus for their use. Further research should focus on variations in evidence-based interventions and indications for the use of interventions in childbirth.
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Affiliation(s)
- A. E. Seijmonsbergen-Schermers
- Department of Midwifery Science, AVAG, Amsterdam Public Health research Institute, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands
| | - D. C. Zondag
- Department of Midwifery Science, AVAG, Amsterdam Public Health research Institute, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands
| | - M. Nieuwenhuijze
- Research Centre for Midwifery Science, Zuyd University, Universiteitssingel 60, 6229 ER Maastricht, the Netherlands
| | - T. Van den Akker
- Department of Obstetrics, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands
| | - C. J. Verhoeven
- Department of Midwifery Science, AVAG, Amsterdam Public Health research Institute, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands
- Department of Obstetrics and Gynaecology, Maxima Medical Centre, De Run 4600, PO Box 7777, 5500 MB Veldhoven, the Netherlands
| | - C. Geerts
- Department of Midwifery Science, AVAG, Amsterdam Public Health research Institute, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands
| | - F. Schellevis
- NIVEL (Netherlands Institute for Health Services Research), PO Box 1568, 3500 BN Utrecht, the Netherlands
- Department of General Practice & Elderly Care Medicine, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, the Netherlands
| | - A. De Jonge
- Department of Midwifery Science, AVAG, Amsterdam Public Health research Institute, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands
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12
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Caini S, Alonso WJ, Séblain CEG, Schellevis F, Paget J. The spatiotemporal characteristics of influenza A and B in the WHO European Region: can one define influenza transmission zones in Europe? ACTA ACUST UNITED AC 2018; 22:30606. [PMID: 28877844 PMCID: PMC5587899 DOI: 10.2807/1560-7917.es.2017.22.35.30606] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 03/15/2017] [Indexed: 12/24/2022]
Abstract
We aimed to assess the epidemiology and spatiotemporal patterns of influenza in the World Health Organization (WHO) European Region and evaluate the validity of partitioning the Region into five influenza transmission zones (ITZs) as proposed by the WHO. We used the FluNet database and included over 650,000 influenza cases from 2000 to 2015. We analysed the data by country and season (from July to the following June). We calculated the median proportion of cases caused by each virus type in a season, compared the timing of the primary peak between countries and used a range of cluster analysis methods to assess the degree of overlap between the WHO-defined and data-driven ITZs. Influenza A and B caused, respectively, a median of 83% and 17% cases in a season. There was a significant west-to-east and non-significant (p = 0.10) south-to-north gradient in the timing of influenza activity. Typically, influenza peaked in February and March; influenza A earlier than influenza B. Most countries in the WHO European Region would fit into two ITZs: ‘Western Europe’ and ‘Eastern Europe’; countries bordering Asia may be better placed into extra-European ITZs. Our findings have implications for the presentation of surveillance data and prevention and control measures in this large WHO Region.
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Affiliation(s)
- Saverio Caini
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
| | | | | | - François Schellevis
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.,Department of General Practice and Elderly Care Medicine, EMGO Institute for Health and Care research, VU University Medical Center, Amsterdam, The Netherlands
| | - John Paget
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
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13
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van der Heide I, Snoeijs S, Quattrini S, Struckmann V, Hujala A, Schellevis F, Rijken M. Patient-centeredness of integrated care programs for people with multimorbidity. Results from the European ICARE4EU project. Health Policy 2018; 122:36-43. [DOI: 10.1016/j.healthpol.2017.10.005] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 10/26/2017] [Accepted: 10/30/2017] [Indexed: 10/18/2022]
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14
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Borlée F, Yzermans CJ, Aalders B, Rooijackers J, Krop E, Maassen CBM, Schellevis F, Brunekreef B, Heederik D, Smit LAM. Air Pollution from Livestock Farms Is Associated with Airway Obstruction in Neighboring Residents. Am J Respir Crit Care Med 2017; 196:1152-1161. [DOI: 10.1164/rccm.201701-0021oc] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Affiliation(s)
- Floor Borlée
- Institute for Risk Assessment Sciences, Utrecht University, the Netherlands
- Netherlands Institute for Health Services Research, Utrecht, the Netherlands
| | - C. Joris Yzermans
- Netherlands Institute for Health Services Research, Utrecht, the Netherlands
| | - Bernadette Aalders
- Netherlands Expertise Centre for Occupational Respiratory Disorders, Utrecht, the Netherlands
| | - Jos Rooijackers
- Netherlands Expertise Centre for Occupational Respiratory Disorders, Utrecht, the Netherlands
| | - Esmeralda Krop
- Institute for Risk Assessment Sciences, Utrecht University, the Netherlands
| | - Catharina B. M. Maassen
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - François Schellevis
- Netherlands Institute for Health Services Research, Utrecht, the Netherlands
- Department of General Practice & Elderly Care Medicine, Amsterdam Public Health Research Institute, Vrije Universiteit, University Medical Center, Amsterdam, the Netherlands; and
| | - Bert Brunekreef
- Institute for Risk Assessment Sciences, Utrecht University, the Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, the Netherlands
| | - Dick Heederik
- Institute for Risk Assessment Sciences, Utrecht University, the Netherlands
| | - Lidwien A. M. Smit
- Institute for Risk Assessment Sciences, Utrecht University, the Netherlands
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15
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Caini S, Alonso WJ, Séblain CEG, Schellevis F, Paget J. Authors' reply: Geographic resolution of surveillance data and influenza prevention in large countries. ACTA ACUST UNITED AC 2017; 22. [PMID: 29019314 PMCID: PMC5710127 DOI: 10.2807/1560-7917.es.2017.22.40.17-00671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Saverio Caini
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
| | | | | | - François Schellevis
- Department of General Practice and Elderly Care Medicine, EMGO Institute for Health and Care research, VU University Medical Center, Amsterdam, The Netherlands.,Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
| | - John Paget
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
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16
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Holvast F, van Hattem BA, Sinnige J, Schellevis F, Taxis K, Burger H, Verhaak PFM. Late-life depression and the association with multimorbidity and polypharmacy: a cross-sectional study. Fam Pract 2017; 34:539-545. [PMID: 28369380 DOI: 10.1093/fampra/cmx018] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Late-life depression often coincides with chronic somatic diseases and, consequently, with polypharmacy, which may complicate medical treatment. OBJECTIVE To determine the associations between patients diagnosed with late-life depression in primary care and multimorbidity and polypharmacy. METHODS This cross-sectional observational study was performed using 2012 primary care data. Depressed patients aged ≥60 years were compared to age and gender matched patients diagnosed with other psychological diagnoses and mentally healthy controls. Morbidity and prescription data were combined, and regression analyses were performed for the associations between depression and chronic disease and chronic drug use. RESULTS We included 4477 patients; 1512 had a record of depression, 1457 of other mental health or psychological diagnoses and 1508 were controls. Depressed patients had a 16% [Prevalence Ratio (PR) 1.16; 95% confidence interval (95% CI) 10%-24%] higher rate of chronic somatic disease and higher odds for multimorbidity (OR 1.55; 95% CI 1.33-1.81) compared with controls. No differences existed between depressed patients and patients with other psychological diagnoses. Compared with controls, depressed patients had a 46% (95% CI 39-53%) higher rate of chronic drug use and higher odds for polypharmacy (OR 2.89; 95% CI 2.41-3.47). Depressed patients also had higher rates of chronic drug use and higher odds for polypharmacy compared with patients with other psychological diagnoses (PR 1.26; OR 1.75; both P < 0.001). CONCLUSIONS Late-life depression in primary care patients is associated with more chronic drug use, even beyond the increased rates of comorbid somatic diseases. General practitioners should consider medication reviews to prevent unnecessary drug-related problems in these patients.
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Affiliation(s)
- Floor Holvast
- Department of General Practice, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Bernard A van Hattem
- Department of General Practice, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Judith Sinnige
- Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, The Netherlands.,NIVEL, Netherlands Institute of Health Services Research, Utrecht, The Netherlands
| | - François Schellevis
- NIVEL, Netherlands Institute of Health Services Research, Utrecht, The Netherlands.,Department of General Practice and Elderly care medicine/EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Katja Taxis
- Department of Pharmacy, Unit of PharmacoTherapy, Epidemiology and Economics, University of Groningen, Groningen, The Netherlands
| | - Huibert Burger
- Department of General Practice, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Peter F M Verhaak
- Department of General Practice, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,NIVEL, Netherlands Institute of Health Services Research, Utrecht, The Netherlands
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17
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Caini S, Alonso WJ, Balmaseda A, Bruno A, Bustos P, Castillo L, de Lozano C, de Mora D, Fasce RA, Ferreira de Almeida WA, Kusznierz GF, Lara J, Matute ML, Moreno B, Pessanha Henriques CM, Rudi JM, El-Guerche Séblain C, Schellevis F, Paget J. Characteristics of seasonal influenza A and B in Latin America: Influenza surveillance data from ten countries. PLoS One 2017; 12:e0174592. [PMID: 28346498 PMCID: PMC5367818 DOI: 10.1371/journal.pone.0174592] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 03/11/2017] [Indexed: 11/19/2022] Open
Abstract
Introduction The increased availability of influenza surveillance data in recent years justifies an actual and more complete overview of influenza epidemiology in Latin America. We compared the influenza surveillance systems and assessed the epidemiology of influenza A and B, including the spatio-temporal patterns of influenza epidemics, in ten countries and sub-national regions in Latin America. Methods We aggregated the data by year and country and characteristics of eighty-two years were analysed. We calculated the median proportion of laboratory-confirmed influenza cases caused by each virus strain, and compared the timing and amplitude of the primary and secondary peaks between countries. Results 37,087 influenza cases were reported during 2004–2012. Influenza A and B accounted for a median of 79% and, respectively, 21% of cases in a year. The percentage of influenza A cases that were subtyped was 82.5%; for influenza B, 15.6% of cases were characterized. Influenza A and B were dominant in seventy-five (91%) and seven (9%) years, respectively. In half (51%) of the influenza A years, influenza A(H3N2) was dominant, followed by influenza A(H1N1)pdm2009 (41%) and pre-pandemic A(H1N1) (8%). The primary peak of influenza activity was in June-September in temperate climate countries, with little or no secondary peak. Tropical climate countries had smaller primary peaks taking place in different months and frequently detectable secondary peaks. Conclusions We found that good influenza surveillance data exists in Latin America, although improvements can still be made (e.g. a better characterization of influenza B specimens); that influenza B plays a considerable role in the seasonal influenza burden; and that there is substantial heterogeneity of spatio-temporal patterns of influenza epidemics. To improve the effectiveness of influenza control measures in Latin America, tropical climate countries may need to develop innovative prevention strategies specifically tailored to the spatio-temporal patterns of influenza in this region.
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Affiliation(s)
- Saverio Caini
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
- * E-mail:
| | - Wladimir J. Alonso
- Fogarty International Center, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Angel Balmaseda
- National Influenza Center, Ministry of Health, Managua, Nicaragua
| | - Alfredo Bruno
- Instituto Nacional de Investigacion en Salud Publica (INSPI), Centro de Referencia Nacional de Influenza y Otros Virus Respiratorios, Guayaquil, Ecuador
| | - Patricia Bustos
- Seccion Virus Respiratorios, Instituto de Salud Publica de Chile, Santiago, Chile
| | - Leticia Castillo
- National Influenza Center, Ministry of Health, Guatemala City, Guatemala
| | - Celina de Lozano
- National Influenza Center, Ministry of Health, San Salvador, El Salvador
| | - Doménica de Mora
- Instituto Nacional de Investigacion en Salud Publica (INSPI), Centro de Referencia Nacional de Influenza y Otros Virus Respiratorios, Guayaquil, Ecuador
| | - Rodrigo A. Fasce
- Seccion Virus Respiratorios, Instituto de Salud Publica de Chile, Santiago, Chile
| | | | - Gabriela F. Kusznierz
- Instituto Nacional de Enfermedades Respiratorias “Dr. Emilio Coni”, ANLIS “C.Malbràn”, Santa Fe, Argentina
| | - Jenny Lara
- National Influenza Center, Ministry of Health, San José, Costa Rica
| | | | - Brechla Moreno
- National Influenza Center, IC Gorgas, Panama City, Panama
| | | | - Juan Manuel Rudi
- Instituto Nacional de Enfermedades Respiratorias “Dr. Emilio Coni”, ANLIS “C.Malbràn”, Santa Fe, Argentina
| | | | - François Schellevis
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
- Department of General Practice and Elderly Care Medicine, EMGO Institute for Health Care Research VU University Medical Center, Amsterdam, The Netherlands
| | - John Paget
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
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18
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Borlée F, Yzermans CJ, Krop E, Aalders B, Rooijackers J, Zock JP, van Dijk CE, Maassen CBM, Schellevis F, Heederik D, Smit LAM. Spirometry, questionnaire and electronic medical record based COPD in a population survey: Comparing prevalence, level of agreement and associations with potential risk factors. PLoS One 2017; 12:e0171494. [PMID: 28273094 PMCID: PMC5342260 DOI: 10.1371/journal.pone.0171494] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 01/21/2017] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND COPD-diagnosis is confirmed by post-bronchodilator (BD) spirometry. However, epidemiological studies often rely on pre-BD spirometry, self-reports, or medical records. This population-based study aims to determine COPD-prevalence based on four different operational definitions and their level of agreement, and to compare associations between COPD-definitions and risk factors. METHODS COPD-prevalence in 1,793 adults from the general Dutch population (aged 18-70 years) was assessed based on self-reported data, Electronic Medical Records (EMR), and post-BD spirometry: using the FEV1/FVC below the lower limit of normal (LLN) and GOLD fixed cut-off (FEV1/FVC <0.70). Using spirometry as a reference, sensitivity was calculated for self-reported and EMR-based COPD. Associations between COPD and known risk factors were assessed with logistic regression. Data were collected as part of the cross-sectional VGO study (Livestock Farming and Neighboring Residents' Health Study). RESULTS The highest prevalence was found based on spirometry (GOLD: 10.9%, LLN: 5.9%), followed by self-report (4.6%) and EMR (2.9%). Self-reported or EMR-based COPD identified less than 30% of all COPD-cases based on spirometry. The direction of association between known risk factors and COPD was similar across the four definitions, however, magnitude and significance varied. Especially indicators of allergy were more strongly associated with self-reported COPD compared to the other definitions. CONCLUSIONS COPD-prevalence varied depending on the used definition. A substantial number of subjects with spirometry-based COPD cannot be identified with questionnaires or medical records which can cause underestimation of COPD-prevalence. The influence of the different COPD-definitions on associations with known risk factors was limited.
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Affiliation(s)
- Floor Borlée
- Institute for Risk Assessment Sciences, IRAS, Utrecht University, Utrecht, The Netherlands
- Netherlands Institute for Health Services Research, NIVEL, Utrecht, The Netherlands
| | - C. Joris Yzermans
- Netherlands Institute for Health Services Research, NIVEL, Utrecht, The Netherlands
| | - Esmeralda Krop
- Institute for Risk Assessment Sciences, IRAS, Utrecht University, Utrecht, The Netherlands
| | - Bernadette Aalders
- Netherlands Expertise Centre for Occupational Respiratory Disorders, Utrecht, The Netherlands
| | - Jos Rooijackers
- Netherlands Expertise Centre for Occupational Respiratory Disorders, Utrecht, The Netherlands
| | - Jan-Paul Zock
- Netherlands Institute for Health Services Research, NIVEL, Utrecht, The Netherlands
| | - Christel E. van Dijk
- Netherlands Institute for Health Services Research, NIVEL, Utrecht, The Netherlands
| | - Catharina B. M. Maassen
- National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control, Bilthoven, The Netherlands
| | - François Schellevis
- Netherlands Institute for Health Services Research, NIVEL, Utrecht, The Netherlands
- Department of General Practice & Elderly Care Medicine/EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Dick Heederik
- Institute for Risk Assessment Sciences, IRAS, Utrecht University, Utrecht, The Netherlands
| | - Lidwien A. M. Smit
- Institute for Risk Assessment Sciences, IRAS, Utrecht University, Utrecht, The Netherlands
- * E-mail:
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Heins M, Korevaar J, Van Dulmen S, Donker G, Schellevis F. Feasibility and acceptability of follow-up care for prostate cancer in primary care. Eur J Cancer 2017. [DOI: 10.1016/s0959-8049(17)30675-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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20
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Van Olmen J, Kegels G, Korachais C, de Man J, Van Acker K, Kalobu JC, van Pelt M, Ku GM, Hen H, Kanda D, Malombo B, Darras C, Schellevis F. The effect of text message support on diabetes self-management in developing countries - A randomised trial. J Clin Transl Endocrinol 2017; 7:33-41. [PMID: 29067248 PMCID: PMC5651290 DOI: 10.1016/j.jcte.2016.12.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/23/2016] [Revised: 12/21/2016] [Accepted: 12/22/2016] [Indexed: 01/05/2023]
Abstract
Report of a randomised trial on an mHealth intervention in 3 low income countries. There was no additional effect of the text message self-management support. Coverage, routine care and disease progression interfere with the potential impact.
Objective mHealth interventions have the potential to facilitate self-management. This TEXT4DSM study implemented a mobile phone intervention in existing diabetes programmes in three low- and middle-income countries (Democratic Republic of Congo, Cambodia, and the Philippines). Research design and methods Sub-studies with a similar randomised controlled trial design were conducted in three different countries. Each sub-study included 480 adults with diabetes. Subjects were randomised to receive either routine care or routine care plus text message self-management support. The primary outcome was the difference in the proportion of subjects with well-controlled diabetes after 2 years. Results Baseline and 2-year HbA1c measurements were available for 781 individuals. After 2 years, the proportion of subjects with controlled HbA1c was 2.8% higher in the intervention group than in the control group (difference not statistically significant). In the logistic regression model, the odds ratio for having controlled diabetes after the intervention was 1.1, after adjusting for baseline HbA1c level, sex, receiving insulin treatment, and participating in the routine programme. The HbA1c dynamics over time differed between programmes; the number of people with controlled diabetes tended to increase in DR Congo and decrease in Cambodia. Conclusion This study was the first to test the same mHealth intervention in different countries. The finding that text messages did not show an additional effect on diabetes control implied that expectations about mHealth should be cautious. The degree of coverage, the quality of the routine programme, and the progression of disease can interfere with the expected impact. Trial registration: ISRCTN registry (86247213).
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Affiliation(s)
- Josefien Van Olmen
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.,Department of General Practice and Elderly Care Medicine/EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, Netherlands
| | - Guy Kegels
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Catherine Korachais
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Jeroen de Man
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Kristien Van Acker
- Algemeen ziekenhuis Heilige Familie Reet en Centre de Santé des Fagnes, Chimay, Belgium
| | | | | | - Grace Marie Ku
- Veterans Memorial Medical Center, Philippines.,Institute of Health Policy & Development Studies, National Institutes of Health, University of the Philippines Manila, Philippines
| | | | - Dominique Kanda
- Algemeen ziekenhuis Heilige Familie Reet en Centre de Santé des Fagnes, Chimay, Belgium
| | - Billy Malombo
- Algemeen ziekenhuis Heilige Familie Reet en Centre de Santé des Fagnes, Chimay, Belgium
| | | | - François Schellevis
- NIVEL (Netherlands Institute for Health Services Research), Utrecht, Netherlands.,Department of General Practice and Elderly Care Medicine/EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, Netherlands
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21
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Perdok H, Jans S, Verhoeven C, Henneman L, Wiegers T, Mol BW, Schellevis F, de Jonge A. Opinions of maternity care professionals and other stakeholders about integration of maternity care: a qualitative study in the Netherlands. BMC Pregnancy Childbirth 2016; 16:188. [PMID: 27459967 PMCID: PMC4962345 DOI: 10.1186/s12884-016-0975-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Accepted: 07/14/2016] [Indexed: 11/10/2022] Open
Abstract
Background This study aims to give insight into the opinions of maternity care professionals and other stakeholders on the integration of midwife-led care and obstetrician-led care and on the facilitating and inhibiting factors for integrating maternity care. Methods Qualitative study using interviews and focus groups from November 2012 to February 2013 in the Netherlands. Seventeen purposively selected stakeholder representatives participated in individual semi-structured interviews and 21 in focus groups. One face-to-face focus group included a combined group of midwives, obstetricians and a paediatrician involved in maternity care. Two online focus groups included a group of primary care midwives and a group of clinical midwives respectively. Thematic analysis was performed using Atlas.ti. Two researchers independently coded the interview and focus group transcripts by means of a mind map and themes and relations between them were described. Results Three main themes were identified with regard to integrating maternity care: client-centred care, continuity of care and task shifting between professionals. Opinions differed regarding the optimal maternity care organisation model. Participants considered the current payment structure an inhibiting factor, whereas a new modified payment structure based on the actual amount of work performed was seen as a facilitating factor. Both midwives and obstetricians indicated that they were afraid to loose autonomy. Conclusions An integrated maternity care system may improve client-centred care, provide continuity of care for women during labour and birth and include a shift of responsibilities between health care providers. However, differences of opinion among professionals and other stakeholders with regard to the optimal maternity care organisation model may complicate the implementation of integrated care. Important factors for a successful implementation of integrated maternity care are an appropriate payment structure and maintenance of the autonomy of professionals.
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Affiliation(s)
- Hilde Perdok
- Department of Midwifery Science, Midwifery Academy Amsterdam/Groningen (AVAG) and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands. .,Catharina Hospital, Eindhoven, The Netherlands.
| | - Suze Jans
- Department of Clinical Genetics, Section Community Genetics and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.,TNO Quality of Life, Leiden, The Netherlands
| | - Corine Verhoeven
- Department of Midwifery Science, Midwifery Academy Amsterdam/Groningen (AVAG) and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.,Maxima Medical Centre, Veldhoven, The Netherlands
| | - Lidewij Henneman
- Department of Clinical Genetics, Section Community Genetics and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Therese Wiegers
- Netherlands Institute for Health Services Research, Utrecht, The Netherlands
| | - Ben Willem Mol
- Robinson Institute, School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, Australia
| | - François Schellevis
- Netherlands Institute for Health Services Research, Utrecht, The Netherlands.,Department of General Practice & Elderly Care Medicine, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Ank de Jonge
- Department of Midwifery Science, Midwifery Academy Amsterdam/Groningen (AVAG) and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
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Caini S, Huang QS, Ciblak MA, Kusznierz G, Owen R, Wangchuk S, Henriques CMP, Njouom R, Fasce RA, Yu H, Feng L, Zambon M, Clara AW, Kosasih H, Puzelli S, Kadjo HA, Emukule G, Heraud JM, Ang LW, Venter M, Mironenko A, Brammer L, Mai LTQ, Schellevis F, Plotkin S, Paget J. Epidemiological and virological characteristics of influenza B: results of the Global Influenza B Study. Influenza Other Respir Viruses 2016; 9 Suppl 1:3-12. [PMID: 26256290 PMCID: PMC4549097 DOI: 10.1111/irv.12319] [Citation(s) in RCA: 135] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Literature on influenza focuses on influenza A, despite influenza B having a large public health impact. The Global Influenza B Study aims to collect information on global epidemiology and burden of disease of influenza B since 2000. METHODS Twenty-six countries in the Southern (n = 5) and Northern (n = 7) hemispheres and intertropical belt (n = 14) provided virological and epidemiological data. We calculated the proportion of influenza cases due to type B and Victoria and Yamagata lineages in each country and season; tested the correlation between proportion of influenza B and maximum weekly influenza-like illness (ILI) rate during the same season; determined the frequency of vaccine mismatches; and described the age distribution of cases by virus type. RESULTS The database included 935 673 influenza cases (2000-2013). Overall median proportion of influenza B was 22·6%, with no statistically significant differences across seasons. During seasons where influenza B was dominant or co-circulated (>20% of total detections), Victoria and Yamagata lineages predominated during 64% and 36% of seasons, respectively, and a vaccine mismatch was observed in ≈25% of seasons. Proportion of influenza B was inversely correlated with maximum ILI rate in the same season in the Northern and (with borderline significance) Southern hemispheres. Patients infected with influenza B were usually younger (5-17 years) than patients infected with influenza A. CONCLUSION Influenza B is a common disease with some epidemiological differences from influenza A. This should be considered when optimizing control/prevention strategies in different regions and reducing the global burden of disease due to influenza.
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Affiliation(s)
- Saverio Caini
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
| | - Q Sue Huang
- Institute of Environmental Science and Research, Wellington, New Zealand
| | | | - Gabriela Kusznierz
- Instituto Nacional de Enfermedades Respiratorias Dr. Emilio Coni, Santa Fe, Argentina
| | - Rhonda Owen
- Department of Health and Ageing, Influenza Surveillance Section, Surveillance Branch, Office of Health Protection, Woden, ACT, Australia
| | - Sonam Wangchuk
- Public Health Laboratory, Department of Public Health, Ministry of Health, Thimphu, Bhutan
| | | | - Richard Njouom
- Service de Virologie, Centre Pasteur du Cameroun, Yaounde, Cameroon
| | - Rodrigo A Fasce
- Sección de Virus Respiratorios y Exantemáticos, Instituto de Salud Pública de Chile, Santiago de Chile, Chile
| | - Hongjie Yu
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Luzhao Feng
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Maria Zambon
- Respiratory Virus Unit, Public Health England, Colindale, UK
| | - Alexey W Clara
- US Centers for Disease Control, Central American Region, Guatemala City, Guatemala
| | - Herman Kosasih
- US Naval Medical Research Unit No. 2, Jakarta, Indonesia
| | - Simona Puzelli
- National Influenza Center, Istituto Superiore Sanità, Rome, Italy
| | - Herve A Kadjo
- Respiratory Viruses Unit, Pasteur Institute of Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Gideon Emukule
- US Centers for Disease Control and Prevention, Nairobi, Kenya
| | - Jean-Michel Heraud
- National Influenza Center, Virology Unit, Institut Pasteur of Madagascar, Antananarivo, Madagascar
| | - Li Wei Ang
- Epidemiology and Disease Control Division, Ministry of Health, Singapore, Singapore
| | - Marietjie Venter
- Global Disease Detection, US-CDC, Pretoria, South Africa.,Zoonoses Research Unit, Department of Medical Virology, University of Pretoria, Pretoria, South Africa
| | - Alla Mironenko
- L.V.Gromashevsky Institute of Epidemiology and Infectious Diseases National Academy of Medical Science of Ukraine, Kiev, Ukraine
| | - Lynnette Brammer
- Epidemiology and Prevention Branch, Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - François Schellevis
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
| | | | - John Paget
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
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Caini S, Andrade W, Badur S, Balmaseda A, Barakat A, Bella A, Bimohuen A, Brammer L, Bresee J, Bruno A, Castillo L, Ciblak MA, Clara AW, Cohen C, Daouda C, de Lozano C, De Mora D, Dorji K, Emukule GO, Fasce RA, Feng L, Ferreira de Almeida WA, Guiomar R, Heraud JM, Holubka O, Huang QS, Kadjo HA, Kiyanbekova L, Kosasih H, Kusznierz G, Lee V, Lara J, Li M, Lopez L, Mai HP, Pessanha HC, Matute ML, Mironenko A, Moreno B, Mott JA, Njouom R, Ospanova A, Owen R, Pebody R, Pennington K, Puzelli S, Quynh Le MT, Razanajatovo NH, Rodrigues A, Rudi JM, Venter M, Vernet MA, Wei AL, Wangchuk S, Yang J, Yu H, Zambon M, Schellevis F, Paget J. Correction: Temporal Patterns of Influenza A and B in Tropical and Temperate Countries: What Are the Lessons for Influenza Vaccination? PLoS One 2016; 11:e0155089. [PMID: 27135748 PMCID: PMC4852893 DOI: 10.1371/journal.pone.0155089] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
[This corrects the article DOI: 10.1371/journal.pone.0152310.].
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van Olmen J, Eggermont N, van Pelt M, Hen H, de Man J, Schellevis F, Peters DH, Bigdeli M. Patient-centred innovation to ensure access to diabetes care in Cambodia: the case of MoPoTsyo. J Pharm Policy Pract 2016; 9:1. [PMID: 26798483 PMCID: PMC4720995 DOI: 10.1186/s40545-016-0050-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Accepted: 01/11/2016] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The increasing prevalence of chronic diseases puts a high burden on the health care systems of Low and Middle Income Countries which are often not adapted to provide the care needed. Peer support programmes are promoted to address health system constraints. This case study analyses a peer educator diabetes programme in Cambodia, MoPoTsyo, from a health system's perspective. Which strategies were used and how did these strategies change? How is the programme perceived? METHODS Data were collected through semi-structured interviews with patients, MoPoTsyo staff and peer educators, contracted pharmacy staff and health workers, health care workers and non-contracted pharmacists and managers and policy makers at district, provincial and national level. Four areas were purposively selected to do the interviews. An inductive content analysis was done independently by two researchers. RESULTS MoPoTsyo developed into three stages: a focus on diabetes self-management; a widening scope to ensure affordable medicines and access to other health care services; and aiming for sustainability through more integration with the Cambodian public system and further upscaling. All respondents acknowledged the peer educators' role and competence in patient education, but their ideas about additional tasks and their place in the system differed. Indirectly involved stakeholders and district managers emphasized the particular roles and responsibilities of all actors in the system and the particular role of the peer educator in the community. MoPoTsyo's diagnostics and laboratory services were perceived as useful, especially by patients and project staff. Respondents were positive about the revolving drug fund, but expressed concerns about its integration into the government system. The degree of collaboration between health care staff and peer educators varied. CONCLUSION MoPoTsyo responds to the needs of people with diabetes in Cambodia. Key success factors were: consistent focus on and involvement of the target group, backed up by a strong organisation; simultaneous reduction of other barriers to care; and the ongoing maintenance of relations at all levels within the health system. Despite resistance, MoPoTsyo has established a more balanced relationship between patients and health service providers, empowering patients to self-manage and access services that meet their needs.
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Affiliation(s)
- Josefien van Olmen
- Department of Public Health Antwerp, Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerp, Belgium ; Department of General Practice & Elderly Medicine, EMGO, Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 Amsterdam, The Netherlands
| | - Natalie Eggermont
- University Hospital, University Hospital Brussels, Laarbeeklaan 101, Brussels, Belgium
| | - Maurits van Pelt
- MoPoTsyo, #9E, Street 3C, Phum Trea 1, Stung Meanchey, 12352 Phnom Penh Cambodia
| | - Heang Hen
- MoPoTsyo, #9E, Street 3C, Phum Trea 1, Stung Meanchey, 12352 Phnom Penh Cambodia
| | - Jeroen de Man
- Department of Public Health Antwerp, Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerp, Belgium
| | - François Schellevis
- Department of General Practice & Elderly Medicine, EMGO, Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 Amsterdam, The Netherlands ; NIVEL, Netherlands Institute for Health Services Research, Otterstraat 118-124, Utrecht, 3513 CR The Netherlands
| | - David H Peters
- Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205 USA
| | - Maryam Bigdeli
- World Health Organisation, Alliance for Health Policy and Systems Research, 20 avenue Appia, 1211 Geneva, Switzerland
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van Lier A, Lugnér A, Opstelten W, Jochemsen P, Wallinga J, Schellevis F, Sanders E, de Melker H, van Boven M. Varicella vaccination might result in inequality in health benefits between generations. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv175.221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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26
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Heins M, Korevaar J, Rijken M, Donker G, Van Dulmen S, Schellevis F. 1121 CAPPA: Care for prostate cancer patients. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30503-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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27
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van Lier A, Lugnér A, Opstelten W, Jochemsen P, Wallinga J, Schellevis F, Sanders E, de Melker H, van Boven M. Distribution of Health Effects and Cost-effectiveness of Varicella Vaccination are Shaped by the Impact on Herpes Zoster. EBioMedicine 2015; 2:1494-9. [PMID: 26629544 PMCID: PMC4634630 DOI: 10.1016/j.ebiom.2015.08.017] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 08/07/2015] [Accepted: 08/07/2015] [Indexed: 02/06/2023] Open
Abstract
Introduction Varicella zoster virus (VZV) is the etiological agent of varicella and herpes zoster (HZ). It has been hypothesised that immune boosting of latently infected persons by contact with varicella reduces the probability of HZ. If true, universal varicella vaccination may increase HZ incidence due to reduced VZV circulation. To inform decision-making, we conduct cost-effectiveness analyses of varicella vaccination, including effects on HZ. Methods Effects of varicella vaccination are simulated with a dynamic transmission model, parameterised with Dutch VZV seroprevalence and HZ incidence data, and linked to an economic model. We consider vaccination scenarios that differ by whether or not they include immune boosting, and reactivation of vaccine virus. Results Varicella incidence decreases after introduction of vaccination, while HZ incidence may increase or decrease depending on whether or not immune boosting is present. Without immune boosting, vaccination is expected to be cost-effective or even cost-saving. With immune boosting, vaccination at 95% coverage is not expected to be cost-effective, and may even cause net health losses. Conclusions Cost-effectiveness of varicella vaccination depends strongly on the impact on HZ and the economic time horizon. Our findings reveal ethical dilemmas as varicella vaccination may result in unequal distribution of health effects between generations. Cost-effectiveness of varicella vaccination depends strongly on the impact on herpes zoster and the economic time horizon. Varicella vaccination may result in profound trans-generational differences in distribution of health benefits and losses. Ethical dilemmas could arise, as unvaccinated groups may be exposed to a substantially increased health hazard.
We study the impact of universal childhood varicella vaccination by dynamic transmission modelling and cost-effectiveness analyses. Scenarios that are considered differ by whether or not immune boosting is included, and whether or not reactivation of vaccine virus is possible. Health effects of varicella vaccination in scenarios with immune boosting are unevenly distributed: cohorts born just before introduction of vaccination and persons who refuse vaccination may pay the price for health gains in vaccinated cohorts by an increased lifetime risk of herpes zoster. These results uncover an ethical dilemma, as varicella vaccination could result in significant trans-generational inequalities of health effects.
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Affiliation(s)
- Alies van Lier
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA Bilthoven, The Netherlands
| | - Anna Lugnér
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA Bilthoven, The Netherlands
| | - Wim Opstelten
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands
| | - Petra Jochemsen
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA Bilthoven, The Netherlands
| | - Jacco Wallinga
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA Bilthoven, The Netherlands
| | - François Schellevis
- NIVEL, Netherlands Institute for Health Services Research, PO Box 1568, 3500 BN Utrecht, The Netherlands ; Department of General Practice & Elderly Care Medicine/EMGO Institute for Health and Care Research, VU University Medical Center, v/d Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
| | - Elisabeth Sanders
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA Bilthoven, The Netherlands ; Department of Paediatric Immunology and Infectious Diseases, Wilhelmina's Children Hospital, University Medical Center Utrecht, PO Box 85090, 3508 AB Utrecht, The Netherlands
| | - Hester de Melker
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA Bilthoven, The Netherlands
| | - Michiel van Boven
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA Bilthoven, The Netherlands
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Feijen-de Jong EI, Jansen DEMC, Baarveld F, Spelten E, Schellevis F, Reijneveld SA. Determinants of use of care provided by complementary and alternative health care practitioners to pregnant women in primary midwifery care: a prospective cohort study. BMC Pregnancy Childbirth 2015; 15:140. [PMID: 26104413 PMCID: PMC4479252 DOI: 10.1186/s12884-015-0555-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Accepted: 05/12/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pregnant women visit complementary/alternative health care practitioners in addition to regular maternal health care practitioners. A wide variation has been reported with regard to rates and determinants of use of complementary/alternative medicine (CAM), which may be due to heterogeneous populations. The aim of this study was to examine the prevalence and determinants of use of CAM practitioners by a homogeneous population of low-risk pregnant women in the Netherlands. METHODS Data from the population-based DELIVER study was used, concerning 1500 clients from twenty midwifery practices across the Netherlands in 2009 and 2010. CAM use was measured based on patient reports. Potential determinants were derived from Andersen's behavioural model of health care utilization. RESULTS The prevalence of CAM practitioner use by low-risk pregnant women was 9.4 %. Women were more likely to use CAM if they had supplementary health care insurance (OR 3.11; CI 1.41-6.85), rated their health as 'bad/fair' (OR 2.63; CI 1.65-4.21), reported a chronic illness or handicap (OR 1.93; CI 1.14-3.27), smoked during pregnancy (OR 1.88; CI 1.06-3.33), or used alcohol during pregnancy (OR 2.30; CI 1.46-3.63). CONCLUSIONS CAM is relatively frequently used by low-risk pregnant women. Determinants revealed in this study diverge from other studies using heterogeneous populations. Maternal health care practitioners must be aware of CAM use by low-risk pregnant women and incorporate this knowledge into daily practice by actively discussing this subject with pregnant women.
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Affiliation(s)
- Esther I Feijen-de Jong
- Department of Midwifery Science, AVAG, and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands. .,Academy of Midwifery Amsterdam-Groningen, Dirk Huizingastraat 3-5, 9713 GL, Groningen, The Netherlands.
| | - Danielle E M C Jansen
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. .,Department of Sociology, Interuniversity Center for Social Science Theory and Methodology (ICS), University of Groningen, Groningen, The Netherlands. .,, PO Box 196, 9700 AD, Groningen, The Netherlands.
| | - Frank Baarveld
- National Association for Specialty Training for General Practice and GP Trainers, Utrecht, The Netherlands. .,, PO Box 20072, 3502 LB, Utrecht, The Netherlands.
| | - Evelien Spelten
- Department of Midwifery Science, AVAG, and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands. .,Faculty of Medicine, Nursing, and Health Science, Monash University, Melbourne, Australia. .,Academy of Midwifery Amsterdam-Groningen, Dirk Huizingastraat 3-5, 9713 GL, Groningen, The Netherlands.
| | - François Schellevis
- Department of General Practice, Elderly Care Medicine/EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands. .,Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands. .,, PO Box 1568, 3500 BN, Utrecht, The Netherlands.
| | - Sijmen A Reijneveld
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. .,, PO Box 196, 9700 AD, Groningen, The Netherlands.
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Heins M, Schellevis F, Rijken M, Donker G, van der Hoek L, Korevaar J. Partners of cancer patients consult their GPs significantly more often with both somatic and psychosocial problems. Scand J Prim Health Care 2013; 31:203-8. [PMID: 24299045 PMCID: PMC3860296 DOI: 10.3109/02813432.2013.861153] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVE Partners of cancer patients experience psychological distress and impaired physical health around and after the diagnosis of cancer. It is unknown whether these problems are presented to the general practitioner (GP). This study aimed to establish partners' GP use around the diagnosis of cancer. DESIGN Cohort study. SETTING Primary care. SUBJECTS Partners of 3071 patients with breast, prostate, colorectal, or lung cancer were included. Patients were diagnosed in 2001-2009 and were alive at least two years after diagnosis. MAIN OUTCOME MEASURES Number of GP contacts and health problems in partners between six months before and two years after diagnosis. RESULTS In the first six months after diagnosis, partners' GP use was similar to baseline (18 to six months before diagnosis). Between six and 24 months after diagnosis, GP use was increased in partners of patients with breast, prostate, and colorectal cancer, an increase of 31% (p = 0.001), 26% (p = 0.001), and 19% (p = 0.042), respectively. In partners of patients with breast cancer and colorectal cancer, GP use was increased for both somatic and psychosocial symptoms. In partners of prostate cancer patients, an increase was seen in somatic symptoms, whereas in partners of lung cancer patients, GP use was only increased for psychosocial symptoms. "Problems with the illness of the partner" was a frequently recorded reason for contact in the first six months after diagnosis. CONCLUSION GP use of partners of cancer patients is increased 6-24 months after diagnosis, but health problems vary between cancer types. GPs should be alert for somatic and psychosocial problems in partners of cancer patients.
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Affiliation(s)
- Marianne Heins
- Netherlands Institute for Health Services Research (NIVEL), The Netherlands
| | - François Schellevis
- Netherlands Institute for Health Services Research (NIVEL), The Netherlands
- Department of General Practice/EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam
| | - Mieke Rijken
- Netherlands Institute for Health Services Research (NIVEL), The Netherlands
| | - Gé Donker
- Netherlands Institute for Health Services Research (NIVEL), The Netherlands
| | - Lucas van der Hoek
- Netherlands Institute for Health Services Research (NIVEL), The Netherlands
| | - Joke Korevaar
- Netherlands Institute for Health Services Research (NIVEL), The Netherlands
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Sinnige J, Braspenning J, Schellevis F, Stirbu-Wagner I, Westert G, Korevaar J. The prevalence of disease clusters in older adults with multiple chronic diseases--a systematic literature review. PLoS One 2013; 8:e79641. [PMID: 24244534 PMCID: PMC3823581 DOI: 10.1371/journal.pone.0079641] [Citation(s) in RCA: 111] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Accepted: 10/02/2013] [Indexed: 11/19/2022] Open
Abstract
Background Since most clinical guidelines address single diseases, treatment of patients with multimorbidity, the co-occurrence of multiple (chronic) diseases within one person, can become complicated. Information on highly prevalent combinations of diseases can set the agenda for guideline development on multimorbidity. With this systematic review we aim to describe the prevalence of disease combinations (i.e. disease clusters) in older patients with multimorbidity, as assessed in available studies. In addition, we intend to acquire information that can be supportive in the process of multimorbidity guideline development. Methods We searched MEDLINE, Embase and the Cochrane Library for all types of studies published between January 2000 and September 2012. We included empirical studies focused on multimorbidity or comorbidity that reported prevalence rates of combinations of two or more diseases. Results Our search yielded 3070 potentially eligible articles, of which 19 articles, representing 23 observational studies, turned out to meet all our quality and inclusion criteria after full text review. These studies provided prevalence rates of 165 combinations of two diseases (i.e. disease pairs). Twenty disease pairs, concerning 12 different diseases, were described in at least 3 studies. Depression was found to be the disease that was most commonly clustered, and was paired with 8 different diseases, in the available studies. Hypertension and diabetes mellitus were found to be the second most clustered diseases, both with 6 different diseases. Prevalence rates for each disease combination varied considerably per study, but were highest for the pairs that included hypertension, coronary artery disease, and diabetes mellitus. Conclusions Twenty disease pairs were assessed most frequently in patients with multimorbidity. These disease combinations could serve as a first priority setting towards the development of multimorbidity guidelines, starting with the diseases with the highest observed prevalence rates and those with potential interacting treatment plans.
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Affiliation(s)
- Judith Sinnige
- NIVEL, Netherlands Institute for Health Services Research, Utrecht, the Netherlands
- IQ Healthcare, Scientific Institute for Quality of Healthcare, Radboud University medical centre, Nijmegen, The Netherlands
- * E-mail:
| | - Jozé Braspenning
- IQ Healthcare, Scientific Institute for Quality of Healthcare, Radboud University medical centre, Nijmegen, The Netherlands
| | - François Schellevis
- NIVEL, Netherlands Institute for Health Services Research, Utrecht, the Netherlands
- Department of General Practice and Elderly care medicine/EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Irina Stirbu-Wagner
- NIVEL, Netherlands Institute for Health Services Research, Utrecht, the Netherlands
| | - Gert Westert
- IQ Healthcare, Scientific Institute for Quality of Healthcare, Radboud University medical centre, Nijmegen, The Netherlands
| | - Joke Korevaar
- NIVEL, Netherlands Institute for Health Services Research, Utrecht, the Netherlands
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Meijer L, Schellevis F. P095 The Role Of National Guidelines In Developing Regional Working Arrangements Between Medical Specialists And General Practitioners. BMJ Qual Saf 2013. [DOI: 10.1136/bmjqs-2013-002293.158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Ursum J, Nielen M, Twisk J, Peters M, Schellevis F, Nurmohamed M, Korevaar J. OP0276-PC High Risk for Anaemia, Osteoporosis and Copd After the Onset of Inflammatory Arthritis: Results from a Population-Based Study. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Ursum J, Nielen M, Twisk J, Peters M, Schellevis F, Nurmohamed M, Korevaar J. OP0138-PC High Presence of Chronic Diseases at the Onset of Inflammatory Arthritis: Results from a Population-Based Study. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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34
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van Dulmen S, Schellevis F, Fassaert T, van der Jagt L, Schellevis F. De relatie tussen positieve communicatiestrategieën en het beloop van alledaagse klachten. ACTA ACUST UNITED AC 2012. [DOI: 10.1007/s12445-010-0117-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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35
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Meerhoff TJ, Houben ML, Coenjaerts FEJ, Kimpen JLL, Hofland RW, Schellevis F, Bont LJ. Detection of multiple respiratory pathogens during primary respiratory infection: nasal swab versus nasopharyngeal aspirate using real-time polymerase chain reaction. Eur J Clin Microbiol Infect Dis 2010; 29:365-71. [PMID: 20111881 PMCID: PMC2840676 DOI: 10.1007/s10096-009-0865-7] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2009] [Accepted: 12/21/2009] [Indexed: 11/18/2022]
Abstract
In this study, we present the multiple detection of respiratory viruses in infants during primary respiratory illness, investigate the sensitivity of nasal swabs and nasopharyngeal aspirates, and assess whether patient characteristics and viral load played a role in the sensitivity. Healthy infants were included at signs of first respiratory tract infection. Paired nasopharyngeal aspirates and nasal swabs were collected. Real-time polymerase chain reaction (PCR) was carried out for 11 respiratory pathogens. Paired nasopharyngeal aspirates and nasal swabs were collected in 98 infants. Rhinovirus (n = 67) and respiratory syncytial virus (n = 39) were the most frequently detected. Co-infection occurred in 48% (n = 45) of the infants. The sensitivity of the nasal swab was lower than the nasopharyngeal aspirate, in particular, for respiratory syncytial virus (51% vs. 100%) and rhinovirus (75% vs. 97%). The sensitivity of the nasal swab was strongly determined by the cycle threshold (CT) value (p < 0.001). The sensitivity of the swab for respiratory syncytial virus, but not rhinovirus, was 100% in children with severe symptoms (score ≥11). It is concluded that, for community-based studies and surveillance purposes, the nasal swab can be used, though the sensitivity is lower than the aspirate, in particular, for the detection of mild cases of respiratory syncytial virus (RSV) infection.
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Affiliation(s)
- T J Meerhoff
- NIVEL: Netherlands Institute for Health Services Research, Utrecht, The Netherlands.
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36
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de Jong JD, Groenewegen PP, Spreeuwenberg P, Schellevis F, Westert GP. Do guidelines create uniformity in medical practice? Soc Sci Med 2009; 70:209-16. [PMID: 19879028 DOI: 10.1016/j.socscimed.2009.10.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2008] [Indexed: 10/20/2022]
Abstract
This article aimed to test the general hypothesis that guidelines create uniformity, or reduce variation, in medical practice. Medical practice variation has policy interest and is one of the reasons for developing guidelines. The development and implementation of guidelines was considered in the broader context of processes of rationalization. We focused on the influence of voluntary guidelines developed by the professional organization for family physicians in the Netherlands on variation in drug prescription. Data were used from the First and Second Dutch National Survey of General Practice (DNSGP1 and DNSGP2), collected in 1987 and 2001 respectively. DNSGP1 consisted of 103 practices and 161 GPs serving 335.000 patients. DNSGP2 consisted of 104 practices and 195 GPs serving 390.000 patients. Two groups of diagnoses were created, one containing all diagnoses for which guidelines were introduced and one containing all other diagnoses. For both groups a measure of concentration, Herfindahl-Hirschman Index (HHI), was used to represent variation. This measure of concentration was compared between both groups using multilevel analysis. Results showed that although there was an overall increase in variation (a significantly lower HHI) in prescription, the increase was less in the cases of diagnoses for which guidelines were introduced. Guidelines, primarily, had an effect on variations in single-handed practices. The overall conclusion is that the introduction of guidelines, although it probably tempered the increase in variation, did not reduce variation.
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Meerhoff TJ, Mosnier A, Schellevis F, Paget WJ, the EISS RSV Task Group. Progress in the surveillance of respiratory syncytial virus (RSV) in Europe: 2001-2008. Euro Surveill 2009. [DOI: 10.2807/ese.14.40.19346-en] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Respiratory syncytial virus (RSV) surveillance is important to get insight into the burden of disease and epidemic pattern of RSV infection. This information is useful for healthcare resource allocation as well as the timing of preventive messages and palivizumab prophylaxis. For influenza surveillance the European Influenza Surveillance Scheme (EISS) was established in 1996, but no surveillance platform is available for RSV. To improve surveillance an RSV Task Group was established in 2003 and recommendations for RSV surveillance were developed. By 2008, progress was made for four out of six recommendations: the number of European countries testing specimens for RSV increased from six to fourteen; nose and/or throat swabs were generally used for detection of influenza and RSV; a total of 25 laboratories performed molecular testing for diagnosis and participated in a quality control assessment for RSV with an overall good performance; four of the ten countries that joined EISS in 2004 started reporting RSV detections in addition to influenza in the period 2004-8. Limited progress was achieved for standardising methods and the development of a sentinel surveillance system of representative hospitals. Improving RSV surveillance is possible by further harmonising the data collection and increased reporting of RSV.
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Affiliation(s)
- T J Meerhoff
- Netherlands Institute for Health Services Research (Nederlands instituut voor onderzoek van de gezondheidszorg, NIVEL), Utrecht, the Netherlands
| | - A Mosnier
- Réseau des Groupes Régionaux d’Observation de la Grippe (GROG), Open Rome, Paris, France
| | - F Schellevis
- Department of General Practice, EMGO Institute for Health and Care Research, VU Medical Centre, Amsterdam, the Netherlands
- Netherlands Institute for Health Services Research (Nederlands instituut voor onderzoek van de gezondheidszorg, NIVEL), Utrecht, the Netherlands
| | - W J Paget
- Netherlands Institute for Health Services Research (Nederlands instituut voor onderzoek van de gezondheidszorg, NIVEL), Utrecht, the Netherlands
| | - the EISS RSV Task Group
- The members of the European Influenza Surveillance Scheme (EISS) RSV Task Group are listed at the end of the article
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38
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Meerhoff TJ, Mosnier A, Schellevis F, Paget WJ. Progress in the surveillance of respiratory syncytial virus (RSV) in Europe: 2001-2008. Euro Surveill 2009; 14:19346. [PMID: 19822120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
Respiratory syncytial virus (RSV) surveillance is important to get insight into the burden of disease and epidemic pattern of RSV infection. This information is useful for healthcare resource allocation as well as the timing of preventive messages and palivizumab prophylaxis. For influenza surveillance the European Influenza Surveillance Scheme (EISS) was established in 1996, but no surveillance platform is available for RSV. To improve surveillance an RSV Task Group was established in 2003 and recommendations for RSV surveillance were developed. By 2008, progress was made for four out of six recommendations: the number of European countries testing specimens for RSV increased from six to fourteen; nose and/or throat swabs were generally used for detection of influenza and RSV; a total of 25 laboratories performed molecular testing for diagnosis and participated in a quality control assessment for RSV with an overall good performance; four of the ten countries that joined EISS in 2004 started reporting RSV detections in addition to influenza in the period 2004-8. Limited progress was achieved for standardising methods and the development of a sentinel surveillance system of representative hospitals. Improving RSV surveillance is possible by further harmonising the data collection and increased reporting of RSV.
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Affiliation(s)
- T J Meerhoff
- Netherlands Institute for Health Services Research (Nederlands instituut voor onderzoek van de gezondheidszorg, NIVEL), Utrecht, the Netherlands.
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Razmjou RG, Willemsen SP, Koning S, Oranje AP, Schellevis F, van der Wouden JC. Determinants of regional differences in the incidence of impetigo. Environ Res 2009; 109:590-593. [PMID: 19368906 DOI: 10.1016/j.envres.2009.03.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2008] [Revised: 02/16/2009] [Accepted: 03/16/2009] [Indexed: 05/27/2023]
Abstract
BACKGROUND AND OBJECTIVE Impetigo is a common contagious skin infection, mostly seen in children and caused by Staphylococcus aureus and/or group A B-hemolytic Streptococcus. Two surveys performed in general practice showed a strong geographical gradient in the incidence rates among children in the Netherlands. The incidence in the south was approximately twice as high as in the rest of the Netherlands. We hypothesized that this difference could be explained by differences in the presence of animal farms and differences in temperature. This study examined whether there is a relationship with the numbers of bovines, pigs, sheep, and poultry per km2, and temperature, which could explain the observed regional gradient in the incidence of impetigo. DESIGN AND SETTING In this ecological study, data on the incidence of impetigo in children 0-17 years of age from the second Dutch national survey were linked to data on the density of farm animals from Statistics Netherlands and temperature data from the Dutch Metereological Service. Using logistic regression allowing for overdispersion, we tested the significance of the effect of bovines, pigs, sheep, and poultry per km2, and temperature on the incidence of impetigo, correcting for known risk factors. RESULTS Only the number of sheep at the (COROP) regional level was significant; however, this effect could not explain the regional differences. CONCLUSION The regional differences in the incidence of impetigo in children cannot be explained by the variation in the presence of farm animals or differences in temperature.
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Affiliation(s)
- R Ghotb Razmjou
- Department of General Practice, Erasmus MC-University Medical Center, Room Ff305, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
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Sandfort TGM, Bakker F, Schellevis F, Vanwesenbeeck I. Coping styles as mediator of sexual orientation-related health differences. Arch Sex Behav 2009; 38:253-63. [PMID: 17899350 DOI: 10.1007/s10508-007-9233-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2006] [Revised: 01/29/2007] [Accepted: 01/29/2007] [Indexed: 05/17/2023]
Abstract
The higher prevalence of health problems in homosexual compared to heterosexual populations is usually understood as a consequence of minority stress. We hypothesized that differential rates of health problems also could result from sexual orientation-related differences in coping styles. We explored this using data collected in a general population-based study (N = 9684) via face-to-face interviews. A higher prevalence of both mental and physical health problems, as assessed with individual questions, the GHQ-12, and checklists, was observed in homosexual compared to heterosexual men and women. Coping style was related to sexual orientation in men, but not in women. Compared to heterosexual men, homosexual men more strongly applied emotion-oriented and avoidance coping strategies. Emotion-oriented coping mediated the differences in mental and physical health between heterosexual and homosexual men. Findings suggest the importance of further exploration of the development and use of emotion-oriented and avoidance coping by homosexual men.
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Affiliation(s)
- Theo G M Sandfort
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, 1051 Riverside Drive, Unit 15, New York, NY 10032, USA.
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Roede BM, Bresser P, Prins JM, Schellevis F, Verheij TJM, Bindels PJE. Reduced risk of next exacerbation and mortality associated with antibiotic use in COPD. Eur Respir J 2008; 33:282-8. [PMID: 19047316 DOI: 10.1183/09031936.00088108] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The long-term risk of a subsequent exacerbation of chronic obstructive pulmonary disease (COPD) after treatment with oral corticosteroids without (OS) or with antibiotics (OSA) was compared in a historical general practice-based cohort. Eligible patients were >/=50 yrs of age, had a registered diagnosis of COPD, were on maintenance respiratory drugs, and had experienced at least one exacerbation defined as a prescription OS or OSA. Times to second and third exacerbations were assessed using Kaplan-Meier survival analysis; the risk of a subsequent exacerbation was assessed in a Cox proportional hazards analysis; and all-cause mortality was assessed using Kaplan-Meier survival and Cox proportional hazards analyses. A total of 842 patients had one or more exacerbations. The median time from first to second exacerbation was comparable for the OS and OSA groups, but the time from second to third exacerbation differed: 189 versus 258 days, respectively. The protective effect of OSA was most pronounced during the first 3 months following treatment (hazards ratio 0.72, 95% confidence interval 0.62-0.83). Exposure to antibiotics unrelated to a course of oral corticosteroids almost halved the risk of a new exacerbation. Mortality during follow-up was considerably lower in the OSA group. Adding antibiotics to oral corticosteroids was associated with: reduced risk of subsequent exacerbation, particularly in patients with recurrent exacerbations; and reduced risk of all-cause mortality.
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Affiliation(s)
- B M Roede
- Academic Medical Centre, University of Amsterdam, Dept of Internal Medicine, Division of Infectious Diseases, Tropical Medicine, and AIDS, Room F4-217, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
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Meerhoff TJ, MacKay WG, Meijer A, Paget WJ, Niesters HGM, Kimpen JLL, Schellevis F. The impact of laboratory characteristics on molecular detection of respiratory syncytial virus in a European multicentre quality control study. Clin Microbiol Infect 2008; 14:1173-6. [PMID: 19046164 DOI: 10.1111/j.1469-0691.2008.02100.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The performance of nucleic acid amplification techniques for detecting respiratory syncytial virus (RSV) was evaluated in 25 laboratories across Europe by an external quality assessment study. In addition, factors related to the diagnostic performance of laboratories were explored. The results of this quality control study show that the performance of laboratories for RSV diagnosis in Europe is good, with an overall correct score of 88%. The type of assay (nested or real-time PCR vs. commercial tests) was identified as a significant factor (OR 8.39; 95% CI 1.91-36.78) in predicting a correct result.
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Affiliation(s)
- T J Meerhoff
- Netherlands Institute for Health Services Research (NIVEL), EISS-Coordination Centre, Utrecht, The Netherlands.
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Jabaaij L, Fassaert T, van Dulmen S, Timmermans A, van Essen GA, Schellevis F. Familiarity between patient and general practitioner does not influence the content of the consultation. BMC Fam Pract 2008; 9:51. [PMID: 18816369 PMCID: PMC2566977 DOI: 10.1186/1471-2296-9-51] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/19/2007] [Accepted: 09/24/2008] [Indexed: 11/10/2022]
Abstract
BACKGROUND Personal continuity in general practice is considered to be a prerequisite of high quality patient care based on shared knowledge and mutual understanding. Not much is known about how personal continuity is reflected in the content of GP - patient communication. We explored whether personal continuity of care influences the content of communication during the consultation. METHODS Personal continuity was defined as the degree of familiarity between GP and patient, rated by both the GP and the patient. 394 videotaped consultations between GPs and patients aged 18 years and older were analyzed. GP - patient communication was evaluated with an observation checklist, which rated the following topics of conversation: (1) medical issues, (2) psychological themes, and (3) the social environment of the patient. For each of these topics we coded whether or not it received attention, and was built upon prior knowledge. Data were analyzed using multilevel logistic regression analyses. RESULTS No relationship was found between GP - patient familiarity and the discussion of medical issues, psychological themes, or the social environment of the patient. But if the patient and the GP knew each other very well, the GP more often displayed prior knowledge with the topic in question. Few patient and GP characteristics were associated with differences in content of communication. CONCLUSION Given the relatively small sample size, we carefully conclude that familiarity between a GP and a patient does not influence the content of the communication (medical issues, psychological themes nor topics relating to the social environment). This is remarkable because we expected that familiarity would 'open up the communication' for more psychological and social themes. GPs seem to have the communication skills to put both familiar and non-familiar patients at ease enabling them to freely raise any issue they think necessary.
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Affiliation(s)
- Lea Jabaaij
- NIVEL-Netherlands Institute for Health Services Research, Utrecht, the Netherlands.
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Fassaert T, van Dulmen S, Schellevis F, van der Jagt L, Bensing J. Raising positive expectations helps patients with minor ailments: a cross-sectional study. BMC Fam Pract 2008; 9:38. [PMID: 18590520 PMCID: PMC2459169 DOI: 10.1186/1471-2296-9-38] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/10/2007] [Accepted: 06/30/2008] [Indexed: 11/10/2022]
Abstract
BACKGROUND Consultations for minor ailments constitute a large part of the workload of general practitioners (GPs). As medical interventions are not always available, specific communication strategies, such as active listening and positive communication, might help GPs to handle these problems adequately. This study examines to what extent GPs display both strategies during consultations for minor ailments and investigates how each of these relate to the patients' perceived health, consultation frequency and medication adherence. METHODS 524 videotaped consultations between Dutch GPs and patients aged 18 years or older were selected. All patients presented a minor ailment, and none of them suffered from a diagnosed chronic illness. The observation protocol included the validated Active Listening Observation Scale (ALOS-global), as well as three domains of positive communication, i.e. providing reassurance, a clear explanation, and a favourable prognosis. Patients completed several questionnaires before, immediately after, and two weeks after the consultation. These included measures for state anxiety (STAI), functional health status (COOP/WONCA charts) and medication adherence (MAQ). Consultation frequency was available from an ongoing patient registration. Data were analysed using multivariate regression analyses. RESULTS Reassurance was related to patients' better overall health. Providing a favourable prognosis was linked to patients feeling better, but only when accompanied by a clear explanation of the complaints. A clear explanation was also related to patients feeling better and less anxious, except when patients reported a low mood pre-visit. Active listening alone was positively associated with patients feeling worse. Among patients in a good mood state, active listening was associated with less adherence. CONCLUSION To some extent, it seems helpful when GPs are at the same time clear and optimistic about the nature and course of minor ailments. Yet, it does not seem helpful always and in all cases, e.g. when patients feel low upon entering the consulting room. Although communication strategies might to some extent contribute to the management of minor ailments, the results of this observational study also indicate that it is important for a physician to pay attention to the mood of the patient who enters the consulting room.
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Affiliation(s)
- Thijs Fassaert
- NIVEL (Netherlands Institute for Health Services Research), Utrecht, The Netherlands.
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Rosman S, Le Vaillant M, Schellevis F, Clerc P, Verheij R, Pelletier-Fleury N. Prescribing patterns for upper respiratory tract infections in general practice in France and in the Netherlands. Eur J Public Health 2008; 18:312-6. [DOI: 10.1093/eurpub/ckm118] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Bensing JM, Tromp F, van Dulmen S, van den Brink-Muinen A, Verheul W, Schellevis F. De zakelijke huisarts en de niet-mondige patiënt: veranderingen in communicatie. ACTA ACUST UNITED AC 2008. [DOI: 10.1007/bf03086628] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Fassaert T, van Dulmen S, Schellevis F, Bensing J. Active listening in medical consultations: development of the Active Listening Observation Scale (ALOS-global). Patient Educ Couns 2007; 68:258-64. [PMID: 17689042 DOI: 10.1016/j.pec.2007.06.011] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2007] [Revised: 06/13/2007] [Accepted: 06/23/2007] [Indexed: 05/09/2023]
Abstract
OBJECTIVE Active listening is a prerequisite for a successful healthcare encounter, bearing potential therapeutic value especially in clinical situations that require no specific medical intervention. Although generally acknowledged as such, active listening has not been studied in depth. This paper describes the development of the Active Listening Observation Scale (ALOS-global), an observation instrument measuring active listening and its validation in a sample of general practice consultations for minor ailments. METHODS Five hundred and twenty-four videotaped general practice consultations involving minor ailments were observed with the ALOS-global. Hypotheses were tested to determine validity, incorporating patients' perception of GPs' affective performance, GPs' verbal attention, patients' self-reported anxiety level and gender differences. RESULTS The final 7-item ALOS-global had acceptable inter- and intra-observer agreement. Factor analysis revealed one homogeneous dimension. The scalescore was positively related to verbal attention measured by RIAS, to patients' perception of GPs' performance and to their pre-visit anxiety level. Female GPs received higher active listening scores. CONCLUSION The results of this study are promising concerning the psychometric properties of the ALOS-global. More research is needed to confirm these preliminary findings. PRACTICE IMPLICATIONS After establishing how active listening differentiates between health professionals, the ALOS-global may become a valuable tool in feedback and training aimed at increasing listening skills.
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Affiliation(s)
- Thijs Fassaert
- NIVEL (Netherlands Institute for Health Services Research), Utrecht, the Netherlands
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Verkaik R, Nuyen J, Schellevis F, Francke A. The relationship between severity of Alzheimer's disease and prevalence of comorbid depressive symptoms and depression: a systematic review. Int J Geriatr Psychiatry 2007; 22:1063-86. [PMID: 17457960 DOI: 10.1002/gps.1809] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVES To gain more insight into the association between severity of Alzheimer's Disease (AD) and prevalence of comborbid depression. METHODS A systematic literature review based on the Cochrane methodology was performed. PubMed, PsychINFO and EMBASE databases were searched for existing studies that fulfilled predefined inclusion criteria. The studies were divided into: (1) those that analysed the association between severity of AD and prevalence of depressive symptoms ('continuous' approach) and (2) those that investigated the association between severity of AD and diagnosed depression ('categorical' approach). The quality of existing studies was rated and the results were synthesized with a best evidence synthesis. RESULTS Twenty-four studies fulfilled the inclusion criteria. Nineteen reported results for a continuous approach and seven for a categorical approach. Three of the four high quality studies within the continuous approach did not find a significant association between severity of AD and prevalence of depressive symptoms. None of the three high quality studies using the categorical approach found a significant association between the severity of AD and the prevalence of diagnosed depression. CONCLUSIONS There is evidence for a lack of association between the severity of AD and the prevalence of comorbid depressive symptoms or diagnosed depression. Until new studies contradict this conclusion, prevention and intervention strategies for comorbid depression in AD should be aimed at all patients irrespective their disease severity.
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Borgsteede SD, Deliens L, Beentjes B, Schellevis F, Stalman WAB, Van Eijk JTM, Van der Wal G. Symptoms in patients receiving palliative care: a study on patient-physician encounters in general practice. Palliat Med 2007; 21:417-23. [PMID: 17901101 DOI: 10.1177/0269216307079821] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Most people with an incurable disease prefer to stay and die at home, cared for by their general practitioner (GP). This paper aims at describing the prevalence of symptoms in patients receiving palliative care at home. Within the framework of a nation wide survey of general practice in the Netherlands, GPs received a questionnaire for all patients who died within the 1-year survey period to determine whether patients received palliative care (n = 2,194). The response rate was 73% (n = 1,608), and 38% of these patients received palliative care until death. Information regarding encounters during the last 3 months of life was derived from the records kept by the GPs. Digestive symptoms (59%) and pain (56%) were the most prevalent. The total number of symptoms per patient was higher in cancer patients (11.99) than in non-cancer patients (7.62). Not reported in previous studies were musculoskeletal symptoms (20%) and chronic ulcer (18%). Concluding, this showed that Dutch GPs encounter a diversity and wide range of symptoms in palliative care. To face these complex challenges in patients receiving palliative care at home, GPs have to be trained as well as supported by specialized palliative care consultants.
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Affiliation(s)
- Sander D Borgsteede
- VU University Medical Center, Department of Public and Occupational Health, EMGO Institute, Amsterdam, The Netherlands.
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