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Samenvatting Van der Weegen S, Verwey R, Spreeuwenberg M, Tange H, Van der Weijden T, De Witte L. Technologie om de fysieke activiteit te verhogen. Huisarts Wet 2016;59(6):248-52.

Background: Chronic obstructive pulmonary disease (COPD) is underdiagnosed in general practice. Our aim was to implement a population-based approach for the early detection of COPD and to assess its impact on primary care workload and costs, and the influence of socioeconomic status (SES). Methods: An observational study with mixed methods was performed in 10 Dutch general practices of either low or moderate to high SES. The Respiratory Health Screening Questionnaire was posted during a three-month period to all persons aged 45, 55, and 65 years (one age group per month). The practices calculated the risk, and patients at high risk of COPD were invited for spirometry at the practice. The general practitioner used the spirometric results and a consultation to establish a clinical diagnosis. Qualitative and quantitative data on workload, cost, and barriers were evaluated. Results: Ten practices returned 293 (35.3%) COPD risk tests for the three age groups. Participants from low SES practices responded better than those from moderate to high SES practices (40.8% vs. 30.5%). In practices with low SES 17.9% of the tests indicated high risk compared with 16.1% in practices with moderate to high SES. Nine patients (23%) were newly diagnosed with COPD. The healthcare providers' extra workload averaged 18.5 hours during the three months for one standard practice. The average cost of this survey programme (three age groups in three months) was (sic)520 for low SES practices and (sic)398 for moderate to high SES practices. All healthcare providers affirmed that the extra workload in this survey model is acceptable and feasible when finances are compensated. Conclusions: Early detection of COPD is feasible in daily life primary care. In moderate to high SES practices the costs of detecting COPD were less than in low SES practices.

Doel: Empirisch inzicht verkrijgen in de rol van gebruikersparticipatie bij het ontwerp van een website met CQI-keuzeinformatie. Dit is informatie over patientenervaringen in zorginstellingen. Methode: Op basis van literatuurstudie en eenexpert panel werd een papieren ontwerp voor een CQI-website voor electieve heup- en knieoperaties gemaakt. Dit ontwerp werd aangepast op basis van een kwalitatief-descriptieve studie onder 18 consumenten die recentelijk (