17 results on '"van Schayck, Onno C. P."'
Search Results
2. Effectiveness of intensive practice nurse counselling versus brief general practitioner advice, both combined with varenicline, for smoking cessation: a randomized pragmatic trial in primary care
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van Rossem, Carolien, Spigt, Mark, Viechtbauer, Wolfgang, Lucas, Annelies E. M., van Schayck, Onno C. P., Kotz, Daniel, Promovendi PHPC, Family Medicine, RS: CAPHRI - R5 - Optimising Patient Care, RS: MHeNs - R2 - Mental Health, Psychiatrie & Neuropsychologie, and Huisartsgeneeskunde
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pragmatic trial ,tobacco ,smoking cessation ,counselling ,COST-EFFECTIVENESS ,primary care ,varenicline ,ADHERENCE ,Brief advice ,CLINICAL-PRACTICE ,DEPENDENCE ,SUSTAINED-RELEASE BUPROPION ,practice nurse ,RECEPTOR PARTIAL AGONIST ,PREDICTORS ,POPULATION ,LIGHT SMOKERS ,INTERVENTIONS - Abstract
Aims To study the effectiveness of intensive counselling by a practice nurse (PN) versus brief advice by a general practitioner (GP), each combined with pharmacotherapy, for 6 months' tobacco abstinence (primary outcome). Secondary outcomes included 12-month abstinence, medication adherence and incremental costs per life-year gained. Design A multi-site (n=10), two-group, parallel, pragmatic randomized controlled trial. Setting A network of primary health-care centres in the Netherlands. Participants A total of 295 adult daily smokers (mean age=48 years; mean cigarettes/day=19). Intervention and comparator Patients were randomized to receive individual counselling by a practice nurse (PN) (n=149) or brief advice by a general practitioner (GP) (146). All patients received 12 weeks of open-label varenicline. Measurements The primary outcome was prolonged biochemically validated abstinence from weeks 9 to 26 after treatment initiation. Secondary outcomes included abstinence from weeks 9 to 52, good dosing adherence (>80%days taken) and incremental costs per life-year gained. Findings Abstinence rates in the PN versus GP groups were 32.2% (n=48) versus 39.0% [n=57; odds ratio (OR)=0.71; 95% confidence interval (CI)=0.44-1.16] from weeks 9 to 26 and 25.5% (n=38) versus 28.8% (n=42; OR=0.84, 95% CI=0.50-1.43) from weeks 9 to 52, respectively. Values of the Bayes factor indicated that the PN and GP were equally effective. Good dosing adherence was significantly lower in the PN (45.5%, n=56/123) than in the GP group (62.0%, n=75/121; OR=0.45, 95% CI=0.26-0.77), and the incremental costs per life-year gained were -(sic) 416.10. Conclusions Among people seeking help to stop smoking from their general practice, one-off brief advice from a general practitioner appears to be as effective as several sessions of behavioural support from a practice nurse when smoking cessation medication is provided.
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- 2017
3. Global strategies for reducing the burden from asthma A report of a lecture given at The University of Edinburgh, Edinburgh, UK, October 1st 2012
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van Schayck, Onno C. P., Family Medicine, and RS: CAPHRI School for Public Health and Primary Care
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primary care ,research ,prevention ,diagnosis ,case finding ,global burden ,prevalence ,Asthma - Abstract
Asthma is one of the most important chronic diseases in childhood. For several decades, a steady increase in prevalence has been observed worldwide. In the structural collaboration between the Centre for Population Health Services in Edinburgh and the Research Institute CAPHRI of Maastricht we investigated the possibilities for primary prevention of asthma in childhood. We found that a multifaceted approach might be effective in delaying or preventing asthma, whereas a mono-intervention does not seem to have such a protective effect. The most likely explanation is that the development of a multifactorial disease, such as asthma, is extremely difficult, if not impossible, to prevent by eliminating only one risk factor. Underdiagnosis of asthma is still a big problem in primary care. Most patients do not present bronchial symptoms to the general practitioner, even though they have decreased lung function, so they remain unknown and undiagnosed. However, patients who do present with respiratory problems and who have reduced lung function are not always recognised as such. We found that the perception of dyspnoea seems to determine, at least in part, the presentation to the general practitioner with symptoms. These observations show that both the prevention of the development of asthma in early childhood, as well as case finding of asthma in adulthood, do not seem to be very effective in primary care. More research is needed to clarify what steps can be taken to reduce the global burden from asthma.
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- 2013
4. Prevention of asthma in genetically susceptible children: A multifaceted intervention trial focussed on feasibility in general practice
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Maas, Tanja, Dompeling, Edward, Muris, Jean W. M., Wesseling, Geertjan, Knottnerus, J. Andre, van Schayck, Onno C. P., Family Medicine, Kindergeneeskunde, Pulmonologie, and RS: CAPHRI School for Public Health and Primary Care
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primary care ,childhood asthma ,randomized trials ,environment ,feasibility - Abstract
Background: Although the effectiveness of the multifaceted allergen-reducing interventions for the prevention of asthma in susceptible children was showed to be proven, the feasibility was not clear. Methods: The research question of the PREVention of asthma in susceptible children (PREVASC) trial was focused on the assessment of the effectiveness and feasibility of a multifaceted intervention on the prevention of allergic asthma in general practice. The effectiveness and feasibility of an intervention aimed at the simultaneous reduction in the environmental exposures to inhalant- and food allergens in susceptible children was investigated. A total of 476 children susceptible for developing asthma were initially included during pregnancy and were randomly divided over an intervention group of n = 222 children whose parents were offered a multifaceted environmental exposurereducing intervention. Controls (n = 221) received usual care. The main outcome was diagnosis of allergic asthma at age 6. Results: A significant reduction in inhalant allergen exposure levels of house dust mite [(Der p1), p = 0.043], cat [(Fel d1), p = 0.037], and dog [(Can f1), p = 0.012] was reached. Significantly more intervention group children started using cows milk and solids after the age of 6 months (p = 0.001). No statistical difference, however, was reached between groups on the duration of breast-feeding (p = 0.635) and the reduction in smoke exposure (p = 0829). At age 6, the intervention had no influence on the development of main outcome allergic asthma (OR = 1.010 (CI 0.5801.758). Conclusion: Other primary preventive asthma-reducing interventions were shown to be effective in reducing the occurrence of asthma for at least the first 78 yr of life. The multifaceted PREVASC allergic asthma primary preventive intervention was effective in reducing the exposure to inhalant and food allergens, but was not feasible for the parents. A lack of sufficient room for improvement focus on stimulating adherence seemed to be involved. It is suggested that a multifaceted environmental exposurereducing intervention may have to be adapted to the personal circumstances of patients at baseline.
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- 2011
5. Early intervention for chronic obstructive pulmonary disease by practice nurse and GP teams: a cluster randomized trial.
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Zwar, Nicholas A., Bunker, Jeremy M., Reddel, Helen K., Dennis, Sarah M., Middleton, Sandy, van Schayck, Onno C. P., Crockett, Alan J., Hasan, Iqbal, Hermiz, Oshana, Vagholkar, Sanjyot, Wei Xuan, Marks, Guy B., and Xuan, Wei
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OBSTRUCTIVE lung disease treatment ,EARLY medical intervention ,FAMILY medicine ,NURSING ,QUALITY of life ,RANDOMIZED controlled trials ,INFLUENZA prevention ,OBSTRUCTIVE lung disease diagnosis ,NURSING education ,COMPARATIVE studies ,HEALTH attitudes ,HEALTH care teams ,IMMUNIZATION ,OBSTRUCTIVE lung diseases ,RESEARCH methodology ,MEDICAL cooperation ,MEDICAL protocols ,NURSES ,CONTINUING education of nurses ,PHYSICIANS ,QUESTIONNAIRES ,RESEARCH ,RESPIRATORY measurements ,SMOKING ,CONTINUING medical education ,OCCUPATIONAL roles ,EVALUATION research ,VITAL capacity (Respiration) ,BLIND experiment - Abstract
Background: Early detection and intervention for chronic obstructive pulmonary disease (COPD) could potentially slow disease progress and minimize harm.Objectives: To assess the effectiveness of early intervention by a practice nurse-GP team on quality of life (QoL) and process of care in patients with newly diagnosed COPD, compared with usual care. Nurses and GPs in intervention practices were educated to develop and implement disease management plans for COPD.Methods: A 12-month, multicentre, pragmatic randomized controlled trial with blinded outcome assessment was conducted. Participants were current and former smokers aged 40 to 85 years newly identified as having COPD on post-bronchodilator spirometry. The primary outcome was health-related QoL, assessed with the St George's Respiratory Questionnaire (SGRQ). Secondary outcome measures were other QoL measures, lung function, disease knowledge, smoking and immunization status, inhaler technique and health service use.Results: Of the 10 234 patients from 36 practices in Sydney invited to a case-finding appointment, 1641 (16%) attended and 287 (18%) were diagnosed with COPD. Nineteen practices (144 patients) were randomized to the intervention group and 17 practices (110 patients) to the control group. Only 15.3% (n = 22) patients in the intervention group saw the nurse for COPD care following case finding. There was no between-group difference in SGRQ score at follow-up (mean difference -0.21; P = 0.86). Influenza vaccination was higher in the intervention group (OR 2.31: P = 0.035), but there were no other significant between-group differences in outcomes.Conclusion: Intervention uptake was low and had no additional beneficial effect, over usual care, on participants' health-related QoL. [ABSTRACT FROM AUTHOR]- Published
- 2016
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6. Efficacy of a physical exercise training programme COPD in primary care: study protocol of a randomized controlled trial.
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Fastenau, Annemieke, Muris, Jean W. M., de Bie, Rob A., Hendriks, Erik J. M., Asijee, Guus M., Beekman, Emmylou, Gosselink, Rik, and van Schayck, Onno C. P.
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EXERCISE ,ALTERNATIVE treatment for obstructive lung disease ,PRIMARY care ,MUSCLE weakness ,RANDOMIZED controlled trials - Abstract
Background: Chronic obstructive pulmonary disease (COPD) is recognized as a systemic illness with significant extra-pulmonary features, such as exercise intolerance and muscle weakness. Pulmonary rehabilitation has been shown to be very effective in counteracting these consequences in patients with more advanced COPD. However, limited data is available on the efficacy of a physical exercise training programme in patients with mild to moderate COPD in primary care. Furthermore, it is unknown if improved exercise capacity translates into enhanced daily physical activities. The aim of this paper is to describe the design of a randomized controlled trial to assess the efficacy of a physical exercise training programme in patients with mild to moderate COPD. Methods/design: In this randomized controlled trial situated in the primary care setting, 102 patients with mild to moderate airflow obstruction (FEV1 ≥ 50% of predicted), dyspnoea and a physically inactive lifestyle will be randomized to an intervention or control group. The intervention group receives a 4-month physical exercise training programme at a local physiotherapy practice, which includes exercise training, resistance training, breathing exercises and advises on how to increase the level of physical activity. The control group receives usual care, i.e. advises on how to increase the level of physical activity and a sham treatment at a local physiotherapy practice of which no physiological training stimulus can be expected. Primary outcome is functional exercise capacity at 4-months measured on the six-minute walk distance. Secondary outcomes include peripheral muscle strength, physical activity in daily life, health related quality of life, Medical Research Council (MRC) dyspnoea score and patients' perceived effectiveness. Follow-up measurement will take place at 6 months after baseline. Discussion: This will be one of the first studies to evaluate the efficacy of a physical exercise training programme in patients with mild to moderate COPD completely recruited and assessed in primary care. The results of this trial may give a unique insight into the potential of the implementation of an easy, close-to-home rehabilitation programme. [ABSTRACT FROM AUTHOR]
- Published
- 2014
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7. Validation of the COPD Diagnostic Questionnaire in an Australian general practice cohort: a cross-sectional study.
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Stanley, Anthony J., Hasan, Iqbal, Crockett, Alan J., van Schayck, Onno C. P., and Zwar, Nicholas A.
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- 2014
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8. Discrepancy between functional exercise capacity and daily physical activity: a cross-sectional study in patients with mild to moderate COPD.
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Fastenau, Annemieke, van Schayck, Onno C. P., Gosselink, Rik, Aretz, Karin C. P. M., and Muris, Jean W. M.
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OBSTRUCTIVE lung diseases ,PRIMARY care ,PHYSICAL fitness ,EXERCISE ,PHYSICAL activity - Abstract
Background: In patients with moderate to severe chronic obstructive pulmonary disease (COPD) the six-minute walk distance reflects the functional exercise level for daily physical activity. It is unknown if this also applies to patients with mild to moderate COPD in primary care. Aims: To assess the relationship between functional exercise capacity and physical activity in patients with mild to moderate COPD. Methods: A cross-sectional study was performed in 51 patients with mild to moderate COPD in primary care. Functional exercise capacity was assessed by the six-minute walk test and physical activity was measured with an accelerometer-based activity monitor. Results: Functional exercise capacity was close to normal values. However, the daily physical activity of the patients could be classified as 'sedentary' and 'low active'. No significant correlations were observed between six-minute walk distance (% predicted) and any of the physical activity variables (steps per day, movement intensity during walking, total active time, total walking time, physical activity level, and time spent in moderate physical activity). Conclusions: A discrepancy was found between functional exercise capacity and daily physical activity in patients with mild to moderate COPD recruited and assessed in primary care. We conclude that these variables represent two different concepts. Our results reinforce the importance of measuring daily physical activity in order to fine-tune treatment (i.e. focusing on enhancement of exercise capacity or behavioural change, or both). [ABSTRACT FROM AUTHOR]
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- 2013
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9. Early detection of COPD in general practice: patient or practice managed? A randomised controlled trial of two strategies in different socioeconomic environments.
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Dirven, Joseph A. M., Tange, Huibert J., Muris, Jean W. M., van Haaren, Karin M. A., Vink, Gerrit, and van Schayck, Onno C. P.
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HEALTH risk assessment ,OBSTRUCTIVE lung diseases ,EMPLOYER-sponsored health insurance ,SOCIOECONOMIC factors ,MEDICAL screening ,PULMONARY function tests ,PRIMARY care - Abstract
Background: The burden of chronic obstructive pulmonary disease (COPD) is high. Health benefits can be gained in primary care by early detection and preventive measures. Aims: To compare the effectiveness of two strategies for population-based early detection of COPD, taking into account different socioeconomic status (SES) settings. Methods: Practices were randomised on strategy and stratified on SES setting. The Respiratory Health Screening Questionnaire (RHSQ) was distributed to all participants. In the practice-managed condition, the practice was responsible for the whole procedure, while in the patient-managed condition, patients were responsible for calculating their RHSQ risk score and applying for a spirometry test. The main outcome measure was the rate of COPD diagnoses after screening. Results: More new COPD patients were detected in the practice-managed condition (36%) than in the patient-managed condition (18%). In low SES practices, more high-risk patients were found (16%) than in moderate-to-high SES practices (9%). Recalculated for a standard Dutch practice (2,350 patients), the yield would be 8.9 new COPD diagnoses, which is a 20% increase of known cases. Conclusions: The practice-managed variant of this screening procedure shows a substantial yield of new COPD diagnoses for both low and moderate-to-high SES practices. [ABSTRACT FROM AUTHOR]
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- 2013
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10. Early detection of COPD in general practice: implementation, workload and socioeconomic status. A mixed methods observational study.
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Dirven, Joseph A. M., Tange, Huibert J., Muris, Jean W. M., van Haaren, Karin M. A., Vink, Gerrit, and van Schayck, Onno C. P.
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EARLY diagnosis ,OBSTRUCTIVE lung diseases ,GENERAL practitioners ,FAMILY medicine ,SOCIAL status ,PRIMARY care - Abstract
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 €520 for low SES practices and €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. [ABSTRACT FROM AUTHOR]
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- 2013
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11. Rimonabant improves obesity but not the overall cardiovascular risk and quality of life; results from CARDIO-REDUSE (CArdiometabolic Risk reDuctIOn by Rimonabant: the Effectiveness in Daily practice and its USE).
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Boesten, Jolien E J, Kaper, Janneke, Stoffers, Henri E J H, Kroon, Abraham A, and van Schayck, Onno C P
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RIMONABANT ,OVERWEIGHT persons ,DRUG side effects ,FAMILY medicine ,CARDIOVASCULAR diseases risk factors ,MEDICAL consultation ,QUALITY of life ,CLINICAL trials - Abstract
Background Rimonabant treatment, examined in Phase 3 trials, showed improvement of cardiovascular risk factors in obese patients. Objective The objective of this Phase 4 trial is to assess the effectiveness of rimonabant plus lifestyle counselling when used in daily practice, namely in the general practice. The hypothesis was that the effectiveness in Phase 4 would be smaller than the efficacy in Phase 3 due to different patient selection and treatment conditions. At the end of this trial, rimonabant was suspended of all markets due to psychiatric side effects. Methods This trial randomly assigned 222 patients with enlarged waist circumferences and hyperglycaemia or diabetes mellitus type 2, recruited from Dutch general practices, to double-blinded therapy with either placebo or rimonabant (20 mg/day) for 1 year in addition to lifestyle counselling. Results Compared with placebo, the rimonabant group showed significant improvements in body weight, body mass index, high-density lipoprotein (HDL) cholesterol and the main outcome waist circumference after 1 year. The United Kingdom Prospective Diabetes Study risk calculation showed no significant difference. The rimonabant group showed statistically deterioration, compared with the placebo group, in the quality of life in the EuroQol and two domains of the SF-36: role limitations due to physical health problems and bodily pain. Conclusions The unique real life data of this Phase 4 trial showed that the effectiveness of rimonabant in daily practice is indeed lower than in controlled circumstances (Phase 3). Rimonabant treatment showed improvement of obesity and the HDL cholesterol, but had no positive effect on the other cardiovascular risk factors and the quality of life. [ABSTRACT FROM AUTHOR]
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- 2012
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12. How do dyspnoea scales compare with measurement of functional capacity in patients with COPD and at risk of COPD?
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Boer, Lonneke M., Asijee, Guus M., Van Schayck, Onno C. P., and Schermer, Tjard R. J.
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DYSPNEA ,PRIMARY care ,OBSTRUCTIVE lung diseases ,ANALYSIS of variance ,ASTHMA - Abstract
Background: In primary care, formal functional capacity testing is not always feasible. Guidelines for family practitioners suggest the use of dyspnoea scales to assess exercise tolerance in patients with chronic obstructive pulmonary disease (COPD). Aims: To examine whether the use of activity-based dyspnoea scales can substitute for actual functional capacity testing. Methods: 128 subjects (49% at risk of COPD, 24% GOLD stage I, 17% GOLD stage II, 9% GOLD stage III) performed an Incremental Shuttle Walk Test (ISWT) and completed the Medical Research Council dyspnoea scale (MRC), Baseline Dyspnoea Index (BDI), Oxygen Cost Diagram (OCD), Clinical COPD Questionnaire (CCQ), and St George's Respiratory Questionnaire (SGRQ). Results: Analysis of variance showed that the relationship between the ISWT and the MRC dyspnoea scale was statistically significant but moderate (p<0.001, R
2 =0.166). Correlations between the ISWT and the other dyspnoea scales were also moderate (correlation coefficients 0.34-0.42). Combining the dyspnoea scales in one analysis resulted in a proportion of explained variance of the ISWT of 21.4% (R2 =0.214). Conclusions: Dyspnoea scales cannot substitute for formal functional capacity testing. Authors of COPD guidelines should consider stating more specifically that the MRC and similar scales measure (self-reported) activity-related dyspnoea but cannot replace objectively measured functional capacity. [ABSTRACT FROM AUTHOR]- Published
- 2012
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13. Care delivery pathways for Chronic Obstructive Pulmonary Disease in England and the Netherlands: a comparative study.
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Utens, Cecile M. A., Maarse, J. A. M., Van Schayck, Onno C. P., Maesen, Boudewijn L. P., Rutten, Maureen P. M. H., and Smeenk, Frank W. J. M.
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PUBLIC health administration ,OBSTRUCTIVE lung diseases patients ,COMPARATIVE studies ,PRIMARY care ,DISEASE exacerbation - Abstract
Introduction: A remarkable difference in care delivery pathways for Chronic Obstructive Pulmonary Disease (COPD) is the presence of hospital- at-home for COPD exacerbations in England and its absence in the Netherlands. The objective of this paper is to explain this difference. Methods: Descriptive COPD statistics and care delivery pathways on all care levels within the institutional context, followed by a comparison of care delivery pathways and an explanation of the difference with regard to hospital-at-home. Results: The Netherlands and England show broad similarities in their care delivery pathways for COPD patients. A major difference is the presence of hospital-at-home for COPD exacerbations in England and its absence in the Netherlands. Three possible explanations for this difference are presented: differences in the urgency for alternatives (higher urgency for alternative treatment models in England), the differences in funding (funding in England facilitated the development of hospital-at-home) and the differences in the substitution of tasks to nurses (substitution to nurses has taken place to a larger extent in England). Discussion and Conclusion: The difference between the Netherlands and England regarding hospital-at-home for COPD exacerbations can be explained in three ways. Hospital-at-home has proved to be a safe alternative for hospital care for selected patients, and should be considered as a treatment option for COPD exacerbations in the Netherlands. [ABSTRACT FROM AUTHOR]
- Published
- 2012
14. Diagnostic assessments of spirometry and medical history data by respiratory specialists supporting primary care: are they reliable?
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Lucas, Annelies E. M., Smeenk, Frank J. W. M., van den Borne, Ben E. E. M., Smeele, Ivo J. M., and van Schayck, Onno C. P.
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SPIROMETRY ,PRIMARY care ,RESPIRATORY therapists ,ASTHMATICS ,OBSTRUCTIVE lung diseases patients - Abstract
Aim: To determine the intra- and inter-observer reliability of respiratory specialists' diagnostic assessments of spirometry and written medical history data obtained from primary care. Method: Five respiratory specialists assessed spirometry data and the history of 156 patients randomly selected from referrals to an asthma/COPD-service. The inter-observer reliability was evaluated. After six months, all specialists repeated the assessments and the intraobserver reliability was evaluated. Results: The diagnostic assessments for all patients had reasonable intra- and inter-observer reliability, resulting in a Cohen's kappa (κ) of 0.67 and 0.66 respectively. The intra-observer reliability for assessing the need for additional diagnostic examinations had an average κ 0.56 for new patients and an average κ 0.39 for follow-up examinations. The assessments of clinical stability in follow-up patients - on which therapeutic advice was based - were inconsistent. Conclusion: GPs who are reluctant to perform or interpret spirometry themselves may be supported diagnostically by respiratory specialists in an asthma/COPD-service. The reliability of this advice varies. More appropriate criteria for assessing clinical stability in patients with asthma and COPD are necessary to improve the reliability of the therapeutic advice. [ABSTRACT FROM AUTHOR]
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- 2009
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15. IPCRG Consensus statement: Tackling the smoking epidemic - practical guidance for primary care.
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van Schayck, Onno C. P., Pinnock, Hilary, Ostrem, Anders, Litt, John, Tomlins, Ron, Williams, Siân, Johan Buffels, Giannopoulosh, Dimitri, Henrichsen, Svein, Kaper, Janneke, Korzh, Oleksiy, Rodriguez, Ana Morán, Kawaldip, Sehmi, Zwar, Nick, and Yaman, Hakan
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TOBACCO use ,EARLY death ,DISABILITIES ,NICOTINE ,SMOKING cessation ,PRIMARY care - Abstract
Tobacco use will become the world's foremost cause of premature death and disability within 20 years unless current trends are reversed. Many opportunities to reduce this epidemic are missed in primary care. This Discussion paper from the International Primary Care Respiratory Group (IPCRG) - which reflects the IPCRG's understanding of primary care practitioners' needs - summarises a new approach based on strong evidence for effective interventions. All primary care health professionals can increase smoking cessation rates among their patients, even when time and resources are limited. Medical and non-medical staff can support patients who choose to quit by providing information, referral to telephone counselling services, and behavioural counselling using motivational interviewing techniques, where resources permit. Drug therapy to manage nicotine dependence can significantly improve patients' chances of quitting successfully, and is recommended for people who smoke 10 or more cigarettes per day. All interventions should be tailored to the individual's circumstances and attitudes. [ABSTRACT FROM AUTHOR]
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- 2008
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16. Interpreting the diagnostic accuracy of tools for early detection of COPD.
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Kotz, Daniel and van Schayck, Onno C. P.
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OBSTRUCTIVE lung disease diagnosis ,PRIMARY care ,FLOW meters ,QUESTIONNAIRES ,DIAGNOSTIC examinations - Abstract
The authors reflect on research which examined the diagnostic accuracy of the International Primary Care Airways Group (IPAG) questionnaire and the PiKo-6 expiratory flow meter for early detection of chronic obstructive pulmonary disease (COPD) in primary care. They indicate that most diagnostic tests do not combine both a perfect specificity (SP) and sensitivity (SN) at the same time. They mention that the research showed that early detection of COPD is possible by using the said tools.
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- 2011
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17. The first reference equations for the 6-minute walk distance over a 10 m course.
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Beekman, Emmylou, Mesters, Ilse, Gosselink, Rik, Klaassen, Mariska P. M., Hendriks, Erik J. M., Van Schayck, Onno C. P., and de Bie, Rob A.
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PRIMARY care ,WALKING ,OBSTRUCTIVE lung diseases patients ,CROSS-sectional method ,MULTIPLE regression analysis ,BODY mass index ,HEART beat - Abstract
Rationale As primary care practice space is mostly limited to 10 m, the 6-minute walk test (6MWT) over a 10 m course is a frequently used alternative to evaluate patients' performance in COPD. Considering that course length significantly affects distance walked in 6 minutes (6MWD), this study aims to develop appropriate reference equations for the 10 m 6MWT. Methods 181 healthy subjects, aged 40- 90 years, performed two standardised 6MWTs over a straight 10 m course in a cross-sectional study. Results Average distance achieved was 578±108 m and differed between males and females (p<0.001). Resulting sex-specific reference equations from multiple regression analysis included age, body mass index and change in heart rate, explaining 62% of the variance in 6MWD for males and 71% for females. Conclusions The presented reference equations are the first to evaluate 6MWD over a 10 m course and expand the usefulness of the 6MWT. [ABSTRACT FROM AUTHOR]
- Published
- 2014
- Full Text
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