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2. POS0017 SUCCESSFUL THERAPEUTIC DRUG MONITORING BASED ADALIMUMAB DOSE REDUCTION IN RHEUMATOID ARTHRITIS PATIENT WITH LOW DISEASE ACTIVITY (ADDORA-LOW): A SINGLE BLIND, NON-INFERIORITY, RANDOMIZED CLINICAL TRIAL

Author

Atiqi, S., primary, Wientjes, M. H. M., additional, Leeuw, M., additional, Boekel, L., additional, Hooijberg, F., additional, Loeff, F., additional, Krieckaert, C., additional, De Vries, A., additional, Nurmohamed, M., additional, Rispens, T., additional, Boers, M., additional, Van den Bemt, B., additional, Den Broeder, A. A., additional, and Wolbink, G. J., additional

Published
2024
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3. T cell activation markers CD38 and HLA-DR indicative of non-seroconversion in anti-CD20-treated patients with multiple sclerosis following SARS-CoV-2 mRNA vaccination.

Author

Verstegen, NJM, Hagen, RR, Kreher, C, Kuijper, LH, Dijssel, JVD, Ashhurst, T, Kummer, LYL, Palomares Cabeza, V, Steenhuis, M, Duurland, MC, Jongh, RD, Schoot, CEVD, Konijn, VAL, Mul, E, Kedzierska, K, van Dam, KPJ, Stalman, EW, Boekel, L, Wolbink, G, Tas, SW, Killestein, J, Rispens, T, Wieske, L, Kuijpers, TW, Eftimov, F, van Kempen, ZLE, van Ham, SM, Ten Brinke, A, van de Sandt, CE, T2B! immunity against SARS-CoV-2 study group, Verstegen, NJM, Hagen, RR, Kreher, C, Kuijper, LH, Dijssel, JVD, Ashhurst, T, Kummer, LYL, Palomares Cabeza, V, Steenhuis, M, Duurland, MC, Jongh, RD, Schoot, CEVD, Konijn, VAL, Mul, E, Kedzierska, K, van Dam, KPJ, Stalman, EW, Boekel, L, Wolbink, G, Tas, SW, Killestein, J, Rispens, T, Wieske, L, Kuijpers, TW, Eftimov, F, van Kempen, ZLE, van Ham, SM, Ten Brinke, A, van de Sandt, CE, and T2B! immunity against SARS-CoV-2 study group

Abstract

BACKGROUND: Messenger RNA (mRNA) vaccines provide robust protection against SARS-CoV-2 in healthy individuals. However, immunity after vaccination of patients with multiple sclerosis (MS) treated with ocrelizumab (OCR), a B cell-depleting anti-CD20 monoclonal antibody, is not yet fully understood. METHODS: In this study, deep immune profiling techniques were employed to investigate the immune response induced by SARS-CoV-2 mRNA vaccines in untreated patients with MS (n=21), OCR-treated patients with MS (n=57) and healthy individuals (n=30). RESULTS: Among OCR-treated patients with MS, 63% did not produce detectable levels of antibodies (non-seroconverted), and those who did have lower spike receptor-binding domain-specific IgG responses compared with healthy individuals and untreated patients with MS. Before vaccination, no discernible immunological differences were observed between non-seroconverted and seroconverted OCR-treated patients with MS. However, non-seroconverted patients received overall more OCR infusions, had shorter intervals since their last OCR infusion and displayed higher OCR serum concentrations at the time of their initial vaccination. Following two vaccinations, non-seroconverted patients displayed smaller B cell compartments but instead exhibited more robust activation of general CD4+ and CD8+ T cell compartments, as indicated by upregulation of CD38 and HLA-DR surface expression, when compared with seroconverted patients. CONCLUSION: These findings highlight the importance of optimising treatment regimens when scheduling SARS-CoV-2 vaccination for OCR-treated patients with MS to maximise their humoral and cellular immune responses. This study provides valuable insights for optimising vaccination strategies in OCR-treated patients with MS, including the identification of CD38 and HLA-DR as potential markers to explore vaccine efficacy in non-seroconverting OCR-treated patients with MS.

Published
2024

4. Suppressed IgG4 class switching in dupilumab- and TNF inhibitor-treated patients after mRNA vaccination

Author

Valk, AM, Keijser, JBD, van Dam, KPJ, Stalman, EW, Wieske, L, Steenhuis, M, Kummer, LYL, Spuls, PI, Bekkenk, MW, Musters, AH, Post, NF, Bosma, AL, Horváth, B, Hijnen, DJ, Schreurs, CRG, van Kempen, ZLE, Killestein, J, Volkers, AG, Tas, SW, Boekel, L, Wolbink, GJ, Keijzer, S, Derksen, NIL, van Deelen, M, van Mierlo, G, Kuijpers, TW, Eftimov, F, van Ham, SM, ten Brinke, A, Rispens, T, Valk, AM, Keijser, JBD, van Dam, KPJ, Stalman, EW, Wieske, L, Steenhuis, M, Kummer, LYL, Spuls, PI, Bekkenk, MW, Musters, AH, Post, NF, Bosma, AL, Horváth, B, Hijnen, DJ, Schreurs, CRG, van Kempen, ZLE, Killestein, J, Volkers, AG, Tas, SW, Boekel, L, Wolbink, GJ, Keijzer, S, Derksen, NIL, van Deelen, M, van Mierlo, G, Kuijpers, TW, Eftimov, F, van Ham, SM, ten Brinke, A, and Rispens, T

Abstract

Background: The noninflammatory immunoglobulin G4 (IgG4) is linked to tolerance and is unique to humans. Although poorly understood, prolonged antigenic stimulation and IL-4-signaling along the T helper 2-axis may be instrumental in IgG4 class switching. Recently, repeated SARS-CoV-2 mRNA vaccination has been linked to IgG4 skewing. Although widely used immunosuppressive drugs have been shown to only moderately affect humoral responses to SARS-CoV-2 mRNA vaccination, the effect on IgG4 switching has not been investigated. Methods: Here we study the impact of such immunosuppressive drugs, including the IL-4 receptor-blocking antibody dupilumab, on IgG4 skewing upon repeated SARS-CoV-2 mRNA vaccination. Receptor-binding domain (RBD) specific antibody responses were longitudinally measured in 600 individuals, including patients with immune-mediated inflammatory diseases treated with a TNF inhibitor (TNFi) and/or methotrexate (MTX), dupilumab, and healthy/untreated controls, after repeated mRNA vaccination. Results: We observed a substantial increase in the proportion of RBD-specific IgG4 antibodies (median 21%) in healthy/untreated controls after third vaccination. This IgG4 skewing was profoundly reduced in dupilumab-treated patients (<1%). Unexpectedly, an equally strong suppression of IgG4 skewing was observed in TNFi-treated patients (<1%), whereas MTX caused a modest reduction (7%). RBD-specific total IgG levels were hardly affected by these immunosuppressive drugs. Minimal skewing was observed, when primary vaccination was adenoviral vector-based. Conclusions: Our results imply a critical role for IL-4/IL-13 as well as TNF in vivo IgG4 class switching. These novel findings advance our understanding of IgG4 class switch dynamics, and may benefit humoral tolerance induction strategies, treatment of IgG4 pathologies and mRNA vaccine optimization.

Published
2024

6. Persistence of seroconversion at 6 months following primary immunisation in patients with immune-mediated inflammatory diseases

Author

Wieske, L., Stalman, E.W., Dam, P.J.K. van, Kummer, L.Y., Steenhuis, M., Kempen, Z.L.E. van, Killestein, J., Volkers, A.G., Tas, S.W., Boekel, L., Wolbink, G., Kooi, A. van der, Raaphorst, J., Lowenberg, M., Takkenberg, B., D'Haens, G.R.A.M., Spuls, P.I., Bekkenk, M.W., Musters, A.H., Post, N.F., Bosma, A.L., Hilhorst, M.L., Vegting, Y., Bemelman, F.J., Voskuyl, A., Broens, B., Sanchez, A.P., Els, C.A.C.M. van, Wit, J. de, Rutgers, A., Leeuw, K. de, Horvath, B., Verschuuren, J.J.G.M., Ruiter, A.M., Ouwerkerk, L. van, Woude, D. van der, Allaart, C.F., Teng, Y.K.O., Paassen, P. van, Busch, M.H., Jallah, P.B.P., Brusse, E., Doorn, P.A. van, Baars, A.E., Hijnen, D., Schreurs, C.R.G., Pol, W.L. van der, Goedee, H.S., Keijzer, S., Keijser, J., Cristianawati, O., Brinke, A. ten, Verstegen, N.J.M., Zwinderman, K.A.H., Ham, S.M. van, Kuijpers, T.W., Rispens, T., Eftimov, F., T2B Immunity SARS CoV 2 Study Grp, Interne Geneeskunde, MUMC+: MA Nefrologie (9), MUMC+: MA Klinische Immunologie (9), RS: Carim - B02 Vascular aspects thrombosis and Haemostasis, Neurology, Amsterdam Neuroscience - Neuroinfection & -inflammation, AII - Inflammatory diseases, Rheumatology, Dermatology, Nephrology, and AII - Infectious diseases

Subjects
Rheumatology, SDG 3 - Good Health and Well-being, Immunology, Vaccination, Immunology and Allergy, Tumor Necrosis Factor Inhibitors, Covid-19, General Biochemistry, Genetics and Molecular Biology, Autoimmune Diseases
Abstract

Patients with immune-mediated inflammatory diseases (IMIDs) may have impaired initial humoral responses after SARS-CoV-2 vaccination depending on the type of immunosuppression (ISP) used.1 It is largely unknown how antibody titres develop over time and whether it is needed to adjust timing of booster campaigns for patients with IMID.

Published
2023

7. POS1088 THE PATIENT-PERSPECTIVE AND FEASIBILITY OF HOME FINGER PRICK TESTING TO COMPLEMENT AND FACILITATE LARGE SCALE DIGITAL DATA COLLECTION

Author

Besten, Y., primary, Boekel, L., additional, Steenhuis, M., additional, Hooijberg, F., additional, Leeuw, M., additional, Atiqi, S., additional, Vogelzang, E., additional, Keijser, J., additional, Cristianawati, O., additional, Keijzer, S., additional, Loeff, F., additional, Gerritsen, M., additional, Tas, S., additional, Nurmohamed, M., additional, Rispens, T., additional, and Wolbink, G., additional

Published
2023
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10. Primary SARS-CoV-2 infection in patients with immune-mediated inflammatory diseases

Author

Dam, K.P.J. van, Volkers, A.G., Wieske, L., Stalman, E.W., Kummer, L.Y.L., Kempen, Z.L.E. van, Killestein, J., Tas, S.W., Boekel, L., Wolbink, G.J., Kooi, A.J. van der, Raaphorst, J., Takkenberg, R.B., D'Haens, G.R.A.M.I., Spuls, P.W., Bekkenk, M.H., Musters, A.F., Post, N.L., Bosma, A.L., Hilhorst, M., Vegting, Y.J., Bemelman, F.E., Voskuyl, A., Broens, B., Sanchez, A.P., Els, C.A.C.M. van, Wit, J. de, Rutgers, A., Leeuw, K. de, Horvath, B., Verschuuren, J.J.G.M.M., Ruiter, A.M., Ouwerkerk, L. van, Woude, D. van der, Allaart, R.C.F., Teng, Y.K.O., Paassen, P.H. van, Busch, M.H., Jallah, P.B.P., Brusse, E., Doorn, P.A. van, Baars, A.E., Hijnen, D.J., Schreurs, C.R.G., Pol, W.L. van der, Goedee, H.S., Steenhuis, M., Keijzer, S., Keijser, J.B.D., Cristianawati, O., Brinke, A. ten, Verstegen, N.J.M., Ham, S.M. van, Rispens, T.W., Kuijpers, T., Lowenberg, M., Eftimov, F., and TB2 Immunity Sars-Cov-2 Study Grp

Subjects
Immune-mediated inflammatory diseases, SARS-CoV-2, Autoimmune disease, TNF, Immunity, Disease activity, Covid-19, Immunosuppression, Antibodies, Flare
Abstract

Background: Patients with immune-mediated inflammatory diseases (IMIDs) on immunosuppressants (ISPs) may have impaired long-term humoral immune responses and increased disease activity after SARS-CoV-2 infection. We aimed to investigate long-term humoral immune responses against SARS-CoV-2 and increased disease activity after a primary SARS-CoV-2 infection in unvaccinated IMID patients on ISPs. Methods: IMID patients on active treatment with ISPs and controls (i.e. IMID patients not on ISP and healthy controls) with a confirmed SARS-CoV-2 infection before first vaccination were included from an ongoing prospective cohort study (T2B! study). Clinical data on infections and increased disease activity were registered using electronic surveys and health records. A serum sample was collected before first vaccination to measure SARS-CoV-2 anti-receptor-binding domain (RBD) antibodies. Results: In total, 193 IMID patients on ISP and 113 controls were included. Serum samples from 185 participants were available, with a median time of 173 days between infection and sample collection. The rate of seropositive IMID patients on ISPs was 78% compared to 100% in controls (p < 0.001). Seropositivity rates were lowest in patients on anti-CD20 (40.0%) and anti-tumor necrosis factor (TNF) agents (60.5%), as compared to other ISPs (p < 0.001 and p < 0.001, respectively). Increased disease activity after infection was reported by 68 of 260 patients (26.2%; 95% CI 21.2-31.8%), leading to ISP intensification in 6 out of these 68 patients (8.8%). Conclusion: IMID patients using ISPs showed reduced long-term humoral immune responses after primary SARS-CoV-2 infection, which was mainly attributed to treatment with anti-CD20 and anti-TNF agents. Increased disease activity after SARS-CoV-2 infection was reported commonly, but was mostly mild.

Published
2023

11. Breakthrough infections with the SARS-CoV-2 omicron (B.1.1.529) variant in patients with immune-mediated inflammatory diseases

Author

Stalman, E.W., Wieske, L., Dam, K.P.J. van, Kummer, L.Y., Kempen, Z.L.E. van, Killestein, J., Volkers, A.G., Tas, S.W., Boekel, L., Wolbink, G.J., Kooi, A.J. van der, Raaphorst, J., Lowenberg, M., Takkenberg, R.B., D'Haens, G.R.A.M., Spuls, P.I., Bekkenk, M.W., Musters, A.H., Post, N.F., Bosma, A.L., Hilhorst, M.L., Vegting, Y., Bemelman, F.J., Voskuyl, A.E., Broens, B., Sanchez, A.P., Els, C.A.C.M. van, Wit, J. de, Rutgers, A., Leeuw, K. de, Horvath, B., Verschuuren, J.J.G.M., Ruiter, A.M., Ouwerkerk, L. van, Woude, D. van der, Allaart, C.F., Teng, O.Y.K., Paassen, P. van, Busch, M.H., Jallah, P.B.P., Brusse, E., Doorn, P.A. van, Baars, A.E., Hijnen, D.J., Schreurs, C.R.G., Pol, W.L. van der, Goedee, H.S., Steenhuis, M., Keijzer, S., Keijser, J.B.D., Boogaard, A., Cristianawati, O., Brinke, A. ten, Verstegen, N.J.M., Zwinderman, K.A.H., Rispens, T., Ham, S.M. van, Kuijpers, T.W., Eftimov, F., T2B Immunity Against SARS Co, Neurology, Dermatology, Graduate School, Paediatrics, Gastroenterology and Hepatology, Experimental Immunology, Clinical Immunology and Rheumatology, AII - Inflammatory diseases, Landsteiner Laboratory, ANS - Neuroinfection & -inflammation, ANS - Neurodegeneration, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, APH - Methodology, APH - Quality of Care, AII - Cancer immunology, Nephrology, 01 Internal and external specialisms, ACS - Atherosclerosis & ischemic syndromes, Epidemiology and Data Science, Paediatric Infectious Diseases / Rheumatology / Immunology, ARD - Amsterdam Reproduction and Development, EURO-NMD, Translational Immunology Groningen (TRIGR), SILS Other Research (FNWI), Amsterdam Neuroscience - Neuroinfection & -inflammation, Rheumatology, Molecular cell biology and Immunology, Pediatrics, Interne Geneeskunde, MUMC+: MA Nefrologie (9), MUMC+: MA Klinische Immunologie (9), RS: Carim - B02 Vascular aspects thrombosis and Haemostasis, and MUMC+: MA Med Staf Artsass Interne Geneeskunde (9)

Subjects
COVID-19 Vaccines, SARS-CoV-2, Immunology, Vaccination, Autoimmunity, General Biochemistry, Genetics and Molecular Biology, Autoimmune Diseases, Cohort Studies, Rheumatology, SDG 3 - Good Health and Well-being, Immunology and Allergy, Humans, Prospective Studies, Covid-19, Immunosuppressive Agents
Abstract

ObjectivesTo compare the cumulative incidence and disease severity of reported SARS-CoV-2 omicron breakthrough infections between patients with immune-mediated inflammatory diseases (IMID) on immunosuppressants and controls, and to investigate determinants for breakthrough infections.MethodsData were used from an ongoing national prospective multicentre cohort study on SARS-CoV-2 vaccination responses in patients with IMID in the Netherlands (Target-to-B! (T2B!) study). Patients wih IMID on immunosuppressants and controls (patients with IMID not on immunosuppressants and healthy controls) who completed primary immunisation were included. The observation period was between 1 January 2022 and 1 April 2022, during which the SARS-CoV-2 omicron (BA.1 and BA.2 subvariant) was dominant. A SARS-CoV-2 breakthrough infection was defined as a reported positive PCR and/or antigen test at least 14 days after primary immunisation. A multivariate logistic regression model was used to investigate determinants.Results1593 patients with IMID on immunosuppressants and 579 controls were included. The cumulative incidence of breakthrough infections was 472/1593 (29.6%; 95% CI 27% to 32%) in patients with IMID on immunosuppressants and 181/579 (31.3%; 95% CI 28% to 35%) in controls (p=0.42). Three (0.5%) participants had severe disease. Seroconversion after primary immunisation (relative risk, RR 0.71; 95% CI 0.52 to 0.96), additional vaccinations (RR 0.61; 95% CI 0.49 to 0.76) and a prior SARS-CoV-2 infection (RR 0.60; 95% CI 0.48 to 0.75) were associated with decreased risk of breakthrough infection.ConclusionsThe cumulative incidence of reported SARS-CoV-2 omicron breakthrough infections was high, but similar between patients with IMID on immunosuppressants and controls, and disease severity was mostly mild. Additional vaccinations and prior SARS-CoV-2 infections may reduce the incidence of breakthrough infections.

Published
2022

12. COVID-19 vaccine acceptance over time in patients with immune-mediated inflammatory rheumatic diseases

Author

Boekel, L., Hooijberg, F., Besten, Y.R., Vogelzang, E.H., Steenhuis, M., Leeuw, M. de, Atiqi, S., Vollenhoven, R. van, Lems, W.F., Bos, W.H., Wijbrandts, C.A., Gerritsen, M, Krieckaert, C., Voskuyl, A.E., Horst-Bruinsma, I.E. van der, Tas, S.W., Boers, Maarten, Rispens, T., Nurmohamed, M.T., Wolbink, G., Boekel, L., Hooijberg, F., Besten, Y.R., Vogelzang, E.H., Steenhuis, M., Leeuw, M. de, Atiqi, S., Vollenhoven, R. van, Lems, W.F., Bos, W.H., Wijbrandts, C.A., Gerritsen, M, Krieckaert, C., Voskuyl, A.E., Horst-Bruinsma, I.E. van der, Tas, S.W., Boers, Maarten, Rispens, T., Nurmohamed, M.T., and Wolbink, G.

Abstract

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Published
2022

13. Breakthrough SARS-CoV-2 infections with the delta (B.1.617.2) variant in vaccinated patients with immune-mediated inflammatory diseases using immunosuppressants: a substudy of two prospective cohort studies

Author

Boekel, L., Stalman, E.W., Wieske, L., Hooijberg, F., Dam, K.P.J. van, Besten, Y.R., Kummer, L.Y., Steenhuis, M., Kempen, Z.L.E. van, Killestein, J., Volkers, A.G., Tas, S.W., Kooi, A.J. van der, Raaphorst, J., Löwenberg, M., Takkenberg, R.B., d'Haens, G., Spuls, P.I., Bekkenk, M.W., Musters, A.H., Post, N.F., Bosma, A.L., Hilhorst, M.L., Vegting, Y., Bemelman, F.J., Voskuyl, A.E., Broens, B., Sanchez, A., Els, C. van, Wit, J. de, Rutgers, A., Leeuw, K. de, Horváth, B., Verschuuren, J., Ruiter, A.M. de, Ouwerkerk, L., Woude, D. van der, Allaart, C.F., Teng, Y.K.O., Paassen, P. van, Busch, M.H., Jallah, P.B.P., Brusse, E., Doorn, P.A. van, Baars, A.E., Hijnen, D.J., Schreurs, C.R.G., Pol, W.Ludo van der, Goedee, H.S., Vogelzang, E.H., Leeuw, M. de, Atiqi, S., Vollenhoven, R. van, Gerritsen, M, Horst-Bruinsma, I.E. van der, Lems, W.F., Nurmohamed, M.T., Boers, Maarten, Keijzer, Sofie, Keijser, J. de, Sandt, C., Boogaard, A., Cristianawati, O., Brinke, A. Ten, Verstegen, N.J., Zwinderman, K.A.H., Ham, S.M. van, Rispens, T., Kuijpers, T.W., Wolbink, G., Eftimov, F., Boekel, L., Stalman, E.W., Wieske, L., Hooijberg, F., Dam, K.P.J. van, Besten, Y.R., Kummer, L.Y., Steenhuis, M., Kempen, Z.L.E. van, Killestein, J., Volkers, A.G., Tas, S.W., Kooi, A.J. van der, Raaphorst, J., Löwenberg, M., Takkenberg, R.B., d'Haens, G., Spuls, P.I., Bekkenk, M.W., Musters, A.H., Post, N.F., Bosma, A.L., Hilhorst, M.L., Vegting, Y., Bemelman, F.J., Voskuyl, A.E., Broens, B., Sanchez, A., Els, C. van, Wit, J. de, Rutgers, A., Leeuw, K. de, Horváth, B., Verschuuren, J., Ruiter, A.M. de, Ouwerkerk, L., Woude, D. van der, Allaart, C.F., Teng, Y.K.O., Paassen, P. van, Busch, M.H., Jallah, P.B.P., Brusse, E., Doorn, P.A. van, Baars, A.E., Hijnen, D.J., Schreurs, C.R.G., Pol, W.Ludo van der, Goedee, H.S., Vogelzang, E.H., Leeuw, M. de, Atiqi, S., Vollenhoven, R. van, Gerritsen, M, Horst-Bruinsma, I.E. van der, Lems, W.F., Nurmohamed, M.T., Boers, Maarten, Keijzer, Sofie, Keijser, J. de, Sandt, C., Boogaard, A., Cristianawati, O., Brinke, A. Ten, Verstegen, N.J., Zwinderman, K.A.H., Ham, S.M. van, Rispens, T., Kuijpers, T.W., Wolbink, G., and Eftimov, F.

Abstract

Item does not contain fulltext, BACKGROUND: Concerns have been raised regarding the risks of SARS-CoV-2 breakthrough infections in vaccinated patients with immune-mediated inflammatory diseases treated with immunosuppressants, but clinical data on breakthrough infections are still scarce. The primary objective of this study was to compare the incidence and severity of SARS-CoV-2 breakthrough infections between patients with immune-mediated inflammatory diseases using immunosuppressants, and controls (patients with immune-mediated inflammatory diseases not taking immunosuppressants and healthy controls) who had received full COVID-19 vaccinations. The secondary objective was to explore determinants of breakthrough infections of the delta (B.1.617.2) variant of SARS-CoV-2, including humoral immune responses after vaccination. METHODS: In this substudy, we pooled data collected in two large ongoing prospective multicentre cohort studies conducted in the Netherlands (Target to-B! [T2B!] study and Amsterdam Rheumatology Center COVID [ARC-COVID] study). Both studies recruited adult patients (age ≥18 years) with immune-mediated inflammatory diseases and healthy controls. We sourced clinical data from standardised electronic case record forms, digital questionnaires, and medical files. We only included individuals who were vaccinated against SARS-CoV-2. For T2B!, participants were recruited between Feb 2 and Aug 1, 2021, and for ARC-COVID, participants were recruited between April 26, 2020, and March 1, 2021. In this study we assessed data on breakthrough infections collected between July 1 and Dec 15, 2021, a period in which the delta SARS-CoV-2 variant was the dominant variant in the Netherlands. We defined a SARS-CoV-2 breakthrough infection as a PCR-confirmed or antigen test-confirmed SARS-CoV-2 infection that occurred at least 14 days after vaccination. All breakthrough infections during this period were assumed to be due to the delta variant due to its dominance during the study period. We analysed

Published
2022

14. Antibody development and disease severity of COVID-19 in non-immunised patients with rheumatic immune-mediated inflammatory diseases: data from a prospective cohort study

Author

Boekel, L., Hooijberg, F., Vogelzang, E.H., Besten, Y.R., Leeuw, M. de, Atiqi, S., Vollenhoven, R.F. van, Wijbrandts, C.A., Gerritsen, M, Krieckaert, C., Dijkshoorn, B., Bakhlakh, S., Crooijmans, J.J., Voskuyl, A., Horst-Bruinsma, I.E. van der, Lems, W., Kuijpers, T.W., Ham, S.M. van, Wieske, L., Eftimov, F., Kummer, L.Y., Dam, P.K. van, Stalman, E.W., Steenhuis, M., Keijzer, Sofie, Cristianawati, O., Keijser, J. de, Loeff, F.C., Tas, S.W., Nurmohamed, M.T., Boers, Maarten, Rispens, T., Wolbink, G., Boekel, L., Hooijberg, F., Vogelzang, E.H., Besten, Y.R., Leeuw, M. de, Atiqi, S., Vollenhoven, R.F. van, Wijbrandts, C.A., Gerritsen, M, Krieckaert, C., Dijkshoorn, B., Bakhlakh, S., Crooijmans, J.J., Voskuyl, A., Horst-Bruinsma, I.E. van der, Lems, W., Kuijpers, T.W., Ham, S.M. van, Wieske, L., Eftimov, F., Kummer, L.Y., Dam, P.K. van, Stalman, E.W., Steenhuis, M., Keijzer, Sofie, Cristianawati, O., Keijser, J. de, Loeff, F.C., Tas, S.W., Nurmohamed, M.T., Boers, Maarten, Rispens, T., and Wolbink, G.

Abstract

Contains fulltext : 251778.pdf (Publisher’s version ) (Open Access), BACKGROUND: Research on the disease severity of COVID-19 in patients with rheumatic immune-mediated inflammatory diseases (IMIDs) has been inconclusive, and long-term prospective data on the development of SARS-CoV-2 antibodies in these patients are lacking. METHODS: Adult patients with rheumatic IMIDs from the Amsterdam Rheumatology and Immunology Center, Amsterdam were invited to participate. All patients were asked to recruit their own sex-matched and age-matched control subject. Clinical data were collected via online questionnaires (at baseline, and after 1-4 and 5-9 months of follow-up). Serum samples were collected twice and analysed for the presence of SARS-CoV-2-specific antibodies. Subsequently, IgG titres were quantified in samples with a positive test result. FINDINGS: In total, 3080 consecutive patients and 1102 controls with comparable age and sex distribution were included for analyses. Patients were more frequently hospitalised compared with controls when infected with SARS-CoV-2; 7% vs 0.7% (adjusted OR: 7.33, 95% CI: 0.96 to 55.77). Only treatment with B-cell targeting therapy was independently associated with an increased risk of COVID-19-related hospitalisation (adjusted OR: 14.62, 95% CI: 2.31 to 92.39). IgG antibody titres were higher in hospitalised compared with non-hospitalised patients, and slowly declined with time in similar patterns for patients in all treatment subgroups and controls. INTERPRETATION: We observed that patients with rheumatic IMIDs, especially those treated with B-cell targeting therapy, were more likely to be hospitalised when infected with SARS-CoV-2. Treatment with conventional synthetic disease-modifying antirheumatic drugs (DMARDs) and biological DMARDs other than B-cell targeting agents is unlikely to have negative effects on the development of long-lasting humoral immunity against SARS-CoV-2.

Published
2022

15. Immune dynamics in SARS-CoV-2 experienced immunosuppressed rheumatoid arthritis or multiple sclerosis patients vaccinated with mRNA-1273

Author

Verstegen, NJM, Hagen, RR, van den Dijssel, J, Kuijper, LH, Kreher, C, Ashhurst, T, Kummer, LYL, Steenhuis, M, Duurland, M, de Jongh, R, de Jong, N, van der Schoot, CE, Bos, A, Mul, E, Kedzierska, K, van Dam, KPJ, Stalman, EW, Boekel, L, Wolbink, G, Tas, SW, Killestein, J, van Kempen, ZLE, Wieske, L, Kuijpers, TW, Eftimov, F, Rispens, T, van Ham, SM, ten Brinke, A, van de Sandt, CE, Verstegen, NJM, Hagen, RR, van den Dijssel, J, Kuijper, LH, Kreher, C, Ashhurst, T, Kummer, LYL, Steenhuis, M, Duurland, M, de Jongh, R, de Jong, N, van der Schoot, CE, Bos, A, Mul, E, Kedzierska, K, van Dam, KPJ, Stalman, EW, Boekel, L, Wolbink, G, Tas, SW, Killestein, J, van Kempen, ZLE, Wieske, L, Kuijpers, TW, Eftimov, F, Rispens, T, van Ham, SM, ten Brinke, A, and van de Sandt, CE

Abstract

BACKGROUND: Patients affected by different types of autoimmune diseases, including common conditions such as multiple sclerosis (MS) and rheumatoid arthritis (RA), are often treated with immunosuppressants to suppress disease activity. It is not fully understood how the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-specific humoral and cellular immunity induced by infection and/or upon vaccination is affected by immunosuppressants. METHODS: The dynamics of cellular immune reactivation upon vaccination of SARS-CoV-2 experienced MS patients treated with the humanized anti-CD20 monoclonal antibody ocrelizumab (OCR) and RA patients treated with methotrexate (MTX) monotherapy were analyzed at great depth via high-dimensional flow cytometry of whole blood samples upon vaccination with the SARS-CoV-2 mRNA-1273 (Moderna) vaccine. Longitudinal B and T cell immune responses were compared to SARS-CoV-2 experienced healthy controls (HCs) before and 7 days after the first and second vaccination. RESULTS: OCR-treated MS patients exhibit a preserved recall response of CD8+ T central memory cells following first vaccination compared to HCs and a similar CD4+ circulating T follicular helper 1 and T helper 1 dynamics, whereas humoral and B cell responses were strongly impaired resulting in absence of SARS-CoV-2-specific humoral immunity. MTX treatment significantly delayed antibody levels and B reactivation following the first vaccination, including sustained inhibition of overall reactivation marker dynamics of the responding CD4+ and CD8+ T cells. CONCLUSIONS: Together, these findings indicate that SARS-CoV-2 experienced MS-OCR patients may still benefit from vaccination by inducing a broad CD8+ T cell response which has been associated with milder disease outcome. The delayed vaccine-induced IgG kinetics in RA-MTX patients indicate an increased risk after the first vaccination, which might require additional shielding or alternative strategies such as treatment inte

Published
2022

16. Care staff’s sense-making of intimate and sexual expressions of people with dementia in Dutch nursing homes

Author

Waterschoot, K., Roelofs, T. S., van Boekel, L. C., Luijkx, K. G., Waterschoot, K., Roelofs, T. S., van Boekel, L. C., and Luijkx, K. G.

Abstract

Objectives: The Person-centered Care (PCC) philosophy emphasizes close care relationships to enable care professionals to recognize the needs of nursing home residents with dementia. This study explored how care professionals make sense of resident behavior with regard to intimacy and sexuality. Methods: 26 nursing home care professionals (15 Nurses, 9 Health Care Professionals and 2 Managers) completed in-depth interviews that were subjected to an Interpretative Phenomenological Analysis (IPA). Results: Three thematic layers were identified. 1. Care Professionals pursue a “true” understanding of intimate and sexual behavior that underpins a resident’s expression. 2. When care professionals feel the need to protect themselves, they can reframe a specific care relation in order to continue care. 3. The social context around the resident, from family to professionals (i.e. peers), influences interpretation of behavior and, consequently, the provision of care. Conclusions: Intimate and sexual expressions of residents can put care relations under pressure. Care relations that lack professional distance may compromise care professionals’ judgments, impede their natural boundaries and decrease their well-being. Clinical implications: Along with implementing PCC principles, organizations should empower staff to develop, discuss and include self-reflection skills and personal boundaries within their work.

Published
2022

19. OP0178 COVID-19 BREAKTHROUGH INFECTIONS IN VACCINATED PATIENTS WITH IMMUNE-MEDIATED INFLAMMATORY DISEASES AND CONTROLS – DATA FROM TWO PROSPECTIVE COHORT STUDIES

Author

Boekel, L., primary, Stalman, E., additional, Wieske, L., additional, Hooijberg, F., additional, Besten, Y., additional, Leeuw, M., additional, Atiqi, S., additional, Kummer, L., additional, van Dam, K., additional, Steenhuis, M., additional, van Kempen, Z., additional, Killestein, J., additional, Lems, W., additional, Tas, S., additional, van Vollenhoven, R., additional, Nurmohamed, M., additional, Boers, M., additional, van Ham, M., additional, Rispens, T., additional, Kuijpers, T., additional, Eftimov, F., additional, and Wolbink, G. J., additional

Published
2022
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20. POS1256 RISK FACTORS FOR SHORT-TERM ADVERSE EVENT IN PATIENTS WITH IMMUNE-MEDIATED INFLAMMATORY DISEASES

Author

Kummer, L., primary, Wieske, L., additional, Stalman, E., additional, Van Dam, K., additional, Boekel, L., additional, Wolbink, G., additional, Volkers, A., additional, Steenhuis, M., additional, Verstegen, N., additional, Rispens, T., additional, Ten Brinke, A., additional, Van Kempen, Z., additional, Tas, S., additional, Van Ham, M., additional, Kuijpers, T., additional, and Eftimov, F., additional

Published
2022
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23. Humoral immune response after SARS-CoV-2 vaccination in patients with immune-mediated inflammatory diseases treated with immunosuppressive therapy - a Target to B! study

Author

Volkers, A., Wieske, L., van Dam, K., Steenhuis, M., Stalman, E., Kummer, L., van Kempen, Z., Killestein, J., Tas, S., Boekel, L., Wolbink, G., Takkenberg, B., Spuls, P., Bosma, A., Rutgers, B., Verschuuren, J., van Ouwerkerk, L., van der Woude, D., van Paassen, P., Busch, M., Brusse, E., Hijnen, D., ten Brinke, A., Verstegen, N., D'Haens, G., van Ham, M., Kuijpers, T., Rispens, T., Lowenberg, M., Eftimov, F., Neurology, and Dermatology

Subjects
SDG 3 - Good Health and Well-being
Published
2022

24. Longitudinal humoral response after SARS-CoV-2 vaccination in ocrelizumab treated MS patients: To wait and repopulate?

Author

van Kempen, Z.L.E., primary, Wieske, L., additional, Stalman, E.W., additional, Kummer, L. Y. L, additional, van Dam, P.J., additional, Volkers, A.G., additional, Boekel, L., additional, Toorop, A.A., additional, Strijbis, E.M.M., additional, Tas, S.W., additional, Wolbink, G.J., additional, Löwenberg, M., additional, van Sandt, C., additional, ten Brinke, A., additional, Verstegen, N.J.M., additional, Steenhuis, M., additional, Kuijpers, T.W., additional, van Ham, S.M., additional, Rispens, T., additional, Eftimov, F., additional, and Killestein, J., additional

Published
2022
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25. DOP27 Humoral immune response after SARS-CoV-2 vaccination in patients with immune-mediated inflammatory diseases treated with immunosuppressive therapy - a Target to B! study

Author

Volkers, A, primary, Wieske, L, additional, van Dam, K, additional, Steenhuis, M, additional, Stalman, E, additional, Kummer, L, additional, van Kempen, Z, additional, Killestein, J, additional, Tas, S, additional, Boekel, L, additional, Wolbink, G, additional, Takkenberg, B, additional, Spuls, P, additional, Bosma, A, additional, Rutgers, B, additional, Verschuuren, J, additional, van Ouwerkerk, L, additional, van der Woude, D, additional, van Paassen, P, additional, Busch, M, additional, Brusse, E, additional, Hijnen, D, additional, ten Brinke, A, additional, Verstegen, N, additional, D’Haens, G, additional, van Ham, M, additional, Kuijpers, T, additional, Rispens, T, additional, Löwenberg, M, additional, and Eftimov, F, additional

Published
2022
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26. Bridging the research-to-practice gap in home care: Developing an intervention in co-creation with home care stakeholders based on older adults’ experiences

Author

Vos, W. H., Janssen, M. M., van Boekel, L. C., Leenders, R. T. A. J., Luijkx, K. G., Tranzo, Scientific center for care and wellbeing, Ouderen, and JADS Research

Abstract

Research aim When aging in place, social networks are sources of support and contribute to wellbeing of olderadults. As social networks change, especially when accompanied by health decline, older adults’sources of support change and their wellbeing is challenged. Previous studies predominantly use quantitative measures to examine how older adults’ social networks change. Therefore, we explored social network change qualitatively, examining the impact of social network change on older adults’ lives and how older adults experience social network change and health decline. Additionally, we perceive that home care nurses could benefit from the implementation of our results in their practice, although in literature numerous studies mention a ‘research-to-practice gap’ in healthcare. Therefore, we designed a study to develop an intervention for home care nurses, using previously mentioned results and making an extra effort to bridge the research-to-practice gap. Methods In four rounds, we follow the sequential steps of Intervention Mapping (IM) to develop an intervention for home care nurses to reduce the impact of social network change on older adults who are aging in place. Round 1 is concerned with creating a logic model of the problem and of the change that is intended. Round 1 will be based on results of our previous studies on experiences of older adults and input of home care nurses. Round 2 is concerned with choosing change methods and applications. Round 1 and 2 will be executed by a project group of home care nurses, implementation specialists and a researcher. In round 3 we will hold three co-creation sessions with home care nurses to develop the intervention materials. Round 4 contains the making of an implementation and evaluation plan. After finishing every round, a group of experts (home care teams, managers and health insurance buyers) will be consulted for feedback on the intermediate results and to reach consensus on the definitive result. Key findings An intervention that can be used by home care nurses to reduce the impact of social network change in older adults who are aging in place. Our previous results revealed high-impact experiences of social network change and consecutive stages of social network dynamics. Also, our previous results stated that the impact of social network change and health decline can vary majorly between a rather homogenous group of older adults with similar experiences of social network change and/or health decline. We expect to develop an intervention that will help home care nurses to reduce impact of social network change in older adults. Moreover, we expect to bridge the gap between science and practice and benefit older adults and home care nurses. Discussion Examining experiences of the ones at stake (i.e. older adults who are aging in place) provides a rich insight in their lives and valuable scientific results. However, it takes an additional effort to connect with the practitioners who can benefit from these results and, together, develop a way to use the results. What are suggestions from the audience to facilitate or benefit implementation of the proposed intervention? What are perceived barriers for implementation of the proposed intervention, according to the audience?

Published
2021

29. Dementia enlightened?!: A systematic literature review of the influence of indoor environmental light on the health of older persons with dementia in long-term care facilities

Author

Goudriaan, I., van Boekel, L. C., Verbiest, M. E. A., van Hoof, J., Luijkx, K. G., Goudriaan, I., van Boekel, L. C., Verbiest, M. E. A., van Hoof, J., and Luijkx, K. G.

Abstract

Light therapy for older persons with dementia is often administered with light boxes, even though indoor ambient light may more comfortably support the diverse lighting needs of this population. Our objective is to investigate the influence of indoor daylight and lighting on the health of older adults with dementia living in long-term care facilities. A systematic literature search was performed within PubMed, CINAHL, PsycINFO, Web of Science and Scopus databases. The included articles (n=37) were published from 1991 to 2020. These articles researched the influence of existing and changed indoor light conditions on health and resulted in seven categories of health outcomes. Although no conclusive evidence was found to support the ability of indoor light to decrease challenging behaviors or improve circadian rhythms, findings of two studies indicate that exposure to (very) cool light of moderate intensity diminished agitation. Promising effects of indoor light were to reduce depressive symptoms and facilitate spatial orientation. Furthermore, there were indications that indoor light improved one’s quality of life. Despite interventions with dynamic lighting having yielded little evidence of its efficacy, its potential has been insufficiently researched among this study population. This review provides a clear and comprehensive description of the impact of diverse indoor light conditions on the health of older adults with dementia living in long-term care facilities. Variation was seen in terms of research methods, (the description of) light conditions, and participants’ characteristics (types and severity of dementia), thus confounding the reliability of the findings. The authors recommend further research to corroborate the beneficial effects of indoor light on depression and to clarify its role in supporting everyday activities of this population. An implication for practice in long-term care facilities is raising the awareness of the increased lighting needs of ag

Published
2021

30. Community-dwelling and recently widowed older adults: Effects of spousal loss on psychological well-being, perceived quality of life, and health-care costs

Author

van Boekel, L. C., Cloin, J. C. M., Luijkx, K. G., van Boekel, L. C., Cloin, J. C. M., and Luijkx, K. G.

Abstract

This study is on the effects of spousal loss among older adults who continue to live independently after bereavement. Little longitudinal studies focus on this group, which is of special interest, since in many countries, care policy and system reform are aimed at increasing independent living among older adults. Using longitudinal data from a Dutch public data repository, we investigate the effects of spousal loss on psychological well-being, perceived quality of life, and (indication of) yearly health-care costs. Of the respondents who had a spouse and were living independently (N = 9,400) at baseline, the majority had not lost their spouse after 12 months (T12, n = 9,150), but 2.7% (n = 250) had lost their spouse and still lived independently. We compared both groups using multivariate regression (ordinary least squares) analyses. The results show that spousal loss significantly lowers scores on psychological well-being and perceived quality of life, but we found no effect on health-care costs.

Published
2021

32. Hoe ziet mensgerichte zorg eruit in de praktijk?: Een onderzoek naar hoe mensgerichte zorg wordt vormgegeven in twee zorglocaties met verschillende zorgconcepten

Author

Kools, N., van Boekel, L. C., Luijkx, K. G., Tranzo, Scientific center for care and wellbeing, and Ouderen

Abstract

Doel: Het doel van het huidige onderzoek was om van twee verschillende zorgconcepten in kaart tebrengen hoe zij mensgerichte zorg in de praktijk hebben vormgegeven. Uit de literatuur blijken verschillende elementen belangrijk in het bieden van mensgerichte zorg aan mensen met dementie in zorglocaties, waaronder het behouden van de autonomie, het afstemmen van de zorg op de belevingswereld van de persoon met dementie, het betrekken van naasten in de zorg en het bieden van een fysieke omgeving die mensgerichte zorg faciliteert. In het kader van het huidige onderzoek werd bestudeerd hoe deze elementen in de praktijk zijn gebracht door twee zorglocaties die langdurige zorg bieden aan mensen met dementie. De zorglocaties betroffen De Wever, locatie Satijnhof en De Leyhoeve, locatie Tilburg, beiden gevestigd in Tilburg. In het huidige onderzoek trachtten we antwoord te geven op onderstaande onderzoeksvragen: 1. In hoeverre voldoet de fysieke omgeving aan voorwaarden om mensgerichte zorg te realiseren? 2. Welke attitudes hebben medewerkers over mantelzorgverlening? 3. In welke mate bieden medewerkers mensgerichte zorg? 4. In welke mate wordt mantelzorg verleend en ervaren naasten een rol in de zorg voor de bewoner? 5. Hoe komt autonomie van bewoners tot uitdrukking in het dagelijks leven? Methode: Verschillende meetinstrumenten zijn geselecteerd voor het beantwoorden van de onderzoeksvragen. Middels observaties is in kaart gebracht in hoeverre de fysieke omgeving voldeed aan voorwaarden om mensgerichte zorg te realiseren en daarmee bijdroeg aan het welzijn van de bewoners. Tevens zijn twee vragenlijsten afgenomen: één bij medewerkers en één bij naasten van bewoners. Middels de vragenlijst voor medewerkers is onderzocht in welke mate mensgerichte zorg geboden werd en wat de attitudes van medewerkers waren over mantelzorgverlening. Middels de vragenlijst voor naasten van bewoners is de mate van mantelzorgverlening onderzocht en de attitudes van naasten van bewoners over medewerkers. Tot slot zijn bewoners van de zorglocaties geobserveerd om te onderzoeken hoe mensgerichte zorg tot uitdrukking komt in het dagelijks leven. Resultaten en discussie: In totaal vulden 68 medewerkers een vragenlijst in en 21 naasten. Twaalf bewoners zijn geobserveerd. Echter, vanwege de inclusie van een paar bewoners met alleen somatische klachten binnen De Leyhoeve blijft voorzichtigheid geboden bij het trekken van conclusies over mensen met dementie in het algemeen. De gemiddelde leeftijd van medewerkers was 42,92 jaar (SD = 11,91). Medewerkers van Satijnhof waren significant ouder, hadden meer jaren werkervaring in de langdurige ouderenzorg en waren meer jaren werkzaam in hun organisatie dan medewerkers van De Leyhoeve. Van de medewerkers was 39,7% welzijnsmedewerker (gastvrouw/heer of huiskamermoeder/vader) en was 41,2% zorgmedewerker (verzorgende of verpleegkundige). De gemiddelde leeftijd van de naasten van bewoners was 58,19 jaar (SD = 7,13; range 47-74). De gemiddelde leeftijd van de bewoners waar naasten mantelzorg aan verleenden was 85,55 jaar (SD = 6,88; range 71–97). Tot slot hadden de geobserveerde bewoners een gemiddelde leeftijd van 85,03 jaar (SD = 6,18; range = 72-98). Onderstaand wordt een korte samenvatting gegeven van de antwoorden op de onderzoeksvragen. Ten eerste bleek de fysieke omgeving van de zorglocaties te voldoen aan de meeste voorwaarden om mensgerichte zorg te leveren en draagt daarmee bij aan het welzijn van de bewoner. Er werd met name hoog gescoord op de thema’s privacy en autonomie, faciliteiten- en voorzieningenniveau en huiselijkheid en kleinschaligheid. Er werd relatief laag gescoord op de thema’s Uitzicht en Natuur en Oriëntatie en Routing. Ten tweede hadden medewerkers van beide zorglocaties vrij positieve attitudes ten opzichte van mantelzorgverlening. Opvallend was dat zorgmedewerkers een positievere attitude hadden over naasten van bewoners dan welzijnsmedewerkers. Een mogelijke verklaring kan zijn dat welzijnsmedewerkers in hun dagelijkse werk vaker omgaan met en zaken moeten afstemmen op naasten van bewoners dan de zorgmedewerkers. Dit zou kunnen betekenen dat welzijnsmedewerkers ook vaker geconfronteerd worden met lastige situaties waarin naasten van bewoners bijvoorbeeld niet tevreden zijn over de geleverde zorg of dat bewoners juist onrustig worden van bezoek door naasten. Ten derde zijn medewerkers van beide zorglocaties ervan overtuigd dat zij in relatief hoge mate mensgerichte zorg leveren aan hun bewoners. Hierin vonden we geen verschillen tussen de twee zorglocaties. Wel zien we dat medewerkers van De Leyhoeve in significant hogere mate zorg op de persoon afstemden dan medewerkers van Satijnhof. Daarnaast bleek dat een positievere attitude van medewerkers over mantelzorgverlening voorspeld kon worden door de een grotere mate waarin mensgericht gewerkt wordt, meer jaren werkervaringin de langdurige ouderenzorg en een lagere leeftijd van medewerkers. Ten vierde werd gemiddeld genomen ongeveer 6 uur per week mantelzorg verleend aan de bewoners met dementie in zorglocaties door de naasten die de vragenlijst invulden. Hierin vonden we geen significant verschil in de mate van mantelzorgverlening tussen de twee zorglocaties. Naasten van bewoners van beide zorglocaties ervaren dat zij een vrij grote rol spelen in de zorg voor de bewoner. Ook hier vonden we geen significant verschil tussen de twee zorglocaties. Ten vijfde hebben we middels observaties onderzocht hoe autonomie en mensgerichte zorg er in de praktijk uitziet bij beide zorglocaties. Ondanks dat we in detail konden observeren wat er in de dagelijkse zorg gebeurt, bleek veel informatie niet altijd op een kwantitatieve manier te vatten en mist er veel informatie door de keuze om enkel in de algemene huiskamers te observeren. In toekomstige studies zou ook geobserveerd moeten worden in eigen woonruimtes, zodat een duidelijker beeld geschetst kan worden van de autonomie van bewoners. Tevens leken de bewoners van Satijnhof erg te verschillen in de mate van dementie vergeleken met de bewoners van De Leyhoeve, waarbij de mate van dementie binnen De Leyhoeve minder ernstig leek. Gezien de grote variatie in type bewoners, is voorzichtigheid geboden bij generalisatie naar bewoners met dementie in het algemeen. De onderzoekers hebben door middel van de observaties echter wel een goed beeld van de dagelijkse gang van zaken in de algemene huiskamers van beide zorglocaties. Alhoewel evenveel uren aan observaties zijn uitgevoerd, bleken er meer (inter)acties en gebeurtenissen plaats te vinden bij bewoners van Satijnhof ten opzichte van bewoners van De Leyhoeve. Onderzoekers hadden de indruk dat bewoners van De Leyhoeve beter in staat waren te converseren dan de bewoners van Satijnhof. Bijde Leyhoeve waren gesprekken in de algemene huiskamers vaak levendiger en gevarieerder en tussen meerdere personen in vergelijking tot Satijnhof. Ook kwamen interacties tussen drie of meer personen en interacties tussen medebewoners vaker voor binnen De Leyhoeve dan binnen Satijnhof. Daarnaast merkten de onderzoekers op dat binnen Satijnhof er relatief meer reuring was in de algemene huiskamer door het in- en uitlopen van personeel en doordat de algemene huiskamer direct grensde aan de ingang van de afdeling. De algemene huiskamers bij Leyhoeve waren wat meer afgesloten waardoor er minder mensen in en uit liepen. Dit kwam ook naar voren in de studieresultaten: binnen Satijnhof werden sociale interacties vaker geïnitieerd vanuit medewerkers terwijl binnen de Leyhoeve dit vaker geïnitieerd werd door bewoners. Conclusie: Uit de huidige studie blijkt dat beide zorglocaties mensgerichte zorg bieden. Zo voldoet de fysieke omgeving van beide zorglocaties aan de meeste voorwaarden om mensgerichte zorg te leveren, hebben medewerkers van beide zorglocaties vrij positieve attitudes ten opzichte van mantelzorgverlening, zijn medewerkers ervan overtuigd dat zij in relatief hoge mate mensgerichte zorg verlenen en ervaren naasten van bewoners van beide zorglocaties een vrij grote rol in de zorg voor de bewoners. Door in detail twee verschillende zorglocaties te bestuderen worden verschillen en nuances zichtbaar, zoals dat in beide zorglocaties het zorgmedewerkers een positievere attitude hebben over mantelzorgverlening dan welzijnsmedewerkers. Tevens geeft de huidige studie inzicht in de beperkingen en uitdagingen gerelateerd aan het doen van observaties in zorglocaties die langdurige zorg bieden aan mensen met dementie. Zo zagen we dat observaties een goede indruk kunnen geven van de dagelijkse gang van zaken, de sfeer en dynamiek op een zorglocatie, maar dat het belangrijk is om niet alleen in algemene huiskamers te observeren en de mate van dementie te inventariseren om hier een volledig beeld van te kunnen schetsen.

Published
2020

33. Tips tijdens COVID-19 uitbraak: Tips voor management

Author

van Boekel, L., Tranzo, Scientific center for care and wellbeing, and Ouderen

Abstract

De Academische Werkplaats Ouderen van Tranzo/Tilburg University deed een snelle literatuurstudie. Het doel was om te onderzoeken wat we kunnen leren van andere crisissen of rampen wereldwijd om de zorg voor Nederlandse ouderen in het verpleeghuis tijdens de uitbraak van COVID-19 zo optimaal mogelijk te houden. De literatuurstudie is gepubliceerd in het Tijdschrift voor Gerontologie en Geriatrie (TGG) https://tvgg.nl/artikelen/covid-19-vpz/. Wij delen de belangrijkste tips met je

Published
2020

35. Tips tijdens COVID-19 uitbraak: Tips voor zorgmedewerkers en mantelzorgers

Author

van Boekel, L. and van Boekel, L.

Abstract

De Academische Werkplaats Ouderen van Tranzo/Tilburg University deed een snelle literatuurstudie. Het doel was om te onderzoeken wat we kunnen leren van andere crisissen of rampen wereldwijd om de zorg voor Nederlandse ouderen in het verpleeghuis tijdens de uitbraak van COVID-19 zo optimaal mogelijk te houden. De literatuurstudie is gepubliceerd in het Tijdschrift voor Gerontologie en Geriatrie (TGG) https://tvgg.nl/artikelen/covid-19-vpz/. Wij delen de belangrijkste tips met je!

Published
2020

36. The Academic Collaborative Center Older Adults: A description of co-creation between science, care practice and education with the aim to contribute to person-centered care for older adult

Author

Luijkx, K. G., van Boekel, L. C., Janssen, M. M., Verbiest, M. E. A., Stoop, H. J., Luijkx, K. G., van Boekel, L. C., Janssen, M. M., Verbiest, M. E. A., and Stoop, H. J.

Abstract

Long-term care for older adults is in transition. Organizations offering long-term care for older adults are expected to provide person-centered care (PCC) in a complex context, with older adults aging in place and participating in society for as long as possible, staff shortages and the slow adoption of technological solutions. To address these challenges, these organizations increasingly use scientific knowledge to evaluate and innovate long-term care. This paper describes how co-creation, in the sense of close, intensive, and equivalent collaboration between science, care practice, and education, is a key factor in the success of improving long-term care for older adults. Such co-creation is central in the Academic Collaborative Center (ACC) Older Adults of Tilburg University. In this ACC, Tilburg University has joined forces with ten organizations that provide care for older adults and CZ zorgkantoor to create both scientific knowledge and societal impact in order to improve the quality of person-centered care for older adults. In the Netherlands, a “zorgkantoor” arranges long-term (residential) care on behalf of the national government. A zorgkantoor makes agreements on cost and quality with care providers and helps people that are in need of care to decide what the best possible option in their situation is. The CZ zorgkantoor arranges the long-term (residential) care in the south and southwest of the Netherlands. This paper describes how we create scientific knowledge to contribute to the knowledge base of PCC for older adults by conducting social scientific research in which the perspectives of older adults are central. Subsequently, we show how we create societal impact by facilitating and stimulating the use of our scientific knowledge in daily care practice. In the closing section, our ambitions for the future are discussed.

Published
2020

40. Exploring the impact of social network change: Experiences of older adults ageing in place

Author

Vos, W. H., van Boekel, L. C., Janssen, M. M., Leenders, R. T. A. J., Luijkx, K. G., Vos, W. H., van Boekel, L. C., Janssen, M. M., Leenders, R. T. A. J., and Luijkx, K. G.

Abstract

Social networks are sources of support and contribute to the well-being of older adults who are ageing in place. As social networks change, especially when accompanied by health decline, older adults' sources of support change and their well-being is challenged. Previous studies predominantly used quantitative measures to examine how older adults' social networks change. Alternatively, this study explores the impact of changing social networks on older adults' lives by examining their personal experiences. We held four focus groups, two with a total of 14 older adults who are ageing in place and receiving home care and two with a total of 20 home-care nurses from different regions and organisations in the Netherlands. Subsequently, an expert team of home-care professionals and managers discussed and verified the results. Procedures for grounded theory building were used for analysis. We revealed four themes of high-impact experiences: (a) struggling with illness/death of the spouse; (b) working out a changing relationship with (grand)children; (c) regretting the loss of people they have known for so long and (d) feeling dependent and stressed when helpers enter the network. Also, network dynamics were found to follow three consecutive stages: (a) awareness of social network change; (b) surprise when social network change actually occurs and (c) acceptance and adjusting to new circumstances. Together, the four themes of experiences and three stages of network change form an integrative model of the role of social network dynamics for older adults' lives when ageing in place.

Published
2019

46. EXPLORING THE IMPACT OF SOCIAL NETWORK CHANGE: EXPERIENCES OF OLDER ADULTS AGING IN PLACE

Author

Roger Th. A. J. Leenders, W. Vos, Katrien Luijkx, and van Boekel L

Subjects
Abstracts, Health (social science), Social network, Aging in place, business.industry, sense organs, skin and connective tissue diseases, Life-span and Life-course Studies, business, Psychology, Health Professions (miscellaneous), Social psychology
Abstract

When aging in place, social networks are sources of support and contribute to wellbeing. As social networks change, especially when accompanied by health decline, older adults’ sources of support change and their wellbeing is challenged. Previous studies predominantly use quantitative measures to examine how older adults’ social networks change. This study explores the impact of social network change on older adults’ lives by examining their experiences. Four focus groups were held in total with fourteen older adults aging in place and receiving home care and twenty home care nurses from different regions and organizations. In addition, an expert team consisting of home care professionals and managers was consulted to discuss and verify preliminary results. Procedures for grounded theory building were used to extract and analyze data. Although they know social networks change, older adults are surprised when their network changes and experience a major impact. Still, older adults experience good quality of life, although it takes hard work to adjust and adapt to circumstances in which social networks change. Four social network changes impact older adults’ lives the most: 1) illness/death of (self/)spouse, 2) accepting help from their children, 3) deletion of the ones they have known for so long and 4) helpers entering the network. After attending this session, participants will be able to distinguish three phases of social network change experience in older adults’ lives. Additionally, participants will be able to recognize older adults’ experiences of the four social network changes that impact older adults’ lives the most.

Published
2018

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