Projects

Abstract

Hepatitis B virus (HBV) causes 1.3 million deaths per year worldwide, with South Africa's burden intensified by the risks of HIV co-infection. The burden of vaccine-preventable HBV in South Africa has not been accurately determined, complicating the tracking of progress against the goals of elimination of Agenda 2030. We will adopt a modeling framework to estimate the burden of HBV disease more accurately and assess the (cost-)effectiveness of prevention strategies while accounting for HBV and HIV co-infection. The latter increases, for example, mother-to-child transmission during pregnancy. We will share our data-driven insights through close science-policy engagement to inform maternal and neonatal health interventions. Concurrently, we will raise educational standards in disease modeling, leading to a global cadre of emerging researchers. Our focus on bridging the gap for vulnerable populations, preventing mother-to-child transmission, will leverage policy action to integrate HBV services for equitable healthcare.

Researcher(s)

• Promoter: Willem Lander
• Co-promoter: Vanwolleghem Thomas

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

The exchange of medical data does not always run smoothly between the first and second/third lines. In this project we wish to exchange existing 'problem lists' so that existing basic information can always be accurately read into the various file systems of general practitioners or hospitals. We want to do this by: 1. to describe a clear, detailed use case with the first and second line together that illustrates how we can exchange problem lists between first and second line via an extension to the current BE Patient Problemlist project in a way that takes into account the differences in wishes and operation of both lines: who are the parties involved in the exchange, what goal are these parties trying to achieve with this exchange, what are the starting conditions, how should the supporting software support the user to achieve his goal, what freedoms, guidelines and or constraints must be given to the user. 2. to write a supported vision text with concrete recommendations and guidelines based on this use case 3. to work on coordination of the SNOMED CT resources used (where possible, unity of language and content [coordinated thesauri/value sets]) 4. to pay specific attention to the quality of the SNOMED CT problem list in the GP EHR (degree of structure, degree of SNOMED CT coding, ...) to check whether the content of these is 'fit' for structured exchange 5. to provide practical BE Patient problem list training for employees to support successful and high-quality implementation and follow-up 6. monitor the evolution of the technical landscape (FIHR architecture, Caresets, hubs, vaults, connectivity of EHR and EHR suppliers) and map out what is still technically missing for further realization and rollout of the intended bilateral and cross-line exchange of problem list material 7. to set up a demo environment that approximates reality as closely as possible, and that serves both to illustrate the use case and vision text, and to indicate where there are still shortcomings that hinder further realization and upscaling. 8. document the project approach and report on the experiences and lessons learned

Researcher(s)

• Promoter: Wens Johan

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

The Red Cross Flanders published the handbook Listen! First Aid for Mental Health Problems for the first time in 2019 as a reference work accompanying the then-new First Aid for Mental Health Problems (FAMHP) training sessions. Now, five years later, it is time for a revision. Literature reviews are being conducted again, and there is also an expert panel in place, chaired by Prof. Van den Broeck.

Researcher(s)

• Promoter: Van den Broeck Kris

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project website

Project type(s)

• Research Project

Abstract

This multi-country, prospective Perpetual Observational Study (POS) among patients presenting with symptoms of an acute respiratory infection (ARI) to primary care (PC) aims to provide an estimate of the overall incidence of illness and individual diagnoses, as well as critically important benchmark descriptive data related to patient characteristics, complications, outcome, and risk factors per viral aetiology. These detailed data allow for the identification of variation in management and care within and between countries, suggesting improvements for care planning and informing clinical guidelines. In the longer term, the study will establish a research-ready infrastructure for enhanced observational studies and clinical trials related to treatment, diagnosis, and prevention of ARI in the primary care setting. Such a "plug-in" approach is especially beneficial during epidemics and pandemics because it makes it possible to set up new studies much quicker, without having to go through the full process of regulatory approvals for each individual research.

Researcher(s)

• Promoter: Coenen Samuel
• Co-promoter: Morreel Stefan

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project website

Project type(s)

• Research Project

Abstract

Trial Aim. The study aims at evaluating the best PPI deprescribing strategy in patients who are chronically using PPIs without an established indication for long-term use. Trial Participants and setting. Inclusion: Eligible patients are those of either gender, above the age of 18, eligible to give informed consent. Based on indication: Patients on long-term (>12 weeks) chronic PPI use without therapy indication are eligible to participate. Based on dose: Patients on a "maintenance" PPI dose are eligible for randomization. Maintenance dose is 20 mg of omeprazole, esomeprazole or pantoprazole daily or 15 mg of lansoprazole daily or 10 mg of rabeprazole daily. Patients on "healing" PPI dose (i.e. ≥40 mg esomeprazole, esomeprazole or pantoprazole or ≥30 mg of lansoprazole or ≥20 mg or rabeprazole daily) are also eligible for the study, but need first to down-titrate their dose to "maintenance" dose before they can be considered for randomization. Intervention(s). Chronic PPI therapy is changed to on-demand therapy approach for one month. The dose PPI should be maintenance dose (the lowest dose). PPI intake should occur only when needed to reduce symptoms, followed by PPI interruption (36-40). When symptoms recur during this month, the patient restarts PPI intake until symptoms again resolve, upon which the intake of medication is again stopped. PPI therapy is stopped and replaced by alginate formulation for one month. Alginates have shown effectively reducing GERD symptoms (42-44) and have shown 38 to 40% success rate as deprescribing therapy (12-25). After one month, the use of alginates is stopped. All patients will receive lifestyle adviceand guidelines for antacid use and will be followed up for 1 year. Antacids excluded for use during the study: drugs based on magaldrate such as Riopan® and Gastricalm® and Syngel® as it also includes lidocaine and it is not considered a standard antacid. Control. The comparator for this study will be a gradually decreasing intermittent dosing scheme for one month before stopping the PPI, which is in line with the Belgian guidelines (12) and was already used in a Belgian primary care study (13,14). Also in this arm, all patients will receive lifestyle advice and guidelines for antacids use. Similar to the intervention arms, all patients will be followed for need to restart PPI therapy for one year. Objectives. Outcome measures. Primary Endpoint. To evaluate the best PPI deprescribing strategy in primary care patients who are chronically using PPIs without an established indication. The therapeutic outcome of a patient is determined by the sum of 3 key indicators: (1) No clinically relevant use of PPI (2) treatment satisfaction and (3) willingness to continue with the current treatment. A patient is defined as successful when the sum of these key points is equal to 3, or not successful otherwise. The follow up period of this study starts at visit 3 and is 12 months long. For analysis, the sum of the key indicators as reported by the patient after 12 months follow up will be considered (a.k.a last study visit 5). Secondary failures, i.e; patients who fail to stop the PPI after the initial randomized intervention phase, are not considered to represent success of the intervention even if in the course of the study these patients are able to stop the PPI.

Researcher(s)

• Promoter: van Olmen Josefien

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

This project aims to substantiate nature interventions as a function of a climate-adaptive care environment. We refer here to 'care nature interventions'. A care nature intervention is a scientifically substantiated nature intervention within a certain care context with the aim of (i) increasing biodiversity, (ii) improving health (mental, physical and social) and (iii) contributing to a climate-adaptive environment where water is buffered, carbon is stored and the heat island effect is mitigated. During 4 years, 3 to 5 living labs spread over Flanders will be monitored. In these living labs, more quality nature is set up within walking distance of a specific target group or setting with a social or care need and for which that nature contributes to the recovery of both people and environment. Translated with DeepL.com (free version)

Researcher(s)

• Promoter: Keune Hans

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

This project aims to understand the factors contributing to the psychological vulnerability or vitality of older adults (aged 80 and above). It will investigate various influencing factors, including older adults' medication status concerning anticholinergic burden and prescribing cascades, as well as determinants of psychological vulnerability/mental vitality, particularly focusing on their living environment. Mental health problems affect up to 40% of older adults and often have a greater impact on their overall health status than chronic physical conditions. Common mental health issues include anxiety, depression, psychotic experiences (e.g., delirium), and harmful personality dynamics. Despite efforts, some mental health needs, particularly depression and anxiety, go unrecognized among older adults, leading to misdiagnosis or underdiagnosis. In Belgium, the predominant approach to mental health issues is biomedical, with pharmacotherapy as the primary treatment, resulting in high rates of psychoactive medication prescriptions among older adults. While pharmacotherapy has merits, it also poses risks, especially for older adults, including severe side effects on somatic and cognitive levels due to increased anticholinergic burden. Psychoactive medications often lead to adverse effects such as cognitive decline, confusion, and delirium, which can exacerbate existing mental health issues or trigger new ones, necessitating third-line services' intervention. Additionally, prescribing cascades, where medications are prescribed to counteract the side effects of other medications, are common among older adults and contribute to hospital admissions. Older adults with mental health vulnerabilities often have multiple vulnerabilities, including multimorbidity and polypharmacy, highlighting the need for personalized interventions that go beyond medication. Furthermore, the impact of living environments, including interior design and neighborhood characteristics, on the mental well-being of older adults with psychological vulnerabilities, is understudied. A tailored living environment that promotes autonomy and integrity is crucial for their well-being. Access to outdoor spaces and contact with nature are particularly important, as limited access predicts depressive symptoms. This project seeks to answer key research questions regarding the factors contributing to psychological vulnerability/vitality in older adults, the bi-directional relationship between living environment and mental health, the impact of reducing polypharmacy on mental health, and the development of a tailored intervention mix for psychological vulnerability/mental vitality.

Researcher(s)

• Promoter: Van den Broeck Kris
• Co-promoter: Annemans Margo
• Fellow: Vermeulen Tom

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

CITY-MOVE adapts and implements the WHO Global Action Plan on Physical Activity (GAPPA) in six cities across three continents and develops a cross-contextual evaluation framework for transferability and scalability. Physical activity is a key behavior to reduce the NCD burden, including protecting against cancers and type 2 diabetes. There are many evidence-based interventions for cities to promote physical activity, yet they remain under-implemented, with a whole-of-system approach particularly lacking, and often fail to target the least active or vulnerable groups. Knowledge gaps are: a) how to adapt, b) successfully implement, and c) evaluate interventions, and d) how to transfer lessons to other interventions, target groups and contexts. In partnership with the cities, we identified interventions targeting individuals across the life course, particularly vulnerable and least active groups, aligned with the GAPPA domains of active people, societies, environments and systems. CITY-MOVE will: 1) Develop a city-GAPPA Theory of Change and operationalise assessment measures; 2) Adapt city-GAPPA to six cities, engaging stakeholders in each context; 3) Support cities in successful implementation through action research in living labs; 4) Assess reach, adoption, feasibility, fidelity, and sustainability of selected interventions in each city; 5) Improve the development and utilisation of routinely collected data to support successful implementation; 6) Generate cross-contextual evidence on implementation, evaluation and scalability through multi-criteria decision assessment for 12 interventions in six cities; and 7) Generate global capacity through regional Communities of Practice. CITY-MOVE results lead to increased physical activity by target populations, contributing to reduced premature NCD mortality, and to adaptable solutions ready for take-up by implementers.

Researcher(s)

• Promoter: van Olmen Josefien
• Co-promoter: Bastiaens Hilde
• Co-promoter: Thornton Lukar
• Co-promoter: Wouters Edwin

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project website

Project type(s)

• Research Project

Abstract

This project includes the administrative support of the Working Group Development of Primary Care Guidelines, financed by RIZIV. The task indulged the development, adaptation and update of Belgian Guidelines. The assignment within this project includes financial support of the project -

Researcher(s)

• Promoter: Van Royen Paul

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

This project concerns a literature study in the context of the development of transmural integrated care pathways in the regional care zone Antwerp for elderly patients with chronic care problems. This is a scoping review of transmural care pathways (what types of transmural care pathways exist internationally, in which contexts, i.e. which interventions in which circumstances, but also into which effects were intended and possibly achieved). At the same time, a search will be launched to make an inventory of already started transmural care pathways for this target group throughout Belgium.

Researcher(s)

• Promoter: Van Royen Paul

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

Background COVID-19 and COVID-like-illness cause significant ill-health and mortality, particularly in clinically vulnerable individuals. Despite novel antiviral agents coming to market, it remains imperative that the search for better treatments continues, especially since many new drugs are expensive, require a diagnostic test before they are used, and may have many important drug interactions and exclusions. An adaptive platform trial is an efficient way to test such potential agents as it allows for multiple interventions to be tested under a single master protocol. Main trial Platform randomised, double-blind, multicentre trial for the evaluation of new investigational products (IPs) for treatment of non-hospitalised patients with COVID-19 and COVID-like-illness. Platform trial A "platform trial" is a trial in which multiple IPs for the same illness can be tested simultaneously, and in which new interventions can be added during the course of the trial in accordance with pre-specified criteria. The master protocol describes the overall structure and processes of the platform, while any specifics for the interventions and comparators under investigation are described in separate intervention specific appendices (ISAs). Outcomes The primary outcome will be phase dependent. For Phase IIb/III type evaluations the primary outcome will be time to first self-report of feeling fully recovered from symptoms of COVID-19 or COVID-like-illness. For Phase IIa type evaluations the primary outcome parameter will be viral clearance and impact on biomarkers. Secondary outcomes and possible exploratory outcomes are available in the master protocol. Trial design Screening can be completed face-to face as well as remotely. After obtaining informed consent, eligibility for trial participation will be checked. Eligible participants will be randomly allocated to receive either an IP, or the specified control. Participants will be asked to report their symptoms in a daily or weekly diary. A swab will be (self)-taken at baseline (day 0) and subsequently on day 4, 7 and 14. Participants will receive a phone call on/after day 28 in case their diary is incomplete to capture a minimal outcome data set. For longer-term follow-up, all participants will receive a follow-up call or electronic questionnaire 3 and 6 months after randomisation. Trial population Participants who meet the following main inclusion criteria may be eligible to take part in the main trial: • Aged ≥18 years • Presence of at least two symptoms suggestive of COVID-19 or COVID-like-illness, one respiratory (cough, sore throat, running or congested nose or sinuses, shortness of breath) and one systemic (fever, feeling feverish, sweats/chills or shivering, low energy or tiredness, headache, muscle, joint or body aches, loss of taste and/or smell). • Judged by recruiting medically qualified clinician or research nurse that the illness is due to COVID-19 or COVID-like-illness • Onset of symptoms less than 7 days. • Willing and able to give informed consent for participation in the study. • Willing and able to comply with all trial procedures. Potential additional inclusion criteria for specific IPs will be detailed in the ISA.

Researcher(s)

• Promoter: Coenen Samuel

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project website

Project type(s)

• Research Project

Abstract

People with intellectual disabilities have a higher prevalence of health problems and die at younger ages than the general population. Healthcare professionals are insufficiently trained to recognize clinical signs and specific health needs in this patient group. In addition, they experience difficulties in communication with people with intellectual disabilities. To improve the knowledge and skills of healthcare providers and promote inclusion/participation, we train people with intellectual disabilities to become simulated patients in a skills lab. Subsequently, we offer professional training in a pilot project with future general practitioners.

Researcher(s)

• Promoter: Van Dijck Anke
• Co-promoter: Colliers Annelies

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

Heart failure is a common condition that mainly affects elderly patients. It has a significant impact on quality of life and is associated with repeated hospital admissions and a greatly increased risk of death. Guidelines recommend multidisciplinary care for patients with heart failure. However, this is not yet the reality in Belgium. Healthcare providers in the field also felt this way. In various Flemish regions, multidisciplinary heart failure projects were established with the aim of improving care for patients with heart failure. The Heart Failure Learning Network was launched in 2019 with the support of the Dr. Daniël De Coninck Fund, managed by the King Baudouin Foundation. As a democratic and participatory network, the Learning Network aimed to bring together projects so that they could learn from each other by exchanging experiences and best practices. We have found that the Learning Network is a successful model for supporting or accelerating the implementation of complex projects. All 8 heart failure projects that are part of the network worked transmurally, interdisciplinarily, and placed the patient and their environment at the center. We, as the network, focused on the development of training programs, materials, and protocols that promote the initiation and implementation of a transmural, interdisciplinary project. As a result, we developed a brand-new training program for heart failure educators in primary care and a visual atlas to support patient education. Stakeholder experiences were mapped out. We contributed to the development of a medical-pharmaceutical consultation for heart failure, a multidisciplinary heart failure care pathway, and the update of the heart failure guideline for primary care. Finally, we will describe and evaluate the participating projects. The developed materials and protocols will be launched in the course of 2023. Gradually, the ambition of the network grew. In the next step, we want to scale up integrated heart failure care in new Flemish/Belgian regions. We want to support these regions as a network in implementing integrated heart failure care. Furthermore, one of the major gaps in the current chronic care organization is the lack of patient education and empowerment in primary care. Patient education is only reimbursed for patients with diabetes/chronic kidney insufficiency. All other chronic patients are left out in this regard. We have already taken some steps to address this gap concerning heart failure, but our work in this area is not complete: further development with a focus on health and e-health literacy skills is needed. In several projects of the Learning Network, technology played an important role in the form of telemonitoring. Further research is needed to determine how we can optimally integrate telemonitoring into a multidisciplinary care pathway. Specifically, we want to examine which parameters are truly important for telemonitoring in the home setting and which patients would benefit the most from this telemonitoring. In addition, it is important not only to support healthcare providers in improving heart failure care, but also to provide students in basic education with the necessary tools, with a focus on interdisciplinary collaboration, accessible education, self-management support, and the smart integration of healthcare technology. So far, we have focused on improving and supporting patients with heart failure who live at home. In residential care centers, the prevalence of heart failure is high, and there is still a lot of room for improvement in heart failure care, including the recognition and timely identification of decompensation alarm symptoms by nursing and care staff. The first steps have been taken for the implementation of a heart failure protocol in residential care centers. This is a research line that we want to further expand in the coming years.

Researcher(s)

• Promoter: Wens Johan

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

Current mental health care can be improved and made more efficient, both at individual and organisational level, by taking systematic and epidemiological data into account (KCE, 2019). iPSYcare is a prestigious data capability project in which a database will be developed with patient data from different (psychiatric) hospitals. It will result in a more efficient organisation of care. By developing a dashboard to this anonymised information, care professionals can be supported and consult guiding information in order to propose adequate treatment or support. The objectives of iPSYcare are therefore to: - Map patient flows - Analyse the care provided - Will form the basis for a dynamic dashboard that provides relevant information to healthcare actors about the care provided and can thus act as a policy-support tool.

Researcher(s)

• Promoter: Van den Broeck Kris

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project website

Project type(s)

• Research Project

Abstract

Acute Respiratory Infections (ARI) are one of the most frequent reasons for patient presentation in primary care (PC) and antibiotic use, and can be caused by a broad range of respiratory viruses and bacteria. In the context of the ongoing COVID-19 pandemic, the importance of ARI as a major health concern cannot be overstated, and has raised new challenges in addition to Antimicrobial Resistance (AMR).The main aim of the POS-ARI-PC AUDIT Protocol is to describe the presentation and management (including clinical examination and diagnostic procedures routinely undertaken, medication prescribing and advice given) for ARI in PC. This will be an 'audit-type' study in which clinicians register non-identifiable characteristics of patients and their management, and any results will be presented in aggregated form. Individual consent will therefore not be required. Describing current practice of ARI in contrasting European countries and settings will allow identification of (unwarranted) variation in care, and estimation of congruence of current practice with best-practice guidelines to identify opportunities for improvements in management.

Researcher(s)

• Promoter: Coenen Samuel

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

The Alivia pilot project aims to test a digital tool, developed by the Flemish government, to promote targeted and integrated care for citizens, informal caregivers and care providers (medical, non-medical and welfare). The Antwerp region is one of the two pilot regions where testing will take place in two care settings: palliative setting and chronic care and support needs in the home situation.

Researcher(s)

• Promoter: Van Royen Paul

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

Background: Providing children with healthy meals at schools can benefit the health of children and can positively influence health behavior. However, most studies on this topic are cross-sectional and focus on the short-term effects. Recently, the city authorities of Antwerp invested 40 million euros in the project 'Smakelijke School'. The aim of the project is to provide children with healthy meals at school and consequently to improve the health of children. In Belgium, no studies are conducted yet to evaluate the process and impact of such interventions. The specific aims are: 1. To describe the intervention and implementation process in detail using the 'Template for Intervention Description and Replication' checklist and guideline (TIDieR). 2. Explore the attitudes and experiences of the schools, teachers, parents and children, focusing on feasibility, acceptability and perceived impact on eating behavior. 3. Explore the impact of the intervention on knowledge, attitude and habits (regarding diet and health) and well-being of children. 4. To measure the impact of the intervention on children's cognitive performance, blood pressure, anthropometry and behavior. Methods: • Intervention: In total, 4 schools (participating in the Smakelijke School project) will be included: two high-intensity intervened schools (defined as schools offering a healthy meal/snack every day) and two low-intensity intervened schools (defined as schools that offer a healthy meal/snack no more than twice a week). Low-intensity schools will be compared with high-intensity schools and within the schools children not taking the meals (intervention) will be compared with children taking the meals. • Participants and setting: We will invite schools starting in September 2023. The school management (principals), teachers, children of the 4th grade and their parents will be invited to participate. Work package 1: quantitative assessments • Measurements: o Cognitive function tests: Stroop Test (selective attention), Continuous Performance Test (attention and concentration), Memory Span Test (short-term memory), Digit Symbol Test (information processing), Signal Detection Test (visual information processing). o Anthropometrics (height, weight and fat percentage) and blood pressure measurement o SDQ, KIDSCREEN-27 questionnaire and KAH-questionnaire (knowledge, attitude and habits) regarding food. o Questionnaire for the parents to gather information on individual socio-economic status and child general health and physical activity. Work package 2: qualitative assessments In the first phase of the qualitative aspect, we will describe the intervention and the implementation process and conduct interviews with the school management, teachers, children and parents. Based on the results from the quantitative part (WP 1) of this study, we will select the participants needed to continue the qualitative part of this study. We will organize observations in the schools, focus groups and a class conversation.

Researcher(s)

• Promoter: Bastiaens Hilde
• Co-promoter: Casas Ruiz Lidia
• Co-promoter: Glazemakers Inge
• Co-promoter: Penalvo José Luis

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

This project proposes a methodological framework in the context of respiratory pathogens with pandemic potential, based on historical data of SARS-CoV-2. Clustered social contact patterns have been pivotal in combination with stochasticity to explain disease spread and heterogeneous behaviour. Therefore, we focus on mathematical models that accommodate heterogeneity in infection acquisition and additional randomness at the individual level. However, estimation of key epidemiological parameters based on stochastic and computationally intensive individual-based models is challenging. Especially when we focus on multiple outcomes, which is required when evaluating the health economic impact of preventive measures. A coarse-grained cost-effectiveness analysis is possible through individual-based modelling, yet complicated by a cascade of uncertainties and stochasticity in the underlying disease process. The availability of options to define the most (cost-)effective scenario requires multi-criteria selection techniques. Machine learning methods have been proven useful for this, however, this complex modelling context requires progressive algorithms. Informing the decision making process is particularly challenging in an epidemic setting with unexpected events such as the emergence of new variants of concern. We aim to accelerate decision making in the next pandemic with a public health framework grounded in advanced statistics, health economics and computer sciences.

Researcher(s)

• Promoter: Willem Lander

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project website

Project type(s)

• Research Project

Abstract

Most traditional youth mental health interventions fail to achieve sustainable impact at scale because they overly rely on individualized, medical illness-focused models and treat youth as passive beneficiaries. citiesRISE, a multi-stakeholder initiative founded in 2017 to address these gaps, has worked with youth, communities, and professionals across five cities, as well as social innovators in over twenty countries, to develop a set of evidence-based, scalable youth mental health interventions and implementation models. The YiPEE project aims to provide robust evidence on the feasibility, adaptability, effectiveness, and cost-effectiveness of a multi-component intervention targeting the inner, social, and environmental dimensions that underpin mental health and broader NCD risk reduction outcomes, when implemented using a youth-informed and -activated approach. This will be achieved through a a mixed-methods approach, conducting a realist evaluation across the four sites (Chennai, India; Nairobi, Kenya; Cape Town, South Africa; Stockholm, Sweden) to study key implementation outcomes following the Practical Robust Implementation and Sustainability Model (PRISM) as well as the mechanisms underlying why the intervention works, for whom, and under what real-world conditions. In Chennai, YiPEE will conduct a randomized controlled trial for more robust evaluation of effectiveness and cost-effectiveness in achieving key mental health and other NCD related lifestyle behavioral outcomes. YiPEE focuses on the combination of a school-based multicomponent intervention targeting positive disruption in the inner, social, and environmental dimensions of adolescents' mental health and a youth-informed and -activated implementation model that puts young people at the centre of transformation, working collaboratively with a range of other stakeholders.

Researcher(s)

• Promoter: van Olmen Josefien
• Co-promoter: Willem Lander
• Co-promoter: Wouters Edwin

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

The Flemish government supports the development of primary care. This happens partly within the VAGZ, with the policy instruments regulation and financing. In addition, organisations providing support have been set up, such as VIVEL. VIVEL supports the development of the ELZ with a number of supporting activities and evaluations of themes such as: a) participation of people with care and support needs in care degrees (by Artevelde-Hefboom); b) indicators and identification of vulnerability for ELZ (U Gent); and c) data and dashboard for monitoring care needs and supply at ELZ level (VIVEL working group on data). The VAGZ wants to use its support efficiently and effectively. This planning benefits from knowledge (and experimental learning) about what has worked and knowledge gathering on what works well and what works less well in the first years of the ELZ. There is international comparative research evaluating the COVID-19 response and decentralisation 2,3. However, an evaluation of the functioning of ELZ in Flanders has not been done to date. The aim of the current evaluation is to know whether and how ZR used the resources and function of population managers during the COVID pandemic to strengthen the governance, collaboration and organisation of the ELZ and what process changes and health outcomes this led to.

Researcher(s)

• Promoter: van Olmen Josefien

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

Encouraging women to give birth in health facilities is considered a key strategy to prevent women and babies from dying. However, facility-based delivery (FBD) is increasingly understood not to be enough to reduce maternal and perinatal mortality. Measuring only the coverage of FBD in a particular context does not reflect the content and quality of care women receive. To address this shortcoming, effective coverage measures – which introduce the dimension of quality of care to the measurement of intervention coverage – are proposed as the new best practice. However, the relevance and feasibility of measuring effective coverage of FBD (ECFBD) in low-resource contexts remains understudied. We have limited insight into the conceptual and practical challenges which may hamper operationalisation of this indicator. My project addresses this research gap by investigating the relevance and feasibility of measuring ECFBD across Tanzanian health system levels, from the facility-level in Newala district, up to regional, national, and international levels. By using qualitative research methods and studying experiences 'from the ground up', the project will shed light on the tensions between international measurement demands and local needs, as well as how they might be addressed. My findings will thus be able to inform future efforts to measure ECFBD, hereby contributing to promoting global health measurement that is truly helpful to improve local-level health services and outcomes.

Researcher(s)

• Promoter: van Olmen Josefien
• Fellow: Molenaar Jil

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

Sustainable Development Goal 3 underlines the right of everyone to have timely access to primary healthcare (PHC). Despite the fact that Belgium has put various reforms in place to make PHC more affordable and accessible, inequalities in access to care are even getting bigger – creating the need for innovative measures. A new health care model should thus be designed and tested to link people who have difficulties accessing PHC (PDAP) to the existing PHC system. Such a new model requires new fundamental knowledge, as former solutions have repeatedly failed. Since the country is also confronted with increasing health demands and limited budgets, there is impetus to tap into the potential of reverse innovations from low and middleincome countries (LMICs). A review of health innovations in LMICs and a theoretical analysis on the required characteristics of such a new model resulted in a community health worker (CHW) intervention – inspired by the Family Health System in Brazil and Re-engineering PHC in South Africa. We hypothesise that an outreaching PHC model with a CHW intervention will address the access-to-care challenges in Flanders, Belgium. We will first study the interplay over time between the different barriers PDAP experience throughout the access-to-care continuum in Flanders (WP 1). Secondly, we will investigate the innovative PHC models in South Africa and Brazil to develop the CHW intervention (WP2). In WP3, we will design a new outreaching PHC model which uses CHWs to improve access to care for PDAP in Flanders. In WPs 4 and 5, we will implement and evaluate the CHW intervention in a cluster randomised controlled trial. Finally, we will also assess the cost-effectiveness of the intervention (WP6). Throughout this work, academic experts from sociology, family medicine, and economics closely collaborate with committed societal stakeholders to join scientific insights and implementation knowhow, to optimise fit to practice and societal impact.

Researcher(s)

• Promoter: Bastiaens Hilde
• Co-promoter: Masquillier Caroline
• Co-promoter: van Olmen Josefien

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project website

Project type(s)

• Research Project

Abstract

Moe- are not being used in practice due to multiple reasons. Both BIA and DEXA can't give qualitative information, and CT and MRI lack reference values, besides the fact that both are impractical to use in routine screening. Also, since muscle mass changes occur at least a decade before alterations in muscle strength, the only way to initiate primary preventive therapies is to detect muscle changes in the earliest stage. At present, in clinical practice, it seems that the most direct and detailed measurement of muscle mass quality and quantity and thus early detection of changes in muscle characteristics can only be done by ultrasonography. The use of this technique is new in the assessment of sarcopenia however, which created two main barriers for widespread use. One of these two was the lack of standardization of the measurement technique, which has been solved by recent efforts. Standardization of ultrasonographic measurement of muscle mass is now clearly described, and supported by the European Geriatric Medicine Society. The only remaining barrier for its widespread use is the availability of reference values and clear cut-off points at which the diagnosis of sarcopenia can be made. To remove this last barrier, this project will measure all available muscle mass characteristics in eight groups. Also muscle strength, function and the correlating (loss of) quality of life will be measured. The first group will be the reference group of participants between 20 and 30 years old. The other groups will consist of 30-40 year olds, 40-50 year olds, 50-60 year olds, 60-70 year olds, 70-80 year olds, 80-90 year olds. The eighth group will consist of older people admitted to nursing homes, to check whether this population has specific muscle characteristics. This project hopes to determine the point at which the change in muscle characteristics have an influence on muscle strength and function. This way, an easy screening system can be set up in order to prevent functional decline and all its negative consequences as early as possible.

Researcher(s)

• Promoter: De Cock Anne-Marie
• Co-promoter: Perkisas Stany

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

In this project we want to tackle the problem of cervical cancer (CC) and its inequitable burden of disease in Ecuador, by designing and implementing a feasible strategy for screening and follow up in remote communities. The project combines 1) research aimed at improving and implementing screening facilities with 2) strategies to promote uptake of screening services and 3) a highly innovative component in the construction of a VIA-telemedicine and AI based tool for automatization of diagnosis of cervical abnormalities. Embedding the activities in existing local services and training female local health workers will lead to a sustainable strategy in which women are not only the main beneficiaries but, by their protagonist role in the project, drivers of change. The project builds on the good results we obtained in our SI project ending in August 2022.

Researcher(s)

• Promoter: Verhoeven Veronique
• Co-promoter: Bogers John-Paul
• Co-promoter: Condori Sandra
• Co-promoter: Philips Hilde

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

BIONEXT will develop knowledge, tools, and guidance for mainstreaming biodiversity into policy making and provide concrete options on how to initiate, accelerate and upscale biodiversity relevant transformative change in society. It will deliver an innovative Nexus Modelling Framework that will integrate scenarios and pathways in a co-production process with stakeholders, while modelling interlinkages between biodiversity, water, food, energy, transport, climate, and health, and enabling simulation of the impacts of indirect and direct drivers on biodiversity. Through its database of transformative change cases, BIONEXT will involve policy- and decisionmakers and allows them to explore the concept of just transformative change. Plausible futures and desirable, nature-positive visions for Europe and multiple just transition pathways will be co-created in workshops and focus groups taking place in various cities around Europe. With the involvement of diverse stakeholders, the BIONEXT Pathways App will be delivered as a novel decision support tool that allows users to explore transformational building blocks, for formulating policies and implementation pathways for the biodiversity nexus. The results will contribute to science brokerage, capacity building and networking to IPBES, EU policymakers, and civil society.

Researcher(s)

• Promoter: Keune Hans
• Co-promoter: Springael Johan
• Co-promoter: Van geertruyden Jean-Pierre

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

This project coaches women with Type 2 Diabetes towards a healthier lifestyle and increases their physical activity. In the city of Oujda in Morocco, a safe women-only lifestyle centre opens under supervision of trained female nurses from the adjacent local health centre and a female project coordinator from the local university. The centre becomes a hub bridging practice, education and research. Patients become agents of change in inspiring and instructing other patients towards prevention and treatment of Type 2 Diabetes. Nurses become more apt in their task of diabetes management. Female PhD researchers study the benefits and pitfalls of a gender-sensitive approach. Hence, incentivising education of female nurses and female leadership in health and research, the medical and social outcome, in female T2D patients improves.

Researcher(s)

• Promoter: Van Rompaey Bart

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)
• Centre for Research and Innovation in Care (CRIC)

Project type(s)

• Research Project
• Education Project

Abstract

Space has become a scarce commodity. A third of the surface in Flanders is already taken up, 6 hectares are added every day. Moreover, 16% of the total surface is paved. How can we look at our neighborhood with different eyes? Whose space does it belong to? How can we make it more beautiful, healthier and climate-friendly? 'We are Space' wants to provide schools and neighborhood groups with tools to get started with these questions, through teaching and work packages that we will develop participatively through 5 pilot projects. What? 5 local collaborations (local government, elementary school and community group) for the participatory development of a teaching and work package 5 concrete and feasible plans for an action in the municipality or city, from greener and shared playgrounds and vegetable gardens to car-free school streets and who knows ... Gather insights on the impact of our workshops, brainstorming sessions and methodologies on participant engagement and neighborhood support around sustainable use of space

Researcher(s)

• Promoter: Keune Hans

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project website

Project type(s)

• Research Project

Abstract

Health economic evaluations based on mathematical modelling provide many opportunities in the fields of epidemiology, health care management and quality of care. The aim of this research project is to apply and extend model-based health economic research to primary care practices, nursing teams, infectious disease management and multi-morbidity. Part 1 targets out-of-hours care in Belgium, which is increasingly organized in general practitioner cooperatives. They provide a valuable addition to more expensive emergency departments within the hospital setting. Part 2 targets nursing teams in the acute hospital setting and the cost-effectiveness of interventions based on the decision support instrument BNuT. The aim is to evaluate the costs of different nursing team compositions and interventions to improve the team performance and patient outcomes. Part 3 aims to improve the use of stochastic individual-based modelling for health economic evaluations. Structural issues on the interplay between uncertainty and stochasticity will be investigated with case studies for COVID-19. Part 4 targets economic evaluations of non-communicable and chronic diseases in ageing populations.

Researcher(s)

• Promoter: Willem Lander
• Fellow: Willem Lander

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

The Phd project will focus on the organization and cost-effectiveness of out-of-hours and withinhospital care. For out-of-hours care, patients can choose in Belgium between general practitioner (GP) services and the hospital's emergency department (ED) without former contact or referral. Every ED in Belgium needs to give appropriate care to anyone entering the service and overuse of ED is of concern. The organization of out-of-hours care within GP cooperatives has improved accessibility, sustainability and safety of primary care as trustworthy alternative for EDs. An important difference for the patient is that there is no direct payment at the ED as compared to GP services. Although medical care is largely reimbursed by medical insurance in Belgium, out of pocket payment accounts for approximately 25% of health expenses. In 2014, a database infrastructure iCAREdata was established to link data from GP Cooperatives, ERs and pharmacies during out-of-hours care. Within the doctoral project, the aim is to extent iCAREdata with costing data and extend this valuable initiative with health economic opportunities. Nursing shortage is one of the greatest challenges in global health care. Nurses from the baby boom generation will soon leave the labor market and many younger nurses consider leaving the occupation. In addition, the need for individualized care is increasing and requires additional qualifications of the nursing staff. The computerized decision support instrument "BNuT" aims to support nursing team management based on hard and soft data on nursing teams and patient care. The aim within this Phd project is to evaluate the cost-effectiveness of nursing team interventions in terms of staff numbers, qualifications, competencies, and demographics. The PhD candidate will contribute to the BNuT project by the introduction of cost data. There is already hospital data available from the prototype, though more data will become available soon with the valorization process of the tool.

Researcher(s)

• Promoter: Willem Lander
• Fellow: Phiri Jane

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

Multiple Sclerosis (MS) is a chronic neuroinflammatory and neurodegenerative disease leading to focal and diffuse damage of myelin sheath and axons in the central nervous system (CNS). Pathophysiologically, the adaptive and innate immune system are involved in the inflammatory process, while mitochondrial dysfunction, oxidative stress and failure of remyelination are the main mechanisms in chronic neurodegeneration. Despite currently available disease modifying treatments (DMTs) that target the immune system, patients continue to accumulate disability leading to progression. Unfortunately, no neuroprotective or remyelinating agents are available as therapy for progressive MS. Hence, drugs to tackle disease progression in MS represent a major unmet need. In this respect, metformin is a very interesting drug to investigate in MS patients as a neuroprotective and remyelinating therapy. Several preclinical studies in animal models of MS have shown that metformin has both anti-inflammatory, neuroprotective and remyelinating properties. A clinical study with metformin in a limited sample of MS patients did not demonstrate significant adverse events. As metformin is available as generic drug and the price is low (0.10 eurocent per tablet), pharmaceutical companies have no interest is sponsoring clinical trials with this agent. However, major gains for patients and society may be reached if metformin proves to be a neuroprotective and remyelinating agent. In this research proposal we aim to provide evidence for the neuroprotective and remyelinating effects of metformin (I) in MS patients (P) via measurement of clinical and MRI outcome measures (O), via a multicentre randomized placebo-controlled (C) clinical trial.

Researcher(s)

• Promoter: Bilcke Joke
• Promoter: Willem Lander

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)
• Centre for Health Economics Research and Modelling of Infectious Diseases (CHERMID)

Project type(s)

• Research Project

Abstract

In this project we study whether self screening for HPV, facilitated by GPs, can enhance participation rates for cervical cancer screening. GPs will either actively offer self screening to their patients (intervention arm) or serve as a control group.

Researcher(s)

• Promoter: Verhoeven Veronique

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

Within the framework of the Chair of the Province of Antwerp – Healthcare professions in evolution - PAZOE, financed by the partnership between the Province of Antwerp, Governor Kinsbergen Center (GKC) and University of Antwerp, we are investigating the important dropout and outflow within healthcare professions. More specifically, how the care and welfare sector can deal with the capacity shortages of careproviders in combination with the growing and changing demand for care from society. The healthcare sector is undergoing many changes and is also facing major challenges in the province of Antwerp. The transition from (health)care education to the labor market is difficult. As a result, there are staff shortages. On the other hand, the demand for care from society is increasing due to more chronic, complex care and the increasing aging of the population. Using mixed-method research methods, as well as implementation research, we will (1) analyze and synthesize existing initiatives on working and learning differently within the healthcare sector; (2) build a learning network; (3) roll out three pilot projects based on the initial analysis, supported by the learning network, initially in the primary care zones Middenkempen and De Rupelaar. The chair also wants to ensure a connection between various ongoing projects in interprofessional collaboration between professionals and organizations in the healthcare sector.

Researcher(s)

• Promoter: Van Royen Paul
• Co-promoter: Van Bogaert Peter

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project website

Project type(s)

• Research Project

Abstract

The objective of GOGREEN ROUTES is to position European cities as world ambassadors of urban sustainability. Our inspirational approach shifts the focus of NBS towards the co-benefits to multidimensional health-termed 360-Health. GOGREEN ROUTES transdisciplinary consortium will pioneer a unique approach augmenting NBS, urban design with the goal of fostering a positive human-nature relationship, flourishing nature connectedness and promoting citizen engagement through digital, educational and behavioural innovation. GOGREEN ROUTES components focus on nature-based enterprise (GROW), sustainable physical activity (MOVE), digital, cultural (FEEL) and knowledge innovation (KNOW). GOGREEN ROUTES fosters mental health and well-being by optimising human-nature interactions for all citizens. These innovations will increase the uptake and acceptability of NBS across "Cultivating Cities" (Burgas, Lahti, Limerick, Tallinn, Umea & Versailles), "Seed Cities" (Munich, Murcia region & Malta) and a "Cross-Pollination Network: (Beijing, Mexico, & Tblisi). An urban well-being lab, based on the living lab methodology will couple participatory approaches with the Big Data analyses. To advance knowledge, best practice and dissemination GOGREEN ROUTES will cluster with H2020 projects including those involving our partners (e.g. proGIreg, bluehealth2020, Connecting Nature). In addition, linking all open-sourced data to the OPPLA and Think Nature Hubs, delivering online resource (e.g. Urban 360-Health Toolkit, MOOC's) and empowering citizens in an iterative process of co-creation will ensure perpetuation beyond the end of the project. This novel approach, coupled with the high capacity of the consortium, makes GOGREEN ROUTES an exciting prospect.

Researcher(s)

• Promoter: Keune Hans

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project website

Project type(s)

• Research Project

Abstract

During three years this Chair will be financed by the Provincie Antwerpen and build on the on-going project "Green light" (see below) in which the research department ELIZA collaborates with the Provincie Antwerpen who also finances that project. From 2019 the Chair will focus on research, education and services regarding a better connection between primary health care and the natural living environment: Integration knowledge and practice: practice oriented research (action-research/implementation research) and research oriented practice (practice-evaluation) Integration attention for nature related health benefits & health risks Inter-professional: collaborative research nature sector – health sector – other relevant sectors; knowledge transfer to and from different sectors

Researcher(s)

• Promoter: Keune Hans
• Promoter: Remmen Roy

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project website

Project type(s)

• Education Project
• Research Project

Abstract

As the threat of multimorbidity is increasing worldwide, the enabling of integrated care focused on the quintuple aim is considered necessary. The aim of this study is to construct a data network that integrates the available Belgian data in a dynamic user-friendly dashboard for healthcare providers. Although evidence about how to integrate the principles of PHM into a fragmented healthcare system and data landscape is lacking. This project consists of three Work Packages (WPs): WP 1: Literature Search (UAntwerpen and KULeuven task) WP 2: Mocku-up Dashboard creation (UHasselt task) WP 3: WP3 Iterative Usercentred Approach (focusgroups, UAntwerpen and KULeuven task) In this way a first step of shifting from reactive to proactive and integrated care is taken to minimalize the burden of multimorbidity on the healthcare system in Belgium.

Researcher(s)

• Promoter: Morreel Stefan

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

iCAREdata is a state-of-the-art research database processing routine clinical data of out-of-hours (OOH) patient contacts at general practice cooperatives (GPCs) (huisartsenwachtposten), pharmacies and emergency departments (EDs). The database contains data starting from 2015 until to date. Dataflows are secured by encryption of the social security numbers of the patients by eHealth as a trusted third party (TTP), as well as the RIZIV numbers of the physicians. At no point in the flow, personal data can be matched to clinical data. In de final database, pseudonymised personal data enable the linkage of different patient contacts to the same person, offering the opportunity to describe patient trajectories in the OOH care services; e. g. Person X consults a general practitioner at the GPC on Saturday morning, goes to the pharmacie to collect the prescribed medicines in the afternoon of the same day and finally shows up during the night on Sunday morning at 2am at the emergency department. To realise this data flow and linkage, thorough knowledge about the use and implementation of eHealth services is crucial, besides an up-to-date experience in standardisation and classification systems currently used in medical research datasets. A large network of health care services and health care workers is being part of and has to be fully involved with this project. This is only realised by implementing full transparency about the content of the dataset, how the flow is set up, and for what kind of research the data are used and by who. Researchers as well as data-supplying stakeholders stress the importance of upscaling the datasets by expanding with all GPCs in Flanders (at this moment 38 out of 44 GPCs deliver data on a daily basis) as well as adding extra EDs and pharmacies. Researchers suggest to add routine data of daytime general practices. This is necessary in the long term to be able to follow the entire flow of patients. Also the link with patient contacts in telephone- or selftriage, callcentres for urgent medical care (HC112), and follow-up contacts in general practice or hospitals complete the patient trajectories at different sites. iCAREdata has strong links with newly developed tools in referral to and cooperation with welfare services. This is a unique link between medical care and wellbeing which is in scope to be developed during the upcoming years. Besides research opportunities, iCAREdata also offers the opportunity to add up to a data driven policy on the micro, meso and macro level of health care and welfare services organisation, which was a crucial issue during Covid-19 pandemic. In addition several scientific research topics make the database worthwhile to maintain: evaluation of drug prescriptions by physicians in several contexts (antibiotics, opioids, …), use of health care services, epidemiologic topics like surveillance of infectious diseases, gaps in the offer of health and welfare services, waiting lists…iCAREdata has an experienced team of computer scientists developing modular software based on Normalized Systems Theory (NST). These modular software structures enable the introduction of additional data providers in a fast and reliable way. Thanks to financial resources, iCAREdata will further develop, validate and finalize the link with the emergency services and pharmacies. This enables us to set up valuable use cases to acquire users and (paying) customers. The funding will also be used to further develop the public dashboard and the user dashboards.

Researcher(s)

• Promoter: De Loof Hans
• Promoter: Philips Hilde
• Co-promoter: De Loof Hans
• Co-promoter: Mannaert Herwig
• Co-promoter: Philips Hilde
• Co-promoter: Verelst Jan
• Co-promoter: Verhoeven Veronique

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)
• Physiopharmacology (PHYSPHAR)

Project website

Project type(s)

• Research Project

Abstract

BACKGROUND AND RELEVANCE Sepsis is a life-threatening complication of infection accounting for about 20% of the global mortality. Early recognition of sepsis is crucial for the prognosis. GPs are often the first healthcare providers assessing patients with (possible) sepsis. The risk of sepsis is particularly increased in acute ill patients assessed during home visits at out-of-ours (OOH) GP cooperatives. The decision to refer a patient to the hospital is an essential step in the management of sepsis but guidelines to assist GPs in deciding which patients require prompt referral due to a high sepsis risk are lacking and decisions are currently based on an intuitive process. PROBLEM DEFINITION AND OBJECTIVES Recently, we developed and validated the TeSD-IT sepsis prediction score for use during OOH GP cooperative home visits of acutely ill patients. The aims of the study are to evaluate the feasibility and acceptability of the use of the TeSD-IT score by GPs in everyday practice. RESEACH DESIGN Mixed methods theory informed feasibility and acceptability study. OBJECTS OF THE PROJECT GPs conducting at least one "home visit" shift at an OOH-GP cooperative during the study period of 4 consecutive months. INTERVENTION Routine use of the TeSD-IT score in acutely ill adults who are visited at home by a GP of a OOH GP cooperative. GPs will be instructed to calculate the score based on patients' age, temperature, heart rate, blood pressure, peripheral oxygen saturation, and mental status. Using pocket cards, GPs will be informed about the risk of sepsis for different scoring categories, but no directive guidance for patient management will be provided. INTENDED RESULTS GPs' views and perceptions of the relevance and usability of the TeSD-IT score in their daily practice as well as facilitators and barriers for adoption in routine practice. Other key parameters will include the adoption of the TeSD-IT score (expressed as proportion of all eligible home visits) in daily practice and whether the use of score did impact GPs' management decisions. IMPACT The proposed study will provide key knowledge whether routine use of the TeSD-IT score is feasible and acceptable and, if so, how to optimise the uptake - and thereby the impact - of the score in a future large cost-effectiveness trial. The conduct of such a large evaluation would be the final step prior to widespread implementation of the TeSD-IT score in everyday practice.

Researcher(s)

• Promoter: Anthierens Sibyl

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

This project concerns the development of a partial update of the Domus Medica guideline chronic heart failure. Six clinical questions will be answered : 1. Which self-management/selfcare support is recommended for patients with chronic heart failure ? 2. Which pharmacological treatment is (not) recommended for patients with chronic heart failure? 3. Which follow-up is recommended for patients with chronic heart failure ( specifically after starting-up medication, for anemia)? 4. Which multidisciplinary care is recommended for patients with chronic heart failure? 5. Which type of cardiac revalidation is recommended for patients with chronic heart failure? 6. When is referral to a cardiologist recommended for patients with chronic heart failure? The guideline development follows the ADAPTE procedure and it includes an extensive literature search. Literature will be critically assessed and in formulating recommendations the GRADE and Evidence-to decision frameworks are used

Researcher(s)

• Promoter: Van Royen Paul

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

The Alivia pilot project aims to test a digital tool, developed by the Flemish government, to promote targeted and integrated care for citizens, informal caregivers and care providers (medical, non-medical and welfare). The Antwerp region is one of the two pilot regions where testing will take place in two care settings: palliative setting and chronic care and support needs in the home situation.

Researcher(s)

• Promoter: Van Royen Paul

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

This project consists of writing a country vignette, summarizing good practices on primary mental healthcare in Belgium, in collaboration with the federal governement and colleagues from other universities.

Researcher(s)

• Promoter: Van den Broeck Kris

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

Nature and biodiversity not only have a positive impact on human health, they are also essential for a good and healthy life. Although this theme is receiving increasing attention within healthcare, nature solutions within healthcare still often exist as isolated initiatives without a structural scientific framework. Hence the need to develop a scientifically based evaluation methodology that can generate information and provide evidence regarding health gains to be achieved on the one hand and ecosystem strengthening on the other. In this study, we elaborate on the aforementioned issues and propose a conceptual framework that will serve as the foundation of the project. In doing so, we also introduce some additional approaches that were not called for as such in the specifications, such as a training perspective and considering the role of the microbiome. Furthermore, we deal with the different phases described by the client in a methodological way where we always make the connection with the methodology of intervention mapping that we will apply in an iterative process.

Researcher(s)

• Promoter: Keune Hans
• Co-promoter: Spacova Irina

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

Since not all climate-health issues can be addressed simultaneously, a prioritisation methodology addressed at the same time, a prioritisation methodology urges itself to concretely start the operation of the Flemish climate-health working group to concretely start. During the start-up meeting of the working group, it was therefore decided to set up a sub-working group to develop a methodology for the prioritisation exercise. The prioritisation exercise aims to answer this question: What is greatest need, where is most health gain to be gained in terms of climate health through preventive actions (short- or long-term)? The subworking group is working on a pragmatic method to structure the complex issue of prioritisation. The working group members will be surveyed via a questionnaire. This task includes: - Processing the incoming survey responses - Assigning expert level weights and performing a sensitivity analysis (MCDA)

Researcher(s)

• Promoter: Keune Hans

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project website

Project type(s)

• Research Project

Abstract

This includes the coordination and the chair of the Working Group Development of Primary Care Guidelines, financed by RIZIV. The task indulged the development, adaptation and update of Belgian Guidelines. The assignment within this project includes the following tasks: - Content coordination for the working group development primary care guidelines (preparing, organizing and chairing the meetings of the working group and steering group, contacts with author groups, stakeholders and experts, with RIZIV and EBPracticeNet, website management workgroup). - The development of a team of expertise for the working group. For the systematic approach and methodologically correct development of guidelines revisions, a central expertise section is being developed consisting of some part-time academic staff members. The following tasks will be included for each guideline: elaboration of a systematic literature search, quality assessment and extraction of data, implementation of the various steps of the ADAPTE procedure, finalization and publication of the guideline, final editing, translation to other languages and final editing, preparation of publication. In addition, the Expertise group will also work on the regular updating of the Guidance Development Manual, as well as the development of templates and tools for guideline development - guidance of development of guidelines by external partners and of Federal FOD projects concerning development of guidelines

Researcher(s)

• Promoter: Van Royen Paul

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

Chronic illnesses (CI) encompass a broad range of long-lasting conditions with uncertain trajectories and often with complicated treatment. Chronic illness management (CIM) requires mobilization of a patient's social network. Social network-based interventions have been shown to improve health outcomes for people with CI, however, most research has focused on native populations in high-income countries. The use of such interventions in the promotion of CI self-management among migrants is more complex. In this jPPP, we will adapt, pre-test, and assess the relevance and feasibility of using 2 methods (ClickDiaries and the Social Connections Mapping Tool) to collect data on social networks and their relevance in CIM among non-EU migrants in Antwerp, by means of a rapid literature review, focus group discussions, stakeholder consultations and tool administration. The output will be an adapted tool that can capture the scope, functions, and strength of local but also transnational networks relevant to CIM of migrants; information about why, when, and to what purpose networks are mobilized; and longitudinal insights on how networks can change over the course of a CI. This tool will serve to address research gaps in this area but also can contribute towards design of CIM programs and clinical consultation aids for professionals supporting migrants with CI. The adapted tool will also be used in forthcoming large EU research proposals.

Researcher(s)

• Promoter: van Olmen Josefien

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

Patients with severe mental illness often get few or inadequate somatic care, resulting in reduced life expectancy. In this project, we develop a guideline regarding somatic care for patients with severe mental illness in primary care.

Researcher(s)

• Promoter: Van den Broeck Kris

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project website

Project type(s)

• Research Project

Abstract

Antimicrobial resistance poses a global threat to public health. Belgium remains one of the leaders in Europe in terms of antibiotic usage and the use of broad-spectrum antibiotics. There is a need for a one health approach to combat AMR, meaning that both veterinary and human primary healthcare are specifically considered for this project. Antibiotic prescribing is a common issue, and the obstacles to prescribing quality in both settings are comparable. To shape future initiatives, there is a need for a better understanding of the barriers and facilitators that can lead to behavior change regarding antibiotic use and prescribing practices. Additionally, more insight is required into antibiotic consumption among socioeconomically vulnerable individuals, as antibiotic usage in this population tends to be higher than in more privileged individuals. Lastly, there is a need for more insight into how public campaigns regarding antibiotics can be evaluated. To address these needs, three work packages were proposed. These work packages cover various aspects of antibiotic use management and biocides, both in veterinary and human medicine. The Theoretical Domain Framework served as the theoretical basis to assess which domains are already being addressed and contribute to appropriate antibiotic-related behavior, and which domains require more support.

Researcher(s)

• Promoter: Anthierens Sibyl

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

This includes the coordination and the chair of the Working group Development of Primary Care Guidelines, financed by RIZIV. The task indulged the development and adaptation of Belgian Guidelines. This task is part of the Federal EBP Plan 2021-2025. The assignment within this project includes the following tasks: - Content coordination for the working group development primary care guidelines (preparing, organizing and chairing the meetings of the working group and steering group, contacts with author groups, stakeholders and experts, with RIZIV and EBPracticeNet, website management workgroup). - The development of a team of expertise for the working group. For the systematic approach and methodologically correct development of guidelines revisions, a central expertise section is being developed consisting of some part-time academic staff members. The following tasks will be included for each guideline: elaboration of a systematic literature search, quality assessment and extraction of data, implementation of the various steps of the ADAPTE procedure, finalization and publication of the guideline, final editing, translation to other languages and final editing, preparation of publication. In addition, the Expertise group will also work on the regular updating of the Guidance Development Manual, as well as the development of templates and tools for guideline development - guidance of development of guidelines by external partners and of Federal FOD projects concerning development of guidelines

Researcher(s)

• Promoter: Van Royen Paul

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

The city of Antwerp and the Antwerp primary care zones have organized the COVID response on their territory. Now that the COVID-19 pandemic is reaching an endemic phase, the city wants to evaluate the COVID response on its territory and draw lessons from it in function of potential new similar health crises in the future. This evaluation project responds to the evaluation questions through a systematic method and based on strong scientific research.

Researcher(s)

• Promoter: van Olmen Josefien

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

What can we learn from COVID-19? Was a research project proposal submitted to the FWO but wasn't granted. The aim of the project was to contribute to a better understanding of the links between governance and resilience of urban health systems in superdiverse cities. The general objective was to explore and compare the factors underlying resilience of urban health systems in two selected cities, using COVID-19 as a tracer condition for a shock. We designed six sub-studies, each tackling one specific objective. This jPPP-project is a pilot project to prepare for the 'Urban health systems, shocks and resilience: what can we learn from COVID-19?' project. This is also part of the 'living lab' that the Primary Care and Public Health spearhead is developing with the City of Antwerp.

Researcher(s)

• Promoter: van Olmen Josefien

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

In response to an invitation of the Fondation Botnar, the International Foundation for Science (IFS) substantiated its candidacy for hosting the Young People and Relational Wellbeing Research Program.

Researcher(s)

• Promoter: Keune Hans

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

background cystitis are commonly treated with antibiotics. Shared decision making can be used in cystitis management to discuss various treatment options but is not frequently applied in general practice. aim: identifying barriers and facilitators for applying SDM in cystitis management in general practice design: qualitative explorative research in general practice with healthcare professionals and healthy non-pregnant women with a history of cystitis

Researcher(s)

• Promoter: Anthierens Sibyl

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

This project is a follow-up on the previous project of the same name, expanding the realisations of #CAVASa 1.0 to a larger number of pharmacists in more primary care zones. Again, researchers from UAntwerpen and KU Leuven will look at whether and how pharmacists make referrals, and what is necessary to optimize broader implementation. In close collaboration with the Flemish Pharmacists' Network and the Centres for General Welfare Work.

Researcher(s)

• Promoter: Van den Broeck Kris

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

Background: The resistance to antibiotics is one of the most important causes of death worldwide. 80% of all antibiotics are presribed in primary care settings and acute respiratory infections (CA-ARTI) are the commonest acute reasons for consulting health services in community care setting and for antibiotic use. In clinical trials point of care testing have been proven to be cost effective and could help improve quality of care and patient outcomes. Aim: To record information about patients who seek healthcare for CA-ARTI (e.g. acute cough, sore throat). This will help researchers benchmark patterns of testing and antibiotic prescribing in contrasting European settings simply by observing what happens now in routine care. Design and setting: Prospective audit in 18 European countries. Method: GPs registered patient-, clinical- and management characteristics, and confidence in their antibiotic prescribing decision for patients presenting with sore throat and/or lower RTI (n=4,982). Differences in these characteristics between countries and between pandemic and prepandemic care are described. Factors related to antibiotic prescribing and confidence were analysed using multilevel logistic regression. Results: Care for patients with RTIs rapidly switched to telephone/video consultations (10% in Armenia, 91% in Denmark), and when consultations were face-to-face, GPs used PPE during 97% (95% CI 96% to 98%) of contacts. Laboratory testing for SARS-CoV-2 in primary care patients with RTIs was rapidly implemented in Denmark (59%) and Germany (31%), while overall testing for C reactive protein decreased. The proportion of patients prescribed antibiotics varied considerably between countries (3% in Belgium, 48% in UK) and was lower during the pandemic compared with the months before, except for Greece, Poland and UK. Antibiotic prescribing was related to illness severity, comorbidity, age, fever and 'country', but not to having performed a POC test. In nearly 90% of consultations, GPs were confident in their antibiotic prescribing decision. Conclusion: Despite high confidence in decisions about antibiotic prescribing, there is considerable variation in the primary care of RTI in European countries, with GPs prescribing antibiotics overall more often than is considered appropriate. POC testing may enhance the quality of antibiotic prescribing decisions if it can safely reverse decisions confidently made on clinical grounds alone to prescribe antibiotics.

Researcher(s)

• Promoter: Coenen Samuel

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

The aim is to develop a multidisciplinary good clinical practice guideline on oncological post-acute care in primary care, according to the international standards for the development of an evidence-based guideline and the criteria used by the Belgian Centre for Evidence-Based Medicine (CEBAM) for the validation of guidelines.

Researcher(s)

• Promoter: van Olmen Josefien
• Co-promoter: De Groef An
• Co-promoter: Van Royen Paul
• Co-promoter: Wens Johan

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

Given the crucial role of health promotion and disease prevention in primary care and the limited attention paid to it in current training programmes in Belgium, there is a need for capacity building for disease prevention and health promotion for primary care professionals. With this project, we formulate strategies for a better embedding of health promotion and disease prevention in primary care training, based on international standards and using a European network. The project is carried out by a multidisciplinary consortium of two academic partners from both language areas -University of Antwerp (UA) and Université Catolique de Louvain (UCL) - and the expertise centre on health promotion - Vlaams Instituut Gezond Leven (GL). The multidisciplinary research team consists of general practitioners, psychologists, educational experts and communication scientists. The research group can call upon an extensive steering committee of stakeholders with representatives of care users, educational institutes, professional organisations and policy makers from both parts of the country, both during the inventory phase and for the development of the strategy and dissemination. The inclusion of representatives of vulnerable target groups in the steering committee guarantees specific attention to the needs and input of these groups. The development of strategies is done in 3 phases, organised in 3 work packages. In WP1 we will elaborate a Belgian frame of reference for the provision and quality of education in health promotion and disease prevention through desk research. Existing international frameworks such as the core skills set for health promotion workers by the International Union for Health Promotion and Education (IUHPE) are the starting point for a cross-professional frame of reference adapted to the Belgian context. In WP2, we will make an inventory of the existing provision and of the quality of health promotion and disease prevention in primary health care training in Belgium through a survey starting from the stakeholder network. This also includes a comparative analysis with training courses in other European countries, through the research group's connections to European networks. The trainings will be analysed based on the frame of reference developed in WP1 and Clement's didactic model. WP3 will focus on the development of strategies for the envisaged embedding of health promotion and disease prevention in primary care training based on the results of WP1 and WP2. By means of co-creation work sessions, the research group together with stakeholders will develop a draft strategy in the form of an educational package, which will be tested in a Delphi procedure. The dissemination to training institutes, professional and scientific organisations, target groups and policy makers and the creation of a support base for concrete strategies will take place together with the steering committee. A final symposium and publications in professional journals will contribute to this.

Researcher(s)

• Promoter: van Olmen Josefien
• Co-promoter: Bastiaens Hilde
• Co-promoter: Michels Nele
• Co-promoter: Van Royen Kathleen
• Co-promoter: Van Royen Paul

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

Background. Depression is the main cause of suicide and it is also the condition with the greatest burden of disease when expressed in the number of years lived with a condition. Prevalence increases despite the continuous development of pharmacological and psychotherapeutic interventions. Focus is therefore shifting towards healthcare level-exceeding care starting from easy accessible and continuous guidance of patients in primary healthcare. Aim. The implementation of an integrated intervention with evaluation of the working components, acceptance by patients and care providers, and the contextual conditions which needs to be fulfilled. Method. The IDECA-project consists of three intervention pillars: (i) the integration of the reference person mental health (a case management function) in general medical practice, (ii) the development of a shared care guidance document, and (iii) professional training. Evaluation will take place using a Realist Evaluation approach in combination with the Normalization Process Theory. Context-Mechanism-Outcome constellations will be developed and tested with mainly qualitative research, supported by quantitative data, which will be collected from participating care providers and patients.

Researcher(s)

• Promoter: Van den Broeck Kris

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

We know from literature and practice that better interprofessional and interorganisational cooperation has a major impact on the quality of care and can provide an answer to complex problems. The current experience with the drastic and ever changing measures for and by the COVID 19 pandemic shows more than ever that working together is not easy but feasible. It poses specific challenges and challenges us to be innovative and realistic in our search for appropriate approaches in the ever-changing circumstances. It goes without saying that responding to care issues that come our way in ever-changing circumstances requires flexibility, but above all expertise and experience. The project Collaboration works!? project builds on the expertise within the University of Antwerp and very specifically on the IPCIHC-4U project (Interprofessional collaboration in health care for you). In that project, a first scan of interprofessional cooperation was tested in the context of a residential care centre. Collaboration works!? builds on this by extending test pilots (1) for the scan interprofessional cooperation. From these pilots, the partners in this project will spread the knowledge gained and thus help to create additional support (2) for cooperation in education and the professional field. Furthermore, the pilots will be used to analyse whether and in what way the scan can be used sustainably (3) in the field of work.

Researcher(s)

• Promoter: Tsakitzidis Giannoula

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

Accumulating evidence suggests that onchocerciasis could trigger epilepsy. Indeed, after an introduction of bi-annual community-based treatment with ivermectin and use of ground larviciding to control blackfly breeding sites in rivers in 2012 in northern Uganda, no new nodding syndrome cases have been reported and the number of persons developing other forms of epilepsy also decreased. In Western Uganda onchocerciasis-associated epilepsy (OAE) stopped to appear when onchocerciasis was eliminated. Until now the pathophysiological mechanism of OAE remains unclear. Therefore there is still a lot of skepticism among scientists and public health decision makers whether onchocerciasis is able to cause epilepsy. As a consequence there is little international support for interventions to prevent OAE. Therefore additional research is needed to prove the causal relationship between onchocerciasis and epilepsy and to investigate ways to prevent OAE. There is also a need to reduce the epilepsy treatment gap and to improve the care for persons with epilepsy in onchocerciasis endemic regions. To do so, a decentralized community based treatment system will be needed.

Researcher(s)

• Promoter: Coenen Samuel
• Fellow: Dusabimana Alfred

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project website

Project type(s)

• Research Project

Abstract

The importance of nature for the development of adolescents (12- 18 jaar) is often mentioned in scientific literature. Both for health, well being and school performance, as for founding pro-environental behaviour as citizen. Still adolescents at secundary school seem to lack interest in nature. Despite a diversity of organizations offering nature-education programs, the demand from adolescnts and secundary schools appears to be low. We will investigate this mismatch in lterature review and three case studies.

Researcher(s)

• Promoter: Keune Hans
• Co-promoter: Boeve-de Pauw Jelle
• Co-promoter: Michels Nele
• Co-promoter: Van Petegem Peter

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project website

Project type(s)

• Research Project

Abstract

With this study, we aim to find out whether antiviral drugs are effective in treating symptomatic COVID-19 patients. Two antiviral drugs will be tested: camostat, a drug that has been on the market for over 30 years in Japan and other Asian countries, and molnupiravir, an oral antiviral treatment that was initially developed for treatment of influenza, and has a good safety profile. Patients who are 40 or older, presenting to their GP or local primary care triage point with recent COVID-19 symptoms (for a maximum of 5 days) are eligible for the trial if SARS-CoV-2 infection is confirmed using a rapid antigen or PCR test and if they do not need hospital admission at that time. If patients consent to be included in the trial, they will be randomly assigned to either camostat, molnupiravir or placebo, randomised 1:1:1 between the 3 arms. For up to 30 days after inclusion, patients are asked to fill in a symptom diary every day. This can be done either by using a smartphone app, on the computer or on paper, whatever is most convenient for the patient. Patients will be phoned on day 2, 4 and day 30 by a study nurse, to ask about symptoms, side effects and any other queries the patients may have. Patients will also be visited by a study nurse on day 8. The primary target for evaluating the antivirals are whether they can reduce the time to self-reported recovery. 474 patients will be included in the trial. Other outcomes include their effect on hospitalisation, death, symptom recovery, severity of COVID-19 and quality of life.

Researcher(s)

• Promoter: Coenen Samuel

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

For years, the care sector has been struggling: vacancies are not filled and care courses are also understaffed. On top of that, the perception of working in care, especially in residential care, has deteriorated as a result of the COVID-19 pandemic. Due to a persistent imbalance between the inflow and outflow of personnel, the pressure on the existing workforce has sharply increased. In the Netherlands, the metaphor of the colander is used for this: the inflow of care personnel is in order while the outflow remains unchanged. Blijf aan Z wants to reduce this outflow by focusing on the current care professionals so that they can remain at work as long as possible and long-term absenteeism can be minimised. The project wants to promote sustainable and high-quality employment, resulting in a lower turnover, a positive image of working in the care sector and better support for younger employees and those returning to work. Specifically, an analysis of the problem will be carried out and predictors of outflow and dropout will be identified. A 'dashboard' will monitor these predictors for the partners involved. In addition, Team Champions will be installed and educated in the form of a train-the-trainer programme. The team members are the change managers who intervene from within to increase (team) resilience and reduce retention. As a final aspect, a Community of Practice (COP) is started in which managers of care workers share and learn about leading workplace cultures in which care workers want to (continue to) work. This self-directed development programme significantly broadens the horizons of the participants by placing them in a learning environment with others of similar functions/roles but in totally different contexts.

Researcher(s)

• Promoter: Van den Broeck Kris
• Co-promoter: Franck Erik
• Co-promoter: Van Bogaert Peter

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project website

Project type(s)

• Research Project

Abstract

This project is a follow-up to the 'Mask-19' initiative, a collaborative initiative between the Flemish Pharmacists' Network and the Centres for General Welfare Work, which during the first lockdown period in 2020 made the pharmacy sector a point of contact for help with welfare issues. Project #CAVASa will now continue this by providing training, tips and other support material for the day-to-day practice of local home pharmacists to recognise psychosocial problems, treat them discreetly and refer them to appropriate help. Researchers from UAntwerpen and KU Leuven will look at whether and how pharmacists make referrals, and what things are needed to optimise this.

Researcher(s)

• Promoter: Van den Broeck Kris

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

The Health Insurance Board of the RIZIV has asked the EBPracticeNet vzw Working Group Development Primary Care Guidelines to include the development and adaptation of Belgian Guidelines. This work is part of the Federal EBP Plan 2021-2025 The assignment within this project includes the following tasks: - Content coordination for the working group development primary care guidelines (preparing, organizing and chairing the meetings of the working group and steering group, contacts with author groups, stakeholders and experts, with RIZIV and EBPracticeNet, website management workgroup). - The development of a team of expertise for the working group. For the systematic approach and methodologically correct development of guidelines revisions, a central expertise section is being developed consisting of some part-time academic staff members. The following tasks will be included for each guideline: elaboration of a systematic literature search, quality assessment and extraction of data, implementation of the various steps of the ADAPTE procedure, finalization and publication of the guideline, final editing, translation to other languages and final editing, preparation of publication. In addition, the Expertise group will also work on the regular updating of the Guidance Development Manual, as well as the development of templates and tools for guideline development - guidance of development of guidelines by external partners and of Federal FOD projects concerning development of guidelines

Researcher(s)

• Promoter: Van Royen Paul

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

In this project, the population managers of the primary care zones are guided and supported during the COVID-19 vaccination campaign between 23/02/21 and 30/09/21. On the one hand, training sessions are elaborated that are given during the online exchange sessions with the population managers, organized by VIVEL. On the other hand, the development of a manual for using the population management dashboard is supervised.

Researcher(s)

• Promoter: Philips Hilde

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

Nationale gegevens over de 'severe acute respiratory syndrome coronavirus 2' (SARS-CoV-2) seroprevalentie leveren essentiële informatie over de blootstelling van de bevolking aan het virus en helpen het toekomstige verloop van de epidemie te voorspellen. Deze studie, ook bekend als CHARMING (Coronavirus HuisARtsenpraktijk-MédecINe Générale), focust op de seroprevalentie bij eerstelijnsorgverleners in België. Zij behandelen naast andere patiënten de overgrote meerderheid van de COVID-19-patiënten en spelen daarmee een essentiële rol in het efficiënt organiseren van de zorg. Momenteel ontbreken gegevens over 1. hoeveel eerstelijnsorgverleners besmet raken met SARS-CoV-2 in België, 2. de snelheid waarmee dit gebeurt, 3. hun klinisch spectrum, 4. hun risicofactoren, 5. de effectiviteit van de maatregelen om infectie te voorkomen en 6. de nauwkeurigheid van serologische sneltesten in de eerste lijn. CHARMING zal worden opgezet als een prospectieve cohortstudie. Huisartsen en andere eerstelijnsorgverleners (werkzaam in een huisartsenpraktijk) zullen via professionele netwerken en professionele media worden gerekruteerd om zich online aan te melden voor deelname. Geregistreerde huisartsen en andere eerstelijnsorgverleners zullen op elk meetmoment (n=9) gevraagd worden om met een ​​vingerprikbloedstaal een serologische sneltest (OrientGene®) uit te voeren en een online vragenlijst in te vullen. De primaire uitkomsten zijn de prevalentie en incidentie van antilichamen tegen SARS-CoV-2 in eerstelijnsorgverleners gedurende een follow-upperiode van 12 maanden. Secundaire uitkomsten zijn onder meer de levensduur van antilichamen tegen SARS-CoV-2 na natuurlijke infectie en COVID-19-vaccinatie. Studieprotocol: https://www.sciensano.be/en/biblio/prevalence-and-incidence-antibodies-against-sars-cov-2-among-primary-healthcare-providers-belgium & https://medrxiv.org/cgi/content/short/2021.06.18.21259139v1 Registratie op ClinicalTrials.gov: https://www.clinicaltrials.gov/ct2/show/NCT04779424

Researcher(s)

• Promoter: Coenen Samuel

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project website

Project type(s)

• Research Project

Abstract

Most antibiotics are prescribed in ambulatory care. Children are at high-risk of receiving unnecessary antibiotic prescriptions. The introduction of better diagnostics, such as point-of-care tests for C-reactive protein (CRP), can improve the management of acutely ill children in the outpatient setting. That is why ARON is investigating the (cost) effectiveness of a diagnostic algorithm including a CRP point-of-care test and safety neting advice on the antibiotic prescription percentage and further management in acutely ill children from 6 months to 12 years old presenting to ambulatory care. The CRP point-of-care test is performed in children at higher risk of serious infection according to a validated clinical algorithm with advice on antibiotic management and safety netting. The primary outcome measure is the antibiotic prescribing rate during the clinician's first consultation with the child.

Researcher(s)

• Promoter: Coenen Samuel

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project website

Project type(s)

• Research Project

Abstract

To ensure that future policy initiatives best match the experience and needs of general practitioners, EBPracticeNet, the reference platform for Evidence-Based Practice for all Belgian healthcare providers, together with the academic centers for general practice of UAntwerp and ULiège, is launching the Antibiotics General Practitioner Survey (Antibiotic GPS). We receive support for this in Flanders from all universities and Domus Medica. In the Antibiotics GPS (Antibiotics General Practitioner Survey) general practitioners can indicate which actions, instruments and initiatives they find useful in the fight against antimicrobial resistance. This questionnaire assesses experiences with regard to the prescription of antibiotics, current policy initiatives, supporting instruments, (rapid) tests, guidelines, etc. for the effective use of antibiotics in common infections. The survey also asks what lessons we can draw from the corona crisis that are relevant for antibiotic policy. The results will be used to set up new interventions and to guide Belgian AMR policy.

Researcher(s)

• Promoter: Anthierens Sibyl
• Co-promoter: Coenen Samuel

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

During the course of the COVID-19 outbreak, a wealth of data has been accumulated from the efforts of the health systems to overcome the pandemic. Months of patient encounters with primary to tertiary care systems are leaving an affluence of valuable information reflecting the real impact of the virus in people's health and lives. These real-world data [RWD] offer an unparalleled opportunity to understand COVID-19 but also an important analytical challenge due to the dissimilar and heterogeneous nature of this information. Using complementary data sources from primary health care and hospitals, this project aims to set up a methodological framework for data harmonization, linkage, and analytical development of a novel tool for multi-state risk prediction identifying the role of comorbidities, among other factors, in predicting COVID-19 progression into severity, and subsequent recovery or death. This research will afford a unique instrument for risk stratification and resource allocation in the face of current and future epidemics and will serve as a proof of concept of the usefulness of RWD and the feasibility of the adaptation of novel this methodological framework to other countries/settings based on local data.

Researcher(s)

• Promoter: van Olmen Josefien
• Co-promoter: Philips Hilde

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project website

Project type(s)

• Research Project

Abstract

iCAREdata database processes data in unplannable medical care settings in Flanders. During COVID19, these data are used by the Agentschap Zorg en Gezondheid of Flanders for the monitoring of COVID19 patient contacts at the COVID triage centers and the testcapacity of the Flemish COVID19 test centers.

Researcher(s)

• Promoter: Philips Hilde

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

This project will support the GPs, who play a crucial role in local flare-ups of COVID-19, in structured referral of vulnerable people and groups to local welfare work. The local network of health workers and welfare workers will in this way play its role more optimally in scientifically detect, monitor and evaluate the psychosocial impact of COVID-19 and the associated measures. This project ensures that local flare-ups of the virus are detected and, in addition to the medical ones, will also detect, monitor and tackle the psychosocial impact of the disease. iCAREdata is already operational with detection and follow-up from COVID-19. This database is easily enriched with the social determinants in order to better deal with the pandemic and its impact traces and combat local flare-ups with a focus on vulnerable groups in the local context. This innovative platform supports GPs in correctly referring psychosocial needs to welfare work. The target audience includes the care actors and care providers in primary care zones (ELZ) who want to coordinate care through partnerships on the needs of the citizen, in accordance with GDPR. Secondary target groups are primary care patients, in particular vulnerable groups as well as the policy bodies that want to gain insight into medical and psychosocial care needs with a targeted and local approach.

Researcher(s)

• Promoter: Philips Hilde
• Co-promoter: Bastiaens Hilde

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

Primary health care providers (PHCPs) like general practitioners (GPs) and their co-workers manage the vast majority of COVID-19 and other patients and keep off the pressure from hospitals. Safeguarding PHCPs' capacity during outbreaks is vital, but currently evidence is lacking on 1. how many PHCPs get infected/diseased in our country, 2. the rate at which this happens, 3. their clinical spectrum, 4. their risk factors and 5. the effectiveness of the measures to prevent this from happening. These questions need answers soon to inform policy makers. We also need more accurate (sensitive!) tests of the immune response. For this, we will evaluate a novel microfluidic dried blood spot (DBS) sampling method and digital ELISA. DBS by fingerpricking is a promising, minimally invasive and transmission safe option for blood (self-)sampling, and already applicable in a multitude of areas. In a subgroup of participants, we will compare test accuracy using the easy-to-use novel DBS method, which further minimises the potential risks of contamination and more precisely meters the required blood volume, to standard DBS.

Researcher(s)

• Promoter: Coenen Samuel
• Co-promoter: Goossens Herman
• Co-promoter: Van Damme Pierre

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

)The existing T2DM guideline should be updated. the work is split and divided between different working groups. 1. tracing and tackling people at high risk (pre-diabetes, including follow-up of gestational diabetes; 2. non-drug treatment of T2DM 3. drug treatment of T2DM

Researcher(s)

• Promoter: Wens Johan

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

In this project we want to decrease the morbidity and mortality of cervical cancer in women in Ecuador by introducing screening based on self sampling. The project combines state-of-the-art screening practices with empowering women of different ethnic origins, taking into account cultural beliefs and involving traditional and local caregivers as intermediary health workers. To achieve this, we will develop an operational plan to optimize technical aspects of laboratory diagnosis, set up a logistic pathway, educate health workers and study the acceptability of the proposed strategies for the end-users. A strategy for follow up of screening results by means of telemedicine will be developed and introduced.

Researcher(s)

• Promoter: Verhoeven Veronique
• Co-promoter: Benoy Ina

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

The aim of the project is to create an international platform for the participating universities to exchange case-driven experiences and proven solutions at two levels: 1. train FM/PHC professionals in the competencies of interprofessional team working in the participating countries by exchanging working experiences via an interactive web-based platform and 2. increase knowledge, skills and expertise about early recognition and self-management of type 2 diabetes mellitus (T2DM) through interprofessional learning at community health centres (CHCs) and private clinics (PCs) in urban and rural areas. Though the focus of the case-based experiences will be on T2DM early detection and self-management, the main purpose of this project will be on exchanging needs and experiences for working interprofessionally by the participating academic centres via a web-based platform. There will be a yearly live meeting and regular (bimonthly) webinars or digital meetings (zoom, skype, …) of the leading teams in the different countries, and monthly meetings of the national network of (urban, rural, remote,…) participating CHCs and private clinics within each country.

Researcher(s)

• Promoter: Wens Johan
• Co-promoter: Tsakitzidis Giannoula

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project website

Project type(s)

• Research Project

Abstract

In our rapidly urbanizing world, chronic health conditions associated with urban living are on the rise. One of the main current challenges is unravelling the role of reduced access to and reduced quality and quantity of nature and biodiversity in these living environments. Enhanced immune functioning emerges as one promising candidate for a central pathway between nature and health. Despite mounting evidence that people with a diverse microbiome or who interact with green spaces enjoy better health, studies have yet to directly examine how biodiverse urban green spaces might modify the human microbiome and reduce chronic disease. Another challenge is to enhance access to nature for all, which is unevenly distributed among social groups with different socio-economic and cultural backgrounds. In this project, the environmental microbiome, defined as the microbes in soil, on plants, and associated with air dust, will be targeted, as well as its social distribution. General objectives and underlying research questions B@SEBALL will investigate how biodiversity in the school/playground environment can positively affect children's health (asthma and allergy prevalence) and mental well-being and how this can be linked to human microbiome diversity. B@SEBALL will also investigate the opportunities for reducing health inequalities among children via biodiversity at school environments. Further, B@SEBALL will investigate how school/playground management and design can benefit from this knowledge, as well as relevant policy, education and family practices. Through its partners, B@SEBALL can build on established school projects aimed at greening playgrounds: Flanders (MOS) and Wallonia & Brussels (GoodPlanet Belgium). Methodology B@SEBALL will sample children from "grey" and "green" schools (i.e. the school environment) in "rural" and "urban" landscapes (i.e. the larger environment surrounding the schools) in different Belgian regions. B@SEBALL will investigate the influence of the school environment, mediated by macro- and microbiological characteristics, on asthma/allergy prevalence and mental well-being. Because, previous research has stressed the necessity of taking into account the rural-urban gradient, we expect the effects to depend on this gradient and hypothesise that positive health effects of green school environments will be larger in urban contexts. In this study, we will use the microbiome on leaves of plants growing outside as an indicator reflecting the cumulative effects of these environmental exposures. Children's exposure to airborne microbial fraction will be measured by nostril human microbiome swab samples of the children. B@SEBALL has designated work packages for key elements of the work: WP1 integrated assessments, WP2 school engagement, WP3 environmental assessment, WP4 health assessment, WP5 social assessment and WP6 coordination and communication. B@SEBALL starts with a joint methodological implementation phase across all work packages. Selection of schools will be incorporated in this phase. Next, engagement with schools will be organized, as well as recruitment of study participants. Collaboration with participating schools will be organized, based on which data collection can start. Next, data processing and transfer from designated work packages 3, 4 and 5 will form the basis for integrated assessment in WP1. Based on the integrated assessment, project outcomes will be formulated, which can feed into stakeholder and end-user dialogue, in order to create targeted and practice relevant key messages. In a final communication and dissemination phase, first the study participants will be addressed, before final wide spread external communication. Potential impact of the research on Science, Economy, Society, Culture, Public policy or services, Environment and/or quality of life and/or Collection management and conservation

Researcher(s)

• Promoter: Keune Hans

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project website

Project type(s)

• Research Project

Abstract

Background: This PPAS study is part of a larger project called Value-Dx -the value of diagnostics to combat antimicrobial resistance by optimising antibiotic use- and makes up part of the clinical Work Package Four (WP4). The aim of Value-Dx is to transform clinical practice, improve patient outcomes, and combat antimicrobial resistance (AMR), through the widespread use of clinical and cost-effective innovative diagnostics strategies to achieve more personalised, evidence-based antibiotic prescription and use in community care settings. Study Design: This anonymous cross sectional clinical audit study will run over a 2 to 8-week period from January to March 2020 in approximately 20 European countries. Researchers will collect information from a range of health care settings where antibiotics are prescribed for patients who have respiratory infections Study Participants: People over the age of one-year consulting with community acquired acute respiratory tract infection (CA-ARTI) in community care with participating clinicians in participating countries. Objective: To generate a description of the presentation and management of patients with CA-ARTI by community based care prescribers (CBCP), by benchmarking current practice in approximately 20 European Countries.

Researcher(s)

• Promoter: Coenen Samuel

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project website

Project type(s)

• Research Project

Abstract

Introduction. Globalization, innovation, urbanization, climate change and ageing have consequences for public health and for health care systems. It has led to new health problems, to more diversity among the population, to a different societal context, and to new possibilities and threats in the health care system. Answers to these global and local challenges include intersectoral collaboration and integration. Belgium is undertaking steps to move to more integrated care, with initiatives like first line zones and decentralization of health care towards primary care level. Few initiatives are evaluated, which leaves a knowledge gap on implementation, effectiveness and cost. This proposal aims to contribute to implementation and evidence of high quality integrated care, in Belgium and in other contexts Research objectives. The objectives of the research plan are to increase quality of integrated care, by 1) respond better to diversity and new health needs in the changing society; 2) adaptation, implementation and evaluation of health and care models that strengthen links between public health and primary care and between patient, health providers and community; and 3) to contribute to sustainable change by improving institutional and health system context for integrated care, through linkage between health policy and implementation. Approach and methods. The plan builds upon the transversal themes of 1) diversity and vulnerable groups and changing health needs, in particular multi-morbidity; 2) new forms of organization and collaboration and; 3) role of data and information systems. The underlying conceptual approach takes into account health systems dynamics, meaning the study of the relations between different elements in the system and with the context. It is structured in three work packages. WP1 examines the variation and cost of multi-morbidity; implementation and effectiveness of interventions to address diversity and multi-morbidity; and the monitoring of multi-morbidity in health systems. WP2 studies network dynamics and outcomes of provider collaboration and patient health care utilization in different care models; task-shifting and intersectoral collaboration. WP3 examines digital tools support vulnerable groups; strengthening of data management systems to support collaboration and integrated care and evaluates the impact of increased sharing of health information data on patients and society. The methods will include epidemiological surveys, secondary data analyses of quantitative datasets, health expenditure and costing analyses, and stakeholder analyses using qualitative methods. The identified priority areas in this proposal provide opportunities to link existing research work of the four spearhead research groups, and collaboration with operational partners and policy makers in the local and regional context of Antwerp. Impact. After 5 years, this research strategy has led to the following results. 1) new knowledge on multi-morbidity among different population groups; 2) evidence on effects and cost of new care models in the Belgium context,; and 3) utilization of digital tools and health data for research and practice; and 4) recognition of the spearhead research of the UA on quality of integrated care.

Researcher(s)

• Promoter: van Olmen Josefien
• Fellow: van Olmen Josefien

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

MultiMorbidity (MM), the concurrence of two or more chronic conditions, is a growing phenomenon in all countries, and more prevalent among vulnerable groups in society. Yet, research to understand and address the phenomenon has only recently taken off. In the Belgium context, the burden of multimorbidity, measured by disability, is highest for cardiovascular diseases with or without diabetes; chronic respiratory diseases and depression; neurological diseases and cancers. The prevalence of MM has risen from 8,9% in 1997 to 15,2% in 2018. How patients use health care for their different conditions is not well known, while this has implications for quality of care and cost. Best practices in health care organizations to manage multimorbidity are being documented, but implementation research on feasibility, cost and effectiveness is still patchy. The PhD aims to improve understanding the burden, management and cost of multimorbidity in the Belgium health system, from the patient and health system perspective. Two Research Questions will be examined: 1) What are patterns of health care utilisation and health care cost for people with multiple chronic conditions? 2) Which innovations to manage multimorbidity are implemented, and what is the feasibility acceptability and effectiveness and cost of implementation? Year 1 and 2 will be used to develop the research protocol, explore existing data and to do the analysis of RQ1. Year 2 and 3 will be used for RQ. At least drie peer reviewed articles will be written with the following topics: 1) health care utilization and cost for Belgium patients with multiple chronic conditions; 2) implementation analysis of pilots for integrated care for multimorbidity; and 3) cost-effectiveness of multimorbidity pilots in the Belgium health system.

Researcher(s)

• Promoter: van Olmen Josefien
• Co-promoter: Van Hal Guido
• Fellow: Tran Bich Phuong

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

It is widely acknowledged that the living environment is an important determinant of human health. Historically, planning and health professionals collaborated to foster healthy environments, however, the integration of both disciplines has disappeared over time with the decrease in infectious diseases and the commercialization of medicine. The Flemish region in Belgium is both challenged by high healthcare costs stemming from the domination of curative medicine and increasing pressure on the non-built environments due to urban sprawl and urbanization. These two challenges formed the basis of the project, called Kerngezond, in which a participatory and transdisciplinary process resulted in the development of a dialogue instrument on Healthy Peri-Urban Planning. The instrument aimed to foster the dialogue between environmental and health actors in the planning of healthy environments in the peri-urban context of the Province of Antwerp. Throughout the study process, the instrument was conceptualized together with environmental and health professionals acting at different scales, then applied in the planning of three local case studies, and eventually evaluated on its practical use. From this project we learned that the creation of a common language between health and environmental actors on a complex theme, allowed both disciplines to exchange and integrate knowledge and expertise in the development of healthy peri-urban environments. With the presentation of the dialogue instrument and the description of the study process, we hope to inspire future transdisciplinary projects on healthy spatial planning.

Researcher(s)

• Promoter: Keune Hans

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project website

Project type(s)

• Research Project

Abstract

Action research on burnout coaching on care farms tested at several care farms in Flanders, involving several clients and coaches and supported by an interprofessional group of relevant expert organizations.

Researcher(s)

• Promoter: Keune Hans

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project website

Project type(s)

• Research Project

Abstract

Today we notice that initiatives are being taken on interprofessional collaboration in practice but there is a lack of experience and knowledge sharing, adapted training module for practice, working model with involvement of management, ... IPCIHC-4U wants to use a validated scan of interprofessionality, supplemented with possible tailor-made training modules, offering healthcare organizations (focus on residential care centers with more than 100 residents) a quality improvement project

Researcher(s)

• Promoter: Tsakitzidis Giannoula
• Co-promoter: Van Royen Paul

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

In a first sub-project we map the current use of Sumehrs by the doctors at the general practice cooperative (GPC). This is done on the basis of an evaluation of the available information in the Sumehrs at the GPC and their use. The registered quantitative parameters are: percentage of actually available Sumehrs in the files of the patients who consult the doctor on duty at theGPC, and percentage of use of these Sumehrs by the doctor on duty. With the permission of the GPC, this information is generated automatically from their software package with the help of the software distributors. In a second sub-project we will study perceived quality of the Sumehrs at GPCs. This subproject is running simultaneously with subproject 1. For this we are planning a descriptive qualitative study with telephone interviews with 35 doctors from different Flemish regions during 4 weekends. On the basis of semi-structured telephone interviews, we estimate how high the perceived availability of Sumehrs is, what the doctors experience as added value to the use of Sumehrs, in particular what data from the Sumehr is used by them at the GPC and for what reason, what are deficiencies and what facilitates or complicates their use. This information will also provide input for the development of quality indicators and training on the preparation and consultation of Sumehrs.

Researcher(s)

• Promoter: Philips Hilde

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

The main aim of this study is to establish the assumed superiority of salbutamol over no treatment and the (cost-)effectiveness of salbutamol inhalations versus placebo in children aged 6-24 months presenting to their primary care physician with wheezing. 10% of infants are prescribed short-acting bronchodilators for wheezing per year, yet evidence to support this treatment in children younger than two years old is scarce. With around 30% of all 180,000 Belgian children and 260,000 Dutch children aged 6-24 months having a period of wheeze annually, and salbutamol being prescribed in 30% of cases, 40,000 salbutamol prescriptions can potentially be prevented per year. Eligible children are otherwise healthy in this study, aged 6-24 months, and present with physician-diagnosed wheeze and a baseline respiratory symptom score of at least 7 out of 18. Recruitment will last for two consecutive years, in 40 practices in Belgium. UA will recruit 6 practices. The results of our study could impact guidelines and health care costs. If our trial demonstrates salbutamol has no or only a negligible beneficial effect in infants and young children with wheeze in primary care this will have an impact on national and international guidelines, and as a result on clinical practice. Salbutamol prescriptions may reduce substantially.

Researcher(s)

• Promoter: Coenen Samuel

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

Introduction Problematic benzodiazepine use is a global health issue. Although the adverse side effects of longterm use of benzodiazepines are well known, it remains difficult to implement interventions for discontinuation in primary care. Considering the success of blended care for the treatment of sleeping disorders and the support of substance use disorders, evidence suggests that a blended care approach, combining face-to-face consultations with the general practitioner with web-based self-learning by the patient, is beneficial for the discontinuation of chronic benzodiazepine use for primary insomnia in general practice. Therefore, the aim of this study is to evaluate the effectiveness of such an approach for the discontinuation of benzodiazepine and zdrugs ((z-)BZD) use in the long term and evaluate the implementation process. Methods and analysis This study is a multicenter, pragmatic, cluster randomized controlled trial with 1200 patients, included by 120 general practitioners. Allocation to usual or blended care happens at the level of the general practice in a 1:1 ratio using a block randomization system stratified per language. The study population consists of adult primary care patients who have been using (z-)BZD for primary insomnia on a daily basis for at least six months. Primary outcome measure is the proportion of patients that discontinued (z-)BZD at 12 months assessed by toxicological screening for (z-)BZD in urine. Secondary outcomes include discontinuation of (z-)BZD at 6 months, quality of life, and the number of defined daily doses of (z-)BZD prescribed. Data will be collected using a study-specific online platform and analyzed using the intention-to-treat approach. The process of implementing blended care will be evaluated in a nested study.

Researcher(s)

• Promoter: Anthierens Sibyl
• Co-promoter: Van den Broeck Kris

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project website

Project type(s)

• Research Project

Abstract

BACKGROUND: Antibiotic consumption in Belgium is one of the highest in Europe. Infections are the number one reason to consult in out-of-hours (OOH) primary care, and subsequently antibiotics are one of the most prescribed medications. C-reactive protein point-of-care testing with acute respiratory infections could help general practitioners (GPs) to reduce antibiotic prescribing in OOH care and is currently used in different European countries in this setting. The implementation of CRP POCT in Belgian OOH care has not been studied before. RESEARCH QUESTION: Does the implementation of (CRP POCT) in Belgian OOH care reduce antibiotic prescribing for respiratory tract infections (RTIs) and is implementation feasible and acceptable for GPs and patients? OBJECTIVE: To determine the effects on antibiotic prescribing for acute RTI and to assess the feasibility and acceptability when implementing CRP POCT in Belgian OOH primary care. METHOD: Antibiotic prescribing quality at the level of a General Practitioners Cooperative (GPC) will be assessed before the start of the implementation of CRP POCT using antibiotic prescribing quality indicators and will be compared with other GPCs. This will be used during PDSA (plan-do-study-act) cycle(s) as a quantitative indicator of antibiotic prescribing quality improvement. Alongside a qualitative interview study with GPs and patients on the acceptability and feasibility of implementing CRP POCT in OOH primary care will be performed.

Researcher(s)

• Promoter: Anthierens Sibyl

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

The aim of this project to gather routine data through automatic data collection in a safe environment and to giva accurate and rapidly available information to health care providers and researchers.This project is part of a research between the university of Antwerp and the Flemish government.

Researcher(s)

• Promoter: Van Royen Paul

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

Primary Care Academy, Interdisciplinary Chair Fund Dr. Daniël De Coninck, King Boudouin Foundation This chair was awarded for a period of five years starting April 1, 2019. Why? Given the changing healthcare needs of the Belgian population, the Primary Care Academy (PCA) aims to help create an optimal primary care experience for care receivers, adapted to the context of the community they live in, and with special attention to equity in Flanders. Who? The Primary Care Academy (PCA) is a research and teaching network of four Flemish universities, six university colleges, the White-Yellow Cross and patient representatives. What? The PCA focuses on building more comprehensive and interdisciplinary primary care for populations with moderately complex care needs in order to prevent avoidable deterioration and increasing complexity. The PCA promotes goal-oriented-care as an innovative strategy for pro-active and person-centred care in an inter-professional collaboration model. Attention is paid as well to the self-management support capacity of the caregiving community by developing a toolbox that enhances the sustainable implementation of self-management support in primary care. The PCA contributes to high quality of care by expanding interdisciplinary care and collaboration, involving, and uniting formal and informal care providers and s. To foster the person-centred and community-based approach whilst taking into account the social determinants of health, new models of interprofessional care networks and collaboration will be developed, tested and implemented. How? Based on academic and practice-oriented research, PCA develops optimal roadmaps and hands-on toolkits for primary care policies, practice and education. These strategies and tools facilitate the implementation of proactive and person-centred primary care for the population experiencing moderately complex difficulties. PCA also creates substantial input into innovative training strategies at the bachelor and master levels as well as in continuing education of health and social care professions. To induce sustainable change, the PCA interacts with policy makers of our health system from the outset.

Researcher(s)

• Promoter: Remmen Roy
• Co-promoter: De Loof Hans

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project website

Project type(s)

• Research Project

Abstract

Within the framework of the Center of Excellence Patients Participation, the White Yellow Cross (WGK) Flanders wants to explore the needs and expectations of patients in relation to their own involvement in care. The central objective of the Center of Excellence Patients Participation is to create patient participation tailored to each patient within home care. Gaining insight into the needs, expectations, perceptions and experiences of patients with regard to participation in care forms an important basis for further exploration of patient participation in practice. With this research project we want to gain insight into what makes patients want to participate more or less into their care. These insights can lead to the development of methodologies and strategies that allow care providers to detect and identify the participation needs of their individual patients. This research project starts from the perspective of the patient. The basis of the research design is what matters to the patient and not what we as professionals think that matters to the patient. That is why an inductive qualitative research methodology is chosen in which the experiences and the story of the patient form the basis of our research. This research design is aimed at gaining insight into relevant elements that play a role in the needs of patients to participate in their care

Researcher(s)

• Promoter: Anthierens Sibyl

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

The ultimate goal of this project is to optimize the provision of care for migrant cancer patients and thier families who need to rely on interpreters. We will do so by creating the conditions that enable both patients and their next of kin to better understand the information provided to them in orde for them to be able to be involved in the process of shared decision making. This means that we aim to improve: - the interaction beween patients, their next of kin, interpreters and doctors during interpreter mediated consultations - the interaction between doctors and interpreters during collaboration by offering to all of them evidence-based recommendations on how to interact with each other during the interpreter mediated consultation. It should be clarified at this stage that in this study, we perceive patients and family members attending the consultation as a single recipient of the doctor's communication. Therefore, in this study, we also include family members whose behaviour during the consultation and understanding after the consultation will be investigated next to the patients' own behaviour and understanding.

Researcher(s)

• Promoter: Wens Johan

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

The burden of chronic diseases including type two diabetes mellitus (T2D) is increasing rapidly, especially in low- and middle-income countries. In high-income countries, evidence shows that T2D disproportionally affects socio-economically disadvantaged and vulnerable populations, which makes it an important contributor to inequality. Self-management is an essential and effective strategy for people with T2D, but is poorly adopted in vulnerable groups and low-resource settings. Research on self-management support interventions has been focused on the general population of high-income countries, ignoring the populations that need it the most. The objective of this study is to identify the motivational mechanisms that determine self-management outcomes in vulnerable and socio-economic disadvantaged populations living in suburbs in Sweden, an urban slum in South-Africa, and a rural area in Uganda. The study is based on self-determination theory and hypothesizes that higher intrinsic motivation leads to better self-management which will improve physical and psychological outcomes. Moreover, increase of intrinsic motivation happens through fulfillment of the basic psychological needs which are perceived autonomy, competence and relatedness. In the same framework, we hypothesize that higher psychological adjustment – which refers to the absence of mental distress and the ability to cope with change – leads to better self-management and related outcomes. The study builds on an ongoing cluster-randomized experimental trial evaluating the effectiveness of a context-appropriate community intervention to enhance self-management for people with T2D called SMART2D. The aim of this new proposal is to identify the motivational mechanisms that explain the effect of the intervention in the SMART2D trial. More specifically, this new proposal will assess the mediating role of perceived autonomy, perceived relatedness, perceived competence, intrinsic motivation, and psychological adjustment. Quantitative data on these psychological factors will be collected through the SMART2D project. To determine the mediating effect of these latent variables, a structural equation model will be developed and tested. We will use multi-group structural equation modelling to test the model across the three different sites. This new project will also collect additional qualitative data through semi-structural interviews with the people at risk for or with T2D to further explain the differences across the three study settings. This study will inform us on how self-management support interventions need to be developed when targeting populations in disadvantaged or under-resourced areas, in order to make care more equal and inclusive.

Researcher(s)

• Promoter: Remmen Roy
• Co-promoter: Wouters Edwin
• Fellow: De Man Jeroen

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project website

Project type(s)

• Research Project

Abstract

Introduction: Patients who might also go to the general practitioner (GP) frequently consult emergency departments (ED). This leads to additional costs for both government and patient and a high workload for emergency physicians in Flanders. The Belgian government wants to address this problem by improved collaboration between EDs and general practice cooperatives (GPCs). Intervention: Patients presenting at the ED during out-of-hours (OOH) will be triaged and allocated to the most appropriate service. For this purpose the Manchester Triage System (MTS) which is commonly used in Flemish hospitals, will be extended (eMTS). By doing so a trained nurse will be able to diverge suitable patients towards the GPC. Methodology: We will conduct a cluster RCT in which eligible ED patients will be diverged to the GPC using the eMTS. We will collect data using our operational anonymous database for OOH care (iCAREdata). We will study the use of the eMTS, the effectiveness and effects of triage, work load changes, epidemiology at both departments, patient safety, health insurance (HIS) and patient expenditures. Furthermore facilitators and barriers will be studied and an incident analysis of problem cases will be performed. Outcome: The primary outcome is the proportion of patients who enter the ED and are handled by the GP after triage. Secondary outcome measurements are related to safety: referral rate to the ED by the GP, proportion of patients visiting the ED again within two weeks, proportion of patients not following the triage advice and file review for selected patients. Results: We will generate a generic model of triage applicable to all Belgian EDs and GPCs. The model will consist of a validated triage instrument, a manual for setting up triage and scientific support for both effectiveness and safety. In addition we expect to achieve financial savings for the HIS and for the patient.

Researcher(s)

• Promoter: Verhoeven Veronique
• Co-promoter: De Graeve Diana
• Co-promoter: Philips Hilde

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

Previously called NESTOR, the Primary Care Academy is a network being funded by the Koning Boudewijn Stichting. The partners are 4 universities, 6 university colleges , the White Yellow Cross and the Vlaams Patienten Platform.

Researcher(s)

• Promoter: Remmen Roy

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

This small project aims to examine if disabled people die a "good death". This objective only is possible on condition that a professional framework on care for these vulnerable people exists. However, it seems that care professionals need a lot of support and guidance in the palliative care provision to this specific desired population. Besides assessment of the dying quality, specific needs will be inquired by qualitative research methodology where after specific tools will be suggested and evaluated aiming to achieve the proposed goals.

Researcher(s)

• Promoter: Wens Johan

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project website

Project type(s)

• Research Project

Abstract

The Health Insurance Board of the RIZIV has asked the EBPracticeNet vzw Working Group Development Primary Care Guidelines to include the development and adaptation of Belgian Guidelines. With a part-time staff member of Wit Gele Kruis, a team of expertise is developed for the working group, for the systematic approach and methodologically correct development of guidelines revisions. The following tasks will be included for each guideline: elaboration of a systematic literature search, quality assessment and extraction of data, implementation of the various steps of the ADAPTE procedure, finalization and publication of the guideline, final editing, translation to other languages and final editing, preparation of publication. In addition, the Expertise group will also work on the regular updating of the Guidance Development Manual, as well as the development of templates and tools for guideline development

Researcher(s)

• Promoter: Van Royen Paul

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

Mental illnesses are a growing problem in modern societies. The interaction with the urbanised environment is little understood. The BELSPO funded NAMED-project (July 2017 – July 2021) investigates the impact of the (non-)built environment on mental health in the Brussels Capital Region. Methods will combine quantitative and qualitative research. From ELIZA Hans Keune, Hilde Bastiaens & Roy Remmen are involved.

Researcher(s)

• Promoter: Remmen Roy
• Co-promoter: Bastiaens Hilde

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

The Health Insurance Board of the RIZIV has asked the EBPracticeNet vzw Working Group Development Primary Care Guidelines to include the development and adaptation of Belgian Guidelines. There will be a constant activity for the development of 2 multidisciplinary Belgian guidelines and the revision / updating of 5 Belgian guidelines for primary care per year. The assignment within this project includes the following tasks: - Content coordination for the working group development primary care guidelines (preparing, organizing and chairing the meetings of the working group and steering group, contacts with author groups, stakeholders and experts, with RIZIV and EBPracticeNet, website management workgroup). - The development of a team of expertise for the working group. For the systematic approach and methodologically correct development of guidelines revisions, a central expertise section is being developed consisting of some part-time academic staff members. The following tasks will be included for each guideline: elaboration of a systematic literature search, quality assessment and extraction of data, implementation of the various steps of the ADAPTE procedure, finalization and publication of the guideline, final editing, translation to other languages and final editing, preparation of publication. In addition, the Expertise group will also work on the regular updating of the Guidance Development Manual, as well as the development of templates and tools for guideline development

Researcher(s)

• Promoter: Van Royen Paul

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

In Uganda, 98.9% of rural children developed infections caused by microorganisms resistant to the antibiotic co-trimoxazole (Rutebemberwa 2015). Antibiotic-resistant bacteria increasingly challenges treatment of pneumonia and tuberculosis. Despite this, Uganda has no national policy to deal with antibiotic resistance, and very little public understanding of the consequences of inappropriate use of medicines. This project will contribute to the reduction of antimicrobial resistance in Uganda by increasing the research activity and capacity of the Faculty of Health Science at Busitema University, and providing evidenced-based solutions to reduce antimicrobial resistance. The project maps patterns of antibiotic resistance in Uganda, and the factors which drive them in four regions. Capacity building includes training Ugandan researchers in advanced quantitative and qualitative research methods, and publishing in ISI ranked journals. Dissemination includes training, workshops and training material for health professionals, and raising public awareness

Researcher(s)

• Promoter: Van Royen Paul

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

This project has three phases. In a first phase, we aim to inventory the attitudes of future Flemish general practitioners towards patients with a psychological vulnerability, and the frames they use when talking about these patients. In a second phase, we aim future general practitioners to meet patients with psychological vulnerability. Finally, in the third phase, we will reassess their attitudes.

Researcher(s)

• Promoter: Van den Broeck Kris

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project website

Project type(s)

• Research Project

Abstract

The Health Insurance Board of the RIZIV has asked the EBMPracticeNet vzw Working Group Development Primary Care Guidelines to include the development and adaptation of Belgian Guidelines. There will be a constant activity for the development of 2 multidisciplinary Belgian guidelines and the revision / updating of 10 Belgian guidelines for primary care per year. The assignment within this project includes the further development of a team of expertise for the working group. For the systematic approach and methodologically correct development of guidelines revisions, a central expertise section is being developed consisting of some part-time academic staff members. The following tasks will be included for each guideline: elaboration of a systematic literature search, quality assessment and extraction of data, implementation of the various steps of the ADAPTE procedure, finalization and publication of the guideline, final editing, translation to other languages and final editing, preparation of publication. In addition, the Expertise group will also work on the regular updating of the Guidance Development Manual, as well as the development of templates and tools for guideline development

Researcher(s)

• Promoter: Van Royen Paul

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project website

Project type(s)

• Research Project

Abstract

The Health Insurance Board of the RIZIV has asked the EBMPracticeNet vzw Working Group Development Primary Care Guidelines to include the development and adaptation of Belgian Guidelines. There will be a constant activity for the development of 2 multidisciplinary Belgian guidelines and the revision / updating of 10 Belgian guidelines for primary care per year. The assignment within this project includes the following tasks: - Content coordination for the working group development primary care guidelines (preparing, organizing and chairing the meetings of the working group and steering group, contacts with author groups, stakeholders and experts, with RIZIV and EBMPracticeNet, website management workgroup). - The development of a team of expertise for the working group. For the systematic approach and methodologically correct development of guidelines revisions, a central expertise section is being developed consisting of some part-time academic staff members. The following tasks will be included for each guideline: elaboration of a systematic literature search, quality assessment and extraction of data, implementation of the various steps of the ADAPTE procedure, finalization and publication of the guideline, final editing, translation to other languages and final editing, preparation of publication. In addition, the Expertise group will also work on the regular updating of the Guidance Development Manual, as well as the development of templates and tools for guideline development

Researcher(s)

• Promoter: Van Royen Paul

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project website

Project type(s)

• Research Project

Abstract

In Belgium, the project ´Integrated care for chronic patients´ was launched ((Integreo). About 20 projects will pilot innovative strategies in catchment areas of 100.000-150.000 inhabitants. The Het FAITH.be consortium (Federated consortium for Appraisal of Integrated care Teams in Health in Belgium) is responsible for the support and evaluation of these chronic care projects in Belgium. Four parts can be distinguished. 1. In the outcome evaluation the Triple Aims goals and job satisfaction of providers of care will be studied. 2. The implementation analysis of the projects 3. Support for the projects ti help them to perform auto analysis 4. Support actions to the federal administration bodies The FAITH consortium consists of six Belgian universities. Besides the University of Antwerpen (Department of Primary and Interdisciplinary care, Centre for General Practice), the UGent, KULeuven, VUB, ULg and UCL (coordinator) are partners in the consortium. For the University of Antwerp you may contact Principal researcher: Elien Colman, PhD (elien.colman@uantwerpen.be) Promotors Universiteit Antwerpen: Sibyl Anthierens (sibyl anthierens@uantwerpen.be) en Roy Remmen (roy.remmen@uantwerpen.be)

Researcher(s)

• Promoter: Remmen Roy
• Co-promoter: Anthierens Sibyl

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project website

Project type(s)

• Research Project

Abstract

The overall research objective of the SPICES project is to implement and evaluate a comprehensive CVD prevention and control program in five settings: a rural & semi-urban community in a low-income country (Uganda), middle income (South Africa) and vulnerable groups in three high-income countries (Belgium, France and United Kingdom) as well as to identify and compare the barriers and facilitators across study contexts. The project will be evaluated using a mix of qualitative and quantitative methods. At the beginning of the project, we will conduct baseline assessments including literature reviews, formative studies, household surveys (where feasible) and learn lessons from other projects to understand healthcare and lifestyle practices, barriers, and facilitators. A costeffectiveness and cost benefit analysis will be included. In addition, the teams will conduct site exchanges visits to learn from each other and organise policy dialogues to ensure sustainability and maximise impact of the interventions.

Researcher(s)

• Promoter: Bastiaens Hilde
• Co-promoter: Anthierens Sibyl
• Co-promoter: Van geertruyden Jean-Pierre
• Co-promoter: Van Royen Paul

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project website

Project type(s)

• Research Project

Abstract

The project's overall aim is to improve the health, development and quality of life of children and adults born very preterm (VPT, < 32 weeks of gestation) or very low birth weight (VLBW, < 1500g) – approximately 50 000 births each year in Europe – by establishing an ICT platform to integrate, harmonise and exploit the wealth of data from 20 European cohorts of VPT/VLBW children and adults and their families constituted from the early 1980s to the present, together with data from national registries.

Researcher(s)

• Promoter: Lebeer Jo
• Co-promoter: Merckx Joanna
• Co-promoter: Van Rie Annelies

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project website

Project type(s)

• Research Project

Abstract

Mental illnesses are a growing problem in modern societies. The interaction with the urbanised environment is little understood. The BELSPO funded NAMED-project (July 2017 – July 2021) investigates the impact of the (non-)built environment on mental health in the Brussels Capital Region. Methods will combine quantitative and qualitative research. From ELIZA Hans Keune, Hilde Bastiaens & Roy Remmen are involved.

Researcher(s)

• Promoter: Remmen Roy
• Co-promoter: Bastiaens Hilde

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

The aim of this study is to investigate opinions of Belgian patients, relatives, spiritual counsellors and health care professionals on what they consider '(in)appropriate care' at the end of life and how futile/inappropriate care can be avoided.

Researcher(s)

• Promoter: Wens Johan

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project website

Project type(s)

• Research Project

Abstract

In Belgium, emergency departments and GPs take care of urgent medical care during office and out-of-hours (OOH). Patients have access to the care provider of their choice. Over the last years protocols for triage of unplanned care have been developed by working groups in Belgium. The central aim of the present project is to establish if telephonic triage (using the phone number "1733") with professional call takers using these protocols is feasible, reliable and effective. A pilot project is established in the region Leuven-Tienen, in close collaboration with the emergency departments, the general practice OOH services and the regional emergency call centre which operate in that region. The overall research questions are 1. What is the safety and efficiency of newly developed protocols when used by call takers? 2. What is the epidemiology of unplanned medical care both during office and out-of-hours? 3. What is the influence of telephone triage on the workload and cost of care for unplanned medical problems? Other activities during the project will help to inform the public and the health professionals in the Leuven region. The two year project started May 1, 2016. Results of this study will inform stakeholders about future organisation of OOH care in Belgium. The OOH care research group is part of the General Practice group of the Department of Primary and Interdisciplinary Care Principal investigator: Hilde Philips Co-supervisor Veronique Verhoeven Junior researcher: Hanne Claessen Junior researcher: Annelies Colliers Team member: Roy Remmen

Researcher(s)

• Promoter: Remmen Roy
• Co-promoter: Coenen Samuel
• Co-promoter: Philips Hilde
• Co-promoter: Verhoeven Veronique

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project website

Project type(s)

• Research Project

Abstract

Distress and quality of life during the diagnostic phase and before starting treatment in patients with lung cancer. This study aimed to get insight into the contributing factors to the diagnostic work-up time of lung cancer in the outpatient setting in specialist care, especially in the psychosocial burden for lung cancer patients during the diagnostic work-up . The aim is also to get insight in the way the diagnostic work-up is organised and how the usual care in Flanders is. The findings will provide insights into care trajectories which are relevant for the customization of care according to the patient's needs. There are two parts in the study: - a descriptive prospective study in patients with a (suspected serious) lung disease during the diagnosis process. A quantitative study with the use of standardised questionnaires - Qualitative semi-structured interviews were conducted with ten pulmonologists in Flanders to explore how the diagnosis of lung cancer is being made in the outpatient setting.

Researcher(s)

• Promoter: Van Royen Paul

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project website

Project type(s)

• Research Project

Abstract

"Buen vivir" through integrated health care: optimizing intercultural collaboration in rural areas in Ecuador. Ethnic communities living in Ecuador's SENPLADES zones 6-7 (Amazone and Andes region) have limited access to medical health care. Traditional health care is part of the daily life. There is little cooperation between medical and traditional caregivers. In this project we study the needs and the conditions which compromise intercultural health care in the communities, and provide concrete measures of effective implementation of intercultural integration, in the medical curriculum at UTPL and other universities, as well as for practitioners in the field. The project has 3 parts: A research part where gaps and needs of healthcare in the field are investigated and described. The second phase is an implementation study. The research is performed by a PhD student from UTPL Loja. A medical education part where the curriculum at UTPL Loja implements cultural competences and intercultural communication, use of portfolio and distance education. A capacity building part at UTPL with a Phd trajectory, staff training and scholarships exchange. A capacity building part in the communities with optimizing intercultural collaboration

Researcher(s)

• Promoter: Hendrickx Kristin
• Co-promoter: Michels Nele
• Co-promoter: Verhoeven Veronique

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

Green light. To design a research protocol to study the effects of nature on health, with a focus on frail populations in the Province of Antwerp. We will perform qualitative methods to study priority areas among key stakeholders and analyse the possible use of available quantitative data in future research. Principal researcher Dr Hans Keune Co-researchers professor Hilde Bastiaens and Roy Remmen

Researcher(s)

• Promoter: Remmen Roy
• Co-promoter: Bastiaens Hilde

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

To tailor and implement scientific results of Up to Date 1 in daily practice, in collaboration with primary care organizations, occupational health services and the alcohol and drug work field. Specific objectives - Inform and train GPs and OPs in screening, detection, brief intervention, problem definition of alcohol and other drugs, etc. depending on the context, the person and the product. - Use guidelines in practice. - Facilitate and improve the communication and collaboration between GPs and OPs.

Researcher(s)

• Promoter: Remmen Roy

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project website

Project type(s)

• Research Project

Abstract

Very preterm birth is a principal determinant of motor and cognitive impairment in later life. About 50 000 infants in the EU survive very preterm birth annually and are at much higher risk of cerebral palsy, visual and auditory deficits, impaired cognitive ability, psychiatric disorders and behavioural problems than infants born at term. However, the long term prognosis at initial discharge from hospital for each individual infant is unknown. Follow-up screening and prevention programmes aim to identify health problems early, enable interventions to improve outcome and to allow optimal management of health care. Despite the recognised importance of these programmes, little is known about their actual application and impact. These programmes consume significant resources because of the multidisciplinary staff required for clinical and developmental assessments and interventions, the coordination required to maintain contact with children after discharge and the time input from families. This project uses a unique resource – the EPICE cohort of 6675 babies born before 32 weeks of gestational age and surviving to discharge home in 18 geographically diverse regions in 2011/2012 – to assess the impact of these screening programmes on health, care and quality of life for very preterm infants and their families as well as on coverage, ability to meet needs, health equity and costs at the population-level. It will also generate new knowledge about assessment tools and methods. Four inter-related studies will be carried out in 11 EU countries by a multi-disciplinary consortium of clinicians (in obstetrics, paediatrics, and child development), researchers (in epidemiology, health services research and health economics) and a user organisation. Partners have the expertise to implement this project and the national and international renown to translate its result into better programmes and policies.

Researcher(s)

• Promoter: Lebeer Jo

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

The knowledge database of EBMPracticeNet includes all National Belgian EBM-information products, including the adapted Duodecim guidelines and all Belgian updated monodisciplinary and multidisciplinary guidelines. Within this project the researcher has the ultimate responsibility for the development of the online knowledge base. He/she is responsible for the actualization, coherence and integration of all guidelines and the other Belgian EBM products. There is a strong collaboration with the working group for the development of primary care guidelines, the project leader and the responsible for the clinical decision support system

Researcher(s)

• Promoter: Van Royen Paul
• Co-promoter: Coenen Samuel
• Co-promoter: Remmen Roy

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project website

Project type(s)

• Research Project

Abstract

In the past 5 years, Prof Jean-Pierre Van geertruyden has developed a portfolio of multiple global health research project and programmes, such as large surveys, diagnostic studies and clinical trials in the Democratic Republic of Congo, Peru, Tanzania, Uganda, Zambia and South Africa. More specifically, he is principal or co-investigator of ongoing or recently complete research studies with a focus on parasitological diseases financed by VLIR-UOS, Imperial College, FWO and EDCTP. The present project will focus on parasitological diseases research. Host, parasite and environmental related predictors associated with recurrent P. falciparum infections will be studied, using the clinical and sample databases developed through these studies. Key knowledge on targets and mechanisms of protective immunity is surprisingly limited, with many studies giving negative or contradictory results. The present project builds on two 3-years prospective longitudinal trials. Host, environmental and parasite related factors associated with individual susceptibility to malaria will be assessed. In collaboration with international partners and within a multidisciplinary setting, correlations between the development of clinical immunity and relevant clinical epidemiological features will be explored. This will enable a better understanding of the P. falciparum parasite's biology and host immunology and open new opportunities for malaria control.

Researcher(s)

• Promoter: Van Royen Paul

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

Hilde Philips MD PhD chairs the Guideline Development Unit of Domus Medica, the professional organization of general Practitioners in Belgium (Flanders). The Unit develops guidelines and shares expertise as methodologic experts with other organisations and education in guideline development. Both groups cooperate in GIN (Guidelines International Network).

Researcher(s)

• Promoter: Remmen Roy
• Co-promoter: Philips Hilde

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project website

Project type(s)

• Research Project

Abstract

This study aims to assess the explanatory factors of the underreporting of child abuse by professionals, such as general practitioners, paediatricians, emergency doctors, but also professionals from the educational sector or services involved in prevention. The focus is mainly on the barriers to notify or not abuse, as well as the organisational gaps (how different instances interact, overlap, etc.). This study should result in recommendations on how the reporting and follow-up of child abuse can be improved in order to optimise the medical care and social support for these children.

Researcher(s)

• Promoter: Peremans Lieve

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

This project is part of the European 'Health Workforce Planning and Forcasting' (EUHWForce) project. The overall aim of the project is to support participating countries in the planning of their future potential of health care providers in health care. The Belgian pilot project is looking for the most important drivers and factors determining the need of general practitioners taking in account the future tasks. We propose a comprehensive number of work packages. In the first work package (WP1) we will identify the most important stakeholders. Work package 2 encompasses a literature review which is the base of an interview script. Stakeholders are interviewed in the next work package (WP3). The results will be translated in hypotheses and indicators, which will be submitted at a broad panel of experts (WP4). The results can be used in the Planning Committee to refine the existing mathematical model. The results will be presented on a national and international forum and written down in a report.

Researcher(s)

• Promoter: Peremans Lieve

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project website

Project type(s)

• Research Project

Abstract

This project represents a formal research agreement between UA and on the other RIZIV. UA provides RIZIV research results mentioned in the title of the project under the conditions as stipulated in this contract.

Researcher(s)

• Promoter: Wens Johan
• Co-promoter: Van Den Eynden Bart

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

Proposed by the University, the Francqui Foundation each year awards two Francqui Chairs at the UAntwerp. These are intended to enable the invitation of a professor from another Belgian University or from abroad for a series of ten lessons. The Francqui Foundation pays the fee for these ten lessons directly to the holder of a Francqui Chair.

Researcher(s)

• Promoter: Van Royen Paul

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

This project represents a formal research agreement between UA and on the other hand the Flemish Public Service. UA provides the Flemish Public Service research results mentioned in the title of the project under the conditions as stipulated in this contract.

Researcher(s)

• Promoter: Van Royen Paul
• Co-promoter: Coenen Samuel
• Co-promoter: Remmen Roy

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

This project represents a formal research agreement between UA and on the other hand the client. UA provides the client research results mentioned in the title of the project under the conditions as stipulated in this contract.

Researcher(s)

• Promoter: Remmen Roy
• Co-promoter: Anthierens Sibyl

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

In this poject we propose a scientific analysis and evaluation of projects that aim to facilitate to keep frail elderly in their homes in the national programme protocol 3. In protocol 3 the national health insurance organisation invests more tnah 40.000.000 euro in new health facilities to keep elderly in their homes whilst preserving and improving quality of life.

Researcher(s)

• Promoter: Remmen Roy

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

National referral systems for THB victims exist, but are mostly missing a health component. The health professionals who encounter the victim lack necessary information about how and where to refer a trafficked person and what are the existing services available in a given country. The health professionals are per definition responsible for the weil being of the person and when facing a trafficked victim should decide quickly on the next step. This project focuses on the development of guidelines, made through a consensus method by international experts on THB, for the establishment of national focal points that include health care experts, working together with law enforcement agencies and NGO's. Involvement of the university in this project is aimed at developing guidelines through a research method (consensus Delphi Survey technique). With the focus set on the health care, more victims will be detected and more information will become available for the purpose of juridical proceedings leading to an increased number of convictions.

Researcher(s)

• Promoter: Van Royen Paul
• Co-promoter: Peeraer Griet

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

This project represents a formal research agreement between UA and on the other hand EU. UA provides EU research results mentioned in the title of the project under the conditions as stipulated in this contract.

Researcher(s)

• Promoter: Lebeer Jo

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

The scope of this project is to support medical curriculum reform at the UTPL with emphasis on modern teaching concepts, and to extend this reform to other universities which is in line with the MoH strategy.

Researcher(s)

• Promoter: Hendrickx Kristin
• Co-promoter: Remmen Roy
• Co-promoter: Van Royen Paul

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

This project represents a formal research agreement between UA and on the other hand KdG. UA provides KdG research results mentioned in the title of the project under the conditions as stipulated in this contract.

Researcher(s)

• Promoter: Lebeer Jo

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

The project will aim to describe the effects of policy measures to assist the informal caregiver (ICG) at the micro level in four countries, Flanders, Wallonia and Brussels. In other part of the larger project conducted by KCE, the grey literature has been explored. An inventory of policy measures supporting ICG in their function was already performed. We will use this information to foster a qualitative in depth, cross country multiple cases study.

Researcher(s)

• Promoter: Remmen Roy

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

The primary objective of the project is to estimate the effect of Farmaka's academic detailing service in practices visited before by Farmaka on general practioners appropriate prescribing of anagesics. The study is essential to unequivocally inform policymakers, Farmaka and the scientific community on how to most effectively improve the quality of pharmaceutical care (in Belgium).

Researcher(s)

• Promoter: Coenen Samuel
• Co-promoter: Verhoeven Veronique

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

The project aims to prevent costly complications and frailty in elderly with type 2 diabetes, enabling them to live independent, healthy and active lives as long as possible. This will be achieved by driving innovation and change in the current treatment approach, shifting from diabetes management to chronic care management. A roadmap for implementation of the model will be developed, providing, also guidelines for development of chronic care model in a broader context.

Researcher(s)

• Promoter: Wens Johan

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

Various Belgian authorities generate and disseminate good practice with the intention to promote the quality of health care. With a literature review and a qualitative research with Belgian stakeholders, it will study the effectiveness and efficiency of dissemination and implementation strategies of practical guidelines.

Researcher(s)

• Promoter: Remmen Roy

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project website

Project type(s)

• Research Project

Abstract

This project represents a formal research agreement between UA and on the other RIZIV. UA provides RIZIV research results mentioned in the title of the project under the conditions as stipulated in this contract.

Researcher(s)

• Promoter: Van Den Eynden Bart
• Co-promoter: Wens Johan

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

This project represents a formal research agreement between UA and on the other hand ZNA/HAN. UA provides ZNA/HAN research results mentioned in the title of the project under the conditions as stipulated in this contract.

Researcher(s)

• Promoter: Remmen Roy

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

This study is part of a larger work for the development of a position paper in order to orient the forthcoming health policy on chronic care in Belgium. lts specific objective is to perform a SWOT analysis of the capacity of Belgian health care system to organise care for patients with a chronic disease.This would encompass the perspectives of the important stakeholders of the system. The aim is to develop a set of operational objectives for future actions in the health care system.

Researcher(s)

• Promoter: Remmen Roy

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

This project represents a formal research agreement between UA and on the other hand OCMW Antwerpen. UA provides OCMW Antwerpen research results mentioned in the title of the project under the conditions as stipulated in this contract.

Researcher(s)

• Promoter: Remmen Roy

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

Title Informal caregivers caring for a frail older person living at home: coping with acute and gradual changes in health and dependency. Background In the near future, the ageing of the population will have a major impact on the demand for formal and informal long-term care services. Informal care is mainly provided by relatives, especially spouses and children. In Belgium, almost 10% of persons aged 15 years or over provide informal care. Yet, they are often 'invisible'. They don't seek help quickly, not even when they tend to get overburdened themselves. Aim In this study we want to explore the experience of caring for a frail older person who lives at home. We are especially interested in how informal caregivers cope with acute and gradual changes in health or dependency of the older person. Research questions - How do informal caregivers experience caring for a frail older person living at home and does this experience change over time? - How do they cope with acute and gradual changes in dependency, physical and mental health of the frail older person? - What is the impact of these acute and gradual changes on the physical, mental and social health of the informal caregiver Methodology We plan to do a longitudinal case study research. A purposive sample of approximately 10 informal caregivers of frail elderly will be recruited. In this qualitative research project we prefer to work with a small sample of people to study their experiences in-depth and longitudinal. At baseline and after 6 and 12 months we will perform interviews and assessments with the caregivers in their homes. In between, we will perform monthly semi-structured telephone interviews with the caregivers.

Researcher(s)

• Promoter: Verhoeven Veronique

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

The UP-TO-DATE consortium aims at providing an accurate view of the management of addiction in Belgium, from the physicians' perspective. The purpose of this research is to know 1) what the current demand is for care in the front line; 2) to what extent GPs and OPs are involved in this problem, and 3) what resources they are able to use for providing appropriate response to all types of requests for treatment of substance abuse. Other professionals from the addiction sector will also be interviewed to assess if they consider these physicians as a support, and if the role played by GPs is sufficiently valued.

Researcher(s)

• Promoter: Remmen Roy
• Co-promoter: Peremans Lieve

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

This project represents a formal research agreement between UA and on the other hand Universiteit Maastricht. UA provides Universiteit Maastricht research results mentioned in the title of the project under the conditions as stipulated in this contract.

Researcher(s)

• Promoter: Van Royen Paul

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

The overall aim of this project is the development of best practice guidelines for the detection, prevention and treatment of substances abuse in children and youngsters age 12 tot 25, using the ADAPTE process.

Researcher(s)

• Promoter: Van Royen Paul

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

This project represents a formal service agreement between UA and on the other hand Domus Medica vzw. UA provides Domus Medica vzw research results mentioned in the title of the project under the conditions as stipulated in this contract.

Researcher(s)

• Promoter: Van Royen Paul

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

This research focusses on the implematation of an ouit of hours service in the fysical neighborhoud of a general hospital in Northern Antwerp. Data will be collected before its implementation to study future change of patient fluxes.

Researcher(s)

• Promoter: Remmen Roy
• Co-promoter: Philips Hilde

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

Researcher(s)

• Promoter: Van Royen Paul

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

In this poject we propose a scientific analysis and evaluation of projects that aim to facilitate to keep frail elderly in their homes in the national programme protocol 3. In protocol 3 the national health insurance organisation invests more tnah 40.000.000 euro in new health facilities to keep elderly in their homes whilst preserving and improving quality of life.

Researcher(s)

• Promoter: Remmen Roy

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

This project represents a formal service agreement between UA and on the other hand Domus Medica vzw. UA provides Domus Medica vzw research results mentioned in the title of the project under the conditions as stipulated in this contract.

Researcher(s)

• Promoter: Van Royen Paul

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

This project represents a formal research agreement between UA and on the other hand a private institution. UA provides the private institution research results mentioned in the title of the project under the conditions as stipulated in this contract.

Researcher(s)

• Promoter: Van Royen Paul

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

TRANSFoRm will develop rigorous, generic methods for the integration of Primary Care clinical and research activities, to support patient safety and clinical research via: - rich capture of clinical data, including symptoms and signs rather than just a clinical diagnosis. A generic, dynamic interface, with potential to operate with any electronic health record (eHR), will facilitatie both diagnostic decision support and identification of patients eligible for research, thus enhancing patient safety - distributed interoperability of eHR data and other data sources that maintains provenance, confidentiality and security. This will enable large-scale phenoptype-genotype association studies and follow-up of trials. - software tools and services to enable use of controlled vocabulary and standardised data elements in clinical research. This will enable integration and reuse of clinical data. The scientific aims of this project are to radically advance our understanding of ICT system interoperability relevant to healthcare and clinical research and to develop an EU-wide system capable of integrating Primary Care electronic health record systems and research systems.

Researcher(s)

• Promoter: Van Royen Paul
• Co-promoter: Vermeire Etienne
• Co-promoter: Wens Johan

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project website

Project type(s)

• Research Project

Abstract

The aim of the project is to improve Primary Health Care and Family Medicine (PHC/FM) in Ecuador. This will be achieved by training family physicians who contribute to primary interdisciplinary health care services, oriented towards the real needs of patients, their family and their community. For this the project has 3 dimensions: research, capacity building and extension. In the first phase, research will include defining indicators for PCH/FM and for medical education in Ecuador. Building, implementing and evaluating a PHC/FM oriented medical curriculum at the local partner university will increase the capacity and the performance of trained doctors on different levels: undergraduate, postgraduate and continuing Medical Education. In the project, 3 PhD will evaluate the effect of the renewal of the curriculum on different aspects, and will be trained and incorporated as teachers and researchers in health care areas, strenghtening the research capacity at the local and national level. Finally, networking will be essnetial to ensure the sustainability of the results of the project. This will include the dissemination of the results of our project towards the different involved stakeholders.

Researcher(s)

• Promoter: Van Royen Paul
• Co-promoter: Hendrickx Kristin
• Co-promoter: Remmen Roy

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

Researcher(s)

• Promoter: Van Royen Paul

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

Editor of the magazine "Huisarts Nu".

Researcher(s)

• Promoter: Van Royen Paul

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

The conduct of an analysis of the literature for a RIZIV consensus conference on 'Influenza: vaccines and antiviral medication.' A consensus conference is a method which is useful for the development of medical and professional guidelines that take up a position concerning a controversy of a medical procedure, with the final goal of enhancing the quality of medical care. This consensus is reached by a jury that bases its decisions on the work of the bibliography working group and experts in the field. The bibliography group's task is to retrieve all relevant literature and to judge its methodological quality in order to be able to answer clinical questions that are drawn by the RIZIV Organising Committee. The answers of the bibliography working group and the jury are being accompanied by levels of scientific evidence and levels of recommendation for clinical practice.

Researcher(s)

• Promoter: Van Royen Paul

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

Researcher(s)

• Promoter: Van Royen Paul

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

This project represents a formal research agreement between UA and on the other hand Federatie Palliatieve Zorg Vlaanderen. UA provides Federatie Palliatieve Zorg Vlaanderen research results mentioned in the title of the project under the conditions as stipulated in this contract.

Researcher(s)

• Promoter: Van Royen Paul
• Co-promoter: Remmen Roy

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

Researcher(s)

• Promoter: Van Royen Paul

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

This project includes: - Wrting the recommendations for Good Practice 'Policy on pandemic influenz', carried out on the basis of the methodology of the Steering group Flemish project guidelines - Collaborating in the development of a scenario for the organisation of primary care in case of pandemic influenza.

Researcher(s)

• Promoter: Van Royen Paul
• Co-promoter: Philips Hilde

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

This project is part of a larger project. Two questions are adressed. What is the current status of training practices for medical specialists in Belgium. A document analysis will be performed. What is known about the quality of traing practices and trainers? For this a systematic review of the literature will be performed.

Researcher(s)

• Promoter: Remmen Roy
• Co-promoter: Van Royen Paul

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

The aim of this project is to produce a list of sticking points and barriers to develop and evaluate care pathways. This analysis will be based on the data analysis of the two diabetes projects in Aalst and Leuven. The outcome of this project will be a scenario book with a list of sticking points/barriers, useful for the operationalization of care pathways in future

Researcher(s)

• Promoter: Van Royen Paul

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

(more then 40.000.000 euro). The aim of this project is to make methods, choose instruments and to operationalise the projects for helping frail elderly to living at their homes within the framework of protocol three. protocol three is a national project aiming to find new avenues to keep elderly people in their homes whilst preserving and improving quality of life.

Researcher(s)

• Promoter: Remmen Roy

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

In a previous research project, an aselecte series of samples of 8600 pupils from the various types of regular and special primary and secondary education, were assigned, by collaborators of each of the 73 School Psychological Services to one of the 5 levels of educational needs, 4 clusters of impairments and target groups, based on the data of the pupils' files, known to the SPS in June 2008, according to criteria laid down by the Steering Committee on Needs' Indicators, with the objective of determining feasibility, validity and reliability of the new educational framework indicators. To this end, a manual, wizard and electronic web-based form have been designed, a helpdesk installed, and remarks made by SF5 collaborators, collected and analysed. Results were analysed in a quantitative and qualitative way. Shifts from the present allocation to the new educational allocation have been analysed, as well as a comparison has been made with the theoretical expected allocations. The present project wants to valorize these results, on the one hand by communicating results to the public of SF5 collaborators and schools, and on the other hand suggest a possible trajectory of professionalization in the new educational framework.

Researcher(s)

• Promoter: Lebeer Jo
• Co-promoter: Struyf Elke

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

This project includes: - Wrting the recommendations for Good Practice 'Policy on pandemic influenz', carried out on the basis of the methodology of the Steering group Flemish project guidelines - Collaborating in the development of a scenario for the organisation of primary care in case of pandemic influenza.

Researcher(s)

• Promoter: Van Royen Paul
• Co-promoter: Michiels Barbara

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

Despite the increasing awareness and need for interprofessional collaboration in health care, only few studies demonstrate its effect. The main purpose of this study is to measure the effect of 'learning to collaborate interprofessionally' on the quality of care for residents of nursing homes. The study is divided into four major parts. The first part is a description of what interprofessional collaboration means and how this skill is taught in educational modules. These interprofessional education modules form the basis of the intervention in this study for this project. The second part is a systematic literature review conducted with the aim to obtain outcomes of interprofessional collaboration as an intervention for chronic geriatric care. Evidence is being searched that may or may not demonstrate the effect of 'learning to collaborate interprofessionally 'on the quality of care and how it is to be measured. In the third part, the aim is to get a description of the existing care (region Antwerp) for residents in nursing homes. The description of the existing care (usual care) is based on the experiences of professionals and residents using focus groups and depth interviews. The description will give us a better idea of how the care is being organized ' interprofessionally' and what the current problems are at work. In the fourth and final part of this project, a pilot for a cluster randomized controlled trial in primary care with one year follow-up is being performed. This experimental study attempts to quantify the effect of interprofessional collaboration as an intervention on the quality of care for residents in a nursing home. This study measures the possible influence of learning to collaborate interprofessionally for professional help providers, the nursing homes and their residents. With SWOT- analyses bottlenecks in interprofessional collaboration will be identified. In addition several outcomes are being registered since the implementation of the ' interprofessional collaboration-intervention'. On residents level a number of indicators are being monitored, for example the fall incidence, quality of life, etc. Also on nursing home level the experiences with 'learning to collaborate interprofessionally' are being registered for example work absenteeism, number of personnel, etc. With this doctoral study project, the aim is to measure the possible influence of learning to collaborate interprofessionally' on the quality of care, expressed in a limited number of outcome parameters and compared with the existing care. The hypothesis is that learning to collaborate interprofessionally can help to increase the quality of care in nursing homes.

Researcher(s)

• Promoter: Van Royen Paul
• Co-principal investigator: Truijen Steven
• Co-promoter: Meulemans Herman

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

The aim of the project is to deliver the state of the art concerning pay for quality in helath care. A systematic overview of the literature, a description of foreign countries and Belgium will be executed.

Researcher(s)

• Promoter: Remmen Roy

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

This study aims to review scientific literature on diagnosis and treatment of acute and chronic neck pain. The objective is to propose clinical guidelines to diagnose and treat patients who suffer from neck pain. The implentation of the final recommendations in Belgium will also be considered.

Researcher(s)

• Promoter: Remmen Roy

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

This project is a practice test for the implementation of the new framework for educational assistance in regular education; it wants to develop a web-based form, on the basis of a list of indicators, as developed by a working party of the Ministry of Education of the Flanders Region, to allow the School Guidance Centres to allocate pupils in an efficient way into one of levels of assistance needed, and check validity and practicability, with a representative sample of 8600 pupils from kindergarten, elementary and secondary education

Researcher(s)

• Promoter: Lebeer Jo
• Co-promoter: Struyf Elke

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

The overall aim of this project is to inform best practice and harmonise research in end of life care for cancer patients across Europe through comparison and exchange of approaches and experiences in measurements and research priorities.

Researcher(s)

• Promoter: Van Den Eynden Bart
• Co-promoter: Van Royen Paul

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

This project aims to perform a systematic literature search and appraisal and to find evidence in the medical literatur for medication interventions for chronic heart failure in ambulant care. The studied outcome variables are: cardiovascular and non-cardiovascular mortality, quality of life and number of hospitalisations. The following substances are studied: angiotensin-converting enzyme inhibitors, adrenergic beta-antagonists, Sartanes, Spironolactone, Thiazides, Diuretics, Digitalis, Erythropoietin, Nitrates and calcium channel blockers. The treatment of chronic heart failure is specifically studied for the following three patient groups: elderly (+65 yrs), diabetic patients and patients with renal insufficiency. Also the side effects of the different substances is studied.

Researcher(s)

• Promoter: Van Royen Paul

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

Evaluation of a regional complex intervention for diabetes type 2 based on existing health data. The overall objective of this project is to improve the quality of diabetes care and to contribute in this way to the overall health and quality of life of people living with diabetes. In a previous study, regional shared care interventions for diabetes type 2 were developed and implemented. The aim of this research project is to compare the process and outcome results of these interventions with the quality of care in a control region were usual care continued. An economic evaluation will be completed as well. A regional diabetes database using existing data of health insurance companies and clinical laboratories is being build up to answer following research questions: - Is the follow-up of process-parameters better in the intervention than in the usual care regions? - Do the interventions have a significant effect on HbA1c and/or LDL-cholesterol (primary outcome parameters) compared to the usual care region? - What is the direct medical cost per patient in the intervention and usual care regions? - Which avoided costs can be calculated as a result of the interventions compared to usual care region?

Researcher(s)

• Promoter: Van Royen Paul

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

Researcher(s)

• Promoter: Van Den Eynden Bart

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

The general aim is to develop guidelines for general practice. Guidelines are followed by general practitioners unless they have practie relevant reasons not to do so. Guidelines are developed step by step: starting up authorgroups, developing clinical questions, draft version of the guideline, assessment by the commission, external experts and local quality groups of GPs. Each year one guideline is started up and one other is finalised. All guidelines are regularly updated and reviewed.

Researcher(s)

• Promoter: Van Royen Paul
• Co-promoter: Dirven Kristien

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

This project focusses on reasons to choose general practice in the undergraduate curriculum, and the reasons to leave practice among young general practitioners. Stakeholders interviews are performed.

Researcher(s)

• Promoter: Remmen Roy

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

This project aims to perform a systematic literature search and appraisal and to find evidence in the medical literature for medicinal interventions for the symptomatic treatment of pain. Main points of interest for outcome variables: effectiveness, safety , cost efficiency, different galenic forms, different ways of administration, duration of effectiveness, side affects, association of drugs, compliance to therapy. The analgetics that were searched for in detail are: Paracetamol, Acetylsalicyl acid, Tramadol, Morfine, Methadone, Hydromorfone, Oxycodone, Fentanyl, Dextropropoxyfeen, Buprenorfine, Tilidine, Nefopam, transcutane application systems of narcotic analgetics, previously mentioned anti-epileptica (clonazepam, gabapentine, amantadine, carbamazepine, oxcarbazepine) The search did not include (outside the scope): Migraine and all other kinds of headache, Inpatients, Complex regional pain syndrom (CRPS 1 and 2), Angor, Antidepressants (unless indicated for neuropathic pain; unless with proven effectiveness for other indiations), fibromyalgia, NSAID (unless in comparison with other analgetics), spasmolytics for viscerale pain management, malignant pain

Researcher(s)

• Promoter: Van Royen Paul

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

The general aim is to develop guidelines for general practice. Guidelines are followed by general practitioners unless they have practie relevant reasons not to do so. Guidelines are developed step by step: starting up authorgroups, developing clinical questions, draft version of the guideline, assessment by the commission, external experts and local quality groups of GPs. Each year one guideline is started up and one other is finalised. All guidelines are regularly updated and reviewed.

Researcher(s)

• Promoter: Van Royen Paul
• Co-promoter: Peremans Lieve
• Co-promoter: Philips Hilde

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

In spite of the growing interest in patient-centredness in medical education, there's still a decline in patient-centredness as students progress through medical school. Several causal factors have been suggested, but there's a lack of research into stimulating and inhibiting factors of patient-centredness in medical students. The aim of this study is to describe the determinants of patient-centredness in medical students, and to measure the effect of communication skills training and hospital internships. A measurement scale is developed in order to study the evolution of patient-centredness in medical students in a cross-sectional and longitudinal design. Focus groups and in-depth interviews will deliver information about the inner development of this important competence.

Researcher(s)

• Promoter: Van Royen Paul

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

In this follow up study we investigate the natural history of HPV (human papillomavirus) infections, focussing on humoral and cellular immune responses. This is important to get a better insight in the epidemiology of a virus which is strongly linked to the development of premalign cervical intraepithelial neoplasia (CIN) and cervical cancer.

Researcher(s)

• Promoter: Verhoeven Veronique

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

The prescription of antibiotics for LRTI accounts for a major proportion of antibiotics used in the community and contributes to the rising prevalence of resistance. This qualitative study will explore the factors that contribute to variation in antibiotic use in general medical care in Utrecht and Antwerp. Interviews will be conducted to study the current attitudes and beliefs of both clinicians and patients to antibiotic use and resistance.

Researcher(s)

• Promoter: Coenen Samuel

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

The aim of the projcet is to introduce a framework for quality assurance in General Practice in Belgium. Indicators on organisation and clinical indicators will be used.

Researcher(s)

• Promoter: Remmen Roy

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

The aim of this project is to answer two research questions: Is there new evidence after the last literature search on the different guidelines? Does this new evidence change the key messages of the guidelines ? The literature is searched for in three databases: Medline, Embase and the Cochrane Library from 2000 till now. The selected articles are assessed for their quality with standardised checklists. Evidence tables are made and the key messages of the different guidelines are reformulated with the help of GRADE, an instrument for formulating recommendations

Researcher(s)

• Promoter: Van Royen Paul

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

Researcher(s)

• Promoter: Lebeer Jo

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

In this project, reinfection rates and clinical outcome of patients enrolled in opportunistic CT screening are determined in a prospective cohort study in 30 general practices in Antwerp. Patients with asymptomatic CT infections, diagnosed in a pilot opportunistic screening programme in 2001-2002, are retested with a nucleic acid amplification-based test, and gynaecological and reproductive outcome are assessed.

Researcher(s)

• Promoter: Verhoeven Veronique

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

Treatment of diabetes involves complex changes in behaviour and adherence to complicated regimes. Succesful diabetes management requieres that health care professionasl understand patients' attitudes, beliefs and lifestyle. This kind of information can not be accessed by the population based research methods. This study focuses on the individual as a 'longitudinal case study', trying to understand the individual as a whole within their social context and over time. Between april and november 2005 an intensive datacollection (interviews, diary keeping, medical record data, data on health care consultations) will be undertaken with 6 to 8 diabetic patients and their environment. Feasibility of this multimethod data collection will be assessed and structured comparative case analysis will be used to idendify important factors influencing an individuals' health journey.

Researcher(s)

• Promoter: Van Royen Paul

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

The aim of this study is to formulate policy recommendations for the quality and organisation of diabetes care, taking into account the severity of disease and associated co-morbidity. In the international literature and existing guidelines, quality indicators and essential preconditions for a hig-quality diagnosis, treatment and follow-up of diabetic patients will be searched for. Also organsation models of optimal diabetes care will be looked for. All relevant literature will be put into evidence tables, and will be assesed critically on quality. The policy recommendations will be assessed by a group of experts.

Researcher(s)

• Promoter: Van Royen Paul

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

Researcher(s)

• Promoter: Van Royen Paul

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

This project aims to develop initiatives on improving the collaboration and communication between general practitioners and patients, particularly by an internet based application. Articles and texts, on health prevention will be made available and be published by benevita. Files on health and well-being will be developed, as concepts improving the collaboration and communication between general practitioners and patients. Finally test environments for scientific research will be organised.

Researcher(s)

• Promoter: Van Royen Paul

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

Researcher(s)

• Promoter: Van Royen Paul

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

Researcher(s)

• Promoter: Van Royen Paul
• Co-promoter: Coenen Samuel

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

As preparation for the Belgian consensus meeting on clinical efficacy of medication for complicated hypertension (hypertension with type 2 diabetes, cerebrovascular and heart diseases, chronic kidney disorders), a literature review will be done on clinical studies with the following endpoints: reduction of cardiovascular morbidity and mortality, reduction of renal failure and morbidity, type 2 diabetes morbidity)

Researcher(s)

• Promoter: Van Royen Paul

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

For many problems encountered in primary care strong evidence to support management is lacking. In addition there is a problem of implementing evidence-based management in everyday practice. Both lead to sub-optimal patient care and misuse of available resources. Respiratory tract infections are a good example of this (Coenen S. Antibiotics for coughing in general practice [Dissertation]. University of Anwerp 2003). For lower respiratory tract infections (LRTIs) the evidence for the effectiveness of antibiotics is conflicting. Furthermore, the evidence does not allow to identify those patients who would (not) benefit from antibiotic treatment. For otitis media with effusion (OME) antibiotics are of very limited benefit. On the other hand the relevant evidence base on the overall effectiveness of surgery is provided in OME. Here however poor selectivity for referrals by GPs to ENT was documented. The current research project aims to inform the development of interventions to improve the predictive validity of OM referrals and to improve pragmatic choices about the use of antibiotics for all patients with LRTI and for important clinical subgroups of patients with LRTI.

Researcher(s)

• Promoter: Van Royen Paul
• Co-promoter: Goossens Herman
• Fellow: Coenen Samuel

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

The aim of this project is to assess whether a model of `shared care', coordinated by general practitioners can significantly improve the outcome for patients with type 2 diabetes mellitus. The project will also examine which actions are necessary and effective and will calculate the corresponding care costs. Coordinated primary care teams will be developed, with dieticians, podologists and the diabetes educator as support for the GPs. A shared care program, based on a multidisciplinary care protocol and well-defined tasks and responsibilities, will enable the primary care team to optimalize the care process. The diabetes passport will be a useful instrument for the empowerment of patients. This project also includes collaboration with specialised and hospital care.

Researcher(s)

• Promoter: Van Royen Paul

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

As an experiment, the Belgian Health Care Organization erected a few Palliative day care centers (PDCC). They should increase continuity between in-patient and home care settings and ease the burden of responsibility on the family. PDCC provide facilities for medical, psychological, social and spiritual activities. Their ultimate goal is to guarantee patient's quality of life. Unfortunately, few patients find their way to the PDCC. Are these PDCC unknown among patients' family physician? What are the (dis) advantages of PDCC according to the family physicians? A quantitative study (i.e. postal questionnaire) explores their opinions.

Researcher(s)

• Promoter: Van Royen Paul
• Co-promoter: Van Den Eynden Bart

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

Researcher(s)

• Promoter: Van Royen Paul

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

We expect health workers to be careful in their patient contacts in order to prevent transmission of infectious diseases. One of the possibilities is the influenza vaccination. With this research project we want to study whether this vaccine prevents general practitioners for the symptoms and complications of influenza. Also the carrying of viruses in nose and throat after influenza vaccination will be studied. In a pilot study 30 non-vaccinated general practitioners will be asked to take swabs from their noses and throats several days after contact with a patient who showed signs of influenza infection. They also had to take swabs when they ran a fever (>38°C) in combination with coughing. The results will tell us whether general practitioners carry viruses in nose and throat after contact with patients who are suffering influenza. We also learn when precisely the cultures become positive. In a following study we will compare the virus carrying in a group of 60 vaccinated general practitioners and a non-vaccinated group. Also the factors which influence the virus carrying , will be studied

Researcher(s)

• Promoter: Van Royen Paul

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project