Research Kris Van den Broeck

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 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

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

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

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

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. 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

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

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

Objectives of the Public Mental Health chair Despite the change (s) of the context, we as a society bear the responsibility to provide people with a psychological or psychosocial need the best possible care in a cost-efficient way (with attention to the perception of both healthcare users and caregivers;. With the chair 'Public Mental Health' we want to offer support and guidance to this social responsibility through research, education and services. The research section of the chair will focus on collecting information about the current care needs and the current care offer. After all, there are few data available today about the occurrence of psychosocial and psychological complaints and disorders in Flanders (or Belgium), and their seriousness. The information on the care-delivery side is also incomplete; for example, we have little to no insight into what GPs, freestanding psychiatrists and (primary) psychologists provide to psychological and psychosocial care. We will ask health care users and care providers about (non-filled in) care needs. In addition, existing (linked) databases (from Antwerp care providers and other sources) will be examined in this light. Based on the background of and in combination with international literature, the local findings provide input for the teaching section of the chair. The knowledge about mental health (care) in the general population is relatively limited ('mental health literacy') and the taboo about mental problems and the stigma with regard to people with mental health problems is great, even with ( somatic-oriented) care providers, so that people with mental health problems do not seek help or receive inadequate (somatic) help . With training and education, both for students and for a broader public, this can be tackled. Finally, the research component provides a lot of input for the service part of the chair. With the collected data, we hope to be able to start a data-driven healthcare provision in the province of Antwerp, strengthening the cooperative between the participating hospitals and with other actors in the field. Mental health and mental well-being are gaining weight in society. The zeitgeist is therefore extremely suitable to set up this chair. We are convinced that the chair can act as a lever in the acquisition of additional funds.

Researcher(s)

• Promoter: Dom Geert
• Co-promoter: Remmen Roy
• Co-promoter: Van den Broeck Kris

Research team(s)

• Collaborative Antwerp Psychiatric Research Institute (CAPRI)

Project type(s)

• Research Project

Abstract

Psychiatric disorders and psychosocial complaints are highly prevalent and have large personal and societal impacts. Flemish mental health care has changed dramatically over the past few years. How can we provide these patients with the best possible care? In this project, we will develop a valid methodology to inventory the psychiatric and psychosocial needs in society. In addition, we would like to get a better view on what kind of mental health care interventions are provided in primary care, and provide recommendations to improve the match between care needs and care possiblities.

Researcher(s)

• Promoter: Dom Geert
• Co-promoter: Remmen Roy
• Co-promoter: Van den Broeck Kris

Research team(s)

• Collaborative Antwerp Psychiatric Research Institute (CAPRI)

Project website

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