Research Samuel Coenen

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

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

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 emergence of new pathogens, such as the coronavirus causing the COVID-19 pandemic, and of antibiotic resistance has further increased mortality and morbidity of infectious diseases (ID). To reduce the impact of ID on individual and population health and to advance clinical research on ID, the European Clinical Research Alliance on Infectious Diseases (ECRAID; www.ecraid.eu) was established, a European research infrastructure. The pandemic demonstrated the importance of innovative research into the best management of COVID-19 patients in primary care, where most patients with ID are treated, ideally preventing hospital admission and worse. This is research where both Belgium and Europe lagged behind, and where Flanders could be a pioneer by supporting (B)ECRAID. BECRAID aims to establish a long-term, financially self-sustainable, research infrastructure for primary care research on ID in Flanders and to represent Flanders in the primary care research of ECRAID. BECRAID receives very strong support from its stakeholders and potential users in Flanders and beyond, and has the ambition to expand to nursing homes, to Belgium and even to other relevant diseases.

Researcher(s)

• Promoter: Coenen Samuel
• Co-promoter: Goossens Herman

Research team(s)

• Laboratory of Medical Microbiology (LMM)

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

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

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

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

Mathematical simulation models have become indispensable tools for forecasting and studying the effectiveness of intervention strategies such as lockdowns and screening during the SARS-CoV-2 pandemic. Estimation of key modeling quantities uses the serological footprint of an infection on the host. However, although depending on the type of assay, SARS-CoV-2 antibody titers were frequently not found in young and/or asymptomatic individuals and were shown to wane after a relatively short period, especially in asymptomatic individuals. In contrast, T-cells have been found in different situations – also without antibodies being present - ranging from convalescent asymptomatic to mild SARS-CoV-2 patients and their household members, thereby indicating that T-cells offer more sensitivity to detect past exposure to SARS-CoV-2 than the detection of antibodies can. In this project, we will gather on a population level T-cell and antibody SARS-CoV-2 specific data from different well-described cohorts including 300 individuals (and 200 household members) who have had proven covid-19 infection > 3 months earlier, 100 general practitioners, 100 hospital workers, 500 randomly selected individuals and 75 pre-covid-era PBMC/sera. This data will be used in comparative simulation models and will lead to a reassessment of several key epidemiological estimates such as herd immunity and the reproduction number R that will significantly inform covid-19 related public health interventions.

Researcher(s)

• Promoter: Ogunjimi Benson
• Co-promoter: Beutels Philippe
• Co-promoter: Coenen Samuel
• Co-promoter: Laukens Kris
• Co-promoter: Lion Eva
• Co-promoter: Meysman Pieter
• Co-promoter: Van Damme Pierre

Research team(s)

• Centre for Health Economics Research and Modelling of Infectious Diseases (CHERMID)

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

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

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

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

Antimicrobial resistance (AMR) is of great public health concern, causing numerous losses of lives worldwide and threatening to reverse many of the considerable strides modern medicine has made over the last century. There is a need to stratify antibiotic and alternative treatments in terms of the actual benefit for the patient, improving patient outcome and limit the impact on AMR. High quality, effective and appropriate diagnostic tests to steer appropriate use of antibiotics are available. However, implementation of these tests into daily healthcare practice is hampered due to lack of insight in the medical, technological and health economical value and limited knowledge about psychosocial, ethical, regulatory and organisational barriers to their implementation into clinical practice. VALUE-Dx will define and understand these value indicators and barriers to adoption of diagnostics of Community-Acquired Acute Respiratory Tract Infections (CA-ARTI) in order to develop and improve health economic models to generate insight in the whole value of diagnostics and develop policy and regulatory recommendations. In addition, efficient clinical algorithms and user requirement specifications of tests will be developed fuelling the medical and technological value of CA-ARTI diagnostics. The value of diagnostics will be tested and demonstrated in a unique pan-European clinical and laboratory research infrastructure allowing for innovative adaptive trial designs to evaluate novel CA-ARTI diagnostics. Close and continuous interaction with the VALUE-Dx multi-stakeholder platform provides for optimal alignment of VALUE-Dx activities with stakeholder opinions, expert knowledge and interests. A variety of dissemination and advocacy measures will promote wide-spread adoption of clinical and cost-effective innovative diagnostics to achieve more personalized, evidence-based antibiotic prescription in order to transform clinical practice, improve patient outcomes and combat AMR.

Researcher(s)

• Promoter: Goossens Herman
• Co-promoter: Coenen Samuel
• Co-promoter: Kumar-Singh Samir
• Co-promoter: Malhotra Surbhi

Research team(s)

• Laboratory of Medical Microbiology (LMM)

Project type(s)

• Research Project

Abstract

ECRAID will develop a business plan in line with European-funded networks to create a clinical research infrastructure that will operate from 2021. This business plan is called ECRAID-Plan. It is working with the network partners and Monitor Deloitte to develop a business plan. The business plan will outline ECRAID services, operations, governance structure, and financial sustainability plans. ECRAID is seeking to strengthen alliances with the private sector and international organisations involved in infectious disease interventions to boost investments into protecting European public health.

Researcher(s)

• Promoter: Goossens Herman
• Co-promoter: Coenen Samuel

Research team(s)

• Laboratory of Medical Microbiology (LMM)

Project type(s)

• Research Project

Abstract

Respiratory syncytial virus (RSV) is not well known outside medical circles, yet most people have probably suffered from it in childhood, as it is the most common cause of severe respiratory illness in infants and children worldwide. The elderly and people with weakened immune systems are also vulnerable to RSV infection. While most people's symptoms are mild, it can result in pneumonia and 3.4 million cases annually require hospitalisation. There is no specific treatment or vaccine for RSV. The goal of the RESCEU project is to gather information on the scale of RSV infection in Europe and its economic impacts. It will then use this information to design best practice guidelines to improve the way RSV cases are monitored in Europe, and to shape future vaccination programmes. The team will also gather and analyse patient samples to identify biological markers associated with severe RSV infection. This information could aid in diagnosis and facilitate the development of new treatments and vaccines.

Researcher(s)

• Promoter: Goossens Herman
• Co-promoter: Coenen Samuel

Research team(s)

• Laboratory of Medical Microbiology (LMM)

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

Antivirals for influenza like illness? An adaptive RCT of clinical and cost effectiveness in primary care. Epidemic and pandemic preparedness systems are needed to protect health and socio-economics in the European Union. Much progress has been made in developing structures for adequate public health responses. The clinical research response, however, is often delayed and fragmented, and has therefore too little impact on improving patient outcomes and on developing evidence to inform clinical management strategies. The overall mission of PREPARE (Platform foR European Prepardness Against (Re-)emerging Epidemics; www.prepare-europe.eu) therefore is to establish a European clinical research framework for harmonised, large-scale clinical research studies on infectious diseases. This will enable a rapid response to any severe infectious disease outbreak and proper treatment, by providing real-time evidence for clinical management of patients. The ALIC4E trial, a large multicentre study in primary care patients with influenza-like-illness (ILI), is part of PREPARE and aims to investigate the (cost) effectiveness of antiviral treatments for ILI in primary care, to establish a European primary care research network for clinical research during epidemics or pandemics, and to define recommendations for effective research in European primary care during an epidemic or pandemic.

Researcher(s)

• Promoter: Coenen Samuel

Research team(s)

Project website

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

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: Coenen Samuel
• Co-promoter: Anthierens Sibyl

Research team(s)

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

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

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

Researcher(s)

• Promoter: Coenen Samuel
• Co-promoter: Goossens Herman

Research team(s)

Project type(s)

• Research Project

Abstract

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

Researcher(s)

• Promoter: Goossens Herman
• Co-promoter: Coenen Samuel

Research team(s)

Project type(s)

• Research Project

Abstract

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

Researcher(s)

• Promoter: Goossens Herman
• Co-promoter: Coenen Samuel

Research team(s)

Project type(s)

• Research Project

Abstract

The APRES project aims at providing information and recommendations on the appropriateness of prescribing antibiotics in primary care throughout Europe by collecting information on the antibiotic resistance pattern of bacteria circulating in the community and by combining this information with antibiotic prescribing patterns retrieve from primary care practices. The appropriateness of prescribing antibiotics is defined as the extent to which the pattern of prescribed antibiotics are congruent with the antibiotic resistance pattern of bacteria.

Researcher(s)

• Promoter: Goossens Herman
• Co-promoter: Coenen Samuel

Research team(s)

Project type(s)

• Research Project

Abstract

Researcher(s)

• Promoter: Coenen Samuel

Research team(s)

Project type(s)

• Research Project

Abstract

General objectives: To participate with a Flemisch primary care Network in GRACE. Specific objectives: 1. To determine the proportion of bacterial LRTI. 2. To describe the most important bacterial species in LRTI and to determine to what extent they are resistant to antibiotics. 3. To validate the CRB-65 prediction rule to assess the risk on complications in general practice. 4. To review national and international guidelines on lower respiratory tract infections. 5. To assess whether an evidence-based intervention package reduces antibiotic prescribing for community-acquired LRTI.

Researcher(s)

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

Research team(s)

Project type(s)

• Research Project

Abstract

The research plan over the next years involves four main research themes: 1.1.Modelling infectious diseases; 1.2.Data collection and analysis for burden of (infectious) disease estimates; 1.3.Program evaluations of infectious disease interventions; 1.4.Health economics and program evaluations in general. Each of these research themes departs from the observation that the current methodological approach can be substantially improved by using more sophisticated methods. Since these research themes are each multidisciplinary and interconnected, these improvements are expected to occur within each theme and over all themes combined.

Researcher(s)

• Promoter: Goossens Herman
• Promoter: Van Damme Pierre
• Fellow: Beutels Philippe
• Fellow: Coenen Samuel

Research team(s)

Project type(s)

• Research Project

Abstract

The aim of CHAMP (Changing behaviour of Health care professionals And the general public towards a More Prudent use of anti-microbial agents) is to promote the appropriate use of antibiotics by developing effective tools to change behaviour of health care professionals, patients in primary care, and the general public on the prescription and use of antibiotics. Effective interventions in this field should take into account cultural differences between countries and be based on knowledge of perceptions and behaviour of medical professionals, patients and the general public within the European Union. Therefore the first stage of the project will explore current prevention and management of respiratory tract infections in European primary care and perception, expectations and illness behaviour of primary care patients with respiratory tract infections. Then an up-to-date inventory of both published and unpublished public campaigns and behavioural programs will be made and qualitative information from key-players and stake-holders in this field will be gathered. Cost-effectiveness of the different interventions used until now will be modelled. In addition, information will be gathered systematically on educational programs from medical schools on prevention and management of common respiratory tract infections. The information thus gathered will be analysed and priorities chosen. Consensus will be aimed for among experts and stakeholders on tools to improve the behaviour of medical professionals and the public concerning prevention and management of infectious diseases and antibiotic use. In addition, standard procedures will be developed to measure the effects of educational activities, behavioural programs and public campaigns in this field. Finally, the implementation of the behavioural program that is thus developed will be tried out and evaluated in six GP networks in six different countries. This will be done in close collaboration with the GRACE project.

Researcher(s)

• Promoter: Goossens Herman
• Co-promoter: Coenen Samuel

Research team(s)

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

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

Research team(s)

Project type(s)

• Research Project

Abstract

GRACE is a Network of Excellence focusing on the complex and controversial field of community-acquired lower respiratory tract infections (LRTI), which is one of the leading reasons for seeking medical care-The promiscuous use of antibiotics to treatment of LRTI accounts for a major part of the community burden of antibiotic use and contributes dramatically to the rising prevalence of resistance among major human pathogens. The overall objective of GRACE is to combat antimicrobial resistance through integrating centres of research excellence and exploiting genomics in the investigation of community-acquired LRTI. Microbial and human genomics will be integrated with health sciences research consisting of clinical observational and intervention studies, health economics and health education to specifically change practice in managing community-acquired LRTI. GRACE is exceptional as it brings together investigators from basic laboratory sciences, clinical medicine, and health economics. In the jointly executed research programme, 17 academic groups, spread widely across 9 EU Member States and 5 SMEs will participate. GRACE will organise professional education, including web-based teaching and practical courses, through two leading European scientific societies (European Society of Clinical Microbiology and Infectious Diseases and European Respiratory Society) to disseminate the excellence of the programme. A high level of co-ordination will be obtained through a professionally IT-supported and rigorous management structure, so as to achieve optimal synergy of the components of GRACE. We aim to develop a genomic laboratory network in 8 European countries and a primary care research network in 11 European countries during the first 18 months of the project, and then to build on the infrastructure to create the jointly executed research programme. The consortium will become a virtual "European LRTI Research Centre" potentially leading to a forum promoting research and good practice in the field of community-acquired LRTI.

Researcher(s)

• Promoter: Goossens Herman
• Co-promoter: Coenen Samuel

Research team(s)

Project website

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

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

Acute respiratory tract infections represent a medically, epidemiologically and socio-economically relevant problem. The diagnostic policy in primary health care, following 'coughing' as the reason for encounter, is very specific for this setting: confirm and rule out in a diagnostic landscape with low pretest probability. Which are the arguments used to conduct this policy? How streng are they and which should be used? These research questions will be answered in a partly qualitative (focus-groups) and partly quantitative research design (registration, OSCE test).

Researcher(s)

• Promoter: Van Royen Paul
• Fellow: Coenen Samuel

Research team(s)

Project type(s)

• Research Project

Abstract

Acute respiratory tract infections represent a medically, epidemiologically and socio-economically relevant problem. The diagnostic policy in primary health care, following 'coughing' as the reason for encounter, is very specific for this setting: confirm and rule out in a diagnostic landscape with low pretest probability. Which are the arguments used to conduct this policy? How streng are they and which should be used? These research questions will be answered in a partly qualitative (focus-groups) and partly quantitative research design (registration, OSCE test).

Researcher(s)

• Promoter: Van Royen Paul
• Fellow: Coenen Samuel

Research team(s)

Project type(s)

• Research Project