Research Sibyl Anthierens

Abstract

Recent pandemics showed Europe how serious health threats can be to society. Proactive approaches are needed to ensure that medical countermeasures are available during pandemics. EU-PROACT's overarching objective is to prepare Europe for future pandemics by strengthening upon existing networks of experts and civil society focused on clinical therapeutic platform trials within hospital inpatient settings across Europe. In case of an outbreak, this network will provide capacity to pivot rapidly to implement large, multi-country platform trials studying therapeutics and diagnostic-tool performance. Underpinned by strong community involvement and further strengthened by the inclusion of social and implementation scientists, EU-PROACT centres on six objectives: expand a solid network of clinical centres across Europe that will implement a clinical trial assessing a syndromic approach for respiratory viral infections; strengthen a laboratory network to identify pathogens and biomarkers of disease monitoring for routine surveillance; support a network of methodologists and trialists who will ensure the trials' logistical and methodological aspects; initiate a network of professionals to work on preparedness tools to ensure a smooth pivot from inter-pandemic to the pandemic period in case of an outbreak; build a network of social science researchers who will provide nuanced understanding of the social contexts; and establish a community group to work on activities that will empower patients and citizens in Europe regarding their own health and educate them about science and health issues. By bringing together scientists, social science researchers, and civil society members, EU-PROACT will benefit the entire European population and beyond through decreased mortality and morbidity associated with emerging diseases, lower societal economic costs of morbidity, strengthened research and innovation expertise, human capacities, and know-how for combatting communicable diseases.

Researcher(s)

• Promoter: Anthierens Sibyl

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

The BeCOMe trial focusses on the treatment of patients with chonic edema by means of boosted compression. Boosted compression is the application of compression bandages 3 times/day. Patients: Patients targeted in this proposal comprise individuals afflicted by chronic edema/lymphedema of the lower limbs. Intervention:The intervention entails the incorporation of boosted compression alongside standard care during the intensive treatment phase. Boosted compression involves thrice-daily re-application of a multicomponent short stretch compression bandage, aimed at enhancing the efficacy of compression therapy within edema treatment. Comparison: Comparison will be made between the experimental intervention (boosted compression) and the prevailing standard edema treatment, which adheres to the complex decongestive therapy as stipulated by healthcare services, utilizing a single daily application of compression bandage. Standard care is administered under the supervision of trained physical therapists, specialized in edema treatment. Outcomes: Primary outcomes encompass the determination of: 1. the requisite number of treatment days to attain a non-pitting edema state during the intensive phase of edema treatment; and 2. the non-inferiority of boosted compression in maintaining reduced edema volume during the maintenance phase assessed at 1y of follow-up. Secondary outcomes encompass assessments of: Quality of Life, "acceptance and adherence" to boosted compression, alongside evaluations of time and cost-effectiveness associated with its implementation.

Researcher(s)

• Promoter: Gebruers Nick
• Co-promoter: Anthierens Sibyl
• Co-promoter: De Vrieze Tessa
• Co-promoter: Willem Lander

Research team(s)

• Movement Antwerp (MOVANT)

Project type(s)

• Research Project

Abstract

RESEARCH LINE 1: INTEGRATING INNOVATIONS (GOAL-ORIENTED CARE, INTERPROFESSIONAL COLLABORATION AND SELF-MANAGEMENT SUPPORT) This research line is a continuation of the work done by the researchers and developers during the first term of the Primary Care Academy. It is about further developing the interventions, the strategies and the tools of goal-oriented care, self-management support and interprofessional collaboration and integration towards both re-design and applied research, and an integrated yet diversified, hands-on roadmaps or toolbox for primary care practice and education. Aside from integration, this research line is about implementation and scaling up. In this light, both research and development efforts will be needed as will guidance and training for practice, which require other skillsets. All WPs delivered strategies, tools etc. based on fundamental research. All deliverables of the first term of the Primary Care Academy are in the latest stages of innovation (WP1-6). Some are ready to be implemented, some are already implemented on a small scale in primary care, and others are in the phase of piloting. This has resulted in first insights on levels and barriers for implementation of these specific innovative concepts in primary care11,12,13. Transversally (WP 2) a literature review-based model on implementation in primary care was developed to create a broad understanding of implementation processes to support the successful implementation of innovations14. Central questions focused on how actors engage with and effect change as well as the attributes of change that either hinder or facilitate implementation. Building on these findings, most recently, the innovative concept of goal-oriented care served as 'a case study for implementation' as it has been widely adopted during the last three years by both policy and practice. The attributes, barriers and facilitators in goal-oriented care actions and interventions were assessed and strategies based on the learnings were developed15. Results of the previous research, both specific (WP 3-6) and integrated (WP1, 2), will serve as the foundation for our efforts to sustain knowledge and innovations and to generate societal impact through implementing it in practice. Our focus is now on developing practical tools to help professionals implement and adapt innovations. • When developing an intervention to implement innovations, what is the general approach? How do we recognize and assess change from the beginning to ensure a successful process? • Before assessing successful implementation and beginning evaluation, it is important to understand the intended change and its context. Tools can be used to monitor the implementation process and identify areas of success and improvement. The goal is not to have fixed, predetermined KPIs, but to consider the complexity of the intervention and its context.

Researcher(s)

• Promoter: Anthierens Sibyl

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

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

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

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

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

UC Leuven This course offers a profound training of 6 weeks on the basic principles and methods of epidemiology. An in-depth study of medical statistics with appropriate statistical methods will be integrated with the main epidemiological content. Basic principles of qualitative methods will be explained. Introductory lectures on systematic reviews, health economics and cost-effectiveness are programmed. Throughout the whole course, each participant will have the opportunity to work with his/her own data set (or from the organisers if not available) under the guidance of experienced tutors. Each participant will receive a reader including necessary didactic materials (handouts, power point slides, articles, etc.). To offer a profound training of six weeks in research methods - on the basic principles and methods of epidemiology. - An in-depth study of medical statistics with appropriate statistical methods integrated in the main epidemiological content. - Basic principles of qualitatve methods - Introductory lectures on systematic reviews, health economics and cost-efectiveness

Researcher(s)

• Promoter: Van geertruyden Jean-Pierre
• Co-promoter: Abrams Steven
• Co-promoter: Anthierens Sibyl

Research team(s)

• Global Health Institute (GHI)

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

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

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

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 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