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103. New analyses of Heart Protection Study

Author

Lemiengre, Marc, van Driel, Mieke, Chevalier, Pierre, De Meyere, Marc, Christiaens, Thierry, Collins, Rory, Armitage, Jane, Parish, Sarah, Sleight, Peter, and Peto, Richard

Published
2004

104. Electronic assessment of cardiovascular potentially inappropriate medications in an administrative population database.

Author

Ivanova, Ivana, Elseviers, Monique, Wettermark, Bjorn, Schmidt Mende, Katharina, Vander Stichele, Robert, and Christiaens, Thierry

Subjects
CARDIOVASCULAR agents, DRUG therapy for heart diseases, POLYPHARMACY, MORTALITY, FEASIBILITY studies
Abstract

Aim: To explore the feasibility of the electronic assessment of potentially inappropriate medication (PIM) criteria in a large administrative database and to explore the validity of the cardiovascular subset of PIM criteria, by studying the association with relevant outcome. Method: A cohort study using administrative data from Stockholm County, Sweden (VAL database). Eligible for inclusion were community‐dwelling older people (≥65 years), alive in Stockholm County on 31 December 2015. We applied PIM criteria pertaining to the cardiovascular medication group (first‐level ATC C group), and we assessed the association between PIM use and mortality and hospitalisation. Results: Patients' (n = 315 120) mean age was 74.0 years (range 65‐114), and 54.7% were women. There were 111 cardiovascular PIM criteria in the repository, from which 44 were not registered or prescribed in our population. We excluded another 43 requiring information not available in the database, or duplicates, resulting in 24 applicable criteria. The prevalence of polypharmacy (≥ five medications) was 25.5% and the prevalence of at least one PIM use was 8.3%, including 2.8% underuse and 5.3% misuse. Patients with intake of ≥10 medications had 38% increased mortality risk compared to those with 0‐4 medications. Unplanned hospitalisation and emergency department visits were positively associated with underuse (12% and 25%, respectively) and misuse (13% and 12%, respectively). Conclusion: It was feasible to select a subset of cardiovascular PIM criteria originating from different PIM lists and to apply this subset in an administrative database. Additionally, by applying this subset, we showed significant associations with clinical outcome. [ABSTRACT FROM AUTHOR]

Published
2019
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105. Barriers and enablers to deprescribing in people with a life-limiting disease: A systematic review.

Author

Paque, Kristel, Vander Stichele, Robert, Elseviers, Monique, Pardon, Koen, Dilles, Tinne, Deliens, Luc, and Christiaens, Thierry

Subjects
DEPRESCRIBING, CATASTROPHIC illness, DECISION making, HEALTH care teams, MEDICAL information storage & retrieval systems, INTERPROFESSIONAL relations, LABOR demand, MEDLINE, NURSING home residents, SENSORY perception, PERSONAL space, SYSTEMATIC reviews, PHYSICIAN practice patterns, POLYPHARMACY, PATIENTS' attitudes, FAMILY attitudes
Abstract

Background: Knowing the barriers/enablers to deprescribing in people with a life-limiting disease is crucial for the development of successful deprescribing interventions. These barriers/enablers have been studied, but the available evidence has not been summarized in a systematic review. Aim: To identify the barriers/enablers to deprescribing of medications in people with a life-limiting disease. Design: Systematic review, registered in PROSPERO (CRD42017073693). Data sources: A systematic search of MEDLINE, Embase, Web of Science and CENTRAL was conducted and extended with a hand search. Peer-reviewed, primary studies reporting on barriers/enablers to deprescribing in the context of explicit life-limiting disease were included in this review. Results: A total of 1026 references were checked. Five studies met the criteria and were included in this review. Three types of barriers/enablers were found: organizational, professional and patient (family)-related barriers/enablers. The most prominent enablers were organizational support (e.g. for standardized medication review), involvement of multidisciplinary teams in medication review and the perception of the importance of coming to a joint decision regarding deprescribing, which highlighted the need for interdisciplinary collaboration and involving the patient and his family in the decision-making process. The most important barriers were shortages in staff and the perceived difficulty or resistance of the nursing home resident's family – or the resident himself. Conclusion and implications of key findings: The scarcity of findings in the literature highlights the importance of filling this gap. Further research should focus on deepening the knowledge on these barriers/enablers in order to develop sustainable multifaceted deprescribing interventions in palliative care. [ABSTRACT FROM AUTHOR]

Published
2019
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106. Mortality, hospitalisation, institutionalisation in community-dwelling oldest old: The impact of medication.

Author

UCL - SSS/IRSS-Institut de recherche santé et société, Wauters, Maarten, Elseviers, Monique, Vaes, Bert, Degryse, Jean-Marie, Vander Stichele, Robert, Christiaens, Thierry, Azermai, Majda, UCL - SSS/IRSS-Institut de recherche santé et société, Wauters, Maarten, Elseviers, Monique, Vaes, Bert, Degryse, Jean-Marie, Vander Stichele, Robert, Christiaens, Thierry, and Azermai, Majda

Abstract

Background: High drug use and associated adverse outcomes are common in older adults. This study investigates association of medication use with mortality, hospitalisation, and institutionalisation in a cohort of community-dwelling oldest old (aged 80 and over). Methods: Baseline data included socio-demographic, clinical, and functional characteristics, and prescribed medications. Medications were coded by the Anatomic Therapeutic Chemical classification. Survival analysis was performed at 18 months after inclusion using Kaplan-Meier, and multivariate analysis with Cox regression to control for covariates. Results: Patients' (n = 503) mean age was 84.4 years (range 80-102), and 61.2% was female. The median medication use was 5 (0-16). The mortality, hospitalisation, and institutionalisation rate were 8.9%, 31.0%, and 6.4% respectively. The mortality and hospitalisation group had a higher level of multimorbidity and weaker functional profile. Adjusted multivariate models showed an 11% increased hospitalisation rate for every additional medication taken. No association was found between high medication use and mortality, nor with institutionalisation. A higher association for mortality was observed among verapamil/diltiazem users, hospitalisation was higher among users of verapamil/diltiazem, loop diuretics and respiratory agents. Institutionalisation was higher among benzodiazepines users. Conclusion: In the community-dwelling oldest old (aged 80 and over), high medication was clearly associated with hospitalisation, independent of multimorbidity. The association with mortality was clear in univariate, but not in multivariate analysis. No association with institutionalisation was found. The appropriateness of the high medication use should be further studied in relation to mortality, hospitalisation, and institutionalisation for this specific age group

Published
2016

107. Too many, too few, or too unsafe? Impact of inappropriate prescribing on mortality, and hospitalisation in a cohort of community-dwelling oldest old.

Author

UCL - SSS/IRSS - Institut de recherche santé et société, UCL - SSS/LDRI - Louvain Drug Research Institute, UCL - (SLuc) Département de pharmacie, Wauters, Maarten, Elseviers, Monique, Vaes, Bert, Degryse, Jean-Marie, Dalleur, Olivia, Vander Stichele, Robert, Christiaens, Thierry, Azermai, Majda, UCL - SSS/IRSS - Institut de recherche santé et société, UCL - SSS/LDRI - Louvain Drug Research Institute, UCL - (SLuc) Département de pharmacie, Wauters, Maarten, Elseviers, Monique, Vaes, Bert, Degryse, Jean-Marie, Dalleur, Olivia, Vander Stichele, Robert, Christiaens, Thierry, and Azermai, Majda

Abstract

AIMS: Little is known about the impact of inappropriate prescribing (IP) in community-dwelling adults, aged 80 years and older. The prevalence at baseline (November 2008September 2009) and impact of IP (misuse and underuse) after 18 months on mortality and hospitalization in a cohort of community-dwelling adults, aged 80 years and older (n = 503) was studied. METHODS: Screening Tool of Older People's Prescriptions (STOPP-2, misuse) and Screening Tool to Alert to Right Treatment (START-2, underuse) criteria were cross-referenced and linked to the medication use (in Anatomical Therapeutic Chemical coding) and clinical problems. Survival analysis until death or first hospitalization was performed at 18 months after inclusion using Kaplan-Meier, with Cox regression to control for covariates. RESULTS: Mean age was 84.4 (range 80-102) years. Mean number of medications prescribed was 5 (range 0-16). Polypharmacy (≥5 medications, 58%), underuse (67%) and misuse (56%) were high. Underuse and misuse coexisted in 40% and were absent in 17% of the population. A higher number of prescribed medications was correlated with more misused medications (rs = .51, P < 0.001) and underused medications (rs = .26, P < 0.001). Mortality and hospitalization rate were 8.9%, and 31.0%, respectively. After adjustment for number of medications and misused medications, there was an increased risk of mortality (HR 1.39, 95% CI 1.10, 1.76) and hospitalization (HR 1.26, 95% CI 1.10, 1.45) for every additional underused medication. Associations with misuse were less clear. CONCLUSION: IP (polypharmacy, underuse and misuse) was highly prevalent in adults, aged 80 years and older. Surprisingly, underuse and not misuse had strong associations with mortality and hospitalization.

Published
2016

108. Publicly funded practice-oriented clinical trials : of importance for healthcare payers

Author

Christiaens, Thierry, Demotes, Jacques, Walley, Tom, Hulstaert, Frank, Neyt, Mattias, Christiaens, Thierry, Demotes, Jacques, Walley, Tom, Hulstaert, Frank, and Neyt, Mattias

Abstract

p. 551-560, AIM: Many questions of relevance to patients/society are not answered by industry-sponsored clinical trials. We consider whether there are benefits to governments in funding practice-oriented clinical trials. METHODOLOGY: A literature search including publications on institutions' websites was performed and supplemented with information gathered from (inter)national stakeholders. RESULTS: Areas were identified where public funding of clinical trials is of importance for society, such as head-to-head comparisons or medical areas where companies have no motivation to invest. The available literature suggests publicly funded research programs could provide a positive return on investment. The main hurdles (e.g., sufficient funding and absence of equipoise) and success factors (e.g., selection of research questions and research infrastructure) for the successful conduct of publicly funded trials were identified. CONCLUSION: Governments should see public funding of pragmatic practice-oriented clinical trials as a good opportunity to improve the selection and quality of treatments and stimulate efficient use of limited resources.

Published
2016

110. Community pharmacists’ evaluation of potentially inappropriate prescribing in older community-dwelling patients with polypharmacy: observational research based on the GheOP³S tool

Author

Tommelein, Eline, primary, Mehuys, Els, additional, Van Tongelen, Inge, additional, Petrovic, Mirko, additional, Somers, Annemie, additional, Colin, Pieter, additional, Demarche, Sophie, additional, Van Hees, Thierry, additional, Christiaens, Thierry, additional, and Boussery, Koen, additional

Published
2016
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114. Financer des essais cliniques axés sur la pratique avec des fonds publics : Synthèse

Author

Christiaens, Thierry, Demotes, Jacques, Hulstaert, Frank, Neyt, Mattias, Christiaens, Thierry, Demotes, Jacques, Hulstaert, Frank, and Neyt, Mattias

Abstract

23 p., ill., Beaucoup de questions de soins de santé importantes pour la société ne trouvent pas de réponse dans les essais cliniques menés par l’industrie pharmaceutique. Ainsi, il n’y a que peu d’études qui comparent un traitement médicamenteux et une autre approche (par ex. une comparaison entre des antidépresseurs et une psychothérapie). Dans une nouvelle étude, le Centre fédéral d’Expertise des Soins de Santé (KCE) arrive à la conclusion que le financement de tels essais cliniques par des moyens publics serait un excellent investissement. Il plaide donc pour que nous prenions exemple sur d’autres pays comme le Royaume-Uni ou les Pays-Bas, où cela se fait depuis des années. Le KCE souligne l’importance de la sélection des questions prioritaires à investiguer et de l’existence d’infrastructures professionnelles et de réseaux d’expertise. Il est également important que les résultats de ces études soient mis en pratique au quotidien sur le terrain. À ces conditions, des programmes de recherche clinique financés par le secteur public pourront contribuer à un système de soins de santé plus efficients et à des soins de meilleure qualité., PRÉFACE 1-- SYNTHÈSE 2-- TABLE DES MATIÈRES. 2-- OBJET DE CE RAPPORT 4-- MESSAGES-CLÉS 4-- 1. CONTEXTE 5-- 1.1. LES ESSAIS CLINIQUES FORMENT LE SOCLE DES DÉCISIONS EN MATIÈRE DE SOINS DE SANTÉ 5-- 1.2. LES DIFFÉRENTS TYPES D’ESSAIS CLINIQUES 5-- 1.3. COMPLEXITÉ DES ESSAIS CLINIQUES 8-- 2. POURQUOI FINANCER DES ESSAIS CLINIQUES AVEC DES FONDS PUBLICS? 9-- 2.1. ESSAIS COMPARATIFS D’EFFICACITÉ CLINIQUE DE MÉDICAMENTS 9-- 2.2. ESSAIS CHEZ LES ENFANTS ET DANS LES MALADIES RARES 10-- 2.3. ESSAIS SUR LES DISPOSITIFS MÉDICAUX 10-- 2.4. ESSAIS SUR LES DIAGNOSTICS 10-- 2.5. ESSAIS DANS DES DOMAINES SANS INTÉRÊT POUR L’INDUSTRIE 10-- 3. IMPACT FINANCIER DES ESSAIS CLINIQUES PUBLICS: UN BON INVESTISSEMENT 11-- 4. QUEL EST LE CADRE NÉCESSAIRE POUR OPTIMALISER L’IMPACT DES ESSAIS PUBLICS? 13-- 4.1. UNE INFRASTRUCTURE ET DES RÉSEAUX EFFICACES 13-- 4.2. DES PROGRAMMES NATIONAUX BIEN STRUCTURÉS 15-- 4.2.1. Le programme d’essais cliniques britannique 15-- 4.2.2. Le programme d’essais cliniques néerlandais 17-- 4.2.3. Le programme d’essais cliniques italien 17-- 4.2.4. Ne pas négliger l’évaluation 17-- 4.3. UN CONTEXTE INTERNATIONAL FAVORABLE 17-- 4.4. UN FINANCEMENT SUFFISANT ET JUDICIEUSEMENT ATTRIBUÉ 18-- 4.4.1. Quel budget pour un programme national ? 18-- 4.4.2. Quel budget pour un essai? 19-- 4.4.3. Vers un système auto-suffisant? 19-- 5. CONCLUSION 20-- RECOMMANDATIONS 21

Published
2015

115. Publicly funded Practice-oriented Clinical Trials

Author

Christiaens, Thierry, Demotes, Jacques, Hulstaert, Frank, Neyt, Mattias, Christiaens, Thierry, Demotes, Jacques, Hulstaert, Frank, and Neyt, Mattias

Abstract

98 p., ill., 1 INTRODUCTION 9 -- 1.1 BACKGROUND 9 -- 1.1.1 The importance of RCTs for evidence-based medicine and health technology assessment.9 -- 1.1.2 Publicly funded clinical trials.13 -- 1.2 SCOPE 16 -- 1.3 RESEARCH QUESTIONS.16 -- 1.4 METHODOLOGY 17 -- 2 EXAMPLES OF RESEARCH IMPACT 18 -- 2.1 INDIVIDUAL CASES 20 -- 2.2 RESEARCH PROGRAMS.22 -- 2.3 SOME REMARKS.24 -- 2.3.1 Methodological issues 24 -- 2.3.2 Bias.24 -- 2.3.3 Real-world impact versus projections 24 -- 2.3.4 Problem of attribution and spillover effect 25 -- 2.3.5 Conclusion on return on investment 25 -- 3 WHY DO WE NEED NON-COMMERCIAL CLINICAL TRIALS .26 -- 3.1 COMPARATIVE EFFECTIVENESS TRIALS WITH MEDICINAL PRODUCTS 26 -- 3.2 TRIALS WITH MEDICINAL PRODUCTS IN CHILDREN AND IN RARE DISEASES 28 -- 3.3 NON-COMMERCIAL TRIALS TO COUNTERBALANCE POSSIBLE PUBLICATION BIAS 29 -- 3.4 TRIALS WITH MEDICAL DEVICES 29 -- 3.5 TRIALS ON DIAGNOSTICS AND SCREENING 30 -- 3.6 TRIALS IN MEDICAL AREAS NOT OWNED BY PRIVATE COMPANIES.30 -- 4 HURDLES TO PERFORM PUBLIC FUNDED RCTS 32 -- 4.1 ADVANTAGES AND DISADVANTAGES OF TRIAL PARTICIPATION 32 -- 4.2 COMPETITION BETWEEN TRIALS FOR INCLUSION OF PATIENTS.33 -- 4.3 LACK OF RESEARCH INFRASTRUCTURE 33 -- 4.4 FREE-RIDER BEHAVIOUR OR INTERNATIONAL COLLABORATION 33 -- 4.5 THE DESIGN, INITIATION AND CONDUCT OF TRIALS TAKES TIME, REALISTIC PLANNING NEEDED ..34 -- 4.6 ACCESS TO AND PRICE OF THE COMPARATOR 35 -- 4.6.1 Placebo .35 -- 4.6.2 Off-label drugs 36 -- 4.6.3 Expensive drugs 36 -- 5 THE FRAMEWORK OF CLINICAL TRIALS 37 -- 5.1 QUALITY ASSURANCE.37 -- 5.1.1 GCP guidelines and SOPs.37 -- 5.1.2 Quality of non-commercial trials 38 -- 5.2 REGULATORY REQUIREMENTS 38 -- 5.3 IMPACT OF THE REGULATORY REQUIREMENTS 39 -- 6 NON-COMMERCIAL CLINICAL TRIALS IN EUROPE.42 -- 6.1 EXISTING REPORTS 42 -- 6.2 INTERNATIONAL CLINICAL RESEARCH ORGANIZATIONS 43 -- 6.2.1 European Clinical Research Infrastructures Network (ECRIN) 43 -- 6.2.2 European Organisation for Research and Treatment of Cancer (EORTC) 46 -- 6.2.3 T

Published
2015

116. Praktijkgerichte klinische studies gefinancierd met publieke middelen : Synthese

Author

Christiaens, Thierry, Demotes, Jacques, Hulstaert, Frank, Neyt, Mattias, Christiaens, Thierry, Demotes, Jacques, Hulstaert, Frank, and Neyt, Mattias

Abstract

23 p., ill., Vele vraagstukken in de gezondheidszorg worden niet in klinische studies onderzocht door de farmaceutische industrie, terwijl ze toch een groot maatschappelijk belang hebben. Zo zijn er weinig studies waarbij een geneesmiddel wordt vergeleken met een ander type behandeling (bijvoorbeeld een vergelijking tussen de werking van antidepressiva en van psychotherapie). In een nieuw onderzoeksrapport komt het Federaal Kenniscentrum voor de Gezondheidszorg (KCE) tot de conclusie dat het financieren van zulke studies met publieke middelen een zeer nuttige investering zou zijn. Het pleit er dus voor om het voorbeeld van andere landen zoals het Verenigd Koninkrijk en Nederland te volgen, waar dit al jaren gebeurt. Wel moeten de onderzoeksonderwerpen goed worden geselecteerd, en zijn een professionele infrastructuur en netwerk nodig. Ook de implementatie van de resultaten in de dagelijkse praktijk is cruciaal. Onder die voorwaarden kunnen programma’s van publiek gefinancierd onderzoek leiden tot een betere zorg en een meer efficiënt gezondheidszorgsysteem., VOORWOORD 1 -- SYNTHESE 2 -- INHOUDSTAFEL 2 -- DOELSTELLING VAN DIT RAPPORT 4 -- SLEUTELBOODSCHAPPEN 4 -- 1. CONTEXT 5 -- 1.1. KLINISCHE STUDIES VORMEN DE FUNDAMENTEN VOOR BESLISSINGEN INZAKE GEZONDHEIDSZORG 5 -- 1.2. DE VERSCHILLENDE SOORTEN KLINISCHE STUDIES 5 -- 1.3. COMPLEXITEIT VAN DE KLINISCHE STUDIES 8 -- FIGUUR 1 – COMPLEXITEIT VAN EEN KLINISCHE STUDIE (VEREENVOUDIGDE WEERGAVE) 8 -- 2. WAAROM KLINISCHE STUDIES FINANCIEREN MET PUBLIEKE MIDDELEN? 9 -- 2.1. STUDIES OM DE KLINISCHE DOELTREFFENDHEID VAN GENEESMIDDELEN TE VERGELIJKEN 9 -- 2.2. STUDIES BIJ KINDEREN EN BIJ ZELDZAME AANDOENINGEN 10 -- 2.3. KLINISCHE STUDIES ROND MEDISCHE HULPMIDDELEN 10 -- 2.4. KLINISCHE STUDIES MET DIAGNOSTISCHE TESTEN 10 -- 2.5. STUDIES IN DOMEINEN WAARVOOR DE INDUSTRIE GEEN INTERESSE HEEFT 10 -- 3. IMPACT VAN PUBLIEK GEFINANCIERDE KLINISCHE STUDIES: EEN GOEDE INVESTERING 11 -- 4. KADER OM DE IMPACT VAN DE PUBLIEK GEFINANCIERDE KLINISCHE STUDIES TE OPTIMALISEREN 13 -- 4.1. DOELTREFFENDE INFRASTRUCTUUR EN NETWERKEN 13 -- 4.2. GOED GESTRUCTUREERDE NATIONALE PROGRAMMA’S 15 -- 4.2.1. Het Britse klinische studieprogramma 15 -- 4.2.2. Het Nederlandse klinische studieprogramma 17 -- 4.2.3. Het Italiaanse klinische studieprogramma 17 -- 4.2.4. Belang van de evaluatie 17 -- 4.3. EEN GUNSTIGE INTERNATIONALE CONTEXT 18 -- 4.4. EEN VOLDOENDE EN ZORGVULDIG TOEGEKENDE FINANCIERING 18 -- 4.4.1. Welk budget voor een nationaal programma? 18 -- 4.4.2. Welk budget voor een studie? 19 -- 4.4.3. Naar een zelfvoorzienend systeem? 19 -- 5. CONCLUSIE 20 -- AANBEVELINGEN 21

Published
2015

117. Publicly funded Practice-oriented Clinical Trials : Summary

Author

Christiaens, Thierry, Demotes, Jacques, Hulstaert, Frank, Neyt, Mattias, Christiaens, Thierry, Demotes, Jacques, Hulstaert, Frank, and Neyt, Mattias

Abstract

15 p., ill., FOREWORD 1 -- SYNTHESIS 2 -- KEY MESSAGES 3 -- 1. INTRODUCTION AND PROJECT SCOPE 3 -- 1.1. SCOPE OF THIS REPORT 3 -- 1.2. RESEARCH QUESTIONS 3 -- 1.3. DIFFERENT TYPES OF CLINICAL TRIALS 5 -- 1.4. CLINICAL TRIALS NEED EXPERTISE, ARE EXPENSIVE, AND TAKE TIME 5 -- 2. NEED FOR PUBLICLY FUNDED TRIALS 6 -- 2.1. COMPARATIVE EFFECTIVENESS TRIALS WITH MEDICINAL PRODUCTS 6 -- 2.2. TRIALS IN CHILDREN AND IN RARE DISEASES 7 -- 2.3. TRIALS WITH MEDICAL DEVICES 7 -- 2.4. TRIALS ON DIAGNOSTICS 7 -- 2.5. TRIALS IN MEDICAL AREAS NOT OWNED BY PRIVATE COMPANIES 7 -- 3. THE FRAMEWORK OF CLINICAL TRIALS 7 -- 3.1. THE EUROPEAN CLINICAL TRIALS DIRECTIVE DID NOT HELP 7 -- 3.2. NATIONAL AND INTERNATIONAL TRIAL PROGRAMMES 8 -- 3.3. A WISE INVESTMENT OF PUBLIC MONEY 10 -- 3.4. SUCCESS FACTORS FOR PUBLICLY-FUNDED CLINICAL TRIALS 11 -- 3.5. WHAT CAN WE DO IN BELGIUM? 12 -- RECOMMENDATIONS 13

Published
2015

119. Key Learning Outcomes for Clinical Pharmacology and Therapeutics Education in Europe: A Modified Delphi Study.

Author

Brinkman, David J., Tichelaar, Jelle, Mokkink, Lidwine B., Christiaens, Thierry, Likic, Robert, Maciulaitis, Romaldas, Costa, Joao, Sanz, Emilio J., Maxwell, Simon R., Richir, Milan C., van Agtmael, Michiel A., and the Education Working Group of the European Association for Clinical Pharmacology and Therapeutics (EACPT) and its affiliated Network of Teachers in Pharmacotherapy (NOTIP)

Subjects
PHARMACOLOGY education, THERAPEUTICS, DELPHI method, QUESTIONNAIRES, REQUIRED courses (Education), COLLEGE graduates, EDUCATION
Abstract

Harmonizing clinical pharmacology and therapeutics (CPT) education in Europe is necessary to ensure that the prescribing competency of future doctors is of a uniform high standard. As there are currently no uniform requirements, our aim was to achieve consensus on key learning outcomes for undergraduate CPT education in Europe. We used a modified Delphi method consisting of three questionnaire rounds and a panel meeting. A total of 129 experts from 27 European countries were asked to rate 307 learning outcomes. In all, 92 experts (71%) completed all three questionnaire rounds, and 33 experts (26%) attended the meeting. 232 learning outcomes from the original list, 15 newly suggested and 5 rephrased outcomes were included. These 252 learning outcomes should be included in undergraduate CPT curricula to ensure that European graduates are able to prescribe safely and effectively. We provide a blueprint of a European core curriculum describing when and how the learning outcomes might be acquired. [ABSTRACT FROM AUTHOR]

Published
2018
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120. Changes in medication use in a cohort of patients with advanced cancer: The international multicentre prospective European Palliative Care Cancer Symptom study.

Author

Paque, Kristel, Elseviers, Monique, Vander Stichele, Robert, Pardon, Koen, Hjermstad, Marianne J., Kaasa, Stein, Dilles, Tinne, De Laat, Martine, Van Belle, Simon, Christiaens, Thierry, and Deliens, Luc

Subjects
CANCER chemotherapy, CANCER patients, LONGITUDINAL method, MEDICAL prescriptions, NARCOTICS, PALLIATIVE treatment, CROSS-sectional method, RETROSPECTIVE studies, SEVERITY of illness index
Abstract

Background: Information on medication use in the last months of life is limited. Aim: To describe which medications are prescribed and deprescribed in advanced cancer patients receiving palliative care in relation to time before death and to explore associations with demographic variables. Design: Prospective study, using case report forms for monthly data collection. Medication included cancer treatment and 19 therapeutic groups, grouped into four categories for: (1) cancer therapy, (2) specific cancer-related symptom relief, (3) other symptom relief and (4) long-term prevention. Data were analysed retrospectively using death as the index date. We compared medication use at 5, 4, 3, 2 and 1 month(s) before death by constructing five cross-sectional subsamples with medication use during that month. Paired analyses were done on a subsample of patients with at least two assessments before death. Setting/participants: We studied the medication use of 720 patients (mean age 67, 56% male) in 30 cancer centres representing 12 countries. Results: From 5 to 1 month(s) before death, cancer therapy decreased (55%-24%), most medications for symptom relief increased, for example, opioids (62%-81%) and sedatives (35%-46%), but medication for long-term prevention decreased (38%-27%). The prevalence of chemotherapy was 15.5% in the last month of life, with 9% of new courses started in the last 2 months. With higher age, chemotherapy and opioid use decreased. Conclusion: Medications for symptom relief increased in almost all medication groups. Deprescribing was found in heart medication/ anti-hypertensives and cancer therapy, although use of the latter remained relatively high. [ABSTRACT FROM AUTHOR]

Published
2018
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121. Is it possible to register the ideas, concerns and expectations behind the reason for encounter as a means of classifying patient preferences with ICPC-2?

Author

Schrans, Diego, Boeckxstaens, Pauline, De Sutter, An, Willems, Sara, Avonts, Dirk, Christiaens, Thierry, Matthys, Jan, and Kühlein, Thomas

Subjects
COMMUNICATION, FAMILY medicine, PATIENTS, PRIMARY health care, PATIENT-centered care, MEDICAL coding, DESCRIPTIVE statistics
Abstract

BackgroundFamily practice aims to recognize the health problems and needs expressed by the person rather than only focusing on the disease. Documenting person-related information will facilitate both the understanding and delivery of person-focused care.AimTo explore if the patients’ ideas, concerns and expectations (ICE) behind the reason for encounter (RFE) can be coded with the International Classification of Primary Care, version 2 (ICPC-2) and what kinds of codes are missing to be able to do so.MethodsIn total, 613 consultations were observed, and patients’ expressions of ICE were narratively recorded. These descriptions were consequently translated to ICPC codes by two researchers. Descriptions that could not be translated were qualitatively analysed in order to identify gaps in ICPC-2.ResultsIn all, 613 consultations yielded 672 ICE expressions. Within the 123 that could not be coded with ICPC-2, eight categories could be defined: concern about the duration/time frame; concern about the evolution/severity; concern of being contagious or a danger to others; patient has no concern, but others do; expects a confirmation of something; expects a solution for the symptoms without specification of what it should be; expects a specific procedure; and expects that something is not done.DiscussionAlthough many ICE can be registered with ICPC-2, adding eight new categories would capture almost all ICE. [ABSTRACT FROM PUBLISHER]

Published
2018
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122. Self-medication of regular headache: a community pharmacy-based survey

Author

Mehuys, Els, Paemeleire, Koen, Van Hees, T, Christiaens, Thierry, Van Bortel, Lucas, Van Tongelen, Inge, De Bolle, Leen, Remon, Jean Paul, and Boussery, Koen

Subjects
pharmacy, Medicine and Health Sciences, community, medication, overuse, headache, CLASSIFICATION, self-medication, PREVALENCE
Abstract

Background: This observational community pharmacy-based study aimed to investigate headache characteristics and medication use of persons with regular headache presenting for self-medication. Methods: Participants (n = 1205) completed (i) a questionnaire to assess current headache medication and previous physician diagnosis, (ii) the ID Migraine Screener (ID-M), and (iii) the Migraine Disability Assessment questionnaire. Results: Forty-four percentage of the study population (n = 528) did not have a physician diagnosis of their headache, and 225 of them (225/528, 42.6%) were found to be ID-M positive. The most commonly used acute headache drugs were paracetamol (used by 62% of the study population), NSAIDs (39%), and combination analgesics (36%). Only 12% of patients physician-diagnosed with migraine used prophylactic migraine medication, and 25% used triptans. About 24% of our sample (n = 292) chronically overused acute medication, which was combination analgesic overuse (n = 166), simple analgesic overuse (n = 130), triptan overuse (n = 19), ergot overuse (n = 6), and opioid overuse (n = 5). Only 14.5% was ever advised to limit intake frequency of acute headache treatments. Conclusions: This study identified underdiagnosis of migraine, low use of migraine prophylaxis and triptans, and high prevalence of medication overuse amongst subjects seeking self-medication for regular headache. Community pharmacists have a strategic position in education and referral of these self-medicating headache patients.

Published
2012

125. Barriers to nonpharmacologic treatments for stress, anxiety, and insomnia : family physicians attitudes toward benzodiazepine prescribing

Author

Anthierens, Sibyl, Pasteels, Inge, Habraken, Hilde, Steinberg, Pascale, Declercq, Tom, and Christiaens, Thierry

Subjects
animal structures, education, Human medicine
Abstract

OBJECTIVE To explore the attitudes of FPs toward benzodiazepine (BZD) prescribing and the perceived barriers to nonpharmacologic approaches to managing stress, anxiety, and insomnia. DESIGN A questionnaire including 32 statements about treatment of insomnia, stress, and anxiety. SETTING Local quality groups for FPs in Belgium. PARTICIPANTS A total of 948 Belgian FPs. MAIN OUTCOME MEASURES Barriers to using nonpharmacologic approaches in family practice. RESULTS We identified 3 different groups of FPs according to their attitudes about BZD prescribing. A first relatively big group of FPs (39%) were not really concerned about the risks of BZD prescribing. Those in the second group (17%) were aware of the problems associated with BZDs, but did not perceive it to be their role to use nonpharmacologic approaches in family practice. Those in the third group (44%) were concerned about BZD prescribing and found it to be a "bad solution," but were faced with various barriers to applying nonpharmacologic approaches. Surprisingly, we found that nearly 97% of FPs thought that most people were eligible for nonpharmacologic approaches, but experienced implementation barriers at the level of the patient, the level of the FP, and the level of the health care system. CONCLUSION Using different education and behavioural-change strategies for different FP groups seems important. A large group of FPs does not find prescribing BZDs to be problematic. Sensitizing and alerting FPs to this issue remains very important.

Published
2010

127. 2013 ESH/ESC practice guidelines for the management of arterial hypertension

Author

Mancia, G, Fagard, R, Narkiewicz, K, Redon, J, Zanchetti, A, Böhm, M, Christiaens, T, Cifkova, R, De Backer, G, Dominiczak, A, Galderisi, M, Grobbee, D, Jaarsma, T, Kirchhof, P, Kjeldsen, S, Laurent, S, Manolis, A, Nilsson, P, Ruilope, L, Schmieder, R, Sirnes, P, Sleight, P, Viigimaa, M, Waeber, B, Zannad, F, Mancia, Giuseppe, Fagard, Robert, Narkiewicz, Krzysztof, Redon, Josep, Zanchetti, Alberto, Böhm, Michael, Christiaens, Thierry, Cifkova, Renata, De Backer, Guy, Dominiczak, Anna, Galderisi, Maurizio, Grobbee, Diederick E., Jaarsma, Tiny, Kirchhof, Paulus, Kjeldsen, Sverre E., Laurent, Stephane, Manolis, Athanasios J., Nilsson, Peter M., Ruilope, Luis Miguel, Schmieder, Roland E., Sirnes, Per Anton, Sleight, Peter, Viigimaa, Margus, Waeber, Bernard, Zannad, Faiez, Mancia, G, Fagard, R, Narkiewicz, K, Redon, J, Zanchetti, A, Böhm, M, Christiaens, T, Cifkova, R, De Backer, G, Dominiczak, A, Galderisi, M, Grobbee, D, Jaarsma, T, Kirchhof, P, Kjeldsen, S, Laurent, S, Manolis, A, Nilsson, P, Ruilope, L, Schmieder, R, Sirnes, P, Sleight, P, Viigimaa, M, Waeber, B, Zannad, F, Mancia, Giuseppe, Fagard, Robert, Narkiewicz, Krzysztof, Redon, Josep, Zanchetti, Alberto, Böhm, Michael, Christiaens, Thierry, Cifkova, Renata, De Backer, Guy, Dominiczak, Anna, Galderisi, Maurizio, Grobbee, Diederick E., Jaarsma, Tiny, Kirchhof, Paulus, Kjeldsen, Sverre E., Laurent, Stephane, Manolis, Athanasios J., Nilsson, Peter M., Ruilope, Luis Miguel, Schmieder, Roland E., Sirnes, Per Anton, Sleight, Peter, Viigimaa, Margus, Waeber, Bernard, and Zannad, Faiez

Published
2014

128. 2013 ESH/ESC Practice Guidelines for the Management of Arterial Hypertension

Author

Mancia, Giuseppe, Fagard, Robert, Narkiewicz, Krzysztof, Redon, Josep, Zanchetti, Alberto, Boehm, Michael, Christiaens, Thierry, Cifkova, Renata, De Backer, Guy, Dominiczak, Anna, Galderisi, Maurizio, Grobbee, Diederick E., Jaarsma, Tiny, Kirchhof, Paulus, Kjeldsen, Sverre E., Laurent, Stephane, Manolis, Athanasios J., Nilsson, Peter M., Miguel Ruilope, Luis, Schmieder, Roland E., Sirnes, Per Anton, Sleight, Peter, Viigimaa, Margus, Waeber, Bernard, Zannad, Faiez, Mancia, Giuseppe, Fagard, Robert, Narkiewicz, Krzysztof, Redon, Josep, Zanchetti, Alberto, Boehm, Michael, Christiaens, Thierry, Cifkova, Renata, De Backer, Guy, Dominiczak, Anna, Galderisi, Maurizio, Grobbee, Diederick E., Jaarsma, Tiny, Kirchhof, Paulus, Kjeldsen, Sverre E., Laurent, Stephane, Manolis, Athanasios J., Nilsson, Peter M., Miguel Ruilope, Luis, Schmieder, Roland E., Sirnes, Per Anton, Sleight, Peter, Viigimaa, Margus, Waeber, Bernard, and Zannad, Faiez

Abstract

n/a

Published
2014
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129. Community pharmacists' evaluation of potentially inappropriate prescribing in older community-dwelling patients with polypharmacy: observational research based on the GheOP³S tool.

Author

Tommelein, Eline, Mehuys, Els, Van Tongelen, Inge, Petrovic, Mirko, Somers, Annemie, Colin, Pieter, Demarche, Sophie, Van Hees, Thierry, Christiaens, Thierry, and Boussery, Koen

Subjects
CONFIDENCE intervals, DRUGSTORES, INTERVIEWING, LIFE skills, LONGITUDINAL method, NEUROPSYCHOLOGICAL tests, RESEARCH methodology, SCIENTIFIC observation, POISSON distribution, PROBABILITY theory, SEX distribution, BODY mass index, INDEPENDENT living, POLYPHARMACY, DATA analysis software, DESCRIPTIVE statistics, INAPPROPRIATE prescribing (Medicine), ODDS ratio, OLD age
Abstract

Background In this study, we aimed to (i) determine the prevalence of potentially inappropriate prescribing (PIP) in community-dwelling older polypharmacy patients using the Ghent Older People's Prescriptions community-Pharmacy Screening (GheOP³S) tool, (ii) identify the items that account for the highest proportion of PIP and (iii) identify the patient variables that may influence the occurrence of PIP. Additionally, pharmacist--physician contacts emerging from PIP screening with the GheOP³S tool and feasibility of the GheOP³S tool in daily practice were evaluated. Methods A prospective observational study was carried out between December 2013 and July 2014 in 204 community pharmacies in Belgium. Patients were eligible if they were (i) ≥70 years, (ii) community-dwelling, (iii) using ≥5 chronic drugs, (iv) a regular visitor of the pharmacy and (v) understanding Dutch or French. Community pharmacists used a structured interview to obtain demographic data and medication use and subsequently screened for PIP using the GheOP³S tool. A Poisson regression was used to investigate the association between different covariates and the number of PIP. Results In 987 (97%) of 1016 included patients, 3721 PIP items were detected (median of 3 per patient; inter quartile range: 2-5). Most frequently involved with PIP are drugs for the central nervous system such as hypnosedatives, antipsychotics and antidepressants. Risk factors for a higher PIP prevalence appeared to be a higher number of drugs (30% extra PIPs per 5 extra drugs), female gender (20% extra PIPs), higher body mass index (BMI, 20% extra PIPs per 10-unit increase in BMI) and poorer functional status (30% extra PIPs with 6-point increase). The feasibility of the GheOP³S tool was acceptable although digitalization of the tool would improve implementation. Despite detecting at least one PIP in 987 patients, only 39 physicians were contacted by the community pharmacists to discuss the items. Conclusion A high prevalence of PIP in community-dwelling older polypharmacy patients in Belgium was detected which urges for interventions to reduce PIP. [ABSTRACT FROM AUTHOR]

Published
2017
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132. 2013 ESH/ESC GUIDELINES FOR THE MANAGEMENT OF ARTERIAL HYPERTENSION

Author

Mancia, Giuseppe, primary, Fagard, Robert, additional, Narkiewicz, Krzysztof, additional, Redón, Josep, additional, Zanchetti, Alberto, additional, Böhm, Michael, additional, Christiaens, Thierry, additional, Cifkova, Renata, additional, De Backer, Guy, additional, Dominiczak, Anna, additional, Galderisi, Maurizio, additional, E. Grobbee, Diederick, additional, Jaarsma, Tiny, additional, Kirchhof, Paulus, additional, E. Kjeldsen, Sverre, additional, Laurent, Stéphane, additional, J. Manolis, Athanasios, additional, M. Nilsson, Peter, additional, Miguel Ruilope, Luis, additional, E. Schmieder, Roland, additional, Sirnes, Per Anton, additional, Sleight, Peter, additional, Viigimaa, Margus, additional, Waeber, Bernard, additional, and Zannad, Faiez, additional

Published
2014
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133. 2013 ESH/ESC guidelines for the management of arterial hypertension

Author

Mancia, G, Fagard, R, Narkiewicz, K, Redon, J, Zanchetti, A, Böhm, M, Christiaens, T, Cifkova, R, De Backer, G, Dominiczak, A, Galderisi, M, Grobbee, D, Jaarsma, T, Kirchhof, P, Kjeldsen, S, Laurent, S, Manolis, A, Nilsson, P, Ruilope, L, Schmieder, R, Sirnes, P, Sleight, P, Viigimaa, M, Waeber, B, Zannad, F, Mancia, Giuseppe, Fagard, Robert, Narkiewicz, Krzysztof, Redon, Josep, Zanchetti, Alberto, Böhm, Michael, Christiaens, Thierry, Cifkova, Renata, De Backer, Guy, Dominiczak, Anna, Galderisi, Maurizio, Grobbee, Diederick E., Jaarsma, Tiny, Kirchhof, Paulus, Kjeldsen, Sverre E., Laurent, Stéphane, Manolis, Athanasios J., Nilsson, Peter M., Ruilope, Luis Miguel, Schmieder, Roland E., Sirnes, Per Anton, Sleight, Peter, Viigimaa, Margus, Waeber, Bernard, Zannad, Faiez, Mancia, G, Fagard, R, Narkiewicz, K, Redon, J, Zanchetti, A, Böhm, M, Christiaens, T, Cifkova, R, De Backer, G, Dominiczak, A, Galderisi, M, Grobbee, D, Jaarsma, T, Kirchhof, P, Kjeldsen, S, Laurent, S, Manolis, A, Nilsson, P, Ruilope, L, Schmieder, R, Sirnes, P, Sleight, P, Viigimaa, M, Waeber, B, Zannad, F, Mancia, Giuseppe, Fagard, Robert, Narkiewicz, Krzysztof, Redon, Josep, Zanchetti, Alberto, Böhm, Michael, Christiaens, Thierry, Cifkova, Renata, De Backer, Guy, Dominiczak, Anna, Galderisi, Maurizio, Grobbee, Diederick E., Jaarsma, Tiny, Kirchhof, Paulus, Kjeldsen, Sverre E., Laurent, Stéphane, Manolis, Athanasios J., Nilsson, Peter M., Ruilope, Luis Miguel, Schmieder, Roland E., Sirnes, Per Anton, Sleight, Peter, Viigimaa, Margus, Waeber, Bernard, and Zannad, Faiez

Abstract

The affiliations of the Task Force Members are listed in the Appendix. The disclosure forms of the authors and reviewers are available on the respective society websites http://www.eshonline.org and www.escardio.org/guidelines

Published
2013

134. Guía de práctica clínica de la ESH/ESC para el manejo de la hipertensión arterial (2013)

Author

Mancia, G, Fagard, R, Narkiewicz, K, Redon, J, Zanchetti, A, Böhm, M, Christiaens, T, Cifkova, R, Backer, G, Dominiczak, A, Galderisi, M, Grobbee, D, Jaarsma, T, Kirchhof, P, Kjeldsen, S, Laurent, S, Manolis, A, Nilsson, P, Ruilope, L, Schmieder, R, Sirnes, P, Sleight, P, Viigimaa, M, Waeber, B, Zannad, F, Mancia, Giuseppe, Fagard, Robert, Narkiewicz, Krzysztof, Redon, Josep, Zanchetti, Alberto, Böhm, Michael, Christiaens, Thierry, Cifkova, Renata, Backer, Guy De, Dominiczak, Anna, Galderisi, Maurizio, Grobbee, Diederick E., Jaarsma, Tiny, Kirchhof, Paulus, Kjeldsen, Sverre E., Laurent, Stéphane, Manolis, Athanasios J., Nilsson, Peter M., Ruilope, Luis Miguel, Schmieder, Roland E., Sirnes, Per Anton, Sleight, Peter, Viigimaa, Margus, Waeber, Bernard, Zannad, Faiez, Mancia, G, Fagard, R, Narkiewicz, K, Redon, J, Zanchetti, A, Böhm, M, Christiaens, T, Cifkova, R, Backer, G, Dominiczak, A, Galderisi, M, Grobbee, D, Jaarsma, T, Kirchhof, P, Kjeldsen, S, Laurent, S, Manolis, A, Nilsson, P, Ruilope, L, Schmieder, R, Sirnes, P, Sleight, P, Viigimaa, M, Waeber, B, Zannad, F, Mancia, Giuseppe, Fagard, Robert, Narkiewicz, Krzysztof, Redon, Josep, Zanchetti, Alberto, Böhm, Michael, Christiaens, Thierry, Cifkova, Renata, Backer, Guy De, Dominiczak, Anna, Galderisi, Maurizio, Grobbee, Diederick E., Jaarsma, Tiny, Kirchhof, Paulus, Kjeldsen, Sverre E., Laurent, Stéphane, Manolis, Athanasios J., Nilsson, Peter M., Ruilope, Luis Miguel, Schmieder, Roland E., Sirnes, Per Anton, Sleight, Peter, Viigimaa, Margus, Waeber, Bernard, and Zannad, Faiez

Published
2013

135. The task force for the management ofarterial hypertension of the european society ofhypertension (esh) and of the european society of cardiology (esc)

Author

Mancia, G, Fagard, R, Narkiewicz, K, Redon, J, Zanchetti, A, Bohm, M, Christiaens, T, Cifkova, R, De Backer, G, Dominiczak, A, Galderisi, M, Grobbee, D, Jaarsma, T, Kirchhof, P, Kjeldsen, S, Laurent, S, Manolis, A, Nilsson, P, Ruilope, L, Schmieder, R, Sirnes, P, Sleight, P, Viigimaa, M, Waeber, B, Zannad, F, Mancia, Giuseppe, Fagard, Robert, Narkiewicz, Krzysztof, Redon, Josep, Zanchetti, Alberto, Bohm, Michael, Christiaens, Thierry, Cifkova, Renata, De Backer, Guy, Dominiczak, Anna, Galderisi, Maurizio, Grobbee, Diederick E., Jaarsma, Tiny, Kirchhof, Paulus, Kjeldsen, Sverre E., Laurent, Stephane, Manolis, Athanasios J., Nilsson, Peter M., Ruilope, Luis Miguel, Schmieder, Roland E., Sirnes, Per Anton, Sleight, Peter, Viigimaa, Margus, Waeber, Bernard, Zannad, Faiez, Mancia, G, Fagard, R, Narkiewicz, K, Redon, J, Zanchetti, A, Bohm, M, Christiaens, T, Cifkova, R, De Backer, G, Dominiczak, A, Galderisi, M, Grobbee, D, Jaarsma, T, Kirchhof, P, Kjeldsen, S, Laurent, S, Manolis, A, Nilsson, P, Ruilope, L, Schmieder, R, Sirnes, P, Sleight, P, Viigimaa, M, Waeber, B, Zannad, F, Mancia, Giuseppe, Fagard, Robert, Narkiewicz, Krzysztof, Redon, Josep, Zanchetti, Alberto, Bohm, Michael, Christiaens, Thierry, Cifkova, Renata, De Backer, Guy, Dominiczak, Anna, Galderisi, Maurizio, Grobbee, Diederick E., Jaarsma, Tiny, Kirchhof, Paulus, Kjeldsen, Sverre E., Laurent, Stephane, Manolis, Athanasios J., Nilsson, Peter M., Ruilope, Luis Miguel, Schmieder, Roland E., Sirnes, Per Anton, Sleight, Peter, Viigimaa, Margus, Waeber, Bernard, and Zannad, Faiez

Published
2013

136. 2013 ESH/ESC Guidelines for themanagement of arterial hypertension The Task Force for the management ofarterial hypertension of the European Society ofHypertension (ESH) and of the European Society of Cardiology (ESC)

Author

Mancia, Giuseppe, Fagard, Robert, Narkiewicz, Krzysztof, Redon, Josep, Zanchetti, Alberto, Boehm, Michael, Christiaens, Thierry, Cifkova, Renata, De Backer, Guy, Dominiczak, Anna, Galderisi, Maurizio, Grobbee, Diederick E., Jaarsma, Tiny, Kirchhof, Paulus, Kjeldsen, Sverre E., Laurent, Stephane, Manolis, Athanasios J., Nilsson, Peter M., Ruilope, Luis Miguel, Schmieder, Roland E., Sirnes, Per Anton, Sleight, Peter, Viigimaa, Margus, Waeber, Bernard, Zannad, Faiez, Mancia, Giuseppe, Fagard, Robert, Narkiewicz, Krzysztof, Redon, Josep, Zanchetti, Alberto, Boehm, Michael, Christiaens, Thierry, Cifkova, Renata, De Backer, Guy, Dominiczak, Anna, Galderisi, Maurizio, Grobbee, Diederick E., Jaarsma, Tiny, Kirchhof, Paulus, Kjeldsen, Sverre E., Laurent, Stephane, Manolis, Athanasios J., Nilsson, Peter M., Ruilope, Luis Miguel, Schmieder, Roland E., Sirnes, Per Anton, Sleight, Peter, Viigimaa, Margus, Waeber, Bernard, and Zannad, Faiez

Abstract

n/a

Published
2013
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137. 2013 Practice guidelines for the management of arterial hypertension of the European Society of Hypertension (ESH) and the European Society of Cardiology (ESC)

Author

Mancia, Giuseppe, Fagard, Robert, Narkiewicz, Krzysztof, Redon, Josep, Zanchetti, Alberto, Boehm, Michael, Christiaens, Thierry, Cifkova, Renata, De Backer, Guy, Dominiczak, Anna, Galderisi, Maurizio, Grobbee, Diederick E., Jaarsma, Tiny, Kirchof, Paulus, Kjeldsen, Sverre E., Laurent, Stephane, Manolis, Athanasios J., Nilsson, Peter M., Ruilope, Luis Miguel, Schmieder, Roland E., Sirnes, Per Anton, Sleight, Peter, Viigimaa, Margus, Waeber, Bernard, Zannad, Faiez, Mancia, Giuseppe, Fagard, Robert, Narkiewicz, Krzysztof, Redon, Josep, Zanchetti, Alberto, Boehm, Michael, Christiaens, Thierry, Cifkova, Renata, De Backer, Guy, Dominiczak, Anna, Galderisi, Maurizio, Grobbee, Diederick E., Jaarsma, Tiny, Kirchof, Paulus, Kjeldsen, Sverre E., Laurent, Stephane, Manolis, Athanasios J., Nilsson, Peter M., Ruilope, Luis Miguel, Schmieder, Roland E., Sirnes, Per Anton, Sleight, Peter, Viigimaa, Margus, Waeber, Bernard, and Zannad, Faiez

Abstract

n/a

Published
2013
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138. 2013 ESH/ESC Guidelines for the management of arterial hypertension

Author

Mancia, Giuseppe, Fagard, Robert, Narkiewicz, Krzysztof, Redon, Josep, Zanchetti, Alberto, Boehm, Michael, Christiaens, Thierry, Cifkova, Renata, De Backer, Guy, Dominiczak, Anna, Galderisi, Maurizio, Grobbee, Diederick E., Jaarsma, Tiny, Kirchhof, Paulus, Kjeldsen, Sverre E., Laurent, Stephane, Manolis, Athanasios J., Nilsson, Peter M., Ruilope, Luis Miguel, Schmieder, Roland E., Sirnes, Per Anton, Sleight, Peter, Viigimaa, Margus, Waeber, Bernard, Zannad, Faiez, Mancia, Giuseppe, Fagard, Robert, Narkiewicz, Krzysztof, Redon, Josep, Zanchetti, Alberto, Boehm, Michael, Christiaens, Thierry, Cifkova, Renata, De Backer, Guy, Dominiczak, Anna, Galderisi, Maurizio, Grobbee, Diederick E., Jaarsma, Tiny, Kirchhof, Paulus, Kjeldsen, Sverre E., Laurent, Stephane, Manolis, Athanasios J., Nilsson, Peter M., Ruilope, Luis Miguel, Schmieder, Roland E., Sirnes, Per Anton, Sleight, Peter, Viigimaa, Margus, Waeber, Bernard, and Zannad, Faiez

Abstract

n/a

Published
2013
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139. 2013 ESH/ESC Practice Guidelines for the Management of Arterial Hypertension

Author

Mancia, Giuseppe, primary, Fagard, Robert, additional, Narkiewicz, Krzysztof, additional, Redon, Josep, additional, Zanchetti, Alberto, additional, Böhm, Michael, additional, Christiaens, Thierry, additional, Cifkova, Renata, additional, De Backer, Guy, additional, Dominiczak, Anna, additional, Galderisi, Maurizio, additional, Grobbee, Diederick E., additional, Jaarsma, Tiny, additional, Kirchhof, Paulus, additional, Kjeldsen, Sverre E., additional, Laurent, Stephane, additional, Manolis, Athanasios J., additional, Nilsson, Peter M., additional, Ruilope, Luis Miguel, additional, Schmieder, Roland E., additional, Sirnes, Per Anton, additional, Sleight, Peter, additional, Viigimaa, Margus, additional, Waeber, Bernard, additional, and Zannad, Faiez, additional

Published
2013
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140. Guía de práctica clínica de la ESH/ESC para el manejo de la hipertensión arterial (2013)

Author

Mancia, Giuseppe, primary, Fagard, Robert, additional, Narkiewicz, Krzysztof, additional, Redon, Josep, additional, Zanchetti, Alberto, additional, Böhm, Michael, additional, Christiaens, Thierry, additional, Cifkova, Renata, additional, De Backer, Guy, additional, Dominiczak, Anna, additional, Galderisi, Maurizio, additional, Grobbee, Diederick E., additional, Jaarsma, Tiny, additional, Kirchhof, Paulus, additional, Kjeldsen, Sverre E., additional, Laurent, Stéphane, additional, Manolis, Athanasios J., additional, Nilsson, Peter M., additional, Ruilope, Luis Miguel, additional, Schmieder, Roland E., additional, Sirnes, Per Anton, additional, Sleight, Peter, additional, Viigimaa, Margus, additional, Waeber, Bernard, additional, and Zannad, Faiez, additional

Published
2013
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142. 2013 Practice guidelines for the management of arterial hypertension of the European Society of Hypertension (ESH) and the European Society of Cardiology (ESC)

Author

Mancia, Giuseppe, primary, Fagard, Robert, additional, Narkiewicz, Krzysztof, additional, Redán, Josep, additional, Zanchetti, Alberto, additional, Böhm, Michael, additional, Christiaens, Thierry, additional, Cifkova, Renata, additional, De Backer, Guy, additional, Dominiczak, Anna, additional, Galderisi, Maurizio, additional, Grobbee, Diederick E., additional, Jaarsma, Tiny, additional, Kirchof, Paulus, additional, Kjeldsen, Sverre E., additional, Laurent, Stéphane, additional, Manolis, Athanasios J., additional, Nilsson, Peter M., additional, Ruilope, Luis Miguel, additional, Schmieder, Roland E., additional, Sirnes, Per Anton, additional, Sleight, Peter, additional, Viigimaa, Margus, additional, Waeber, Bernard, additional, and Zannad, Faiez, additional

Published
2013
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143. 2013 ESH/ESC Guidelines for the management of arterial hypertension

Author

Mancia, Giuseppe, primary, Fagard, Robert, additional, Narkiewicz, Krzysztof, additional, Redón, Josep, additional, Zanchetti, Alberto, additional, Böhm, Michael, additional, Christiaens, Thierry, additional, Cifkova, Renata, additional, De Backer, Guy, additional, Dominiczak, Anna, additional, Galderisi, Maurizio, additional, Grobbee, Diederick E., additional, Jaarsma, Tiny, additional, Kirchhof, Paulus, additional, Kjeldsen, Sverre E., additional, Laurent, Stéphane, additional, Manolis, Athanasios J., additional, Nilsson, Peter M., additional, Ruilope, Luis Miguel, additional, Schmieder, Roland E., additional, Sirnes, Per Anton, additional, Sleight, Peter, additional, Viigimaa, Margus, additional, Waeber, Bernard, additional, and Zannad, Faiez, additional

Published
2013
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146. Globaal cardiovasculair risicobeheer

Author

UCL - MD/ESP - Ecole de santé publique, UCL - (SLuc) Service de gériatrie, Boland, Benoît, Christiaens, Thierry, Goderis, Geert, Govaerts, Franz, Philips, Hilde, Smeets, Frank, Van de Vyver, Nathalie, Van Duppen, Dirk, UCL - MD/ESP - Ecole de santé publique, UCL - (SLuc) Service de gériatrie, Boland, Benoît, Christiaens, Thierry, Goderis, Geert, Govaerts, Franz, Philips, Hilde, Smeets, Frank, Van de Vyver, Nathalie, and Van Duppen, Dirk

Abstract

Met deze gloednieuwe aanbeveling kunnen huisartsen op een snelle en accurate manier het risico op hart- en vaatziekten bij hun patiënten vaststellen. Het cardiovasculaire risicoprofiel bij patiënten tussen 40 en 75 jaar kan worden bepaald aan de hand van een 'cardiovasculair algoritme' en de Score Belgium-risicotabellen. Beide hulpmiddelen zijn ook op de bijgevoegde steekkaart terug te vinden

Published
2007

148. The search for person-related information in general practice: a qualitative study.

Author

Schrans, Diego, Avonts, Dirk, Christiaens, Thierry, Willems, Sara, de Smet, Kaat, van Boven, Kees, Boeckxstaens, Pauline, and Kühlein, Thomas

Subjects
FAMILY medicine, PSYCHOLOGY of the sick, MEDICAL decision making, MEDICAL records, HISTORY of medicine, QUALITATIVE research, GENERAL practitioners, PRIMARY health care, PATIENT-centered care
Abstract

Background: General practice is person-focused. Contextual information influences the clinical decision-making process in primary care. Currently, person-related information (PeRI) is neither recorded in a systematic way nor coded in the electronic medical record (EMR), and therefore not usable for scientific use.Aim: To search for classes of PeRI influencing the process of care.Methods: GPs, from nine countries worldwide, were asked to write down narrative case histories where personal factors played a role in decision-making. In an inductive process, the case histories were consecutively coded according to classes of PeRI. The classes found were deductively applied to the following cases and refined, until saturation was reached. Then, the classes were grouped into code-families and further clustered into domains.Results: The inductive analysis of 32 case histories resulted in 33 defined PeRI codes, classifying all personal-related information in the cases. The 33 codes were grouped in the following seven mutually exclusive code-families: 'aspects between patient and formal care provider', 'social environment and family', 'functioning/behaviour', 'life history/non-medical experiences', 'personal medical information', 'socio-demographics' and 'work-/employment-related information'. The code-families were clustered into four domains: 'social environment and extended family', 'medicine', 'individual' and 'work and employment'.Conclusion: As PeRI is used in the process of decision-making, it should be part of the EMR. The PeRI classes we identified might form the basis of a new contextual classification mainly for research purposes. This might help to create evidence of the person-centredness of general practice. [ABSTRACT FROM AUTHOR]

Published
2016
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150. Are antihistamines effective in children? A review of the evidence

Author

De Bruyne, Pauline, Christiaens, Thierry, Boussery, Koen, Mehuys, Els, and Van Winckel, Myriam

Abstract

Background and aimsDuring the last decades, much attention has been paid to off-label and unlicensed prescriptions in paediatrics. However, on-label prescribing can also cause health issues. In this paper, the case of first-generation H1-antihistamines is investigated, notably the range of indications for which products are licensed in different European countries and the evidence base (or lack thereof) for each indication, as well as reported adverse drug reactions.MethodsReview of the Summary of Product Characteristics of first-generation H1-antihistamines with a focus on paediatric use. This is plotted against the evidence available in the literature.ResultsThis investigation shows a large variability in labelled indications and licensing ages when compared in five different European countries. Moreover, most of the indications are not based on clinical trials evaluating efficacy and safety of these drugs in children.ConclusionsMany of the licensed indications of first-generation antihistamines do not appear to be evidence based.

Published
2017
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