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101. Effectiveness and cost-effectiveness of proactive and multidisciplinary integrated care for older people with complex problems in general practice: an individual participant data meta-analysis

Author

Blom, Jeanet W., Hout, W.B. Van den, Elzen, W.P.J. Den, Drewes, Y.M., Bleijenberg, Nienke, Fabbricotti, Isabelle N., Koopmans, R.T.C.M., Melis, R.J.F., Ruikes, F.G.H., Wind, A.W., Gussekloo, J., Blom, Jeanet W., Hout, W.B. Van den, Elzen, W.P.J. Den, Drewes, Y.M., Bleijenberg, Nienke, Fabbricotti, Isabelle N., Koopmans, R.T.C.M., Melis, R.J.F., Ruikes, F.G.H., Wind, A.W., and Gussekloo, J.

Abstract

Contains fulltext : 195261.pdf (Publisher’s version ) (Open Access)

Published
2018

102. Effectiveness and cost-effectiveness of proactive and multidisciplinary integrated care for older people with complex problems in general practice: an individual participant data meta-analysis

Author

Blom, J. W., Van den Hout, W. B., Den Elzen, W. P. J., Drewes, Y. M., Bleijenberg, N., Fabbricotti, I. N., Jansen, A. P. D., Kempen, G. I. J. M., Koopmans, R., Looman, W. M., Melis, R. J. F., Metzelthin, S. F., van Charante, E. P. Moll, Muntinga, M. E., Numans, M. E., Ruikes, F. G. H., Spoorenberg, S. L. W., Stijnen, T., Suijker, J. J., De Wit, N. J., Wynia, K., Wind, A. W., Gussekloo, J., Blom, J. W., Van den Hout, W. B., Den Elzen, W. P. J., Drewes, Y. M., Bleijenberg, N., Fabbricotti, I. N., Jansen, A. P. D., Kempen, G. I. J. M., Koopmans, R., Looman, W. M., Melis, R. J. F., Metzelthin, S. F., van Charante, E. P. Moll, Muntinga, M. E., Numans, M. E., Ruikes, F. G. H., Spoorenberg, S. L. W., Stijnen, T., Suijker, J. J., De Wit, N. J., Wynia, K., Wind, A. W., and Gussekloo, J.

Published
2018

103. Study protocol: A randomised controlled trial on the clinical effects of levothyroxine treatment for subclinical hypothyroidism in people aged 80 years and over

Author

Du Puy, R.S. (R. S.), Postmus, D. (Douwe), Stott, D.J. (David. J.), Blum, M.R. (Manuel), Poortvliet, R.K.E. (R. K.E.), Elzen, W.P.J. (Wendy) den, Peeters, R.P. (Robin), Munster, B.C. (Barbara), Wolffenbuttel, B.H.R. (B. H.R.), Westendorp, R.G.J. (Rudi), Kearney, P.M. (Patricia M.), Ford, I. (Ian), Kean, S. (S.), Messow, C.M. (C. M.), Watt, T. (T.), Jukema, J.W. (Jan Wouter), Dekkers, O.M. (Olaf), Smit, J.W.A. (Jan), Rodondi, N. (Nicolas), Gussekloo, J. (Jacobijn), Mooijaart, S.P. (Simon), Du Puy, R.S. (R. S.), Postmus, D. (Douwe), Stott, D.J. (David. J.), Blum, M.R. (Manuel), Poortvliet, R.K.E. (R. K.E.), Elzen, W.P.J. (Wendy) den, Peeters, R.P. (Robin), Munster, B.C. (Barbara), Wolffenbuttel, B.H.R. (B. H.R.), Westendorp, R.G.J. (Rudi), Kearney, P.M. (Patricia M.), Ford, I. (Ian), Kean, S. (S.), Messow, C.M. (C. M.), Watt, T. (T.), Jukema, J.W. (Jan Wouter), Dekkers, O.M. (Olaf), Smit, J.W.A. (Jan), Rodondi, N. (Nicolas), Gussekloo, J. (Jacobijn), and Mooijaart, S.P. (Simon)

Abstract

Background: Subclinical hypothyroidism is common in older people and its contribution to health and disease needs to be elucidated further. Observational and clinical trial data on the clinical effects of subclinical hypothyroidism in persons aged 80 years and over is inconclusive, with some studies suggesting harm and some suggesting benefits, translating into equipoise whether levothyroxine therapy provides clinical benefits. This manuscript describes the study protocol for the Institute for Evidence-Based Medicine in Old Age (IEMO) 80-plus thyroid trial to generate the necessary evidence base. Methods: The IEMO 80-plus thyroid trial was explicitly designed as an ancillary experiment to the Thyroid hormone Replacement for Untreated older adults with Subclinical hypothyroidism randomised placebo controlled Trial (TRUST) with a nea

Published
2018
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104. Effectiveness and cost-effectiveness of proactive and multidisciplinary integrated care for older people with complex problems in general practice: An individual participant data meta-analysis

Author

Blom, J.W. (Jeanet), Hout, W.B. (Wilbert) van den, Elzen, W.P.J. (Wendy) den, Drewes, Y.M. (Yvonne M.), Bleijenberg, N. (Nienke), Fabbricotti, I.N. (Isabelle), Jansen, A.P.D. (Aaltje), Kempen, G.I.J.M. (Gertrudis), Koopmans, R. (R.), Looman, W.M. (Willemijn), Melis, R.J.F. (René), Metzelthin, S.F. (S. F.), Van Charante, E.P.M. (E.P. Moll), Muntinga, M.E. (Maaike E.), Numans, M.E. (Mattijs), Ruikes, F.G.H. (F. G.H.), Spoorenberg, S.L.W. (S. L.W.), Stijnen, T. (T.), Suijker, J.J. (J. J.), De Wit, N.J. (N. J.), Wynia, K. (K.), Wind, A.W. (Annet), Gussekloo, J. (Jacobijn), Blom, J.W. (Jeanet), Hout, W.B. (Wilbert) van den, Elzen, W.P.J. (Wendy) den, Drewes, Y.M. (Yvonne M.), Bleijenberg, N. (Nienke), Fabbricotti, I.N. (Isabelle), Jansen, A.P.D. (Aaltje), Kempen, G.I.J.M. (Gertrudis), Koopmans, R. (R.), Looman, W.M. (Willemijn), Melis, R.J.F. (René), Metzelthin, S.F. (S. F.), Van Charante, E.P.M. (E.P. Moll), Muntinga, M.E. (Maaike E.), Numans, M.E. (Mattijs), Ruikes, F.G.H. (F. G.H.), Spoorenberg, S.L.W. (S. L.W.), Stijnen, T. (T.), Suijker, J.J. (J. J.), De Wit, N.J. (N. J.), Wynia, K. (K.), Wind, A.W. (Annet), and Gussekloo, J. (Jacobijn)

Abstract

Purpose: to support older people with several healthcare needs in sustaining adequate functioning and independence, more proactive approaches are needed. This purpose of this study is to summarise the (cost-) effectiveness of proactive, multidisciplinary, integrated care programmes for older people in Dutch primary care. Methods design: individual patient data (IPD) meta-analysis of eight clinically controlled trials. Setting: primary care sector. Interventions: combination of (i) identification of older people with complex problems by means of screening, followed by (ii) a multidisciplinary integrated care programme for those identified. Main outcome: activities of daily living, i.e. a change on modified Katz-15 scale between baseline and 1-year follow-up. Secondary outcomes: quality of life (visual analogue scale 0-10), psychological (mental well-being scale Short Form Health Survey (SF)-36) and social well-being (single item, SF-36), quality-adjusted life years (Euroqol-5dimensions-3level (EQ-5D-3L)), healthcare utilisation and cost-effectiveness. Analysis: intention-to-treat analysis, two-stage IPD and subgroup analysis based on patient and intervention characteristics. Results: included were 8,678 participants: median age of 80.5 (interquartile range 75.3; 85.7) years; 5,496 (63.3%) women. On the modified Katz-15 scale, the pooled difference in change between the intervention and control group was -0.01 (95% confidence interval -0.10 to 0.08). No significant differences were found in the other patient outcomes or subgroup analyses. Compared to usual care, the probability of the intervention group to be cost-effective was less than 5%. Conclusion: compared to usual care at 1-year follow-up, strategies for identification of frail older people in primary care combined with a proactive integrated care intervention are probably not (cost-) effective.

Published
2018
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105. Unravelling complex primary-care programs to maintain independent living in older people: a systematic overview

Author

Smit, L.C. (Linda C.), Schuurmans, M.J. (Marieke ), Blom, J.W. (Jeanet), Fabbricotti, I.N. (Isabelle), Jansen, A.P.D. (Aaltje), Kempen, G.I.J.M. (Gertrudis), Koopmans, R. (Raymond), Looman, W.M. (Willemijn), Melis, R.J.F. (René), Metzelthin, S.F. (Silke F.), Moll van Charante, E.P. (Eric P.), Muntinga, M.E. (Maaike E.), Ruikes, F.G.H. (Franca G.H.), Spoorenberg, S.L.W. (Sophie L.W.), Suijker, J.J. (Jacqueline J.), Wynia, K. (Klaske), Gussekloo, J. (Jacobijn), Wit, N.J. (Niek) de, Bleijenberg, N. (Nienke), Smit, L.C. (Linda C.), Schuurmans, M.J. (Marieke ), Blom, J.W. (Jeanet), Fabbricotti, I.N. (Isabelle), Jansen, A.P.D. (Aaltje), Kempen, G.I.J.M. (Gertrudis), Koopmans, R. (Raymond), Looman, W.M. (Willemijn), Melis, R.J.F. (René), Metzelthin, S.F. (Silke F.), Moll van Charante, E.P. (Eric P.), Muntinga, M.E. (Maaike E.), Ruikes, F.G.H. (Franca G.H.), Spoorenberg, S.L.W. (Sophie L.W.), Suijker, J.J. (Jacqueline J.), Wynia, K. (Klaske), Gussekloo, J. (Jacobijn), Wit, N.J. (Niek) de, and Bleijenberg, N. (Nienke)

Abstract

Objectives: Complex interventions are criticized for being a “black box”, which makes it difficult to determine why they succeed or fail. Recently, nine proactive primary-care programs aiming to prevent functional decline in older adults showed inconclusive effects. The aim of this study was to systematically unravel, compare, and synthesize the development and evaluation of nine primary-care programs within a controlled trial to further improve the development and evaluation of complex interventions. Study Design and Setting: A systematic overview of all written data on the nine proactive primary-care programs was conducted using a validated item list. The nine proactive primary-care programs involved 214 general practices throughout the Netherlands. Results: There was little or no focus on the (1) context surrounding the care program, (2) modeling of processes and outcomes, (3) intervention fidelity and adaptation, and (4) content and evaluation of training for interventionists. Conclusions: An in-depth analysis of the context, modeling of the processes and outcomes, measurement and reporting of intervention fidelity, and implementation of effective training for interventionists is needed to enhance the development and replication of future complex interventions.

Published
2018
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107. Effectiveness and cost-effectiveness of proactive and multidisciplinary integrated care for older people with complex problems in general practice: an individual participant data meta-analysis

Author

Verplegingswetenschap, Infection & Immunity, Unit Opleiding Aios, Medische staf Anesthesiologie, HAG Netwerken, General Practice & Nursing Science, Child Health, Cancer, JC Overig onderzoek, Blom, J. W., Van den Hout, W. B., Den Elzen, W. P. J., Drewes, Y. M., Bleijenberg, N., Fabbricotti, I. N., Jansen, A. P. D., Kempen, G. I. J. M., Koopmans, R., Looman, W. M., Melis, R. J. F., Metzelthin, S. F., van Charante, E. P. Moll, Muntinga, M. E., Numans, M. E., Ruikes, F. G. H., Spoorenberg, S. L. W., Stijnen, T., Suijker, J. J., De Wit, N. J., Wynia, K., Wind, A. W., Gussekloo, J., Verplegingswetenschap, Infection & Immunity, Unit Opleiding Aios, Medische staf Anesthesiologie, HAG Netwerken, General Practice & Nursing Science, Child Health, Cancer, JC Overig onderzoek, Blom, J. W., Van den Hout, W. B., Den Elzen, W. P. J., Drewes, Y. M., Bleijenberg, N., Fabbricotti, I. N., Jansen, A. P. D., Kempen, G. I. J. M., Koopmans, R., Looman, W. M., Melis, R. J. F., Metzelthin, S. F., van Charante, E. P. Moll, Muntinga, M. E., Numans, M. E., Ruikes, F. G. H., Spoorenberg, S. L. W., Stijnen, T., Suijker, J. J., De Wit, N. J., Wynia, K., Wind, A. W., and Gussekloo, J.

Published
2018

108. Study protocol:a randomised controlled trial on the clinical effects of levothyroxine treatment for subclinical hypothyroidism in people aged 80 years and over

Author

Du Puy, R S, Postmus, I, Stott, D J, Blum, M R, Poortvliet, R K E, Den Elzen, W P J, Peeters, R P, van Munster, B C, Wolffenbuttel, B H R, Westendorp, Rudolf Gerardus Johannes, Kearney, P M, Ford, I, Kean, S, Messow, C M, Watt, T., Jukema, J W, Dekkers, O M, Smit, J W A, Rodondi, N, Gussekloo, J, Mooijaart, S P, Du Puy, R S, Postmus, I, Stott, D J, Blum, M R, Poortvliet, R K E, Den Elzen, W P J, Peeters, R P, van Munster, B C, Wolffenbuttel, B H R, Westendorp, Rudolf Gerardus Johannes, Kearney, P M, Ford, I, Kean, S, Messow, C M, Watt, T., Jukema, J W, Dekkers, O M, Smit, J W A, Rodondi, N, Gussekloo, J, and Mooijaart, S P

Abstract

BACKGROUND: Subclinical hypothyroidism is common in older people and its contribution to health and disease needs to be elucidated further. Observational and clinical trial data on the clinical effects of subclinical hypothyroidism in persons aged 80 years and over is inconclusive, with some studies suggesting harm and some suggesting benefits, translating into equipoise whether levothyroxine therapy provides clinical benefits. This manuscript describes the study protocol for the Institute for Evidence-Based Medicine in Old Age (IEMO) 80-plus thyroid trial to generate the necessary evidence base.METHODS: The IEMO 80-plus thyroid trial was explicitly designed as an ancillary experiment to the Thyroid hormone Replacement for Untreated older adults with Subclinical hypothyroidism randomised placebo controlled Trial (TRUST) with a near identical protocol and shared research infrastructure. Outcomes will be presented separately for the IEMO and TRUST 80-plus groups, as well as a pre-planned combined analysis of the 145 participants included in the IEMO trial and the 146 participants from the TRUST thyroid trial aged 80 years and over. The IEMO 80-plus thyroid trial is a multi-centre randomised double-blind placebo-controlled parallel group trial of levothyroxine treatment in community-dwelling participants aged 80 years and over with persistent subclinical hypothyroidism (TSH ≥4.6 and ≤ 19.9 mU/L and fT4 within laboratory reference ranges). Participants are randomised to levothyroxine 25 or 50 micrograms daily or matching placebo with dose titrations according to TSH levels, for a minimum follow-up of one and a maximum of three years. Primary study endpoints: hypothyroid physical symptoms and tiredness on the thyroid-related quality of life patient-reported outcome (ThyPRO) at one year. Secondary endpoints: generic quality of life, executive cognitive function, handgrip strength, functional ability, blood pressure, weight, body mass index, and mortality. Advers

Published
2018

109. Effectiveness and cost-effectiveness of proactive and multidisciplinary integrated care for older people with complex problems in general practice: an individual participant data meta-analysis

Author

Blom, JW, van den Hout, W, den Elzen, WPJ, Drewes, YM, Bleijenberg, N, Fabbricotti, Isabelle, Jansen, APD, Kempen, GIJM, Koopmans, R, Looman, Willemijn, Melis, RJF, Metzelthin, SF, Moll van Charante, EP, Muntinga, ME, Numans, ME, Ruikes, FGH, Spoorenberg, SLW, Stijnen, T, Suijker, JJ, De Wit, NJ, Wynia, K, Wind, AW, Gussekloo, J, Blom, JW, van den Hout, W, den Elzen, WPJ, Drewes, YM, Bleijenberg, N, Fabbricotti, Isabelle, Jansen, APD, Kempen, GIJM, Koopmans, R, Looman, Willemijn, Melis, RJF, Metzelthin, SF, Moll van Charante, EP, Muntinga, ME, Numans, ME, Ruikes, FGH, Spoorenberg, SLW, Stijnen, T, Suijker, JJ, De Wit, NJ, Wynia, K, Wind, AW, and Gussekloo, J

Published
2018

110. Study protocol: a randomised controlled trial on the clinical effects of levothyroxine treatment for subclinical hypothyroidism in people aged 80 years and over

Author

Du Puy, RS, Postmus, I, Stott, DJ, Blum, MR, Poortvliet, RKE, den Elzen, WPJ, Peeters, Robin, van Munster, BC, Wolffenbuttel, BHR, Westendorp, RGJ, Kearney, PM, Ford, I, Kean, S, Messow, CM, Watt, T, Jukemal, JW, Dekkers, OM, Smit, JWA, Rodondi, N, Gussekloo, J, Mooijaart, SP, Du Puy, RS, Postmus, I, Stott, DJ, Blum, MR, Poortvliet, RKE, den Elzen, WPJ, Peeters, Robin, van Munster, BC, Wolffenbuttel, BHR, Westendorp, RGJ, Kearney, PM, Ford, I, Kean, S, Messow, CM, Watt, T, Jukemal, JW, Dekkers, OM, Smit, JWA, Rodondi, N, Gussekloo, J, and Mooijaart, SP

Published
2018

111. Functional task exercise and physical therapy as prevention of functional decline in community dwelling older people

Author

Blom, J., Siemonsma, P., Hofstetter, H., van Hespen, A., Gussekloo, J., Drewes, Y., and van Meeteren, N.

Subjects
older people, functional task exercise, ddc: 610, 610 Medical sciences, Medicine, physiotherapy
Abstract

Background: A physically active lifestyle in older people contributes to the preservation of good health. Question: What is the effect of physiotherapy on daily functioning among community dwelling older people with complex health problems identified with screening, vs care as usual. In addition,[for full text, please go to the a.m. URL], 51. Kongress für Allgemeinmedizin und Familienmedizin

Published
2017

113. Measurement properties of the EQ-5D across four major geriatric conditions : Findings from TOPICS-MDS

Author

Lutomski, Jennifer E., Krabbe, Paul F M, Bleijenberg, N., Blom, Jeanett, Kempen, Gertrudis I J M, MacNeil-Vroomen, Janet, Muntinga, Maaike E., Steyerburg, Ewout, Olde Rikkert, Marcel G M, Melis, René J.F., Blom, J. W., Melis, R.J.F., Muntinga, M. E., Steyerberg, Ewout W., Gussekloo, J., van den Brink, D., Lutomski, J.E., Qin, L., Kempen, G. I.J.M., Krabbe, P. F M, Buurman, B.M., van der Horst, H.E., de Rooij, S.E.J.A., Schols, Jos M. G. A., Schuurmans, M. J., Smilde, D. A., and TOPICS Consortium

Subjects
Quality of life, Joint diseases, EQ-5D, Urinary incontinence, Public Health, Environmental and Occupational Health, Journal Article, Hearing loss, Validation Studies, Dizziness
Abstract

Background: As populations age, chronic geriatric conditions linked to progressive organ failure jeopardize health-related quality of life (HRQoL). Thus, this research assessed the validity and applicability of the EQ-5D (a common HRQoL instrument) across four major chronic geriatric conditions: hearing issues, joint damage, urinary incontinence, or dizziness with falls. Methods: The study sample comprised 25,637 community-dwelling persons aged 65 years and older residing in the Netherlands (Data source: TOPICS-MDS, www.topics-mds.eu ). Floor and ceiling effects were examined. To assess convergent validity, random effects meta-correlations (Spearman's rho) were derived between individual EQ-5D domains and related survey items. To further examine construct validity, the association between sociodemographic characteristics and EQ-5D summary scores were assessed using linear mixed models. Outcomes were compared to the overall study population as well as a 'healthy' subgroup reporting no major chronic conditions. Results: Whereas ceiling effects were observed in the overall study population and the 'healthy' subgroup, such was not the case in the geriatric condition subgroups. The majority of hypotheses regarding correlations between survey items and sociodemographic associations were supported. EQ-5D summary scores were lower in respondents who were older, female, widowed/single, lower educated, and living alone. Increasing co-morbidity had a clear negative effect on EQ-5D scores. Conclusion: This study supported the construct validity of the EQ-5D across four major geriatric conditions. For older persons who are generally healthy, i.e. reporting few to no chronic conditions, the EQ-5D confers poor discriminative ability due to ceiling effects. Although the overall dataset initially suggested poor discriminative ability for the EQ-5D, such was not the case within subgroups presenting with major geriatric conditions.

Published
2017

114. Examining the construct and known-group validity of a composite endpoint for The Older Persons and Informal Caregivers Survey Minimum Data Set (TOPICS-MDS); A large-scale data sharing initiative

Author

Hofman, Cynthia S., Lutomski, Jennifer E., Boter, Han, Buurman, Bianca M., De Craen, Anton J M, Donders, A Rogier T, Rikkert, Marcel G M Olde, Makai, Peter, Melis, René J.F., Bleijenberg, N., Blom, J. W., Kempen, G. I J M, Krabbe, P. F M, Moll van Charante, E.P., Muntinga, M. E., Steyerberg, Ewout W., Gussekloo, J., van der Horst, H.E., Olde Rikkert, Marcel G M, de Rooij, S.E.J.A., Schols, Jos M. G. A., Schuurmans, M. J., Smilde, D. A., Van Den Brink, D., Qin, L., TOPICS-MDS research consortium, Steering Committee, Working group, Ethics, Law & Medical humanities, APH - Aging & Later Life, APH - Societal Participation & Health, General practice, APH - Mental Health, APH - Quality of Care, Geriatrics, and Amsterdam Movement Sciences

Subjects
Gerontology, Male, Comparative Effectiveness Research, Alzheimer`s disease Donders Center for Medical Neuroscience [Radboudumc 1], Stress-related disorders Donders Center for Medical Neuroscience [Radboudumc 13], lcsh:Medicine, Social Sciences, Otology, Care, Biochemistry, 0302 clinical medicine, Sociology, QUALITY-OF-LIFE, Medicine and Health Sciences, Medicine, 030212 general & internal medicine, lcsh:Science, Medicine(all), education.field_of_study, Minimum Data Set, HEALTH-STATUS, Multidisciplinary, Agricultural and Biological Sciences(all), 030503 health policy & services, Neurology, Caregivers, Research Design, Vertigo, Patient groups, Female, Metric (unit), 0305 other medical science, Research Article, PATIENT GROUPS, Quality of life, Clinical Research Design, Comparative effectiveness research, Population, MEDLINE, Research and Analysis Methods, Health status, Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18], Education, 03 medical and health sciences, Quality of life (healthcare), Mental Health and Psychiatry, Journal Article, Adults, Dementia, Humans, education, Primary Care, Educational Attainment, Aged, business.industry, Biochemistry, Genetics and Molecular Biology(all), lcsh:R, Other Research Radboud Institute for Health Sciences [Radboudumc 0], Life satisfaction, Correction, ADULTS, CARE, medicine.disease, Health Care, Otorhinolaryngology, lcsh:Q, Geriatric Care, Health Statistics, Morbidity, business, Genetics and Molecular Biology(all)
Abstract

Contains fulltext : 174198.pdf (Publisher’s version ) (Open Access) BACKGROUND: Preference-weighted multi-faceted endpoints have the potential to facilitate comparative effectiveness research that incorporates patient preferences. The Older Persons and Informal Caregivers Survey-Composite endpoint (TOPICS-CEP) is potentially a valuable outcome measure for evaluating interventions in geriatric care as it combines multiple outcomes relevant to older persons in a single metric. The objective of this study was to validate TOPICS-CEP across different study settings (general population, primary care and hospital). METHODS: Data were extracted from TOPICS Minimum Dataset (MDS), a pooled public-access national database with information on older persons throughout the Netherlands. Data of 17,603 older persons were used. Meta-correlations were performed between TOPICS-CEP indexed scores, EuroQol5-D utility scores and Cantril's ladder life satisfaction scores. Mixed linear regression analyses were performed to compare TOPICS-CEP indexed scores between known groups, e.g. persons with versus without depression. RESULTS: In the complete sample and when stratified by study setting TOPICS-CEP and Cantril's ladder were moderately correlated, whereas TOPICS-CEP and EQ-5D were highly correlated. Higher mean TOPICS-CEP scores were found in persons who were: married, lived independently and had an education at university level. Moreover, higher mean TOPICS-CEP scores were found in persons without dementia, depression, and dizziness with falls, respectively. Similar results were found when stratified by subgroup. CONCLUSION: This study supports that TOPICS-CEP is a robust measure which can potentially be used in broad settings to identify the effect of intervention or of prevention in elderly care.

Published
2017
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115. Thyroid Hormone Therapy for Older Adults with Subclinical Hypothyroidism

Author

Stott, D.J., Rodondi, N., Kearney, P.M., Ford, I., Westendorp, R.G.J., Mooijaart, S.P., Sattar, N., Aubert, C.E., Aujesky, D., Bauer, D.C., Baumgartner, C., Blum, M.R., Browne, J.P., Byrne, S., Collet, T.H., Dekkers, O.M., Elzen, W.P.J. den, Puy, R.S. du, Ellis, G., Feller, M., Floriani, C., Hendry, K., Hurley, C., Jukema, J.W., Kean, S., Kelly, M., Krebs, D., Langhorne, P., McCarthy, G., McCarthy, V., McConnachie, A., McDade, M., Messow, M., O'Flynn, A., O'Riordan, D., Poortvliet, R.K.E., Quinn, T.J., Russell, A., Sinnott, C., Smit, J.W.A., Dorland, H.A. van, Walsh, K.A., Walsh, E.K., Watt, T., Wilson, R., Gussekloo, J., TRUST Study Grp, Sinnott, Carol [0000-0002-8620-7461], and Apollo - University of Cambridge Repository

Subjects
Male, endocrine system, medicine.medical_specialty, Pediatrics, endocrine system diseases, medicine.medical_treatment, Levothyroxine, Thyrotropin, General Medicine, 030209 endocrinology & metabolism, Reference range, 610 Medicine & health, 030204 cardiovascular system & hematology, Placebo, law.invention, Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18], 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, Double-Blind Method, Hypothyroidism, law, 360 Social problems & social services, Subclinical hypothyroidism, medicine, Humans, Treatment Failure, Fatigue, Subclinical infection, Aged, Aged, 80 and over, Intention-to-treat analysis, business.industry, Thyroid, R1, 3. Good health, Intention to Treat Analysis, Clinical trial, Thyroxine, medicine.anatomical_structure, Physical therapy, Quality of Life, Female, Hormone therapy, business, hormones, hormone substitutes, and hormone antagonists, medicine.drug
Abstract

Item does not contain fulltext BACKGROUND: The use of levothyroxine to treat subclinical hypothyroidism is controversial. We aimed to determine whether levothyroxine provided clinical benefits in older persons with this condition. METHODS: We conducted a double-blind, randomized, placebo-controlled, parallel-group trial involving 737 adults who were at least 65 years of age and who had persisting subclinical hypothyroidism (thyrotropin level, 4.60 to 19.99 mIU per liter; free thyroxine level within the reference range). A total of 368 patients were assigned to receive levothyroxine (at a starting dose of 50 mug daily, or 25 mug if the body weight was

Published
2017
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116. Subclinical thyroid dysfunction and depressive symptoms: protocol for a systematic review and individual participant data meta-analysis of prospective cohort studies

Author

Wildisen, L., Moutzouri, E., Beglinger, S., Syrogiannouli, L., Cappola, A.R., Asvold, B.O., Bakker, S.J.L., Ceresini, G., Dullaart, R., Ferrucci, L., Grabe, H., Jukema, J.W., Nauck, M., Trompet, S., Volzke, H., Westendorp, R.G.J., Gussekloo, J., Peeters, R.P., Kloppel, S., Aujesky, D., Bauer, D.C., Rodondi, N., Giovane, C. del, Feller, M., Thyroid Studies Collaboration, Erasmus MC other, and Internal Medicine

Subjects
Epidemiology, Thyrotropin, Thyroid Function Tests, 030204 cardiovascular system & hematology, Logistic regression, Cohort Studies, depressive symptoms, 0302 clinical medicine, systematic review, Protocol, Medicine, 030212 general & internal medicine, 610 Medicine & health, Prospective cohort study, Depression (differential diagnoses), Subclinical infection, RISK, Depression, General Medicine, individual participant data (IPD) meta-analysis, subclinical hypothyroidism, Mental Health, Research Design, Meta-analysis, Cohort, Public Health and Health Services, subclinical hyperthyroidism, 360 Social problems & social services, Clinical psychology, Thyroid Hormones, Clinical Sciences, CINAHL, 03 medical and health sciences, Meta-Analysis as Topic, Behavioral and Social Science, Humans, Psychiatric Status Rating Scales, Other Medical and Health Sciences, subclinical thyroid dysfunction, business.industry, Prevention, Thyroid Studies Collaboration, Beck Depression Inventory, Thyroid Diseases, HYPOTHYROIDISM, business, Systematic Reviews as Topic
Abstract

IntroductionProspective cohort studies on the association between subclinical thyroid dysfunction and depressive symptoms have yielded conflicting findings, possibly because of differences in age, sex, thyroid-stimulating hormone cut-off levels or degree of baseline depressive symptoms. Analysis of individual participant data (IPD) may help clarify this association.Methods and analysis: We will conduct a systematic review and IPD meta-analysis of prospective studies on the association between subclinical thyroid dysfunction and depressive symptoms. We will identify studies through a systematic search of the literature in the Ovid Medline, Ovid Embase, Cochrane Central Register of Controlled Trials (CENTRAL) and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases from inception to April 2019 and from the Thyroid Studies Collaboration. We will ask corresponding authors of studies that meet our inclusion criteria to collaborate by providing IPD. Our primary outcome will be depressive symptoms at the first available individual follow-up, measured on a validated scale. We will convert all the scores to the Beck Depression Inventory scale. For each cohort, we will estimate the mean difference of depressive symptoms between participants with subclinical hypothyroidism or hyperthyroidism and control adjusted for depressive symptoms at baseline. Furthermore, we will adjust our multivariable linear regression analyses for age, sex, education and income. We will pool the effect estimates of all studies in a random-effects meta-analysis. Heterogeneity will be assessed by I2. Our secondary outcomes will be depressive symptoms at a specific follow-up time, at the last available individual follow-up and incidence of depression at the first, last and at a specific follow-up time. For the binary outcome of incident depression, we will use a logistic regression model.Ethics and disseminationFormal ethical approval is not required as primary data will not be collected. Our findings will have considerable implications for patient care. We will seek to publish this systematic review and IPD meta-analysis in a high-impact clinical journal This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/

Published
2019
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119. Ipertiroidismo subclinico e rischio cardiovascolare e mortalità

Author

Collet, T. H., Gussekloo, J., Bauer, D. C., den Elzen, W. P., Cappola, A. R., Balmer, P., Iervasi, G., Asvold, B. O., Sgarbi, J. A., Völzke, H., Gencer, B., Maciel, R. M., Molinaro, S., Bremner, A., Luben, R. N., Maisonneuve, P., Cornuz, J., Newman, A. B., Khaw, K. T., Westendorp, R. G., Franklyn, J. A., Vittinghoff, E., Walsh, J. P., Rodondi, N., Marinò, Michele, and Thyroid Studies Collaboration

Published
2012
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120. Study protocol; Thyroid hormone Replacement for Untreated older adults with Subclinical hypothyroidism - a randomised placebo controlled Trial (TRUST)

Author

Stott, D.J., Gussekloo, J., Kearney, P.M., Rodondi, N., Westendorp, R.G., Mooijaart, S., Kean, S., Quinn, T.J., Sattar, N., Hendry, K., Puy, R. Du, Elzen, W.P. den, Poortvliet, R.K., Smit, J.W.A., Jukema, J.W., Dekkers, O.M., Blum, M., Collet, T.H., McCarthy, V., Hurley, C., Byrne, S., Browne, J., Watt, T., Bauer, D., Ford, I., Stott, D.J., Gussekloo, J., Kearney, P.M., Rodondi, N., Westendorp, R.G., Mooijaart, S., Kean, S., Quinn, T.J., Sattar, N., Hendry, K., Puy, R. Du, Elzen, W.P. den, Poortvliet, R.K., Smit, J.W.A., Jukema, J.W., Dekkers, O.M., Blum, M., Collet, T.H., McCarthy, V., Hurley, C., Byrne, S., Browne, J., Watt, T., Bauer, D., and Ford, I.

Abstract

Contains fulltext : 170037.pdf (publisher's version ) (Open Access), BACKGROUND: Subclinical hypothyroidism (SCH) is a common condition in elderly people, defined as elevated serum thyroid-stimulating hormone (TSH) with normal circulating free thyroxine (fT4). Evidence is lacking about the effect of thyroid hormone treatment. We describe the protocol of a large randomised controlled trial (RCT) of Levothyroxine treatment for SCH. METHODS: Participants are community-dwelling subjects aged >/=65 years with SCH, diagnosed by elevated TSH levels (>/=4.6 and /= three months apart, with fT4 levels within laboratory reference range. The study is a randomised double-blind placebo-controlled parallel group trial, starting with levothyroxine 50 micrograms daily (25 micrograms in subjects <50Kg body weight or known coronary heart disease) with titration of dose in the active treatment group according to TSH level, and a mock titration in the placebo group. The primary outcomes are changes in two domains (hypothyroid symptoms and fatigue / vitality) on the thyroid-related quality of life questionnaire (ThyPRO) at one year. The study has 80% power (at p = 0.025, 2-tailed) to detect a change with levothyroxine treatment of 3.0% on the hypothyroid scale and 4.1% on the fatigue / vitality scale with a total target sample size of 750 patients. Secondary outcomes include general health-related quality of life (EuroQol), fatal and non-fatal cardiovascular events, handgrip strength, executive cognitive function (Letter Digit Coding Test), basic and instrumental activities of daily living, haemoglobin, blood pressure, weight, body mass index and waist circumference. Patients are monitored for specific adverse events of interest including incident atrial fibrillation, heart failure and bone fracture. DISCUSSION: This large multicentre RCT of levothyroxine treatment of subclinical hypothyroidism is powered to detect clinically relevant change in symptoms / quality of life and is likely to be highly influential in

Published
2017

121. Examining the construct and known-group validity of a composite endpoint for the Older Persons and Informal Caregivers Survey Minimum Data Set (TOPICS-MDS); A largescale data sharing initiative

Author

Hofman, Cynthia S., Lutomski, Jennifer E., Boter, Han, Buurman, Bianca M., De Craen, Anton J M, Donders, A Rogier T, Rikkert, Marcel G M Olde, Makai, Peter, Melis, René J.F., Bleijenberg, N., Blom, J. W., Kempen, G. I J M, Krabbe, P. F M, Moll van Charante, E.P., Muntinga, M. E., Steyerberg, Ewout W., Gussekloo, J., van der Horst, H.E., Olde Rikkert, Marcel G M, de Rooij, S.E.J.A., Schols, Jos M. G. A., Schuurmans, M. J., Smilde, D. A., Van Den Brink, D., Qin, L., TOPICS-MDS research consortium, Steering Committee, Working group, Hofman, Cynthia S., Lutomski, Jennifer E., Boter, Han, Buurman, Bianca M., De Craen, Anton J M, Donders, A Rogier T, Rikkert, Marcel G M Olde, Makai, Peter, Melis, René J.F., Bleijenberg, N., Blom, J. W., Kempen, G. I J M, Krabbe, P. F M, Moll van Charante, E.P., Muntinga, M. E., Steyerberg, Ewout W., Gussekloo, J., van der Horst, H.E., Olde Rikkert, Marcel G M, de Rooij, S.E.J.A., Schols, Jos M. G. A., Schuurmans, M. J., Smilde, D. A., Van Den Brink, D., Qin, L., and TOPICS-MDS research consortium, Steering Committee, Working group

Published
2017

122. Measurement properties of the EQ-5D across four major geriatric conditions: Findings from TOPICS-MDS

Author

Lutomski, J.E. (Jennifer E.), Krabbe, P.F.M. (Paul), Bleijenberg, N. (Nienke), Blom, J. (Jeanett), Kempen, G.I.J.M. (Gertrudis), MacNeil-Vroomen, J. (Janet), Muntinga, M.E. (Maaike E.), Steyerburg, E. (Ewout), Olde-Rikkert, M.G.M. (Marcel), Melis, R.J.F. (René), Blom, J.W. (Jeanet), Melis, R.J.F., Steyerberg, E.W. (Ewout), Gussekloo, J. (Jacobijn), Olde-Rikkert, M.G.M., van den Brink, D. (Danielle), Lutomski, J.E. (Jennifer), Qin, L. (Li), Kempen, G.I.J.M. (Gertrudis I.J.M.), Krabbe, P.F.M. (Paul F. M.), Buurman, B.M. (Bianca), Horst, H.E. (Henriette) van der, Rooij, S.E.J.A. (Sophia) de, Schols, J.M.G.A. (Jos), Schuurmans, M.J. (Marieke ), Smilde, D.A., Lutomski, J.E. (Jennifer E.), Krabbe, P.F.M. (Paul), Bleijenberg, N. (Nienke), Blom, J. (Jeanett), Kempen, G.I.J.M. (Gertrudis), MacNeil-Vroomen, J. (Janet), Muntinga, M.E. (Maaike E.), Steyerburg, E. (Ewout), Olde-Rikkert, M.G.M. (Marcel), Melis, R.J.F. (René), Blom, J.W. (Jeanet), Melis, R.J.F., Steyerberg, E.W. (Ewout), Gussekloo, J. (Jacobijn), Olde-Rikkert, M.G.M., van den Brink, D. (Danielle), Lutomski, J.E. (Jennifer), Qin, L. (Li), Kempen, G.I.J.M. (Gertrudis I.J.M.), Krabbe, P.F.M. (Paul F. M.), Buurman, B.M. (Bianca), Horst, H.E. (Henriette) van der, Rooij, S.E.J.A. (Sophia) de, Schols, J.M.G.A. (Jos), Schuurmans, M.J. (Marieke ), and Smilde, D.A.

Abstract

Background: As populations age, chronic geriatric conditions linked to progressive organ failure jeopardize health-related quality of life (HRQoL). Thus, this research assessed the validity and applicability of the EQ-5D (a common HRQoL instrument) across four major chronic

Published
2017
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123. Thyroid function tests in the reference range and fracture: Individual participant analysis of prospective cohorts

Author

Aubert, C.E. (Carole E.), Floriani, C. (Carmen), Bauer, D.C. (Douglas), B.R. da Costa (Bruno), Segna, D. (Daniel), Blum, M.R. (Manuel), Collet, T.-H. (Tinh-Hai), Fink, H.A. (Howard A.), Cappola, A.R. (Anne), Syrogiannouli, L. (Lamprini), Peeters, R.P. (Robin), Asvold, B.O. (Bjorn O.), Elzen, W.P.J. (Wendy) den, Luben, R.N. (Robert), Bremner, A. (Alexandra), Gogakos, A. (Apostolos), Eastell, R. (Richard), Kearney, P.M. (Patricia M.), Hoff, M. (Mari), Le Blanc, E. (Erin), Ceresini, G. (Graziano), Rivadeneira, F. (Fernando), Uitterlinden, A.G. (André), Khaw, K.T., Langhammer, A. (Arnulf), Stott, D.J. (David. J.), Westendorp, R.G.J. (Rudi), Ferrucci, L. (Luigi), Williams, G. (Graham), Gussekloo, J. (Jacobijn), Walsh, J.P. (John), Aujesky, D. (Drahomir), Rodondi, N. (Nicolas), Aubert, C.E. (Carole E.), Floriani, C. (Carmen), Bauer, D.C. (Douglas), B.R. da Costa (Bruno), Segna, D. (Daniel), Blum, M.R. (Manuel), Collet, T.-H. (Tinh-Hai), Fink, H.A. (Howard A.), Cappola, A.R. (Anne), Syrogiannouli, L. (Lamprini), Peeters, R.P. (Robin), Asvold, B.O. (Bjorn O.), Elzen, W.P.J. (Wendy) den, Luben, R.N. (Robert), Bremner, A. (Alexandra), Gogakos, A. (Apostolos), Eastell, R. (Richard), Kearney, P.M. (Patricia M.), Hoff, M. (Mari), Le Blanc, E. (Erin), Ceresini, G. (Graziano), Rivadeneira, F. (Fernando), Uitterlinden, A.G. (André), Khaw, K.T., Langhammer, A. (Arnulf), Stott, D.J. (David. J.), Westendorp, R.G.J. (Rudi), Ferrucci, L. (Luigi), Williams, G. (Graham), Gussekloo, J. (Jacobijn), Walsh, J.P. (John), Aujesky, D. (Drahomir), and Rodondi, N. (Nicolas)

Abstract

Context: Hyperthyroidism is associated with increased fracture risk, but it is not clear if lower thyroid-stimulating hormone (TSH) and higher free thyroxine (FT4) in euthyroid individuals are associated with fracture risk. Objective: To evaluate the association of TSH and FT4 with incident fractures in euthyroid individuals. Design: Individual participant data analysis. Setting: Thirteen prospective cohort studies with baseline examinations between 1981 and 2002. Participants: Adults with baseline TSH 0.45 to 4.49 mIU/L. Main Outcome Measures: Primary outcome was incident hip fracture. Secondary outcomes were any, nonvertebral, and vertebral fractures. Results were presented as hazard ratios (HRs) with 95% confidence interval (CI) adjusted for age and sex. For clinical relevance, we studied TSH according to five categories: 0.45 to 0.99 mIU/L; 1.00 to 1.49 mIU/L; 1.50 to 2.49 mIU/L; 2.50 to 3.49 mIU/L; and 3.50 to 4.49 mIU/L (reference). FT4 was assessed as study-specific standard deviation increase, because assays varied between cohorts. Results: During 659,059 person-years, 2,565 out of 56,835 participants had hip fracture (4.5%; 12 studies with data on hip fracture). The pooled adjusted HR (95% CI) for hip fracture was 1.25 (1.05 to 1.49) for TSH 0.45 to 0.99 mIU/L, 1.19 (1.01 to 1.41) for TSH 1.00 to 1.49 mIU/L, 1.09 (0.93 to 1.28) for TSH 1.50 to 2.49 mIU/L, and 1.12 (0.94 to 1.33) for TSH 2.50 to 3.49 mIU/L (P for trend = 0.004). Hip fracture was also associated with FT4 [HR (95% CI) 1.22 (1.11 to 1.35) per one standard deviation increase in FT4]. FT4 only was associated with any and nonvertebral fractures. Results remained similar in sensitivity analyses. Conclusions: Among euthyroid adults, lower TSH and higher FT4 are associated with an increased risk of hip fracture. These findings may help refine the definition of optimal ranges of thyroid function tests.

Published
2017
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124. Examining the construct and known-group validity of a composite endpoint for the Older Persons and Informal Caregivers Survey Minimum Data Set (TOPICS-MDS); A largescale data sharing initiative

Author

Hofman, C.S. (Cynthia S.), Lutomski, J.E. (Jennifer), Boter, M. (Marjan), Buurman, B.M. (Bianca), Craen, A.J. (Anton) de, Donders, R. (Rogier), Rikkert, M.G.M.O. (Marcel G.M.Olde), Makai, P. (Peter), Melis, R.J.F. (René), Bleijenberg, N. (Nienke), Blom, J.W. (Jeanet), Kempen, G.I.J.M. (Gertrudis), Krabbe, P.F.M. (Paul), Moll van Charante, E.P. (Eric P.), Muntinga, M.E. (Maaike E.), Steyerberg, E.W. (Ewout), Gussekloo, J. (Jacobijn), Horst, H.E. (Henriette) van der, Olde Rikkert, M.G.M. (Marcel), Rooij, S.E.J.A. (Sophia) de, Schols, J.M.G.A. (Jos), Schuurmans, M.J. (Marieke ), Smilde, D.A., van den Brink, D. (Danielle), Qin, L. (Li), Hofman, C.S. (Cynthia S.), Lutomski, J.E. (Jennifer), Boter, M. (Marjan), Buurman, B.M. (Bianca), Craen, A.J. (Anton) de, Donders, R. (Rogier), Rikkert, M.G.M.O. (Marcel G.M.Olde), Makai, P. (Peter), Melis, R.J.F. (René), Bleijenberg, N. (Nienke), Blom, J.W. (Jeanet), Kempen, G.I.J.M. (Gertrudis), Krabbe, P.F.M. (Paul), Moll van Charante, E.P. (Eric P.), Muntinga, M.E. (Maaike E.), Steyerberg, E.W. (Ewout), Gussekloo, J. (Jacobijn), Horst, H.E. (Henriette) van der, Olde Rikkert, M.G.M. (Marcel), Rooij, S.E.J.A. (Sophia) de, Schols, J.M.G.A. (Jos), Schuurmans, M.J. (Marieke ), Smilde, D.A., van den Brink, D. (Danielle), and Qin, L. (Li)

Abstract

Background Preference-weighted multi-faceted endpoints have the potential to facilitate comparative effectiveness research that incorporates patient preferences. The Older Persons and Informal Caregivers Survey Composite endpoint (TOPICS-CEP) is potentially a valuable outcome measure for evaluating interventions in geriatric care as it combines multiple outcomes relevant to older persons in a single metric. The objective of this study was to validate TOPICS-CEP across different study settings (general population, primary care and hospital). Methods Data were extracted from TOPICS Minimum Dataset (MDS), a pooled public-access national database with information on older persons throughout the Netherlands. Data of 1

Published
2017
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125. Effectiveness and cost-effectiveness of proactive and multidisciplinary integrated care for older people with complex problems in general practice. An Individual Participant Data meta-analysis

Author

Blom, J, van Den Hout, W, Den Elzen, W, Drewes, Y, Bleijenberg, N, Fabbricotti, I, Jansen, D, Kempen, R, Koopmans, R, Looman, W, Melis, R, Metzelthin, S, Moll van Charante, E, Muntinga, M, Numans, M, Ruikes, F, Spoorenberg, S, Stijnen, T, Suijker, J, de Wit, N, Wynia, K, Wind, A, Gussekloo, J, Blom, J, van Den Hout, W, Den Elzen, W, Drewes, Y, Bleijenberg, N, Fabbricotti, I, Jansen, D, Kempen, R, Koopmans, R, Looman, W, Melis, R, Metzelthin, S, Moll van Charante, E, Muntinga, M, Numans, M, Ruikes, F, Spoorenberg, S, Stijnen, T, Suijker, J, de Wit, N, Wynia, K, Wind, A, and Gussekloo, J

Published
2017

127. Measurement properties of the EQ-5D across four major geriatric conditions: Findings from TOPICS-MDS

Author

UMC Utrecht, Verplegingswetenschap, Infection & Immunity, Pathologie, Unit Opleiding Aios, Healthcare Innovation & Evaluation, Circulatory Health, JC onderzoeksprogramma Methodologie, Lutomski, Jennifer E., Krabbe, Paul F M, Bleijenberg, N., Blom, Jeanett, Kempen, Gertrudis I J M, MacNeil-Vroomen, Janet, Muntinga, Maaike E., Steyerburg, Ewout, Olde Rikkert, Marcel G M, Melis, René J.F., Blom, J. W., Melis, R.J.F., Muntinga, M. E., Steyerberg, Ewout W., Gussekloo, J., van den Brink, D., Lutomski, J.E., Qin, L., Kempen, G. I.J.M., Krabbe, P. F M, Buurman, B.M., van der Horst, H.E., de Rooij, S.E.J.A., Schols, Jos M. G. A., Schuurmans, M. J., Smilde, D. A., TOPICS Consortium, UMC Utrecht, Verplegingswetenschap, Infection & Immunity, Pathologie, Unit Opleiding Aios, Healthcare Innovation & Evaluation, Circulatory Health, JC onderzoeksprogramma Methodologie, Lutomski, Jennifer E., Krabbe, Paul F M, Bleijenberg, N., Blom, Jeanett, Kempen, Gertrudis I J M, MacNeil-Vroomen, Janet, Muntinga, Maaike E., Steyerburg, Ewout, Olde Rikkert, Marcel G M, Melis, René J.F., Blom, J. W., Melis, R.J.F., Muntinga, M. E., Steyerberg, Ewout W., Gussekloo, J., van den Brink, D., Lutomski, J.E., Qin, L., Kempen, G. I.J.M., Krabbe, P. F M, Buurman, B.M., van der Horst, H.E., de Rooij, S.E.J.A., Schols, Jos M. G. A., Schuurmans, M. J., Smilde, D. A., and TOPICS Consortium

Published
2017

128. Examining the construct and known-group validity of a composite endpoint for the Older Persons and Informal Caregivers Survey Minimum Data Set (TOPICS-MDS); A largescale data sharing initiative

Author

UMC Utrecht, Verplegingswetenschap, Infection & Immunity, Healthcare Innovation & Evaluation, Circulatory Health, JC onderzoeksprogramma Methodologie, Hofman, Cynthia S., Lutomski, Jennifer E., Boter, Han, Buurman, Bianca M., De Craen, Anton J M, Donders, A Rogier T, Rikkert, Marcel G M Olde, Makai, Peter, Melis, René J.F., Bleijenberg, N., Blom, J. W., Kempen, G. I J M, Krabbe, P. F M, Moll van Charante, E.P., Muntinga, M. E., Steyerberg, Ewout W., Gussekloo, J., van der Horst, H.E., Olde Rikkert, Marcel G M, de Rooij, S.E.J.A., Schols, Jos M. G. A., Schuurmans, M. J., Smilde, D. A., Van Den Brink, D., Qin, L., TOPICS-MDS research consortium, Steering Committee, Working group, UMC Utrecht, Verplegingswetenschap, Infection & Immunity, Healthcare Innovation & Evaluation, Circulatory Health, JC onderzoeksprogramma Methodologie, Hofman, Cynthia S., Lutomski, Jennifer E., Boter, Han, Buurman, Bianca M., De Craen, Anton J M, Donders, A Rogier T, Rikkert, Marcel G M Olde, Makai, Peter, Melis, René J.F., Bleijenberg, N., Blom, J. W., Kempen, G. I J M, Krabbe, P. F M, Moll van Charante, E.P., Muntinga, M. E., Steyerberg, Ewout W., Gussekloo, J., van der Horst, H.E., Olde Rikkert, Marcel G M, de Rooij, S.E.J.A., Schols, Jos M. G. A., Schuurmans, M. J., Smilde, D. A., Van Den Brink, D., Qin, L., and TOPICS-MDS research consortium, Steering Committee, Working group

Published
2017

129. Unravelling complex primary care programmes to maintain independent living in older people: a systematic overview.

Author

Smits, LC, Schuurmans, MJ, Blom, JW (Jeanet), Fabbricotti, Isabelle, Jansen, APD, Kempen, GIJM, Koopmans, R, Looman, Willemijn, Melis, RJF, Metzelthin, SF, Moll van Charante, EP, Muntinga, ME, Ruikes, FGH, Spoorenberg, SLW, Suijker, JJ, Wynia, K, Gussekloo, J, De Wit, NJ, Bleijenberg, N, Smits, LC, Schuurmans, MJ, Blom, JW (Jeanet), Fabbricotti, Isabelle, Jansen, APD, Kempen, GIJM, Koopmans, R, Looman, Willemijn, Melis, RJF, Metzelthin, SF, Moll van Charante, EP, Muntinga, ME, Ruikes, FGH, Spoorenberg, SLW, Suijker, JJ, Wynia, K, Gussekloo, J, De Wit, NJ, and Bleijenberg, N

Published
2017

131. Measurement properties of the EQ-5D across four major geriatric conditions: Findings from TOPICS-MDS

Author

Lutomski, Jennifer E., Krabbe, Paul F M, Bleijenberg, N., Blom, Jeanett, Kempen, Gertrudis I J M, MacNeil-Vroomen, Janet, Muntinga, Maaike E., Steyerburg, Ewout, Olde Rikkert, Marcel G M, Melis, René J.F., Blom, J. W., Melis, R.J.F., Muntinga, M. E., Steyerberg, Ewout W., Gussekloo, J., van den Brink, D., Lutomski, J.E., Qin, L., Kempen, G. I.J.M., Krabbe, P. F M, Buurman, B.M., van der Horst, H.E., de Rooij, S.E.J.A., Schols, Jos M. G. A., Schuurmans, M. J., Smilde, D. A., Methods in Medicines evaluation & Outcomes research (M2O), Value, Affordability and Sustainability (VALUE), Geriatrics, APH - Aging & Later Life, APH - Quality of Care, Nursing, RS: CAPHRI - R1 - Ageing and Long-Term Care, RS: Academische Werkplaats Ouderenzorg, Health Services Research, Ethics, Law & Medical humanities, APH - Societal Participation & Health, General practice, APH - Mental Health, and Public Health

Subjects
Gerontology, Male, Alzheimer`s disease Donders Center for Medical Neuroscience [Radboudumc 1], Activities of daily living, Urinary incontinence, RESPONSIVENESS, 0302 clinical medicine, Quality of life, QUALITY-OF-LIFE, Surveys and Questionnaires, Activities of Daily Living, Health Status Indicators, 030212 general & internal medicine, POPULATION, Netherlands, education.field_of_study, 030503 health policy & services, Joint diseases, General Medicine, Convergent validity, Population study, Female, Public Health, URINARY-INCONTINENCE, medicine.symptom, 0305 other medical science, Population, MULTIMORBIDITY, Dizziness, Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18], 03 medical and health sciences, AGE, EQ-5D, PEOPLE, Journal Article, medicine, Humans, Validation Studies, education, Geriatric Assessment, Aged, OLDER, business.industry, Research, Environmental and Occupational Health, Public Health, Environmental and Occupational Health, Construct validity, Reproducibility of Results, Hearing loss, HEALTH-CARE, Chronic Disease, PATTERNS, business
Abstract

Background As populations age, chronic geriatric conditions linked to progressive organ failure jeopardize health-related quality of life (HRQoL). Thus, this research assessed the validity and applicability of the EQ-5D (a common HRQoL instrument) across four major chronic geriatric conditions: hearing issues, joint damage, urinary incontinence, or dizziness with falls. Methods The study sample comprised 25,637 community-dwelling persons aged 65 years and older residing in the Netherlands (Data source: TOPICS-MDS, www.topics-mds.eu). Floor and ceiling effects were examined. To assess convergent validity, random effects meta-correlations (Spearman’s rho) were derived between individual EQ-5D domains and related survey items. To further examine construct validity, the association between sociodemographic characteristics and EQ-5D summary scores were assessed using linear mixed models. Outcomes were compared to the overall study population as well as a ‘healthy’ subgroup reporting no major chronic conditions. Results Whereas ceiling effects were observed in the overall study population and the ‘healthy’ subgroup, such was not the case in the geriatric condition subgroups. The majority of hypotheses regarding correlations between survey items and sociodemographic associations were supported. EQ-5D summary scores were lower in respondents who were older, female, widowed/single, lower educated, and living alone. Increasing co-morbidity had a clear negative effect on EQ-5D scores. Conclusion This study supported the construct validity of the EQ-5D across four major geriatric conditions. For older persons who are generally healthy, i.e. reporting few to no chronic conditions, the EQ-5D confers poor discriminative ability due to ceiling effects. Although the overall dataset initially suggested poor discriminative ability for the EQ-5D, such was not the case within subgroups presenting with major geriatric conditions. Electronic supplementary material The online version of this article (doi:10.1186/s12955-017-0616-x) contains supplementary material, which is available to authorized users.

Published
2016
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133. Subclinical Thyroid Dysfunction and Depressive Symptoms among the Elderly: A Prospective Cohort Study

Author

Blum, M.R., Wijsman, L.W., Virgini, V.S., Bauer, D.C., Elzen, W.P.J. den, Jukema, J.W., Buckley, B.M., Craen, A.J.M. de, Kearney, P.M., Stott, D.J., Gussekloo, J., Westendorp, R.G.J., Mooijaart, S.P., Rodondi, N., and PROSPER Study Grp

Subjects
Male, medicine.medical_specialty, Thyroid Hormones, endocrine system, endocrine system diseases, Endocrinology, Diabetes and Metabolism, Thyrotropin, 610 Medicine & health, 030209 endocrinology & metabolism, Thyroid Function Tests, Thyroid function tests, Cohort Studies, 03 medical and health sciences, Cellular and Molecular Neuroscience, 0302 clinical medicine, Endocrinology, Internal medicine, medicine, Humans, Euthyroid, Prospective cohort study, Depression (differential diagnoses), Elderly subjects, Subclinical infection, Aged, Aged, 80 and over, Psychiatric Status Rating Scales, Thyroid, medicine.diagnostic_test, Endocrine and Autonomic Systems, business.industry, Depression, PROSPER study, Thyroid Diseases, Longitudinal design, medicine.anatomical_structure, Geriatric Depression Scale, Female, business, Subclinical dysfunction, 030217 neurology & neurosurgery, Cohort study
Abstract

Background: Subclinical hypothyroidism has been associated with depressive symptoms in cross-sectional studies, but prospective data and data on subclinical hyperthyroidism are scarce. Methods: In the Leiden substudy of the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER), thyroid-stimulating hormone and free T4 levels were measured at baseline and repeated after 6 months in adults aged 70-82 years with preexisting cardiovascular disease or known cardiovascular risk factors to define persistent thyroid functional status. Main outcome measures were depressive symptoms, assessed with the Geriatric Depression Scale 15 (GDS-15) at baseline and after 3 years. All analyses were adjusted for age, gender and education. Results: In 606 participants (41% women; mean age 75 years) without antidepressant medication, GDS-15 scores at baseline did not differ for participants with subclinical hypothyroidism (n = 47; GDS-15 score 1.75, 95% CI 1.29-2.20, p = 0.53) or subclinical hyperthyroidism (n = 13; GDS-15 score 1.64, 95% CI 0.78-2.51, p = 0.96) compared to euthyroid participants (n = 546; mean GDS-15 score 1.60, 95% CI 1.46-1.73). After 3 years, compared to the euthyroid participants, changes in GDS-15 scores did not differ for participants with subclinical hypothyroidism (ΔGDS-15 score -0.03, 95% CI -0.50 to 0.44, p = 0.83), while subclinical hyperthyroidism was associated with an increase in GDS scores (ΔGDS-15 score 1.13, 95% CI 0.32-1.93, p = 0.04). All results were similar for persistent subclinical thyroid dysfunction. Conclusions: In this largest prospective study on the association of persistent subclinical thyroid dysfunction and depression, subclinical hypothyroidism was not associated with increased depressive symptoms among older adults at high cardiovascular risk. Persistent subclinical hyperthyroidism might be associated with increased depressive symptoms, which requires confirmation in a larger prospective study.

Published
2016
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135. Gezondheidsraad. Wet op het bevolkingsonderzoek: onderzoek naar ontlastingstests in het bevolkingsonderzoek naar darmkanker

Author

van Delden, J.J.M., Gussekloo, J., Adang, E.M.M., Boere-Boonekamp, M.M., Cornel, M.C., Dondorp, W.J., Dute, J.C.J., van Gils, C.H., van Langen, I.M., Middelkoop, B.J.C., Ploem, M.C., Stiggelbout, M., Verbeek, A.L.M., van der Wilt, G.J., Clinical genetics, Public and occupational health, EMGO - Quality of care, Faculty of Religion and Theology, and EMGO+ - Quality of Care

Published
2015

136. Gezondheidsraad. Briefadvies Amendement DENSE-studie

Author

van Delden, J.J.M., Gussekloo, J., Adang, E.M.M., Boere-Boonekamp, M.M., Cornel, M.C., Dondorp, W.J., Dute, J.C.J., van Gils, C.H., van Langen, I.M., Middelkoop, B.J.C., Ploem, M.C., Stiggelbout, M., van der Wilt, G.J., Berkhout-van der Meulen, M.K., Kleefkens, M.G., Clinical genetics, Public and occupational health, and EMGO - Quality of care

Published
2015

139. Gezondheidsraad. Wet op het bevolkingsonderzoek: prevalentie van maagdarmaandoeningen onderzocht met een videocapsule

Author

Gussekloo, J., Adang, E.M.M., Boere-Boonekamp, M.M., Cornel, M.C., van Delden, J.J.M., Dondorp, W.J., Drewes, Y.M., van Gils, C.H., van Langen, I.M., Middelkoop, B.J.C., Ploem, M.C., Stiggelbout, M., van der Wilt, G.J., Clinical genetics, Public and occupational health, EMGO - Quality of care, Faculty of Religion and Theology, and EMGO+ - Quality of Care

Published
2015

142. Physician's Prescribing Preference as an Instrumental Variable: Exploring Assumptions Using Survey Data.

Author

Boef, A.G., Cessie, S. le, Dekkers, O.M., Frey, P., Kearney, P.M., Kerse, N., Mallen, C.D., McCarthy, V.J., Mooijaart, S.P., Muth, C., Rodondi, N., Rosemann, T., Russell, A., Schers, H.J., Virgini, V., Waal, M.W. de, Warner, A., Gussekloo, J., Elzen, W.P. den, Boef, A.G., Cessie, S. le, Dekkers, O.M., Frey, P., Kearney, P.M., Kerse, N., Mallen, C.D., McCarthy, V.J., Mooijaart, S.P., Muth, C., Rodondi, N., Rosemann, T., Russell, A., Schers, H.J., Virgini, V., Waal, M.W. de, Warner, A., Gussekloo, J., and Elzen, W.P. den

Abstract

Item does not contain fulltext

Published
2016

143. Cognitive function in the oldest old: women perform better than men

Author

Exel, E Van, Gussekloo, J, De Craen, A J M, Der Wiel, A Bootsma-Van, Houx, P, Knook, D L., and Westendorp, R G J

Subjects
Sex differences in education -- Research -- Psychological aspects, Aged -- Psychological aspects -- Research, Cognition in old age -- Research -- Psychological aspects, Sex differences (Psychology) -- Research -- Psychological aspects, Education -- Psychological aspects -- Netherlands, Health, Psychology and mental health, Psychological aspects, Research
Abstract

Abstract Objective--Limited formal education is associated with poor cognitive function. This could explain sex differences in cognitive function in the oldest old. Whether limited formal education explains differences in cognitive [...]

Published
2001

144. Cochrane corner: is integrated disease management for patients with COPD effective?

Author

Kruis, A.L., Smidt, N., Assendelft, W.J.J., Gussekloo, J., Boland, M.R.S., Rutten-van Molken, M., Chavannes, N.H., Health Economics (HE), and Life Course Epidemiology (LCE)

Subjects
Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18]
Abstract

Item does not contain fulltext Patients with COPD experience respiratory symptoms, impairments of daily living and recurrent exacerbations. The aim of integrated disease management (IDM) is to establish a programme of different components of care (ie, self-management, exercise, nutrition) in which several healthcare providers (ie, nurses, general practitioners, physiotherapists, pulmonologists) collaborate to provide efficient and good quality of care. The aim of this Cochrane systematic review was to evaluate the effectiveness of IDM on quality of life, exercise tolerance and exacerbation related outcomes. Searches for all available evidence were carried out in various databases. Included randomised controlled trials (RCTs) consisted of interventions with multidisciplinary (>/=2 healthcare providers) and multitreatment (>/=2 components) IDM interventions with duration of at least 3 months. Two reviewers independently searched, assessed and extracted data of all RCTs. A total of 26 RCTs were included, involving 2997 patients from 11 different countries with a follow-up varying from 3 to 24 months. In all 68% of the patients were men, with a mean age of 68 years and a mean forced expiratory volume in 1 s (FEV1) predicted value of 44.3%. Patients treated with an IDM programme improved significantly on quality of life scores and reported a clinically relevant improvement of 44 m on 6 min walking distance, compared to controls. Furthermore, the number of patients with >/=1 respiratory related hospital admission reduced from 27 to 20 per 100 patients. Duration of hospitalisation decreased significantly by nearly 4 days.

Published
2014

147. SUBCLINICAL THYROID DYSFUNCTION AND FRACTURE RISK: AN INDIVIDUAL PARTICIPANT DATA ANALYSIS OF PROSPECTIVE COHORTS

Author

Blum, M.R., Bauer, D., Costa, B.R. da, Wirth, C.D., Cappola, A.R., Peeters, R.P., Asvold, B.O., Fink, H.A., Elzen, W.P. den, Luben, R.N., Imaizumi, M., Langhammer, A., Bremner, A.P., Gogakos, A., Eastell, R., Strotmeyer, E.S., Wallace, E., Hoff, M., Khaw, K.T., Ceresini, G., Rivadeneira, F., Ferrucci, L., Uitterlinden, A., Williams, G.R., Westendorp, R.G., Walsh, J.P., Gussekloo, J., Aujesky, D., and Rodondi, N.

Published
2014

148. Subclinical Thyroid Dysfunction and Functional Capacity Among Elderly

Author

Virgini, V.S., Wijsman, L.W., Rodondi, N., Bauer, D.C., Kearney, P.M., Gussekloo, J., Elzen, W.P.J. den, Jukema, J.W., Westendorp, R.G.J., Ford, I., Stott, D.J., Mooijaart, S.P., and PROSPER Study Grp

Subjects
Male, endocrine system, medicine.medical_specialty, Activities of daily living, endocrine system diseases, Endocrinology, Diabetes and Metabolism, Thyroid Gland, Thyrotropin, 610 Medicine & health, Hyperthyroidism, law.invention, Endocrinology, Hypothyroidism, Randomized controlled trial, Risk Factors, law, Internal medicine, Activities of Daily Living, Humans, Medicine, Euthyroid, Prospective Studies, Prospective cohort study, Aged, Subclinical infection, Aged, 80 and over, business.industry, Thyroid, Original StudiesThyroid Dysfunction: Hypothyroidism, Thyrotoxicosis, and Thyroid Function Tests, Thyroid Diseases, Thyroxine, medicine.anatomical_structure, Physical therapy, Female, Thyroid function, business, Pravastatin, medicine.drug
Abstract

Background: Subclinical thyroid dysfunction is common among older people and has been associated with decreased functional capacity but with conflicting data. The aim of this study was to assess the association between subclinical thyroid dysfunction and functional capacity in an elderly population. Methods: We included 5182 participants with a mean age of 75.2 years from the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER). Self-reported functional capacity was assessed using the Barthel Index (BI) and the Instrumental Activities of Daily Living (IADL) scores at baseline and during follow-up. Participants with subclinical hyperthyroidism (n=65) and subclinical hypothyroidism (n=173) were compared to euthyroid participants (n=4944). The association between persistent subclinical thyroid dysfunction and functional capacity and decline was also investigated. Results: At baseline, compared to euthyroid participants (BI 19.73±SE 0.06; IADL 13.52±0.02), there was no difference in functional capacity for participants with subclinical hyperthyroidism (BI 19.60±0.09; IADL 13.51±0.12, p>0.05) or subclinical hypothyroidism (BI 19.82±0.06; IADL 13.55±0.08, p>0.05). Over a mean 3.2-year follow-up period, there was no association between thyroid function and annual decline of either BI or IADL (p>0.05). No association was found between persistent subclinical thyroid dysfunction and functional capacity at baseline or during follow-up (p>0.05). Results were similar after excluding participants with a maximum BI and/or IADL score at baseline. Conclusion: Among well-functioning community-dwelling elderly, we found no evidence that subclinical thyroid dysfunction contributes to decreased functional capacity.

Published
2014
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149. Cost-effectiveness of integrated COPD care: the RECODE cluster randomised trial

Author

Boland, M.R., Kruis, A.L., Tsiachristas, A., Assendelft, W.J.J., Gussekloo, J., Blom, C.M.G., Chavannes, N.H., Rutten-van Molken, M.P., Boland, M.R., Kruis, A.L., Tsiachristas, A., Assendelft, W.J.J., Gussekloo, J., Blom, C.M.G., Chavannes, N.H., and Rutten-van Molken, M.P.

Abstract

Contains fulltext : 152081.pdf (publisher's version ) (Open Access), OBJECTIVES: To investigate the cost-effectiveness of a chronic obstructive pulmonary disease (COPD) disease management (COPD-DM) programme in primary care, called RECODE, compared to usual care. DESIGN: A 2-year cluster-randomised controlled trial. SETTING: 40 general practices in the western part of the Netherlands. PARTICIPANTS: 1086 patients with COPD according to GOLD (Global Initiative for COPD) criteria. Exclusion criteria were terminal illness, cognitive impairment, alcohol or drug misuse and inability to fill in Dutch questionnaires. Practices were included if they were willing to create a multidisciplinary COPD team. INTERVENTIONS: A multidisciplinary team of caregivers was trained in motivational interviewing, setting up individual care plans, exacerbation management, implementing clinical guidelines and redesigning the care process. In addition, clinical decision-making was supported by feedback reports provided by an ICT programme. MAIN OUTCOME MEASURES: We investigated the impact on health outcomes (quality-adjusted life years (QALYs), Clinical COPD Questionnaire, St. George's Respiratory Questionnaire and exacerbations) and costs (healthcare and societal perspective). RESULTS: The intervention costs were euro324 per patient. Excluding these costs, the intervention group had euro584 (95% CI euro86 to euro1046) higher healthcare costs than did the usual care group and euro645 (95% CI euro28 to euro1190) higher costs from the societal perspective. Health outcomes were similar in both groups, except for 0.04 (95% CI -0.07 to -0.01) less QALYs in the intervention group. CONCLUSIONS: This integrated care programme for patients with COPD that mainly included professionally directed interventions was not cost-effective in primary care. TRIAL REGISTRATION NUMBER: Netherlands Trial Register NTR2268.

Published
2015

150. International variation in GP treatment strategies for subclinical hypothyroidism in older adults: a case-based survey.

Author

Elzen, W.P. den, Lefebre-van de Fliert, A.A., Virgini, V., Mooijaart, S.P., Frey, P., Kearney, P.M., Kerse, N., Mallen, C.D., McCarthy, V.J., Muth, C., Rosemann, T., Russell, A., Schers, H.J., Stott, D.J., Waal, M.W. de, Warner, A., Westendorp, R.G., Rodondi, N., Gussekloo, J., Elzen, W.P. den, Lefebre-van de Fliert, A.A., Virgini, V., Mooijaart, S.P., Frey, P., Kearney, P.M., Kerse, N., Mallen, C.D., McCarthy, V.J., Muth, C., Rosemann, T., Russell, A., Schers, H.J., Stott, D.J., Waal, M.W. de, Warner, A., Westendorp, R.G., Rodondi, N., and Gussekloo, J.

Abstract

Item does not contain fulltext

Published
2015

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