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4. A Sustained-Release Butyrate Tablet Suppresses Ex Vivo T Helper Cell Activation of Osteoarthritis Patients in a Double-Blind Placebo-Controlled Randomized Trial

Author

Korsten, Sandra G.P.J., Hartog, Merel, Berends, Alinda J., Koenders, Marije I., Popa, Calin D., Vromans, Herman, Garssen, Johan, van de Ende, Cornelia H.M., Vermeiden, Jan P.W., Willemsen, Linette E.M., Korsten, Sandra G.P.J., Hartog, Merel, Berends, Alinda J., Koenders, Marije I., Popa, Calin D., Vromans, Herman, Garssen, Johan, van de Ende, Cornelia H.M., Vermeiden, Jan P.W., and Willemsen, Linette E.M.

Published
2024

5. Quality of reporting and nature of harms in clinical trials on supervised exercise in patients with rheumatoid arthritis or axial spondyloarthritis

Author

Teuwen, Max M H, Vliet Vlieland, Thea P.M., van Weely, Salima F.E., Schoones, Jan W., Rausch, Anne-Kathrin, Juhl, Carsten B., Niedermann Schneider, Karin, Gademan, Maaike G.J., van den Ende, Cornelia H.M., Teuwen, Max M H, Vliet Vlieland, Thea P.M., van Weely, Salima F.E., Schoones, Jan W., Rausch, Anne-Kathrin, Juhl, Carsten B., Niedermann Schneider, Karin, Gademan, Maaike G.J., and van den Ende, Cornelia H.M.

Abstract

To describe the quality of reporting and the nature of reported harms in clinical studies on the effectiveness of supervised exercises in patients with rheumatoid arthritis (RA) or axial spondyloarthritis (axSpA). We performed a systematic review, searching eight databases up to February 2023. Randomized controlled trials (RCTs) evaluating supervised exercises in adults with RA or axSpA were considered eligible. Data on harms were extracted according to the CONSORT Harms 2022 Checklist. Among others, it was recorded if harms were prespecified or non-prespecified. Moreover, the nature of reported harms was listed. Forty RCTs were included for RA and 25 for axSpA, of which 29 (73%) and 13 (52%) reported information on harms. In 13 (33%) RCTs in RA and four (16%) in axSpA, the collection of harms outcomes was described in the methods section. Prespecified outcomes were reported by eight (RA) and two (axSpA) RCTs. Non-specified harms outcomes were reported by six (RA) and four (axSpA) RCTs. Prespecified harms outcomes included measures of pain, disease activity, inflammation, and structural joint changes. The nature of non-prespecified harms outcomes varied largely, with pain being most common. A considerable proportion of trials on supervised exercise in RA or axSpA does not or inadequately report harms outcomes. Pain was the most commonly reported prespecified or non-specified harm. For a considerate interpretation of the balance between benefits and harms of supervised exercise in RA or axSpA, use of the CONSORT Harms 2022 Checklist for the design, conduct and reporting of trials is advocated.

Published
2024

6. Delivery of a quality improvement program in team-based rehabilitation for patients with rheumatic and musculoskeletal diseases: a mixed methods study.

Author

Sand-Svartrud, Anne-Lene, Berdal, Gunnhild, Aanerud, Gerd Jenny, Azimi, Maryam, Bjørnerud, Anne Merete, Nygaard Dager, Turid, Van den Ende, Cornelia H.M., Johansen, Inger, Lindtvedt Valaas, Helene, Dagfinrud, Hanne, and Kjeken, Ingvild

Subjects
CLINICAL medicine, HUMAN services programs, MEDICAL quality control, INTERPROFESSIONAL relations, SELF-management (Psychology), RESEARCH funding, MUSCULOSKELETAL system diseases, MEDICAL care, KEY performance indicators (Management), QUESTIONNAIRES, SEX distribution, EVALUATION of human services programs, HUMAN research subjects, GOAL (Psychology), DESCRIPTIVE statistics, REHABILITATION centers, ATTITUDES of medical personnel, RESEARCH methodology, INFORMED consent (Medical law), QUALITY assurance, DATA analysis software, RHEUMATISM, PROFESSIONAL competence
Abstract

To investigate how a quality improvement program (BRIDGE), designed to promote coordination and continuity in rehabilitation services, was delivered and perceived by providers in routine practice for patients with rheumatic and musculoskeletal diseases. A convergent mixed methods approach was nested within a stepped-wedge, randomized controlled trial. The intervention program was developed to bridge gaps between secondary and primary healthcare, comprising the following elements: motivational interviewing; patient-specific goal setting; written rehabilitation-plans; personalized feedback on progress; and tailored follow-up. Data from health professionals who delivered the program were collected and analyzed separately, using two questionnaires and three focus groups. Results were integrated during the overall interpretation and discussion. The program delivery depended on the providers' skills and competence, as well as on contextual factors in their teams and institutions. Suggested possibilities for improvements included follow-up with sufficient support from next of kin and external services, and the practicing of action and coping plans, standardized outcome measures, and feedback on progress. Leaders and clinicians should discuss efforts to ensure confident and qualified rehabilitation delivery at the levels of individual providers, teams, and institutions, and pay equal attention to each component in the process from admission to follow-up. Quality in rehabilitation should be characterized by a continuous and coordinated process from goal setting to follow-up. To improve the quality, sufficient involvement of next of kin and external services is needed. Clinicians may need training to build confidence in motivational interviewing, action- and coping planning, feedback on progress, and follow-up. Leaders should organize education sessions, optimize schedules, insert standardized outcome measures, and facilitate collaboration across levels of care and services. [ABSTRACT FROM AUTHOR]

Published
2024
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8. Association of Low-Dose Colchicine With Incidence of Knee and Hip Replacements

Author

Heijman, Michelle W.J., primary, Fiolet, Aernoud T.L., additional, Mosterd, Arend, additional, Tijssen, Jan G.P., additional, van den Bemt, Bart J.F., additional, Schut, Astrid, additional, Eikelboom, John W., additional, Thompson, Peter L., additional, van den Ende, Cornelia H.M., additional, Nidorf, Stefan M., additional, Popa, Calin D., additional, and Cornel, Jan H., additional

Published
2023
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9. Delivery of a quality improvement program in team-based rehabilitation for patients with rheumatic and musculoskeletal diseases: a mixed methods study

Author

Sand-Svartrud, Anne-Lene, primary, Berdal, Gunnhild, additional, Aanerud, Gerd Jenny, additional, Azimi, Maryam, additional, Bjørnerud, Anne Merete, additional, Nygaard Dager, Turid, additional, Van den Ende, Cornelia H.M., additional, Johansen, Inger, additional, Lindtvedt Valaas, Helene, additional, Dagfinrud, Hanne, additional, and Kjeken, Ingvild, additional

Published
2023
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16. I-CONTENT tool for assessing therapeutic quality of exercise programs employed in randomised clinical trials

Author

Hoogeboom, Thomas J., Kousemaker, Martijn C., Van Meeteren, Nico L.U., Howe, Tracey, Bo, Kari, Tugwell, Peter, Ferreira, Manuela, De Bie, Rob A., Van Den Ende, Cornelia H.M., Stevens-Lapsley, Jennifer E., Hoogeboom, Thomas J., Kousemaker, Martijn C., Van Meeteren, Nico L.U., Howe, Tracey, Bo, Kari, Tugwell, Peter, Ferreira, Manuela, De Bie, Rob A., Van Den Ende, Cornelia H.M., and Stevens-Lapsley, Jennifer E.

Abstract

Objective When appraising the quality of randomised clinical trial (RCTs) on the merits of exercise therapy, we typically limit our assessment to the quality of the methods. However, heterogeneity across studies can also be caused by differences in the quality of the exercise interventions (ie, € the potential effectiveness of a specific intervention given the potential target group of patients') -a challenging concept to assess. We propose an internationally developed, consensus-based tool that aims to assess the quality of exercise therapy programmes studied in RCTs: the international Consensus on Therapeutic Exercise aNd Training (i-CONTENT) tool. Methods Forty-nine experts (from 12 different countries) in the field of physical and exercise therapy participated in a four-stage Delphi approach to develop the i-CONTENT tool: (1) item generation (Delphi round 1), (2) item selection (Delphi rounds 2 and 3), (3) item specification (focus group discussion) and (4) tool development and refinement (working group discussion and piloting). Results Out of the 61 items generated in the first Delphi round, consensus was reached on 17 items, resulting in seven final items that form the i-CONTENT tool: (1) patient selection; (2) qualified supervisor; (3) type and timing of outcome assessment; (4) dosage parameters (frequency, intensity, time); (5) type of exercise; (6) safety of the exercise programme and (7) adherence to the exercise programme. Conclusion The i-CONTENT-tool is a step towards transparent assessment of the quality of exercise therapy programmes studied in RCTs, and ultimately, towards the development of future, higher quality, exercise interventions.

Published
2021

22. Position Statement on Exercise Dosage in Rheumatic and Musculoskeletal Diseases: The Fole of the IMPACT-RMD Toolkit

Author

Metsios, George S., primary, Brodin, Nina, primary, Vlieland, Thea P.M. Vliet, primary, Van den Ende, Cornelia H.M., primary, Stavropoulos-Kalinoglou, Antonios, primary, Fatouros, Ioannis, primary, van der Esch, Martin, primary, Tzika, Katerina, primary, Moe, Rikke Helene, primary, van Zanten, Jet J.C.S. Veldhuijzen, primary, Koutedakis, Yiannis, primary, Swinnen, Thijs Willem, primary, Veskoukis, Aristidis S., primary, Boström, Carina, primary, Kennedy, Norelee, primary, Nikiphorou, Elena, primary, Fragoulis, George E., primary, Niedermann, Karin, primary, and Kitas, George D., primary

Published
2021
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27. Room for improvement in non-pharmacological systemic sclerosis care?-a cross-sectional online survey of 650 patients

Author

MS Reumatologie/Immunologie/Infectie, Infection & Immunity, Stöcker, Juliane K., Vonk, Madelon C., Van Den Hoogen, Frank H.J., Nijhuis-Van Der Sanden, Maria W.G., Spierings, Julia, Staal, J. Bart, Satink, Ton, Van Den Ende, Cornelia H.M., MS Reumatologie/Immunologie/Infectie, Infection & Immunity, Stöcker, Juliane K., Vonk, Madelon C., Van Den Hoogen, Frank H.J., Nijhuis-Van Der Sanden, Maria W.G., Spierings, Julia, Staal, J. Bart, Satink, Ton, and Van Den Ende, Cornelia H.M.

Published
2020

30. Comparison of high and low intensity training in well controlled rheumatoid arthritis. Results of a randomised clinical trial

Author

Ende, Cornelia H.M. van den, Hazes, Johanna M.W., le Cessie, Saskia, Mulder, Wim J., Belfor, Diane G., Breedveld, Ferdinand C., and Dijkmans, Ben A.C.

Subjects
Rheumatoid arthritis -- Care and treatment, Arthritics, Exercise therapy -- Usage, Health
Abstract

Higher impact, organized, and varied exercise programs seem to provide short-term improvement in joint and overall physical fitness among stable patients with rheumatoid arthritis. One hundred patients with rheumatoid arthritis participated in one of four 12-week exercise programs. The programs consisted of either higher or lower impact group exercise, personalized lower impact exercise, or self-directed exercise. Participants in the higher impact group exercise program showed a greater improvement in joint mobility and physical fitness scores than the other three groups. This variation diminished 12 weeks later.

Published
1996

31. Association between healthcare practitioners' beliefs about statins and patients' beliefs and adherence.

Author

Huiskes, Victor J.B., Ende, Cornelia H.M., Dijk, Liset, Burger, David M., and Bemt, Bartholomeus J.F.

Subjects
*STATINS (Cardiovascular agents), *PATIENT compliance, *PHARMACY technicians, *SPECIALTY pharmacies, *REGRESSION analysis, *MEDICAL care
Abstract

Aims: Adherence to statins ranges from 32% to 79%. Patients' beliefs about medication are associated with adherence. There is lack of insight into the possible association between beliefs of healthcare practitioners (HCPs) about statins and patients' beliefs and adherence. This study aims to examine whether HCPs' beliefs about statins are associated with patients' beliefs and adherence about/to statins. Methods: Cross‐sectional study in 48 pharmacies and affiliated physicians' practices between 3 September 2014 and 20 March 2015. HCPs' (prescribers and pharmacy staff) and patients' beliefs about statins were assessed with the Beliefs about Medicine Questionnaire (BMQ) specific. Adherence to statins was assessed with the MARS‐5 questionnaire. Multilevel regression analysis was performed to assess the association between HCPs' beliefs and patients' beliefs and adherence. Results: 1504 patients (mean age 66.8 [s.d. ± 9.9] years, 46.5% female) and 734 HCPs (209 physicians, 118 pharmacists and 366 pharmacy technicians) participated in this study. Patients have higher BMQ necessity (16.9 [s.d. ± 4.3]) and BMQ concern (12.3 [s.d. ± 3.9]) scores than HCPs (15.0 [s.d. ± 3.0] and 11.5 [s.d. ± 2.9], P < 0.001). No associations were found between any of the HCPs' BMQ and patients' BMQ scores and adherence to statins. Patients' BMQ necessity, concern and necessity‐concerns (NC)‐differential scores were associated with patients' adherence (MARS‐5) scores. B (95% CI) coefficients were 0.057 (0.035‐0.079), −0.040 (−0.064 to –0.016) and.061 (0.043‐0.079). Conclusions: Patients have stronger beliefs about medication compared to HCPs. No associations were found between HCPs' BMQ scores on the one hand and patients' BMQ scores and adherence to statins on the other hand. [ABSTRACT FROM AUTHOR]

Published
2021
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33. Factors Associated With Referral to Secondary Care in Patients With Osteoarthritis of the Hip or Knee After Implementation of a Stepped-Care Strategy

Author

Barten, Di Janne J.A., Smink, Agnes, Swinkels, Ilse C.S., Veenhof, Cindy, Schers, Henk J., Vliet Vlieland, Thea, de Bakker, Dinny H., Dekker, Joost, van den Ende, Cornelia H.M., AII - Inflammatory diseases, APH - Mental Health, APH - Health Behaviors & Chronic Diseases, Rehabilitation medicine, and APH - Aging & Later Life

Subjects
Journal Article, Observational Study
Abstract

Objective: We introduced a stepped-care strategy (SCS) for hip and knee osteoarthritis, focusing on delivery of high-quality stepped care. In this study, we aimed to identify factors associated with various steps of the SCS. Methods: We used data from a 2-year observational prospective cohort study, including 313 patients visiting their general practitioner (GP) with a new episode of hip/knee osteoarthritis. We used logistic multilevel analyses to identify factors at the level of the patient, the GP, and the general practice, related to treatment limited to primary care, referral to nonsurgical secondary care, or surgical procedures. Results: Patients whose treatment had been limited to primary care tended to function physically better (odds ratio [OR] 1.03). Furthermore, they less often received exercise therapy (OR 0.46), intraarticular injections (OR 0.08), and radiologic assessments (OR 0.06). Continuation of nonsurgical care after referral was more likely in employed patients (OR 2.90) and patients who had no exercise therapy (OR 0.19) or nonsteroidal antiinflammatory drugs (OR 0.35). Surgically treated patients more often received exercise therapy (OR 7.42). Referral and surgical treatment depended only to a limited extent on the GP or the general practice. Conclusion: After implementation of the SCS in primary care, the performance of exercise therapy, rather than disease severity or psychologic factors, seems to play a key role in the decision whether or not to refer for surgical or nonsurgical treatment in secondary care. To optimize patient-tailored treatment, future research should be adressed to determine the optimal moment of switching from primary to secondary care in patients with hip/knee osteoarthritis.

Published
2017
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35. Educational needs of health professionals working in rheumatology in Europe

Author

Vliet Vlieland, Theodora P M, primary, van den Ende, Cornelia H.M, additional, Alliot-Launois, Francoise, additional, Beauvais, Catherine, additional, Gobbo, Milena, additional, Iagnocco, Annamaria, additional, Lundberg, Ingrid E, additional, Munuera-Martínez, Pedro V, additional, Opava, Christina H, additional, Prior, Yeliz, additional, Redmond, Anthony, additional, Smucrova, Hana, additional, and Wiek, Dieter, additional

Published
2016
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39. Patient Acceptable Symptom State in Knee Osteoarthritis Patients Succeeds Across Different Patient-reported Outcome Measures Assessing Physical Function, But Fails Across Other Dimensions and Rheumatic Diseases

Author

Mahler, Elien A.M., Boers, Nadine, Bijlsma, Johannes W.J., van den Hoogen, Frank H.J., den Broeder, Alfons A., and van den Ende, Cornelia H.M.

Abstract

Objective.The aims of this study are (1) to establish the Patient Acceptable Symptom State (PASS) cutoff values of different patient-reported outcome measures (PROM) assessing physical function in patients with knee osteoarthritis (OA), and (2) to assess the influence of sex, age, duration of symptoms, and presence of depressive feelings on being in PASS.Methods.Patients fulfilling the clinical American College of Rheumatology knee OA criteria received standardized nonsurgical treatment and completed different questionnaires at baseline and 3 months assessing physical function: Knee Injury and Osteoarthritis Outcome Score, Lequesne Algofunctional Index, Lower Extremity Functional Scale, numerical rating scale, and the physical function subscale of the Western Ontario and McMaster Universities Osteoarthritis Index. PASS values were defined as the 75th percentile of the score of questionnaires for those patients who consider their state acceptable.Results.Of the 161 included patients, 62% were women with a mean age of 59 years (SD 9) and body mass index of 30 kg/m2(SD 5). Standardized PASS values (95% CI) for different questionnaires for physical function varied between 48 (44–54) and 54 (50–56). Female patients and patients feeling depressed were found to have a lower probability to be in PASS for physical function, with OR (95% CI) varying from 0.45 (0.23–0.91) to 0.50 (0.26–0.97) and from 0.27 (0.14–0.55) to 0.38 (0.19–0.77), respectively.Conclusion.PASS cutoff values for physical function are robust across different PROM in patients with knee OA. Our results indicate that PASS values are not consistent across dimensions and rheumatic diseases, and that the use of a generic PASS value for patients with OA or even patients with other rheumatic diseases might not be justifiable.

Published
2018
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40. Comparison of high and low intensity training in well controlled rheumatoid arthritis. Results...

Author

van den Ende, Cornelia H.M. and Hazes, Johanna M.W.

Subjects
RHEUMATOID arthritis, EXERCISE therapy
Abstract

Investigates the benefit of intensive dynamic exercises in comparison to range of motion (ROM) and isometric exercises in rheumatoid arthritis. Effect of aerobic activity on muscle strength and joint mobility; Effect of discontinuation of activity on muscle strength and joint mobility; Mechanics of exercise programs.

Published
1996
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