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2. RELEASE-HF study:a protocol for an observational, registry-based study on the effectiveness of telemedicine in heart failure in the Netherlands

Author

van Eijk, Jorna, Luijken, Kim, Jaarsma, Tiny, Reitsma, Johannes B., Schuit, Ewoud, Frederix, Geert W.J., Derks, Lineke, Schaap, Jeroen, Rutten, Frans H., Brugts, Jasper, de Boer, Rudolf A., Asselbergs, Folkert W., Trappenburg, Jaap C.A., van Eijk, Jorna, Luijken, Kim, Jaarsma, Tiny, Reitsma, Johannes B., Schuit, Ewoud, Frederix, Geert W.J., Derks, Lineke, Schaap, Jeroen, Rutten, Frans H., Brugts, Jasper, de Boer, Rudolf A., Asselbergs, Folkert W., and Trappenburg, Jaap C.A.

Abstract

Introduction:Meta-analyses show postive effects of telemedicine in heart failure (HF) management on hospitalisation, mortality and costs. However, these effects are heterogeneous due to variation in the included HF population, the telemedicine components and the quality of the comparator usual care. Still, telemedicine is gaining acceptance in HF management. The current nationwide study aims to identify (1) in which subgroup(s) of patients with HF telemedicine is (cost-)effective and (2) which components of telemedicine are most (cost-) effective. Methods and analysis:The RELEASE-HF ('REsponsible roLl-out of E-heAlth through Systematic Evaluation -Heart Failure') study is a multicentre, observational, registry-based cohort study that plans to enrol 6480 patients with HF using data from the HF registry facilitated by the Netherlands Heart Registration. Collected data include patient characteristics, treatment information and clinical outcomes, and are measured at HF diagnosis and at 6 and 12 months afterwards. The components of telemedicine are described at the hospital level based on closed-ended interviews with clinicians and at the patient level based on additional data extracted from electronic health records and telemedicine-generated data. The costs of telemedicine are calculated using registration data and interviews with clinicians and finance department staff. To overcome missing data, additional national databases will be linked to the HF registry if feasible. Heterogeneity of the effects of offering telemedicine compared with not offering on days alive without unplanned hospitalisations in 1 year is assessed across predefined patient characteristics using exploratory stratified analyses. The effects of telemedicine components are assessed by fitting separate models for component contrasts. Ethics and dissemination:The study has been approved by the Medical Ethics Committee 2021 of the University Me

Published
2024

7. What Are Effective Program Characteristics of Self-Management Interventions in Patients With Heart Failure? An Individual Patient Data Meta-analysis

Author

Jonkman, Nini H., Westland, Heleen, Groenwold, Rolf H.H., Ågren, Susanna, Anguita, Manuel, Blue, Lynda, Bruggink-André de la Porte, Pieta W.F., DeWalt, Darren A., Hebert, Paul L., Heisler, Michele, Jaarsma, Tiny, Kempen, Gertrudis I.J.M., Leventhal, Marcia E., Lok, Dirk J.A., Mårtensson, Jan, Muñiz, Javier, Otsu, Haruka, Peters-Klimm, Frank, Rich, Michael W., Riegel, Barbara, Strömberg, Anna, Tsuyuki, Ross T., Trappenburg, Jaap C.A., Schuurmans, Marieke J., and Hoes, Arno W.

Published
2016
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10. Fidelity of primary care nurses' delivery of a behavioural change intervention enhancing physical activity in patients at risk of cardiovascular disease: An observational study

Author

Research UMC Utrecht, Verplegingswetenschap, Brain, Circulatory Health, JC onderzoeksprogramma Methodologie, Professionalisering in de Zorg, Westland, Heleen, Trappenburg, Jaap C.A., Schuurmans, Marieke J., Zonneveld, Michelle H., Schröder, Carin D., Research UMC Utrecht, Verplegingswetenschap, Brain, Circulatory Health, JC onderzoeksprogramma Methodologie, Professionalisering in de Zorg, Westland, Heleen, Trappenburg, Jaap C.A., Schuurmans, Marieke J., Zonneveld, Michelle H., and Schröder, Carin D.

Published
2021

11. How can we build and maintain the resilience of our health care professionals during COVID-19?: Recommendations based on a scoping review

Author

Verplegingswetenschap, Epi Methoden Team 4, JC onderzoeksprogramma Methodologie, Infection & Immunity, Brain, Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Rieckert, Anja, Schuit, Ewoud, Bleijenberg, Nienke, Ten Cate, Debbie, De Lange, Wendela, De Man-Van Ginkel, Janneke M., Mathijssen, Elke, Smit, Linda C., Stalpers, Dewi, Schoonhoven, Lisette, Veldhuizen, Jessica D., Trappenburg, Jaap C.A., Verplegingswetenschap, Epi Methoden Team 4, JC onderzoeksprogramma Methodologie, Infection & Immunity, Brain, Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Rieckert, Anja, Schuit, Ewoud, Bleijenberg, Nienke, Ten Cate, Debbie, De Lange, Wendela, De Man-Van Ginkel, Janneke M., Mathijssen, Elke, Smit, Linda C., Stalpers, Dewi, Schoonhoven, Lisette, Veldhuizen, Jessica D., and Trappenburg, Jaap C.A.

Published
2021

12. SAFE@HOME: Digital health platform facilitating a new care path for women at increased risk of preeclampsia – A case-control study

Author

MS Verloskunde, Child Health, Circulatory Health, Verplegingswetenschap, JC onderzoeksprogramma Methodologie, Brain, van den Heuvel, Josephus F.M., Lely, A. Titia, Huisman, Jolijn J., Trappenburg, Jaap C.A., Franx, Arie, Bekker, Mireille N., MS Verloskunde, Child Health, Circulatory Health, Verplegingswetenschap, JC onderzoeksprogramma Methodologie, Brain, van den Heuvel, Josephus F.M., Lely, A. Titia, Huisman, Jolijn J., Trappenburg, Jaap C.A., Franx, Arie, and Bekker, Mireille N.

Published
2020

13. Status of theory use in self-care research

Author

Verplegingswetenschap, Circulatory Health, Brain, JC onderzoeksprogramma Methodologie, Jaarsma, Tiny, Westland, Heleen, Vellone, Ercole, Freedland, Kenneth E., Schröder, Carin, Trappenburg, Jaap C.A., Strömberg, Anna, Riegel, Barbara, Verplegingswetenschap, Circulatory Health, Brain, JC onderzoeksprogramma Methodologie, Jaarsma, Tiny, Westland, Heleen, Vellone, Ercole, Freedland, Kenneth E., Schröder, Carin, Trappenburg, Jaap C.A., Strömberg, Anna, and Riegel, Barbara

Published
2020

14. Effect of inspiratory muscle training before cardiac surgery in routine care

Author

Valkenet, Karin, de Heer, Frederiek, Backx, Frank J.G., Trappenburg, Jaap C.A., Hulzebos, Erik H.J., Kwant, Simone, van Herwerden, Lex A., and van de Port, Ingrid G.L.

Subjects
Heart -- Surgery, Therapeutics, Physiological -- Research, Physical therapy -- Research, Health
Abstract

Background. Inspiratory muscle training (IMT) before cardiac surgery has proved to be a promising intervention to reduce postoperative pneumonia in a randomized controlled trial setting. Effects of IMT in routine care have not been reported. Objective. The purpose of this study was to investigate the effect of IMT before cardiac surgery on postoperative pneumonia in routine care at a Dutch university medical center using propensity scoring. Design. This was an observational cohort study. Methods. All candidates for cardiac surgery were preoperatively stratified by a physical therapist for low risk or high risk for postoperative pulmonary complications. Patients at high risk either engaged in an unsupervised IMT program (20 minutes a day) at home for at least 2 weeks before surgery (group 1) or received usual care (no IMT) (group 2). Results in terms of outcome measures were adjusted with propensity scores to reduce bias caused by nonrandom treatment assignment. Results. The results showed that of the 94 patients at high risk in group 1, I patient (1.1%) developed a postoperative pneumonia. In group 2, 8 out of the 252 patients at high risk (3.2%) developed this pulmonary complication (adjusted odds ratio= 0.34, 95% confidence interval=0.04-3.38). No significant differences were found regarding median (25th-75th percentile) ventilation time (7 [5-9] hours versus 7 [5-10] hours), length of stay in the intensive care unit (23 [21-24] hours versus 23 [21-25] hours), or total postoperative length of stay (7 [6-11] days versus 7 [5-9] days). Limitations. The most important limitations of this study were confounding, incomplete data collection, and a low incidence of the primary outcome. Conclusions. Propensity scoring is believed to be a valuable tool of great potential interest to researchers in the field of observational studies. Whether IMT in routine care resulted in less postoperative pneumonia cannot be concluded., Cardiac surgery may be followed by pulmonary complications due to the disruption of normal ventilation. (1) Postoperative infection is the main noncardiac complication after cardiac surgery. (2) Patients undergoing cardiac [...]

Published
2013
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15. Characteristics of self-care interventions for patients with a chronic condition: A scoping review

Author

Riegel, Barbara, primary, Westland, Heleen, additional, Iovino, Paolo, additional, Barelds, Ingrid, additional, Bruins Slot, Joyce, additional, Stawnychy, Michael A., additional, Osokpo, Onome, additional, Tarbi, Elise, additional, Trappenburg, Jaap C.A., additional, Vellone, Ercole, additional, Strömberg, Anna, additional, and Jaarsma, Tiny, additional

Published
2020
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16. Nurses' perceptions towards the delivery and feasibility of a behaviour change intervention to enhance physical activity in patients at risk for cardiovascular disease in primary care: a qualitative study

Author

Westland, Heleen, Koop, Y., Schroder, Carin D., Schuurmans, Marieke J., Slabbers, P., Trappenburg, Jaap C.A., Vervoort, Sigrid C.J.M., Westland, Heleen, Koop, Y., Schroder, Carin D., Schuurmans, Marieke J., Slabbers, P., Trappenburg, Jaap C.A., and Vervoort, Sigrid C.J.M.

Abstract

Contains fulltext : 199500.pdf (publisher's version ) (Open Access)

Published
2018

17. Nurses' perceptions towards the delivery and feasibility of a behaviour change intervention to enhance physical activity in patients at risk for cardiovascular disease in primary care: A qualitative study

Author

UMC Utrecht, Verplegingswetenschap, Brain, RF&S Team 1 Medisch, GSLS PhD Course Center, Professionalisering in de Zorg, Circulatory Health, JC onderzoeksprogramma Methodologie, Cancer Center, Verpleegkundig Specialisten, Westland, Heleen, Koop, Yvonne, Schröder, Carin D., Schuurmans, Marieke J., Slabbers, P., Trappenburg, Jaap C.A., Vervoort, Sigrid C.J.M., UMC Utrecht, Verplegingswetenschap, Brain, RF&S Team 1 Medisch, GSLS PhD Course Center, Professionalisering in de Zorg, Circulatory Health, JC onderzoeksprogramma Methodologie, Cancer Center, Verpleegkundig Specialisten, Westland, Heleen, Koop, Yvonne, Schröder, Carin D., Schuurmans, Marieke J., Slabbers, P., Trappenburg, Jaap C.A., and Vervoort, Sigrid C.J.M.

Published
2018

18. Unravelling effectiveness of a nurse-led behaviour change intervention to enhance physical activity in patients at risk for cardiovascular disease in primary care

Author

Westland, Heleen, Bos-Touwen, Irene D., Trappenburg, Jaap C.A., Schröder, Carin D., Wit,de, Niek J., and Schuurmans, Marieke

Subjects
hart- en vaatziekten, activiteit, sense organs, gedragsverandering, zelfzorg
Abstract

Background: Self-management interventions are considered effective in patients with chronic disease, but trials have shown inconsistent results, and it is unknown which patients benefit most. Adequate self-management requires behaviour change in both patients and health care providers. Therefore, the Activate intervention was developed with a focus on behaviour change in both patients and nurses. The intervention aims for change in a single self-management behaviour, namely physical activity, in primary care patients at risk for cardiovascular disease. The aim of this study is to evaluate the effectiveness of the Activate intervention. Methods/design: A two-arm cluster randomised controlled trial will be conducted to compare the Activate intervention with care as usual at 31 general practices in the Netherlands. Approximately 279 patients at risk for cardiovascular disease will participate. The Activate intervention is developed using the Behaviour Change Wheel and consists of 4 nurse-led consultations in a 3-month period, integrating 17 behaviour change techniques. The Behaviour Change Wheel was also applied to analyse what behaviour change is needed in nurses to deliver the intervention adequately. This resulted in 1-day training and coaching sessions (including 21 behaviour change techniques). The primary outcome is physical activity, measured as the number of minutes of moderate to vigorous physical activity using an accelerometer. Potential effect modifiers are age, body mass index, level of education, social support, depression, patient-provider relationship and baseline number of minutes of physical activity. Data will be collected at baseline and at 3 months and 6 months of follow-up. A process evaluation will be conducted to evaluate the training of nurses, treatment fidelity, and to identify barriers to and facilitators of implementation as well as to assess participants’ satisfaction. Discussion: To increase physical activity in patients and to support nurses in delivering the intervention, behaviour change techniques are applied to change behaviours of the patients and nurses. Evaluation of the effectiveness of the intervention, exploration of which patients benefit most, and evaluation of our theory-based training for primary care nurses will enhance understanding of what works and for whom, which is essential for further implementation of self-management in clinical practice.

Published
2017

20. Self-management behaviors to reduce exacerbation impact in COPD patients: a Delphi study

Author

UMC Utrecht, Verplegingswetenschap, Healthcare Innovation & Evaluation, Circulatory Health, JC onderzoeksprogramma Methodologie, Korpershoek, Yvonne J.G., Bruins Slot, Joyce C., Effing-Tijdhof, Tanja W, Schuurmans, Marieke J., Trappenburg, Jaap C.A., UMC Utrecht, Verplegingswetenschap, Healthcare Innovation & Evaluation, Circulatory Health, JC onderzoeksprogramma Methodologie, Korpershoek, Yvonne J.G., Bruins Slot, Joyce C., Effing-Tijdhof, Tanja W, Schuurmans, Marieke J., and Trappenburg, Jaap C.A.

Published
2017

21. Patient and disease characteristics associated with activation for self-management in patients with diabetes, chronic obstructive pulmonary disease, chronic heart failure and chronic renal disease

Author

Bos-Touwen, Irene D., Schuurmans, Marieke, Monninkhof, Evelyn M., Korpershoek, Yvonne, Spruit-Bentvelzen, Lotte, Ertugrul-van der Graaf, Inge, Wit,de, Niek, and Trappenburg, Jaap C.A.

Subjects
chronisch zieken, zelfmanagement
Abstract

A substantial proportion of chronic disease patients do not respond to self-management interventions, which suggests that one size interventions do not fit all, demanding more tailored interventions. To compose more individualized strategies, we aim to increase our understanding of characteristics associated with patient activation for self-management and to evaluate whether these are disease-transcending. A cross-sectional survey study was conducted in primary and secondary care in patients with type-2 Diabetes Mellitus (DM-II), Chronic Obstructive Pulmonary Disease (COPD), Chronic Heart Failure (CHF) and Chronic Renal Disease (CRD). Using multiple linear regression analysis, we analyzed associations between self-management activation (13-item Patient Activation Measure; PAM-13) and a wide range of socio-demographic, clinical, and psychosocial determinants. Furthermore, we assessed whether the associations between the determinants and the PAM were disease-transcending by testing whether disease was an effect modifier. In addition, we identified determinants associated with low activation for self-management using logistic regression analysis. We included 1154 patients (53% response rate); 422 DM-II patients, 290 COPD patients, 223 HF patients and 219 CRD patients. Mean age was 69.6±10.9. Multiple linear regression analysis revealed 9 explanatory determinants of activation for selfmanagement: age, BMI, educational level, financial distress, physical health status, depression, illness perception, social support and underlying disease, explaining a variance of 16.3%. All associations, except for social support, were disease transcending. This study explored factors associated with varying levels of activation for self-management. These results are a first step in supporting clinicians and researchers to identify subpopulations of chronic disease patients less likely to be engaged in self-management. Increased scientific efforts are needed to explain the greater part of the factors that contribute to the complex nature of patient activation for self-management.

Published
2015

22. Feasibility of Exercise Training in Cancer Patients Scheduled for Elective Gastrointestinal Surgery

Author

Valkenet, Karin, Trappenburg, Jaap C.A., Schippers, Carlo C., Wanders, Lisa, Lemmens, Lidwien, Backx, Frank J.G., van Hillegersberg, Richard, Valkenet, Karin, Trappenburg, Jaap C.A., Schippers, Carlo C., Wanders, Lisa, Lemmens, Lidwien, Backx, Frank J.G., and van Hillegersberg, Richard

Abstract

Background/Aims: This study examines the feasibility of a preoperative exercise program to improve the physical fitness of a patient before gastrointestinal surgery. Methods: An outpatient exercise program was developed to increase preoperative aerobic capacity, peripheral muscle endurance and respiratory scheduled within 2 weeks. Results: The 115 participants followed on average 5.7 (3.5) training sessions. Adherence to the exercise program was high: 82% of muscle function in patients with pancreatic, liver, intestinal, gastric or esophageal cancer. During a consult at the outpatient clinic, patients were invited to participate in the exercise program when their surgery was not the planned training sessions were attended, and no adverse events occurred. Mixed model analyses showed a significant increase of maximal inspiratory muscle strength (84.1-104.7 cm H2O; p = 0.00) and inspiratory muscle endurance (35.0-39.5 cm H2O; p = 0.00). No significant changes were found in aerobic capacity and peripheral muscle strength. Conclusion: This exercise program in patients awaiting oncological surgery is feasible in terms of participation and adherence. Inspiratory muscle function improved significantly as a result of inspiratory muscle training. The exercise program however failed to result in improved aerobic capacity and peripheral muscle strength, probably due to the limited number of training sessions as a result of the restricted time interval between screening and surgery.

Published
2016

23. Characteristics of effective self-management interventions in patients with COPD: individual patient data meta-analysis

Author

Jonkman, Nini H., primary, Westland, Heleen, additional, Trappenburg, Jaap C.A., additional, Groenwold, Rolf H.H., additional, Bischoff, Erik W.M.A., additional, Bourbeau, Jean, additional, Bucknall, Christine E., additional, Coultas, David, additional, Effing, Tanja W., additional, Epton, Michael, additional, Gallefoss, Frode, additional, Garcia-Aymerich, Judith, additional, Lloyd, Suzanne M., additional, Monninkhof, Evelyn M., additional, Nguyen, Huong Q., additional, van der Palen, Job, additional, Rice, Kathryn L., additional, Sedeno, Maria, additional, Taylor, Stephanie J.C., additional, Troosters, Thierry, additional, Zwar, Nicholas A., additional, Hoes, Arno W., additional, and Schuurmans, Marieke J., additional

Published
2016
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24. Do Self-Management Interventions Work in Patients With Heart Failure?

Author

Jonkman, Nini H., primary, Westland, Heleen, additional, Groenwold, Rolf H.H., additional, Ågren, Susanna, additional, Atienza, Felipe, additional, Blue, Lynda, additional, Bruggink-André de la Porte, Pieta W.F., additional, DeWalt, Darren A., additional, Hebert, Paul L., additional, Heisler, Michele, additional, Jaarsma, Tiny, additional, Kempen, Gertrudis I.J.M., additional, Leventhal, Marcia E., additional, Lok, Dirk J.A., additional, Mårtensson, Jan, additional, Muñiz, Javier, additional, Otsu, Haruka, additional, Peters-Klimm, Frank, additional, Rich, Michael W., additional, Riegel, Barbara, additional, Strömberg, Anna, additional, Tsuyuki, Ross T., additional, van Veldhuisen, Dirk J., additional, Trappenburg, Jaap C.A., additional, Schuurmans, Marieke J., additional, and Hoes, Arno W., additional

Published
2016
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