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5. Implementation and evaluation of a complex intervention to improve information availability at the interface between inpatient and outpatient care in older patients with multimorbidity and polypharmacy (HYPERION-TransCare) — study protocol for a pilot and feasibility cluster-randomized controlled trial in general practice in Germany

Author

Klein, Astrid-Alexandra, Petermann, Jenny, Brosse, Franziska, Piller, Steve, Kramer, Martin, Hanf, Maria, Dinh, Truc Sophia, Schulz-Rothe, Sylvia, Engler, Jennifer, Mergenthal, Karola, Seidling, Hanna M., Klasing, Sophia, Timmesfeld, Nina, van den Akker, Marjan, and Voigt, Karen

Published
2023
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8. Multimedikation

Author

van den Akker, Marjan, Harder, Sebastian, Dieckelmann, Mirjam, Muth, Christiane, Schröder, Helmut, editor, Thürmann, Petra, editor, Telschow, Carsten, editor, Schröder, Melanie, editor, and Busse, Reinhard, editor

Published
2022
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11. Control in the Hospital by Extensive Clinical rules for Unplanned hospitalizations in older Patients (CHECkUP); study design of a multicentre randomized study

Author

Linkens, Aimée E. M. J. H., Milosevic, Vanja, van Nie, Noémi, Zwietering, Anne, de Leeuw, Peter W., van den Akker, Marjan, Schols, Jos M. G. A., Evers, Silvia M. A. A., Gonzalvo, Carlota Mestres, Winkens, Bjorn, van de Loo, Bob P. A., de Wolf, Louis, Peeters, Lucretia, de Ree, Monique, Spaetgens, Bart, Hurkens, Kim P. G. M., and van der Kuy, Hugo M.

Published
2022
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13. Epidemiology of multimorbidity in Nepal: A systematic review and meta-analysis.

Author

Sinha, Abhinav, Suman, S. Shradha, Subedi, Narayan, Sahoo, Krushna Chandra, Poudel, Mukesh, Chauhan, Arohi, Sahoo, Banamber, van den Akker, Marjan, Weller, David, Mercer, Stewart W, and Pati, Sanghamitra

Subjects
RISK assessment, MEDICAL information storage & retrieval systems, MIDDLE-income countries, CINAHL database, RESIDENTIAL patterns, META-analysis, DISEASE prevalence, DESCRIPTIVE statistics, SYSTEMATIC reviews, MEDLINE, AGING, METROPOLITAN areas, ONLINE information services, CONFIDENCE intervals, LITERACY, COMORBIDITY, LOW-income countries, DISEASE risk factors
Abstract

Background: Multimorbidity is rising in low-and middle-income countries such as Nepal, yet the research has not gained pace in this field. We aimed to systematically review the existing multimorbidity literature in Nepal and estimate the prevalence and map its risk factors and consequences. Methods: We reviewed data collated from PubMed, Embase and CINAHL by including original studies that reported prevalence of multimorbidity in Nepal. The quality of included studies was assessed using the Appraisal Tool for Cross-sectional Studies. The summary of the review is presented both qualitatively as well as through meta-analysis to give pooled prevalence. We prospectively registered in PROSPERO (CRD42024499598). Results: We identified 423 studies out of which seven were included in this review. All studies were conducted in a community setting except one which was hospital based. The prevalence reported across various studies ranged from 13.96% to 70.1%. The pooled prevalence of multimorbidity was observed to be 25.05% (95% CI: 16.99 to 34.09). The number of conditions used to assess multimorbidity ranged from four to nine. The major risk factors identified were increasing age, urban residence, and lower literacy rates. Conclusion: A wide variance in the prevalence of multimorbidity was observed. Moreover, multimorbidity assessment tool/conditions considered for assessing multimorbidity were heterogeneous. [ABSTRACT FROM AUTHOR]

Published
2024
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14. Psychosocial Well-Being of Older Spouses During End-of-Life Caregiving for Their Partners With Cancer: A Phenomenological Study

Author

Peters, Sanne, Van Hout, Elien, Jansen, Leontien, and van den Akker, Marjan

Subjects
Aged -- Social aspects -- Health aspects -- Beliefs, opinions and attitudes, Cancer patients -- Care and treatment -- Social aspects, Married people -- Social aspects -- Health aspects -- Beliefs, opinions and attitudes, Terminal care -- Social aspects -- Psychological aspects, Caregivers -- Social aspects -- Health aspects -- Beliefs, opinions and attitudes, Health, Seniors
Abstract

Specific burdens of older spousal caregivers often remain invisible, and spousal caregivers rarely receive the support they need to perform their role. To provide suitable support for spousal caregivers, it is crucial to develop a comprehensive understanding of their well-being, particularly during end-of-life caregiving. The aim of the current study was to gain more insight into the psychosocial well-being of older spouses engaged in end-of-life caregiving for their partners with cancer. This qualitative study uses a phenomenological approach with in-depth interviews conducted with older (aged ≥65 years) spousal caregivers of individuals who died of cancer. Eleven spouses participated in the study. Strains on psychosocial well-being during end-of-life caregiving fell into four major themes: The Disease Itself, The Caregiving Process, The Partner Relationship, and Support From Others. Results suggest that older spousal caregivers are experiencing issues that might be more pronounced due to their older age, for example, physical and emotional exhaustion and loneliness. Providing care is time-consuming and often leads to a reduced social network, which enhances loneliness. Moreover, as relationships with ailing partners changed and communication deteriorated, participants reported feeling more like a caregiver rather than a partner. [Journal of Gerontological Nursing, 48(6), 33–39.], Approximately 68% of cancer deaths occur among individuals aged >65 years and cancer is the second leading cause of death in this age group (Francis et al., 2016). Among older [...]

Published
2022
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16. Implementation of a virtual community of practice to promote the empowerment of middle-aged people with multimorbidity: study protocol of a randomised controlled trial

Author

Campillejo, Alba, primary, Gefaell-Larrondo, Ileana, additional, Ramos-García, Vanesa, additional, Koatz, Débora, additional, Santos-Álvarez, Anthea, additional, Barrio-Cortes, Jaime, additional, Gómez-Rueda, Sara, additional, Calderón-Larrañaga, Amaia, additional, Cifuentes, Patricia, additional, Company-Sancho, Consuelo, additional, Domínguez-Coello, Santiago, additional, García-García, Francisco Javier, additional, Garrido-Elustondo, Sofía, additional, González de León, Beatriz, additional, Ramón-Vazquez, José, additional, Martín, Candelaria, additional, Suárez-Fernández, Carmen, additional, Parra-Caballero, Pedro, additional, Vicente-Rabaneda, Esther F, additional, Quiroga-Colina, Patricia, additional, Ramírez-Puerta, Ana Belén, additional, Ruíz-López, Marta, additional, Tello-Bernabé, María-Eugenia, additional, Sanchez-Gamborino, Estrella, additional, Ugalde-Abiega, Beatriz, additional, Vall-Roqué, Helena, additional, Duarte-Díaz, Andrea, additional, Abt-Sacks, Analía, additional, Hernández-Yumar, Aránzazu, additional, Torres-Castaño, Alezandra, additional, Álvarez-Pérez, Yolanda, additional, Muth, Christiane, additional, van den Akker, Marjan, additional, Montori, Victor M, additional, Orrego, Carola, additional, Perestelo-Pérez, Lilisbeth, additional, and González-González, Ana Isabel, additional

Published
2024
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17. Digital medication management in polypharmacy

Author

Brünn, Robin, primary, Basten, Jale, additional, Lemke, Dorothea, additional, Piotrowski, Alexandra, additional, Söling, Sara, additional, Surmann, Bastian, additional, Greiner, Wolfgang, additional, Grandt, Daniel, additional, Kellermann-Mühlhoff, Petra, additional, Harder, Sebastian, additional, Glasziou, Paul, additional, Perera, Rafael, additional, Köberlein-Neu, Juliane, additional, Ihle, Peter, additional, van den Akker, Marjan, additional, Timmesfeld, Nina, additional, and Muth, Christiane, additional

Published
2024
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19. Predicting negative health outcomes in older general practice patients with chronic illness: Rationale and development of the PROPERmed harmonized individual participant data database

Author

González-González, Ana I., Dinh, Truc S., Meid, Andreas D., Blom, Jeanet W., van den Akker, Marjan, Elders, Petra J.M., Thiem, Ulrich, Kuellenberg de Gaudry, Daniela, Snell, Kym I.E., Perera, Rafael, Swart, Karin M.A., Rudolf, Henrik, Bosch-Lenders, Donna, Trampisch, Hans-Joachim, Meerpohl, Joerg J., Flaig, Benno, Kom, Ghainsom, Gerlach, Ferdinand M., Hafaeli, Walter E., Glasziou, Paul P., and Muth, Christiane

Published
2021
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20. A prognostic model predicted deterioration in health-related quality of life in older patients with multimorbidity and polypharmacy

Author

González-González, Ana I., Meid, Andreas D., Dinh, Truc S., Blom, Jeanet W., van den Akker, Marjan, Elders, Petra J.M., Thiem, Ulrich, De Gaudry, Daniela Küllenberg, Swart, Karin M.A., Rudolf, Henrik, Bosch-Lenders, Donna, Trampisch, Hans-Joachim, Meerpohl, Joerg J., Gerlach, Ferdinand M., Flaig, Benno, Kom, Ghainsom, Snell, Kym I.E., Perera, Rafael, Haefeli, Walter E., Glasziou, Paul P., and Muth, Christiane

Published
2021
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23. Effect of modelling choices in the unit commitment problem

Author

Wuijts, Rogier, van den Akker, Marjan, van den Broek, Machteld, Wuijts, Rogier, van den Akker, Marjan, and van den Broek, Machteld

Abstract

In power system studies the unit commitment problem (UC) is solved to support market decisions and assess system adequacy. Simplifications are made to solve the UC faster, but they are made without considering the consequences on solution quality. In this study we thoroughly investigated the impacts of simplifications on solution quality and computation time on a benchmark set consisting of almost all the available instances in the literature. We found that omitting the minimum up- and downtime and simplifying the startup cost resulted in a significant quality loss without reducing the computation time. Omitting reserve requirements, ramping limits and transmission limits reduced the computation time, but degraded the solution significantly. However, the linear relaxation resulted in less quality loss with a significant speed-up and resulted in no difference when unserved energy was minimized. Finally, we found that the average and maximum capacity factor difference is large for all model variants.

Published
2024

24. The Power of Scheduling: the Scheduling of Power

Author

Sub Algorithms and Complexity, Algorithms and Complexity, Bodlaender, Hans, van den Akker, Marjan, Brouwer, Roelof Jacob Jan, Sub Algorithms and Complexity, Algorithms and Complexity, Bodlaender, Hans, van den Akker, Marjan, and Brouwer, Roelof Jacob Jan

Published
2024

25. Effect of modelling choices in the unit commitment problem

Author

Energy System Analysis, Sub Algorithmic Data Analysis, Algorithmic Data Analysis, Wuijts, Rogier, van den Akker, Marjan, van den Broek, Machteld, Energy System Analysis, Sub Algorithmic Data Analysis, Algorithmic Data Analysis, Wuijts, Rogier, van den Akker, Marjan, and van den Broek, Machteld

Published
2024

32. Informational continuity of medication management in transitions of care: Qualitative interviews with stakeholders from the HYPERION-TransCare study.

Author

Dinh, Truc Sophia, Hanf, Maria, Klein, Astrid-Alexandra, Brueckle, Maria-Sophie, Rietschel, Lisa, Petermann, Jenny, Brosse, Franziska, Schulz-Rothe, Sylvia, Klasing, Sophia, Muth, Christiane, Seidling, Hanna, Engler, Jennifer, Mergenthal, Karola, Voigt, Karen, and van den Akker, Marjan

Subjects
MEDICATION therapy management, CAREGIVERS, MEDICAL personnel, OUTPATIENT medical care, INPATIENT care, OLDER patients, FRAIL elderly
Abstract

Background: The transition of patients between inpatient and outpatient care can lead to adverse events and medication-related problems due to medication and communication errors, such as medication discontinuation, the frequency of (re-)hospitalizations, and increased morbidity and mortality. Older patients with multimorbidity and polypharmacy are particularly at high risk during transitions of care. Previous research highlighted the need for interventions to improve transitions of care in order to support information continuity, coordination, and communication. The HYPERION-TransCare project aims to improve the continuity of medication management for older patients during transitions of care. Methods and findings: Using a qualitative design, 32 expert interviews were conducted to explore the perspectives of key stakeholders, which included healthcare professionals, patients and one informal caregiver, on transitions of care. Interviews were conducted between October 2020 and January 2021, transcribed verbatim and analyzed using content analysis. We narratively summarized four main topics (stakeholders' tasks, challenges, ideas for solutions and best practice examples, and patient-related factors) and mapped them in a patient journey map. Lacking or incomplete information on patients' medication and health conditions, inappropriate communication and collaboration between healthcare providers within and across settings, and insufficient digital support limit the continuity of medication management. Conclusions: The study confirms that medication management during transitions of care is a complex process that can be compromised by a variety of factors. Legal requirements and standardized processes are urgently needed to ensure adequate exchange of information and organization of medication management before, during and after hospital admissions. Despite the numerous barriers identified, the findings indicate that involved healthcare professionals from both the inpatient and outpatient care settings have a common understanding. [ABSTRACT FROM AUTHOR]

Published
2024
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33. Impact of individual, household, and area characteristics on health and social care outcomes for people with multimorbidity: Protocol for a multilevel analysis

Author

MacRae, Clare, primary, Mercer, Stewart W., additional, Lawson, Andrew, additional, Marshall, Alan, additional, Pearce, Jamie, additional, Abubakar, Eleojo, additional, Zheng, Chunyu, additional, van den Akker, Marjan, additional, Williams, Thomas, additional, Swann, Olivia, additional, Pollock, Louisa, additional, Rawlings, Anna, additional, Fry, Rich, additional, Lyons, Ronan A., additional, Lyons, Jane, additional, Mizen, Amy, additional, Dibben, Chris, additional, and Guthrie, Bruce, additional

Published
2023
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40. Robust Recoverable Path Using Backup Nodes

Author

van den Akker, Marjan, Bodlaender, Hans L., van Dijk, Thomas C., Hoogeveen, Han, van Ommeren, Erik, Hutchison, David, Series editor, Kanade, Takeo, Series editor, Kittler, Josef, Series editor, Kleinberg, Jon M., Series editor, Mattern, Friedemann, Series editor, Mitchell, John C., Series editor, Naor, Moni, Series editor, Pandu Rangan, C., Series editor, Steffen, Bernhard, Series editor, Terzopoulos, Demetri, Series editor, Tygar, Doug, Series editor, Weikum, Gerhard, Series editor, Freivalds, Rūsiņš Mārtiņš, editor, Engels, Gregor, editor, and Catania, Barbara, editor

Published
2016
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41. Performing Multicut on Walkable Environments : Obtaining a Minimally Connected Multi-layered Environment from a Walkable Environment

Author

Hillebrand, Arne, van den Akker, Marjan, Geraerts, Roland, Hoogeveen, Han, Hutchison, David, Series editor, Kanade, Takeo, Series editor, Kittler, Josef, Series editor, Kleinberg, Jon M., Series editor, Mattern, Friedemann, Series editor, Mitchell, John C., Series editor, Naor, Moni, Series editor, Pandu Rangan, C., Series editor, Steffen, Bernhard, Series editor, Terzopoulos, Demetri, Series editor, Tygar, Doug, Series editor, Weikum, Gerhard, Series editor, Chan, T-H. Hubert, editor, Li, Minming, editor, and Wang, Lusheng, editor

Published
2016
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49. Scheduling Electric Buses with Stochastic Driving Times

Author

de Bruin, Philip, van den Akker, Marjan, Hoogeveen, Han, van Kooten Niekerk, Marcel, de Bruin, Philip, van den Akker, Marjan, Hoogeveen, Han, and van Kooten Niekerk, Marcel

Abstract

To try to make the world more sustainable and reduce air pollution, diesel buses are being replaced with electric buses. This leads to challenges in scheduling, as electric buses need recharging during the day. Moreover, buses encounter varying traffic conditions and passenger demands, leading to delays. Scheduling electric buses with these stochastic driving times is also called the Stochastic Vehicle Scheduling Problem. The classical approach to make a schedule more robust against these delays, is to add slack to the driving time. However, this approach doesn't capture the variance of a distribution well, and it doesn't account for dependencies between trips. We use discrete event simulation in order to evaluate the robustness of a schedule. Then, to create a schedule, we use a hybrid approach, where we combine integer linear programming and simulated annealing with the use of these simulations. We show that with the use of our hybrid algorithm, the punctuality of the buses increase, and they also have a more timely arrival. However, we also see a slight increase in operating cost, as we need slightly more buses compared to when we use deterministic driving times.

Published
2023

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