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1. Cost-effectiveness of adding oseltamivir to primary care for influenza-like-illness: economic evaluation alongside the randomised controlled ALIC4E trial in 15 European countries

Author

Li, Xiao, Bilcke, Joke, van der Velden, Alike W., Bruyndonckx, Robin, Coenen, Samuel, Bongard, Emily, de Paor, Muirrean, Chlabicz, Slawomir, Godycki-Cwirko, Maciek, Francis, Nick, Aabenhus, Rune, Bucher, Heiner C., Colliers, Annelies, De Sutter, An, Garcia-Sangenis, Ana, Glinz, Dominik, Harbin, Nicolay J., Kosiek, Katarzyna, Lindbæk, Morten, Lionis, Christos, Llor, Carl, Mikó-Pauer, Réka, Radzeviciene Jurgute, Ruta, Seifert, Bohumil, Sundvall, Pär-Daniel, Touboul Lundgren, Pia, Tsakountakis, Nikolaos, Verheij, Theo J., Goossens, Herman, Butler, Christopher C., and Beutels, Philippe

Published
2023
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5. Direct and Indirect Costs of Influenza-Like Illness Treated with and Without Oseltamivir in 15 European Countries: A Descriptive Analysis Alongside the Randomised Controlled ALIC4E Trial

Author

Li, Xiao, Bilcke, Joke, van der Velden, Alike W., Bongard, Emily, Bruyndonckx, Robin, Sundvall, Pär-Daniel, Harbin, Nicolay J., Coenen, Samuel, Francis, Nick, Bruno, Pascale, Garcia-Sangenis, Ana, Glinz, Dominik, Kosiek, Katarzyna, Mikó-Pauer, Réka, Radzeviciene Jurgute, Ruta, Seifert, Bohumil, Tsakountakis, Nikolaos, Aabenhus, Rune, Butler, Christopher C., and Beutels, Philippe

Published
2021
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6. Did aetiology matter in illness duration and complications in patients presenting in primary care with acute respiratory tract infections early in the COVID-19 pandemic: An observational study in nine countries

Author

HAG Onderzoek, Infection & Immunity, Child Health, Biostatistiek Onderzoek, CTM & Statistical consultation, Other research (not in main researchprogram), HAG Infectieziekten, Ecraid, JC onderzoeksprogramma Infectieziekten, Venekamp, Roderick P, Eijkemans, Marinus J C, Zuithoff, Nicolaas P A, Böhmer, Femke, Chlabicz, Slawomir, Colliers, Annelies, García-Sangenís, Ana, Malania, Lile, Pauer, Jozsef, Tomacinschii, Angela, Verheij, Theo J, Goossens, Herman, Vellinga, Akke, Butler, Christopher C, van der Velden, Alike W, HAG Onderzoek, Infection & Immunity, Child Health, Biostatistiek Onderzoek, CTM & Statistical consultation, Other research (not in main researchprogram), HAG Infectieziekten, Ecraid, JC onderzoeksprogramma Infectieziekten, Venekamp, Roderick P, Eijkemans, Marinus J C, Zuithoff, Nicolaas P A, Böhmer, Femke, Chlabicz, Slawomir, Colliers, Annelies, García-Sangenís, Ana, Malania, Lile, Pauer, Jozsef, Tomacinschii, Angela, Verheij, Theo J, Goossens, Herman, Vellinga, Akke, Butler, Christopher C, and van der Velden, Alike W

Published
2024

7. Communication training for general practitioners aimed at improving antibiotic prescribing: a controlled before-after study in multicultural Dutch cities

Author

HAG Infectieziekten, Infection & Immunity, JC onderzoeksprogramma Infectieziekten, Lescure, Dominique L A, Erdem, Özcan, Nieboer, Daan, Huijser van Reenen, Natascha, Tjon-A-Tsien, Aimée M L, van Oorschot, Wilbert, Brouwer, Rob, Vos, Margreet C, van der Velden, Alike W, Richardus, Jan Hendrik, Voeten, Hélène A C M, HAG Infectieziekten, Infection & Immunity, JC onderzoeksprogramma Infectieziekten, Lescure, Dominique L A, Erdem, Özcan, Nieboer, Daan, Huijser van Reenen, Natascha, Tjon-A-Tsien, Aimée M L, van Oorschot, Wilbert, Brouwer, Rob, Vos, Margreet C, van der Velden, Alike W, Richardus, Jan Hendrik, and Voeten, Hélène A C M

Published
2024

8. Diagnosis-linked antibiotic prescribing quality indicators: demonstrating feasibility using practice-based routine primary care data, reliability, validity and their potential in antimicrobial stewardship

Author

Infection & Immunity, Epi Infectieziekten Team 1, HAG Infectieziekten, JC onderzoeksprogramma Infectieziekten, van den Eijnde, Sharon E J D, van der Linden, Paul D, van der Velden, Alike W, Infection & Immunity, Epi Infectieziekten Team 1, HAG Infectieziekten, JC onderzoeksprogramma Infectieziekten, van den Eijnde, Sharon E J D, van der Linden, Paul D, and van der Velden, Alike W

Published
2024

9. Communication training for general practitioners aimed at improving antibiotic prescribing:A controlled before-after study in multicultural Dutch cities

Author

Lescure, Dominique L.A., Erdem, Özcan, Nieboer, Daan, Huijser van Reenen, Natascha, Tjon-A-Tsien, Aimée M.L., van Oorschot, Wilbert, Brouwer, Rob, Vos, Margreet C., van der Velden, Alike W., Richardus, Jan Hendrik, Voeten, Hélène A.C.M., Lescure, Dominique L.A., Erdem, Özcan, Nieboer, Daan, Huijser van Reenen, Natascha, Tjon-A-Tsien, Aimée M.L., van Oorschot, Wilbert, Brouwer, Rob, Vos, Margreet C., van der Velden, Alike W., Richardus, Jan Hendrik, and Voeten, Hélène A.C.M.

Abstract

Introduction: Suboptimal doctor-patient communication drives inappropriate prescribing of antibiotics. We evaluated a communication intervention for general practitioners (GPs) in multicultural Dutch cities to improve antibiotic prescribing for respiratory tract infections (RTI). Methods: This was a non-randomized controlled before-after study. The study period was pre-intervention November 2019 – April 2020 and post-intervention November 2021 – April 2022. The intervention consisted of a live training (organized between September and November 2021), an E-learning, and patient material on antibiotics and antibiotic resistance in multiple languages. The primary outcome was the absolute number of prescribed antibiotic courses indicated for RTIs per GP; the secondary outcome was all prescribed antibiotics per GP. We compared the post-intervention differences in the mean number of prescribed antibiotics between the intervention (N = 25) and the control group (N = 110) by using an analysis of covariance (ANCOVA) test, while adjusting for the pre-intervention number of prescribed antibiotics. Additionally, intervention GPs rated the training and their knowledge and skills before the intervention and 3 months thereafter. Results: There was no statistically significant difference in the mean number of prescribed antibiotics for RTI between the intervention and the control group, nor for mean number of overall prescribed antibiotics. The intervention GPs rated the usefulness of the training for daily practice a 7.3 (on a scale from 1–10) and there was a statistically significant difference between pre- and post-intervention on four out of nine items related to knowledge and skills. Discussion: There was no change in GPs prescription behavior between the intervention and control group. However, GPs found the intervention useful and showed some improvement on self-rated knowledge and communication skills.

Published
2024

10. Communication training for general practitioners aimed at improving antibiotic prescribing: a controlled before-after study in multicultural Dutch cities

Author

Lescure, Dominique L. A., primary, Erdem, Özcan, additional, Nieboer, Daan, additional, Huijser van Reenen, Natascha, additional, Tjon-A-Tsien, Aimée M. L., additional, van Oorschot, Wilbert, additional, Brouwer, Rob, additional, Vos, Margreet C., additional, van der Velden, Alike W., additional, Richardus, Jan Hendrik, additional, and Voeten, Hélène A. C. M., additional

Published
2024
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11. Using microbiological data to improve the use of antibiotics for respiratory tract infections: A protocol for an individual patient data meta-analysis

Author

Boateng, Irene, primary, Stuart, Beth, additional, Becque, Taeko, additional, Barrett, Bruce, additional, Bostock, Jennifer, additional, Bruyndonckx, Robin, additional, Carr-Knox, Lucy, additional, Ciccone, Emily J., additional, Coenen, Samuel, additional, Ebell, Mark, additional, Gillespie, David, additional, Hayward, Gail, additional, Hedin, Katarina, additional, Hood, Kerenza, additional, Lau, Tin Man Mandy, additional, Little, Paul, additional, Merenstein, Dan, additional, Mulogo, Edgar, additional, Ordóñez-Mena, Jose, additional, Muir, Peter, additional, Samuel, Kirsty, additional, Shaikh, Nader, additional, Tonner, Sharon, additional, van der Velden, Alike W., additional, Verheij, Theo, additional, Wang, Kay, additional, Hay, Alastair D., additional, and Francis, Nick, additional

Published
2023
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12. Clinical diagnosis of SARS-CoV-2 infection: An observational study of respiratory tract infection in primary care in the early phase of the pandemic

Author

van der Velden, Alike W., primary, Shanyinde, Milensu, additional, Bongard, Emily, additional, Böhmer, Femke, additional, Chlabicz, Slawomir, additional, Colliers, Annelies, additional, García-Sangenís, Ana, additional, Malania, Lile, additional, Pauer, Jozsef, additional, Tomacinschii, Angela, additional, Yu, Ly-Mee, additional, Loens, Katherine, additional, Ieven, Margareta, additional, Verheij, Theo J., additional, Goossens, Herman, additional, Vellinga, Akke, additional, and Butler, Christopher C., additional

Published
2023
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13. Informal and Formal Learning of General Practitioners

Author

Spaan, Nadia Roos, Dekker, Anne R. J., and van der Velden, Alike W.

Abstract

Purpose: The purpose of this study is to understand the influence of formal learning from a web-based training and informal (workplace) learning afterwards on the behaviour of general practitioners (GPs) with respect to prescription of antibiotics. Design/methodology/approach: To obtain insight in various learning processes, semi-structured interviews were conducted with 19 GPs. These interviews were transcribed and analysed with a theory-based template, that had been defined beforehand, but with an open mind for emerging themes. Findings: The web-based training was perceived by GPs to change their prescription behaviour, mostly as a result of informal learning processes. Being a research participant and being a supervisor appeared to create most opportunities for informal learning. Practical implications: The current research shows that being a research participant and/or a supervisor enhance informal learning activities, for example, reflection and social interaction, and thereby formal training becomes more effective. It is recommended to remind GPs regularly to reflect on their prescribing behaviour and to stimulate them to reflect and seek social interaction besides participating in formal training. Originality/value: Our study adds to the existing literature by considering informal learning processes in an evaluation of the perceived effects of formal training. Our findings have implications for the design and evaluation of formal trainings with the purpose of behavioural change of doctors.

Published
2016
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14. Initial symptoms and three months follow-up after acute COVID-19 in outpatients: An international prospective cohort study

Author

Hedin, Katarina, van der Velden, Alike W., Hansen, Malene Plejdrup, Moberg, Anna, Balan, Anca, Bruno, Pascale, Coenen, Samuel, Johansen, Eskild, Kowalczyk, Anna, Kurotschka, Peter Konstantin, van der Linde, Sanne R., Malania, Lile, Rohde, Jorn, Verbakel, Jan, Vornhagen, Heike, Vellinga, Akke, Hedin, Katarina, van der Velden, Alike W., Hansen, Malene Plejdrup, Moberg, Anna, Balan, Anca, Bruno, Pascale, Coenen, Samuel, Johansen, Eskild, Kowalczyk, Anna, Kurotschka, Peter Konstantin, van der Linde, Sanne R., Malania, Lile, Rohde, Jorn, Verbakel, Jan, Vornhagen, Heike, and Vellinga, Akke

Abstract

Background: Most studies on long-term follow-up of patients with COVID-19 focused on hospitalised patients. No prospective study with structured follow-up has been performed in non-hospitalised patients with COVID-19. Objectives: To assess long-COVID and post-COVID (WHO definition: symptomatic at least 12 weeks), describe lingering symptoms, their impact on daily activities, and general practice visits and explore risk factors for symptom duration in outpatients. Methods: A prospective study of adult outpatients with confirmed SARS-CoV-2 infection and symptoms consistent with COVID-19 in 11 European countries, recruited during 2020 and 2021 from primary care and the community. Structured follow-up by phone interviews (symptom rating, symptom impact on daily activities and general practice visits) was performed at weeks 2, 4, 8, and 12 by study personnel. Data was analysed descriptively by using correlation matrixes and Cox regression. Results: Of 270 enrolled patients, 52% developed long-COVID and 32% post-COVID-syndrome. When only considering the presence of moderate or (very) severe symptoms at weeks 8 and 12, these percentages were 28% and 18%, respectively. Fatigue was the most often reported symptom during follow-up. The impact of lingering symptoms was most evident in sports and household activities. About half (53%) had at least one general practice contact during follow-up. Obese patients took twice as long to return to usual health (HR: 0.5, 95%CI: 0.3-0.8); no other risk profile could predict lingering symptoms. Conclusion: Long-COVID and post-COVID are also common in outpatients. In 32%, it takes more than 12 weeks to return to usual health.

Published
2023
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15. Cost-effectiveness of adding oseltamivir to primary care for influenza-like-illness:economic evaluation alongside the randomised controlled ALIC4E trial in 15 European countries

Author

Li, Xiao, Bilcke, Joke, van der Velden, Alike W., Bruyndonckx, Robin, Coenen, Samuel, Bongard, Emily, de Paor, Muirrean, Chlabicz, Slawomir, Godycki-Cwirko, Maciek, Francis, Nick, Aabenhus, Rune, Bucher, Heiner C., Colliers, Annelies, De Sutter, An, Garcia-Sangenis, Ana, Glinz, Dominik, Harbin, Nicolay J., Kosiek, Katarzyna, Lindbaek, Morten, Lionis, Christos, Llor, Carl, Miko-Pauer, Reka, Jurgute, Ruta Radzeviciene, Seifert, Bohumil, Sundvall, Par-Daniel, Lundgren, Pia Touboul, Tsakountakis, Nikolaos, Verheij, Theo J., Goossens, Herman, Butler, Christopher C., Beutels, Philippe, Li, Xiao, Bilcke, Joke, van der Velden, Alike W., Bruyndonckx, Robin, Coenen, Samuel, Bongard, Emily, de Paor, Muirrean, Chlabicz, Slawomir, Godycki-Cwirko, Maciek, Francis, Nick, Aabenhus, Rune, Bucher, Heiner C., Colliers, Annelies, De Sutter, An, Garcia-Sangenis, Ana, Glinz, Dominik, Harbin, Nicolay J., Kosiek, Katarzyna, Lindbaek, Morten, Lionis, Christos, Llor, Carl, Miko-Pauer, Reka, Jurgute, Ruta Radzeviciene, Seifert, Bohumil, Sundvall, Par-Daniel, Lundgren, Pia Touboul, Tsakountakis, Nikolaos, Verheij, Theo J., Goossens, Herman, Butler, Christopher C., and Beutels, Philippe

Abstract

Background Oseltamivir is usually not often prescribed (or reimbursed) for non-high-risk patients consulting for influenza-like-illness (ILI) in primary care in Europe. We aimed to evaluate the cost-effectiveness of adding oseltamivir to usual primary care in adults/adolescents (13 years +) and children with ILI during seasonal influenza epidemics, using data collected in an open-label, multi-season, randomised controlled trial of oseltamivir in 15 European countries. Methods Direct and indirect cost estimates were based on patient reported resource use and official country-specific unit costs. Health-Related Quality of Life was assessed by EQ-5D questionnaires. Costs and quality adjusted life-years (QALY) were bootstrapped (N = 10,000) to estimate incremental cost-effectiveness ratios (ICER), from both the healthcare payers' and the societal perspectives, with uncertainty expressed through probabilistic sensitivity analysis and expected value for perfect information (EVPI) analysis. Additionally, scenario (self-reported spending), comorbidities subgroup and country-specific analyses were performed. Results The healthcare payers' expected ICERs of oseltamivir were euro22,459 per QALY gained in adults/adolescents and euro13,001 in children. From the societal perspective, oseltamivir was cost-saving in adults/adolescents, but the ICER is euro8,344 in children. Large uncertainties were observed in subgroups with comorbidities, especially for children. The expected ICERs and extent of decision uncertainty varied between countries (EVPI ranged euro1-euro35 per patient). Conclusion Adding oseltamivir to primary usual care in Europe is likely to be cost-effective for treating adults/adolescents and children with ILI from the healthcare payers' perspective (if willingness-to-pay per QALY gained > euro22,459) and cost-saving in adults/adolescents from a societal perspective.

Published
2023

16. Disease-Specific Quality Indicators for Outpatient Antibiotic Prescribing for Respiratory Infections (ESAC Quality Indicators) Applied to Point Prevalence Audit Surveys in General Practices in 13 European Countries

Author

Vellinga, Akke, Luke-Currier, Addiena, Garzón-Orjuela, Nathaly, Aabenhus, Rune, Anastasaki, Marilena, Balan, Anca, Böhmer, Femke, Lang, Valerija Bralić, Chlabicz, Slawomir, Coenen, Samuel, García-Sangenís, Ana, Kowalczyk, Anna, Malania, Lile, Tomacinschii, Angela, van der Linde, Sanne R., Bongard, Emily, Butler, Christopher C., Goossens, Herman, van der Velden, Alike W., Vellinga, Akke, Luke-Currier, Addiena, Garzón-Orjuela, Nathaly, Aabenhus, Rune, Anastasaki, Marilena, Balan, Anca, Böhmer, Femke, Lang, Valerija Bralić, Chlabicz, Slawomir, Coenen, Samuel, García-Sangenís, Ana, Kowalczyk, Anna, Malania, Lile, Tomacinschii, Angela, van der Linde, Sanne R., Bongard, Emily, Butler, Christopher C., Goossens, Herman, and van der Velden, Alike W.

Abstract

Up to 80% of antibiotics are prescribed in the community. An assessment of prescribing by indication will help to identify areas where improvement can be made. A point prevalence audit study (PPAS) of consecutive respiratory tract infection (RTI) consultations in general practices in 13 European countries was conducted in January–February 2020 (PPAS-1) and again in 2022 (PPAS-4). The European Surveillance of Antibiotic Consumption quality indicators (ESAC-QI) were calculated to identify where improvements can be made. A total of 3618 consultations were recorded for PPAS-1 and 2655 in PPAS-4. Bacterial aetiology was suspected in 26% (PPAS-1) and 12% (PPAS-4), and an antibiotic was prescribed in 30% (PPAS-1) and 16% (PPAS-4) of consultations. The percentage of adult patients with bronchitis who receive an antibiotic should, according to the ESAC-QI, not exceed 30%, which was not met by participating practices in any country except Denmark and Spain. For patients (≥1) with acute upper RTI, less than 20% should be prescribed an antibiotic, which was achieved by general practices in most countries, except Ireland (both PPAS), Croatia (PPAS-1), and Greece (PPAS-4) where prescribing for acute or chronic sinusitis (0–20%) was also exceeded. For pneumonia in adults, prescribing is acceptable for 90–100%, and this is lower in most countries. Prescribing for tonsillitis (≥1) exceeded the ESAC-QI (0–20%) in all countries and was 69% (PPAS-1) and 75% (PPAS-4). In conclusion, ESAC-QI applied to PPAS outcomes allows us to evaluate appropriate antibiotic prescribing by indication and benchmark general practices and countries., Up to 80% of antibiotics are prescribed in the community. An assessment of prescribing by indication will help to identify areas where improvement can be made. A point prevalence audit study (PPAS) of consecutive respiratory tract infection (RTI) consultations in general practices in 13 European countries was conducted in January–February 2020 (PPAS-1) and again in 2022 (PPAS-4). The European Surveillance of Antibiotic Consumption quality indicators (ESAC-QI) were calculated to identify where improvements can be made. A total of 3618 consultations were recorded for PPAS-1 and 2655 in PPAS-4. Bacterial aetiology was suspected in 26% (PPAS-1) and 12% (PPAS-4), and an antibiotic was prescribed in 30% (PPAS-1) and 16% (PPAS-4) of consultations. The percentage of adult patients with bronchitis who receive an antibiotic should, according to the ESAC-QI, not exceed 30%, which was not met by participating practices in any country except Denmark and Spain. For patients (≥1) with acute upper RTI, less than 20% should be prescribed an antibiotic, which was achieved by general practices in most countries, except Ireland (both PPAS), Croatia (PPAS-1), and Greece (PPAS-4) where prescribing for acute or chronic sinusitis (0–20%) was also exceeded. For pneumonia in adults, prescribing is acceptable for 90–100%, and this is lower in most countries. Prescribing for tonsillitis (≥1) exceeded the ESAC-QI (0–20%) in all countries and was 69% (PPAS-1) and 75% (PPAS-4). In conclusion, ESAC-QI applied to PPAS outcomes allows us to evaluate appropriate antibiotic prescribing by indication and benchmark general practices and countries.

Published
2023

17. Using microbiological data to improve the use of antibiotics for respiratory tract infections: A protocol for an individual patient data meta-analysis

Author

HAG Infectieziekten, Infection & Immunity, JC onderzoeksprogramma Infectieziekten, Boateng, Irene, Stuart, Beth, Becque, Taeko, Barrett, Bruce, Bostock, Jennifer, Bruyndonckx, Robin, Carr-Knox, Lucy, Ciccone, Emily J, Coenen, Samuel, Ebell, Mark, Gillespie, David, Hayward, Gail, Hedin, Katarina, Hood, Kerenza, Lau, Tin Man Mandy, Little, Paul, Merenstein, Dan, Mulogo, Edgar, Ordóñez-Mena, Jose, Muir, Peter, Samuel, Kirsty, Shaikh, Nader, Tonner, Sharon, van der Velden, Alike W, Verheij, Theo, Wang, Kay, Hay, Alastair D, Francis, Nick, HAG Infectieziekten, Infection & Immunity, JC onderzoeksprogramma Infectieziekten, Boateng, Irene, Stuart, Beth, Becque, Taeko, Barrett, Bruce, Bostock, Jennifer, Bruyndonckx, Robin, Carr-Knox, Lucy, Ciccone, Emily J, Coenen, Samuel, Ebell, Mark, Gillespie, David, Hayward, Gail, Hedin, Katarina, Hood, Kerenza, Lau, Tin Man Mandy, Little, Paul, Merenstein, Dan, Mulogo, Edgar, Ordóñez-Mena, Jose, Muir, Peter, Samuel, Kirsty, Shaikh, Nader, Tonner, Sharon, van der Velden, Alike W, Verheij, Theo, Wang, Kay, Hay, Alastair D, and Francis, Nick

Published
2023

18. Clinical diagnosis of SARS-CoV-2 infection: An observational study of respiratory tract infection in primary care in the early phase of the pandemic

Author

HAG Infectieziekten, JC onderzoeksprogramma Infectieziekten, Infection & Immunity, Ecraid, van der Velden, Alike W, Shanyinde, Milensu, Bongard, Emily, Böhmer, Femke, Chlabicz, Slawomir, Colliers, Annelies, García-Sangenís, Ana, Malania, Lile, Pauer, Jozsef, Tomacinschii, Angela, Yu, Ly-Mee, Loens, Katherine, Ieven, Margareta, Verheij, Theo J, Goossens, Herman, Vellinga, Akke, Butler, Christopher C, HAG Infectieziekten, JC onderzoeksprogramma Infectieziekten, Infection & Immunity, Ecraid, van der Velden, Alike W, Shanyinde, Milensu, Bongard, Emily, Böhmer, Femke, Chlabicz, Slawomir, Colliers, Annelies, García-Sangenís, Ana, Malania, Lile, Pauer, Jozsef, Tomacinschii, Angela, Yu, Ly-Mee, Loens, Katherine, Ieven, Margareta, Verheij, Theo J, Goossens, Herman, Vellinga, Akke, and Butler, Christopher C

Published
2023

19. Disease-Specific Quality Indicators for Outpatient Antibiotic Prescribing for Respiratory Infections (ESAC Quality Indicators) Applied to Point Prevalence Audit Surveys in General Practices in 13 European Countries

Author

HAG Infectieziekten, Infection & Immunity, JC onderzoeksprogramma Infectieziekten, Vellinga, Akke, Luke-Currier, Addiena, Garzón-Orjuela, Nathaly, Aabenhus, Rune, Anastasaki, Marilena, Balan, Anca, Böhmer, Femke, Lang, Valerija Bralić, Chlabicz, Slawomir, Coenen, Samuel, García-Sangenís, Ana, Kowalczyk, Anna, Malania, Lile, Tomacinschii, Angela, van der Linde, Sanne R, Bongard, Emily, Butler, Christopher C, Goossens, Herman, van der Velden, Alike W, HAG Infectieziekten, Infection & Immunity, JC onderzoeksprogramma Infectieziekten, Vellinga, Akke, Luke-Currier, Addiena, Garzón-Orjuela, Nathaly, Aabenhus, Rune, Anastasaki, Marilena, Balan, Anca, Böhmer, Femke, Lang, Valerija Bralić, Chlabicz, Slawomir, Coenen, Samuel, García-Sangenís, Ana, Kowalczyk, Anna, Malania, Lile, Tomacinschii, Angela, van der Linde, Sanne R, Bongard, Emily, Butler, Christopher C, Goossens, Herman, and van der Velden, Alike W

Published
2023

20. Initial symptoms and three months follow-up after acute COVID-19 in outpatients: An international prospective cohort study

Author

HAG Infectieziekten, Infection & Immunity, JC onderzoeksprogramma Infectieziekten, Hedin, Katarina, van der Velden, Alike W., Hansen, Malene Plejdrup, Moberg, Anna B., Balan, Anca, Bruno, Pascale, Coenen, Samuel, Johansen, Eskild, Kowalczyk, Anna, Kurotschka, Peter Konstantin, van der Linde, Sanne R., Malania, Lile, Rohde, Jörn, Verbakel, Jan, Vornhagen, Heike, Vellinga, Akke, HAG Infectieziekten, Infection & Immunity, JC onderzoeksprogramma Infectieziekten, Hedin, Katarina, van der Velden, Alike W., Hansen, Malene Plejdrup, Moberg, Anna B., Balan, Anca, Bruno, Pascale, Coenen, Samuel, Johansen, Eskild, Kowalczyk, Anna, Kurotschka, Peter Konstantin, van der Linde, Sanne R., Malania, Lile, Rohde, Jörn, Verbakel, Jan, Vornhagen, Heike, and Vellinga, Akke

Published
2023

21. Cost-effectiveness of adding oseltamivir to primary care for influenza-like-illness: economic evaluation alongside the randomised controlled ALIC4E trial in 15 European countries.

Author

HAG Infectieziekten, Infection & Immunity, JC onderzoeksprogramma Infectieziekten, Li, Xiao, Bilcke, Joke, van der Velden, Alike W, Bruyndonckx, Robin, Coenen, Samuel, Bongard, Emily, de Paor, Muirrean, Chlabicz, Slawomir, Godycki-Cwirko, Maciek, Francis, Nick, Aabenhus, Rune, Bucher, Heiner C, Colliers, Annelies, De Sutter, An, Garcia-Sangenis, Ana, Glinz, Dominik, Harbin, Nicolay J, Kosiek, Katarzyna, Lindbæk, Morten, Lionis, Christos, Llor, Carl, Mikó-Pauer, Réka, Radzeviciene Jurgute, Ruta, Seifert, Bohumil, Sundvall, Pär-Daniel, Touboul Lundgren, Pia, Tsakountakis, Nikolaos, Verheij, Theo J, Goossens, Herman, Butler, Christopher C, Beutels, Philippe, ALIC4Etrial investigators, HAG Infectieziekten, Infection & Immunity, JC onderzoeksprogramma Infectieziekten, Li, Xiao, Bilcke, Joke, van der Velden, Alike W, Bruyndonckx, Robin, Coenen, Samuel, Bongard, Emily, de Paor, Muirrean, Chlabicz, Slawomir, Godycki-Cwirko, Maciek, Francis, Nick, Aabenhus, Rune, Bucher, Heiner C, Colliers, Annelies, De Sutter, An, Garcia-Sangenis, Ana, Glinz, Dominik, Harbin, Nicolay J, Kosiek, Katarzyna, Lindbæk, Morten, Lionis, Christos, Llor, Carl, Mikó-Pauer, Réka, Radzeviciene Jurgute, Ruta, Seifert, Bohumil, Sundvall, Pär-Daniel, Touboul Lundgren, Pia, Tsakountakis, Nikolaos, Verheij, Theo J, Goossens, Herman, Butler, Christopher C, Beutels, Philippe, and ALIC4Etrial investigators

Published
2023

22. Using microbiological data to improve the use of antibiotics for respiratory tract infections: A protocol for an individual patient data meta-analysis

Author

Boateng, Irene, Stuart, Beth, Becque, Taeko, Barrett, Bruce, Bostock, Jennifer, Bruyndonckx, Robin, Carr-Knox, Lucy, Ciccone, Emily J., Coenen, Samuel, Ebell, Mark, Gillespie, David, Hayward, Gail, Hedin, Katarina, Hood, Kerenza, Lau, Tin Man Mandy, Little, Paul, Merenstein, Dan, Mulogo, Edgar, Ordonez-Mena, Jose, Muir, Peter, Samuel, Kirsty, Shaikh, Nader, Tonner, Sharon, van der Velden, Alike W., Verheij, Theo, Wang, Kay, Hay, Alastair D., Francis, Nick, Boateng, Irene, Stuart, Beth, Becque, Taeko, Barrett, Bruce, Bostock, Jennifer, Bruyndonckx, Robin, Carr-Knox, Lucy, Ciccone, Emily J., Coenen, Samuel, Ebell, Mark, Gillespie, David, Hayward, Gail, Hedin, Katarina, Hood, Kerenza, Lau, Tin Man Mandy, Little, Paul, Merenstein, Dan, Mulogo, Edgar, Ordonez-Mena, Jose, Muir, Peter, Samuel, Kirsty, Shaikh, Nader, Tonner, Sharon, van der Velden, Alike W., Verheij, Theo, Wang, Kay, Hay, Alastair D., and Francis, Nick

Abstract

BackgroundResistance to antibiotics is rising and threatens future antibiotic effectiveness. 'Antibiotic targeting' ensures patients who may benefit from antibiotics receive them, while being safely withheld from those who may not. Point-of-care tests may assist with antibiotic targeting by allowing primary care clinicians to establish if symptomatic patients have a viral, bacterial, combined, or no infection. However, because organisms can be harmlessly carried, it is important to know if the presence of the virus/bacteria is related to the illness for which the patient is being assessed. One way to do this is to look for associations with more severe/prolonged symptoms and test results. Previous research to answer this question for acute respiratory tract infections has given conflicting results with studies has not having enough participants to provide statistical confidence.AimTo undertake a synthesis of IPD from both randomised controlled trials (RCTs) and observational cohort studies of respiratory tract infections (RTI) in order to investigate the prognostic value of microbiological data in addition to, or instead of, clinical symptoms and signs.MethodsA systematic search of Cochrane Central Register of Controlled Trials, Ovid Medline and Ovid Embase will be carried out for studies of acute respiratory infection in primary care settings. The outcomes of interest are duration of disease, severity of disease, repeated consultation with new/worsening illness and complications requiring hospitalisation. Authors of eligible studies will be contacted to provide anonymised individual participant data. The data will be harmonised and aggregated. Multilevel regression analysis will be conducted to determine key outcome measures for different potential pathogens and whether these offer any additional information on prognosis beyond clinical symptoms and signs.Trial registrationPROSPERO Registration number: CRD42023376769., Funding Agencies|National Institute for Health and Care Research (NIHR) School for Primary Care Research [589]

Published
2023
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23. Initial symptoms and three months follow-up after acute COVID-19 in outpatients: An international prospective cohort study

Author

Hedin, Katarina, primary, van der Velden, Alike W., additional, Hansen, Malene Plejdrup, additional, Moberg, Anna B., additional, Balan, Anca, additional, Bruno, Pascale, additional, Coenen, Samuel, additional, Johansen, Eskild, additional, Kowalczyk, Anna, additional, Kurotschka, Peter Konstantin, additional, van der Linde, Sanne R., additional, Malania, Lile, additional, Rohde, Jörn, additional, Verbakel, Jan, additional, Vornhagen, Heike, additional, and Vellinga, Akke, additional

Published
2023
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24. Perpetual observational studies: new strategies to support efficient implementation of observational studies and randomized trials in infectious diseases

Author

Hassoun-Kheir, Nasreen, primary, van Werkhoven, C. Henri, additional, Dunning, Jake, additional, Jaenisch, Thomas, additional, van Beek, Janko, additional, Bielicki, Julia, additional, Butler, Christopher C., additional, Francois, Bruno, additional, Harbarth, Stephan, additional, Hernandez Padilla, Ana C., additional, Horby, Peter, additional, Koopmans, Marion, additional, Lee, James, additional, Rodriguez-Baño, Jesús, additional, Tacconelli, Evelina, additional, Themistocleous, Yrene, additional, van der Velden, Alike W., additional, Bonten, Marc, additional, Goossens, Herman, additional, and de Kraker, Marlieke E.A., additional

Published
2022
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25. Cost-effectiveness of adding oseltamivir to primary care for influenza-like-illness: economic evaluation alongside the randomised controlled ALIC4E trial in 15 European countries.

Author

Li, Xiao, Bilcke, Joke, van der Velden, Alike W., Bruyndonckx, Robin, Coenen, Samuel, Bongard, Emily, de Paor, Muirrean, Chlabicz, Slawomir, Godycki-Cwirko, Maciek, Francis, Nick, Aabenhus, Rune, Bucher, Heiner C., Colliers, Annelies, De Sutter, An, Garcia-Sangenis, Ana, Glinz, Dominik, Harbin, Nicolay J., Kosiek, Katarzyna, Lindbæk, Morten, and Lionis, Christos

Subjects
RANDOMIZED controlled trials, PRIMARY care, QUALITY of life, OSELTAMIVIR, SEASONAL influenza
Abstract

Background: Oseltamivir is usually not often prescribed (or reimbursed) for non-high-risk patients consulting for influenza-like-illness (ILI) in primary care in Europe. We aimed to evaluate the cost-effectiveness of adding oseltamivir to usual primary care in adults/adolescents (13 years +) and children with ILI during seasonal influenza epidemics, using data collected in an open-label, multi-season, randomised controlled trial of oseltamivir in 15 European countries. Methods: Direct and indirect cost estimates were based on patient reported resource use and official country-specific unit costs. Health-Related Quality of Life was assessed by EQ-5D questionnaires. Costs and quality adjusted life-years (QALY) were bootstrapped (N = 10,000) to estimate incremental cost-effectiveness ratios (ICER), from both the healthcare payers' and the societal perspectives, with uncertainty expressed through probabilistic sensitivity analysis and expected value for perfect information (EVPI) analysis. Additionally, scenario (self-reported spending), comorbidities subgroup and country-specific analyses were performed. Results: The healthcare payers' expected ICERs of oseltamivir were €22,459 per QALY gained in adults/adolescents and €13,001 in children. From the societal perspective, oseltamivir was cost-saving in adults/adolescents, but the ICER is €8,344 in children. Large uncertainties were observed in subgroups with comorbidities, especially for children. The expected ICERs and extent of decision uncertainty varied between countries (EVPI ranged €1–€35 per patient). Conclusion: Adding oseltamivir to primary usual care in Europe is likely to be cost-effective for treating adults/adolescents and children with ILI from the healthcare payers' perspective (if willingness-to-pay per QALY gained > €22,459) and cost-saving in adults/adolescents from a societal perspective. [ABSTRACT FROM AUTHOR]

Published
2023
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26. Perpetual Observational Studies: New strategies to support efficient implementation of observational studies and randomized trials in the infectious diseases arena

Author

Hassoun-Kheir, Nasreen, van Werkhoven, C Henri, Dunning, Jake, Jaenisch, Thomas, van Beek, Janko, Bielicki, Julia, Butler, Christopher C, Francois, Bruno, Harbarth, Stephan, Hernandez Padilla, Ana C, Horby, Peter, Koopmans, Marion, Lee, James, Rodriguez-Baño, Jesús, Tacconelli, Evelina, Themistocleous, Yrene, van der Velden, Alike W, Bonten, Marc, Goossens, Herman, de Kraker, Marlieke E A, ECRAID-Base consortium, Virology, and Ecraid-Base Consortium

Subjects
Emerging infectious diseases, FOS: Computer and information sciences, Microbiology (medical), Study methodology, Research network, General Medicine, Antimicrobial resistance, Communicable Diseases, Perpetual observational studies, Methodology (stat.ME), Infectious Diseases, SDG 3 - Good Health and Well-being, Humans, Human medicine, Biology, Statistics - Methodology, Randomized Controlled Trials as Topic
Abstract

The increasing threat of emerging infectious diseases and antimicrobial resistance requires more efficient, high-quality research. Perpetual Observational Studies (POS) nested within a clinical research network can improve planning, quality and efficiency of interventional and observational studies, although real-life benefits and challenges need to be assessed. Ecraid (European Clinical Research Alliance on Infectious Diseases) has initiated POS and will monitor the impact for five specific infectious syndromes., 16 pages, 2 tables

Published
2022

27. Prevalencia de gripe confirmada microbiológicamente en pacientes con síntomas gripales en atención primaria y características clínico-epidemiológicas

Author

Moragas, Ana, Garcia-Sangenís, Ana, Escudero, Alex Prats, Faro, Carolina Bayona, Ibáñez, Rosario Hernández, Brotons, Carlos, Vilella, Teresa, Puig, Mireia, Casaponsa, Rosa Freixedas, Guerrero, Silvia Cobo, Pera, Helena, van der Velden, Alike W, Butler, Christopher C., and Llor, Carles

Subjects
Evaluación de síntomas, Primary Health Care, Original, Diagnóstico, Gripe, Atención primaria, Influenza, Diagnosis, Influenza, Human, Prevalence, Humans, Symptom Assessment, Human, Retrospective Studies
Abstract

RESUMEN Objetivos Evaluar la prevalencia de la infección por gripe confirmada microbiológicamente en pacientes con síntomas gripales y comparar las características clínicas y epidemiológicas de los pacientes con y sin gripe confirmada. Métodos Estudio retrospectivo de una cohorte de pacientes con síntomas gripales entre 2016 y 2018 que participaron en un ensayo clínico realizado en trece centros de atención primaria urbanos de Cataluña. Se recogieron datos epidemiológicos y los pacientes puntuaron los diferentes síntomas y signos en una escala de Likert (ausente, problema leve, problema moderado y problema intenso) así como su estado de salud autodeclarado con la escala visual analógica de EuroQol. Se tomó un hisopo nasofaríngeo para el aislamiento microbiológico de virus influenza y otros microorganismos. Resultados Se incluyeron 427 pacientes. Se confirmó gripe microbiológicamente en 240 pacientes (56,2%). El porcentaje de pacientes con sensación moderada a intensa de tos, dolores musculares, cansancio y mareos fue significativamente más alta entre los pacientes con gripe que aquellos sin infección confirmada. El estado de salud autodeclarado fue significativamente menor en el grupo de pacientes con gripe confirmada (media de 36,3 ± 18,2 vs 41,7 ± 17,8 en pacientes sin gripe; p

Published
2021

29. Point-of care testing, antibiotic prescribing, and prescribing confidence for respiratory tract infections in primary care:a prospective audit in 18 European countries

Author

van der Velden, Alike W., van de Pol, Alma C., Bongard, Emily, Cianci, Daniela, Aabenhus, Rune, Balan, Anca, Böhmer, Femke, Lang, Valerija Bralić, Bruno, Pascale, Chlabicz, Slawomir, Coenen, Samuel, Colliers, Annelies, García-Sangenís, Ana, Ghazaryan, Hrachuhi, Godycki-Ćwirko, Maciej, Jensen, Siri, Lionis, Christos, van der Linde, Sanne R., Malania, Lile, Pauer, Jozsef, Tomacinschii, Angela, Vellinga, Akke, Zastavnyy, Ihor, Emmerich, Susanne, Zerda, Adam, Verheij, Theo J., Goossens, Herman, Butler, Christopher C., van der Velden, Alike W., van de Pol, Alma C., Bongard, Emily, Cianci, Daniela, Aabenhus, Rune, Balan, Anca, Böhmer, Femke, Lang, Valerija Bralić, Bruno, Pascale, Chlabicz, Slawomir, Coenen, Samuel, Colliers, Annelies, García-Sangenís, Ana, Ghazaryan, Hrachuhi, Godycki-Ćwirko, Maciej, Jensen, Siri, Lionis, Christos, van der Linde, Sanne R., Malania, Lile, Pauer, Jozsef, Tomacinschii, Angela, Vellinga, Akke, Zastavnyy, Ihor, Emmerich, Susanne, Zerda, Adam, Verheij, Theo J., Goossens, Herman, and Butler, Christopher C.

Abstract

Background: Between-country differences have been described in antibiotic prescribing for respiratory tract infection (RTI) in primary care, but not yet for diagnostic testing procedures and prescribing confidence. Aim: To describe between-country differences in RTI management, particularly diagnostic testing and antibiotic prescribing, and investigate which factors relate to antibiotic prescribing and GPs’ prescribing confidence. Design & setting: Prospective audit in 18 European countries. Method: An audit of GP-registered patient, clinical, and management characteristics for patients presenting with sore throat and/or lower RTI (n = 4982), and GPs' confidence in their antibiotic prescribing decision. Factors related to antibiotic prescribing and confidence were analysed using multi-level logistic regression. Results: Antibiotic prescribing proportions varied considerably: <20% in four countries, and >40% in six countries. There was also considerable variation in point-of care (POC) testing (0% in Croatia, Moldova, and Romania, and >65% in Denmark and Norway, mainly for C-reactive protein [CRP] and group A streptococcal [strep A] infection), and in laboratory or hospital-based testing (<3% in Hungary, the Netherlands, and Spain, and >30% in Croatia, Georgia, Greece, and Moldova, mainly chest X-ray and white blood cell counting). Antibiotic prescribing was related to illness severity, comorbidity, age, fever, and country, but not to having performed a POC test. In nearly 90% of consultations, GPs were confident in their antibiotic prescribing decision. Conclusion: Despite high confidence in decisions about antibiotic prescribing, there is considerable variation in the primary care of RTI in European countries, with GPs prescribing antibiotics overall more often than is considered appropriate. POC testing may enhance the quality of antibiotic prescribing decisions if it can safely reverse decisions confidently made on clinical grounds alone to

Published
2022

30. Perspectives of Immigrants and Native Dutch on Antibiotic Use:A Qualitative Study

Author

Lescure, Dominique L. A., van der Velden, Alike W., van Reenen, Natascha Huijser, Richardus, Jan Hendrik, Voeten, Helene A. C. M., Lescure, Dominique L. A., van der Velden, Alike W., van Reenen, Natascha Huijser, Richardus, Jan Hendrik, and Voeten, Helene A. C. M.

Abstract

Immigrants constitute large proportions of the population in many high-income countries. Knowledge about their perceptions of antibiotics, in comparison to native populations, is limited. We explored these perceptions by organizing nine homogeneous focus group discussions (FGDs) with first-generation immigrant and native Dutch participants (N = 64) from Rotterdam and Utrecht, who were recruited with the assistance of immigrant (community support) organizations. The FGDs were audio-recorded and transcribed verbatim. Inductive thematic analyses were performed with the qualitative analysis software Atlas.ti, using open and axial coding. We did not find noteworthy differences between immigrants and native Dutch participants; all participants had an overall reluctant attitude towards antibiotics. Within-group differences were larger than between-group differences. In each FGD there were, for instance, participants who adopted an assertive stance in order to receive antibiotics, who had low antibiotic-related knowledge, or who used antibiotics incorrectly. Native Dutch participants expressed similar difficulties as immigrant participants in the communication with their GP, which mainly related to time constraints. Immigrants who encountered language barriers experienced even greater communicational difficulties and reported that they often feel embarrassed and refrain from asking questions. To stimulate more prudent use of antibiotics, more attention is needed for supportive multilingual patient materials. In addition, GPs need to adjust their information, guidance, and communication for the individual's needs, regardless of the patient's migration background.

Published
2022

31. Clinical prediction of laboratory-confirmed influenza in adults with influenza-like illness in primary care:A randomized controlled trial secondary analysis in 15 European countries

Author

Ouchi, Dan, García-Sangenís, Ana, Moragas, Ana, van der Velden, Alike W, Verheij, Theo J, Butler, Christopher C, Bongard, Emily, Coenen, Samuel, Cook, Johanna, Francis, Nick A, Godycki-Cwirko, Maciek, Lundgren, Pia Touboul, Lionis, Christos, Radzeviciene Jurgute, Ruta, Chlabicz, Sławomir, De Sutter, An, Bucher, Heiner C, Seifert, Bohumil, Kovács, Bernadett, de Paor, Muireann, Sundvall, Pär-Daniel, Aabenhus, Rune, Harbin, Nicolay Jonassen, Ieven, Greet, Goossens, Herman, Lindbæk, Morten, Bjerrum, Lars, Llor, Carl, Ouchi, Dan, García-Sangenís, Ana, Moragas, Ana, van der Velden, Alike W, Verheij, Theo J, Butler, Christopher C, Bongard, Emily, Coenen, Samuel, Cook, Johanna, Francis, Nick A, Godycki-Cwirko, Maciek, Lundgren, Pia Touboul, Lionis, Christos, Radzeviciene Jurgute, Ruta, Chlabicz, Sławomir, De Sutter, An, Bucher, Heiner C, Seifert, Bohumil, Kovács, Bernadett, de Paor, Muireann, Sundvall, Pär-Daniel, Aabenhus, Rune, Harbin, Nicolay Jonassen, Ieven, Greet, Goossens, Herman, Lindbæk, Morten, Bjerrum, Lars, and Llor, Carl

Abstract

BACKGROUND: Clinical findings do not accurately predict laboratory diagnosis of influenza. Early identification of influenza is considered useful for proper management decisions in primary care.OBJECTIVE: We evaluated the diagnostic value of the presence and the severity of symptoms for the diagnosis of laboratory-confirmed influenza infection among adults presenting with influenza-like illness (ILI) in primary care.METHODS: Secondary analysis of patients with ILI who participated in a clinical trial from 2015 to 2018 in 15 European countries. Patients rated signs and symptoms as absent, minor, moderate, or major problem. A nasopharyngeal swab was taken for microbiological identification of influenza and other microorganisms. Models were generated considering (i) the presence of individual symptoms and (ii) the severity rating of symptoms.RESULTS: A total of 2,639 patients aged 18 or older were included in the analysis. The mean age was 41.8 ± 14.7 years, and 1,099 were men (42.1%). Influenza was microbiologically confirmed in 1,337 patients (51.1%). The area under the curve (AUC) of the model for the presence of any of seven symptoms for detecting influenza was 0.66 (95% confidence interval [CI]: 0.65-0.68), whereas the AUC of the symptom severity model, which included eight variables-cough, fever, muscle aches, sweating and/or chills, moderate to severe overall disease, age, abdominal pain, and sore throat-was 0.70 (95% CI: 0.69-0.72).CONCLUSION: Clinical prediction of microbiologically confirmed influenza in adults with ILI is slightly more accurate when based on patient reported symptom severity than when based on the presence or absence of symptoms.

Published
2022

32. Perspectives of Immigrants and Native Dutch on Antibiotic Use: A Qualitative Study

Author

HAG Infectieziekten, Infection & Immunity, JC onderzoeksprogramma Infectieziekten, Lescure, Dominique L A, van der Velden, Alike W, Huijser van Reenen, Natascha, Richardus, Jan Hendrik, Voeten, Helene A C M, HAG Infectieziekten, Infection & Immunity, JC onderzoeksprogramma Infectieziekten, Lescure, Dominique L A, van der Velden, Alike W, Huijser van Reenen, Natascha, Richardus, Jan Hendrik, and Voeten, Helene A C M

Published
2022

33. The Opportunity of Point-of-Care Diagnostics in General Practice: Modelling the Effects on Antimicrobial Resistance

Author

HAG Infectieziekten, Infection & Immunity, JC onderzoeksprogramma Infectieziekten, van der Pol, Simon, Jansen, Danielle E M C, van der Velden, Alike W, Butler, Christopher C, Verheij, Theo J M, Friedrich, Alex W, Postma, Maarten J, van Asselt, Antoinette D I, HAG Infectieziekten, Infection & Immunity, JC onderzoeksprogramma Infectieziekten, van der Pol, Simon, Jansen, Danielle E M C, van der Velden, Alike W, Butler, Christopher C, Verheij, Theo J M, Friedrich, Alex W, Postma, Maarten J, and van Asselt, Antoinette D I

Published
2022

34. Impact of Adding Oseltamivir to Usual Care on Quality-Adjusted Life-Years During Influenza-Like Illness

Author

HAG Infectieziekten, Infection & Immunity, JC onderzoeksprogramma Infectieziekten, Bruyndonckx, Robin, Bilcke, Joke, van der Velden, Alike W, Li, Xiao, Hens, Niel, Coenen, Samuel, Butler, Christopher C, Beutels, Philippe, HAG Infectieziekten, Infection & Immunity, JC onderzoeksprogramma Infectieziekten, Bruyndonckx, Robin, Bilcke, Joke, van der Velden, Alike W, Li, Xiao, Hens, Niel, Coenen, Samuel, Butler, Christopher C, and Beutels, Philippe

Published
2022

35. Clinical prediction of laboratory-confirmed influenza in adults with influenza-like illness in primary care. A randomized controlled trial secondary analysis in 15 European countries

Author

HAG Infectieziekten, Infection & Immunity, JC onderzoeksprogramma Infectieziekten, Ouchi, Dan, García-Sangenís, Ana, Moragas, Ana, van der Velden, Alike W, Verheij, Theo J, Butler, Christopher C, Bongard, Emily, Coenen, Samuel, Cook, Johanna, Francis, Nick A, Godycki-Cwirko, Maciek, Lundgren, Pia Touboul, Lionis, Christos, Radzeviciene Jurgute, Ruta, Chlabicz, Sławomir, De Sutter, An, Bucher, Heiner C, Seifert, Bohumil, Kovács, Bernadett, de Paor, Muireann, Sundvall, Pär-Daniel, Aabenhus, Rune, Harbin, Nicolay Jonassen, Ieven, Greet, Goossens, Herman, Lindbæk, Morten, Bjerrum, Lars, Llor, Carl, HAG Infectieziekten, Infection & Immunity, JC onderzoeksprogramma Infectieziekten, Ouchi, Dan, García-Sangenís, Ana, Moragas, Ana, van der Velden, Alike W, Verheij, Theo J, Butler, Christopher C, Bongard, Emily, Coenen, Samuel, Cook, Johanna, Francis, Nick A, Godycki-Cwirko, Maciek, Lundgren, Pia Touboul, Lionis, Christos, Radzeviciene Jurgute, Ruta, Chlabicz, Sławomir, De Sutter, An, Bucher, Heiner C, Seifert, Bohumil, Kovács, Bernadett, de Paor, Muireann, Sundvall, Pär-Daniel, Aabenhus, Rune, Harbin, Nicolay Jonassen, Ieven, Greet, Goossens, Herman, Lindbæk, Morten, Bjerrum, Lars, and Llor, Carl

Published
2022

37. Point-of-care testing, antibiotic prescribing, and prescribing confidence for respiratory tract infections in primary care: a prospective audit in 18 European countries

Author

van der Velden, Alike W, primary, van de Pol, Alma C, additional, Bongard, Emily, additional, Cianci, Daniela, additional, Aabenhus, Rune, additional, Balan, Anca, additional, Böhmer, Femke, additional, Bralić Lang, Valerija, additional, Bruno, Pascale, additional, Chlabicz, Slawomir, additional, Coenen, Samuel, additional, Colliers, Annelies, additional, García-Sangenís, Ana, additional, Ghazaryan, Hrachuhi, additional, Godycki-Ćwirko, Maciej, additional, Jensen, Siri, additional, Lionis, Christos, additional, van der Linde, Sanne R, additional, Malania, Lile, additional, Pauer, Jozsef, additional, Tomacinschii, Angela, additional, Vellinga, Akke, additional, Zastavnyy, Ihor, additional, Emmerich, Susanne, additional, Zerda, Adam, additional, Verheij, Theo J, additional, Goossens, Herman, additional, and Butler, Christopher C, additional

Published
2021
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38. Clinical presentation, microbiological aetiology and disease course in patients with flu-like illness: a post hoc analysis of randomised controlled trial data

Author

Verheij, Theo J, primary, Cianci, Daniela, additional, van der Velden, Alike W, additional, Butler, Christopher C, additional, Bongard, Emily, additional, Coenen, Samuel, additional, Colliers, Annelies, additional, Francis, Nick A, additional, Little, Paul, additional, Godycki-Cwirko, Maciek, additional, Llor, Carl, additional, Chlabicz, Sławomir, additional, Lionis, Christos, additional, Sundvall, Pär-Daniel, additional, Bjerrum, Lars, additional, De Sutter, An, additional, Aabenhus, Rune, additional, Harbin, Nicolay Jonassen, additional, Lindbæk, Morten, additional, Glinz, Dominik, additional, Bucher, Heiner C, additional, Kovács, Bernadett, additional, Seifert, Bohumil, additional, Jurgute, Ruta Radzeviciene, additional, Lundgren, Pia Touboul, additional, de Paor, Muireann, additional, Matheeussen, Veerle, additional, Goossens, Herman, additional, and Ieven, Margareta, additional

Published
2021
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40. A Strong Decline in the Incidence of Childhood Otitis Media During the COVID-19 Pandemic in the Netherlands

Author

Hullegie, Saskia, primary, Schilder, Anne G. M., additional, Marchisio, Paola, additional, de Sévaux, Joline L. H., additional, van der Velden, Alike W., additional, van de Pol, Alma C., additional, Boeijen, Josi A., additional, Platteel, Tamara N., additional, Torretta, Sara, additional, Damoiseaux, Roger A. M. J., additional, and Venekamp, Roderick P., additional

Published
2021
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41. Clinical prediction of laboratory-confirmed influenza in adults with influenza-like illness in primary care. A randomized controlled trial secondary analysis in 15 European countries

Author

Ouchi, Dan, primary, García-Sangenís, Ana, additional, Moragas, Ana, additional, van der Velden, Alike W, additional, Verheij, Theo J, additional, Butler, Christopher C, additional, Bongard, Emily, additional, Coenen, Samuel, additional, Cook, Johanna, additional, Francis, Nick A, additional, Godycki-Cwirko, Maciek, additional, Lundgren, Pia Touboul, additional, Lionis, Christos, additional, Radzeviciene Jurgute, Ruta, additional, Chlabicz, Sławomir, additional, De Sutter, An, additional, Bucher, Heiner C, additional, Seifert, Bohumil, additional, Kovács, Bernadett, additional, de Paor, Muireann, additional, Sundvall, Pär-Daniel, additional, Aabenhus, Rune, additional, Harbin, Nicolay Jonassen, additional, Ieven, Greet, additional, Goossens, Herman, additional, Lindbæk, Morten, additional, Bjerrum, Lars, additional, and Llor, Carl, additional

Published
2021
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42. Does C-reactive protein predict time to recovery and benefit from oseltamivir treatment in primary care patients with influenza-like illness? A randomized controlled trial secondary analysis

Author

Harbin, Nicolay Jonassen, primary, Rystedt, Karin, additional, Lindbaek, Morten, additional, Radzeviciene, Ruta, additional, Westin, Johan, additional, Gunnarsson, Ronny, additional, Butler, Christopher C., additional, van der Velden, Alike W., additional, Verheij, Theo J., additional, and Sundvall, Pär-Daniel, additional

Published
2021
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44. Primary care for patients with respiratory tract infection before and early on in the COVID-19 pandemic: an observational study in 16 European countries

Author

van der Velden, Alike W, primary, Bax, Eva A, additional, Bongard, Emily, additional, Munck Aabenhus, Rune, additional, Anastasaki, Marilena, additional, Anthierens, Sibyl, additional, Balan, Anca, additional, Böhmer, Femke, additional, Bruno, Pascale, additional, Chlabicz, Slawomir, additional, Coenen, Samuel, additional, Colliers, Annelies, additional, Emmerich, Susanne, additional, Garcia-Sangenis, Ana, additional, Ghazaryan, Hrachuhi, additional, van der Linde, Sanne R, additional, Malania, Lile, additional, Pauer, József, additional, Tomacinschii, Angela, additional, Tonkin-Crine, Sarah, additional, Vellinga, Akke, additional, Zastavnyy, Ihor, additional, Verheij, Theo, additional, Goossens, Herman, additional, and Butler, Christopher C, additional

Published
2021
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45. Primary care for patients with respiratory tract infection before and early on in the COVID-19 pandemic:an observational study in 16 European countries

Author

van der Velden, Alike W., Bax, Eva A., Bongard, Emily, Aabenhus, Rune Munck, Anastasaki, Marilena, Anthierens, Sibyl, Balan, Anca, Bohmer, Femke, Bruno, Pascale, Chlabicz, Slawomir, Coenen, Samuel, Colliers, Annelies, Emmerich, Susanne, Garcia-Sangenis, Ana, Ghazaryan, Hrachuhi, van der Linde, Sanne R., Malania, Lile, Pauer, Jozsef, Tomacinschii, Angela, Tonkin-Crine, Sarah, Vellinga, Akke, Zastavnyy, Ihor, Verheij, Theo, Goossens, Herman, Butler, Christopher C., van der Velden, Alike W., Bax, Eva A., Bongard, Emily, Aabenhus, Rune Munck, Anastasaki, Marilena, Anthierens, Sibyl, Balan, Anca, Bohmer, Femke, Bruno, Pascale, Chlabicz, Slawomir, Coenen, Samuel, Colliers, Annelies, Emmerich, Susanne, Garcia-Sangenis, Ana, Ghazaryan, Hrachuhi, van der Linde, Sanne R., Malania, Lile, Pauer, Jozsef, Tomacinschii, Angela, Tonkin-Crine, Sarah, Vellinga, Akke, Zastavnyy, Ihor, Verheij, Theo, Goossens, Herman, and Butler, Christopher C.

Abstract

Objective To describe primary health care (consultation characteristics and management) for patients contacting their general practitioner (GP) with a respiratory tract infection (RTI) early on in the COVID-19 pandemic in contrasting European countries, with comparison to prepandemic findings. Setting Primary care in 16 countries (79 practices), when no routine SARS-CoV-2 testing was generally available. Design and participants Before (n=4376) and early in the pandemic (n=3301), patients with RTI symptoms were registered in this prospective audit study. Outcome measures Consultation characteristics (type of contact and use of PPE) and management characteristics (clinical assessments, diagnostic testing, prescribing, advice and referral) were registered. Differences in these characteristics between countries and between pandemic and prepandemic care are described. Results Care for patients with RTIs rapidly switched to telephone/video consultations (10% in Armenia, 91% in Denmark), and when consultations were face-to-face, GPs used PPE during 97% (95% CI 96% to 98%) of contacts. Laboratory testing for SARS-CoV-2 in primary care patients with RTIs was rapidly implemented in Denmark (59%) and Germany (31%), while overall testing for C reactive protein decreased. The proportion of patients prescribed antibiotics varied considerably between countries (3% in Belgium, 48% in UK) and was lower during the pandemic compared with the months before, except for Greece, Poland and UK. GPs provided frequent and varied COVID-related advice and more frequently scheduled a follow-up contact (50%, 95% CI 48% to 52%). GPs reported a slightly higher degree of confidence in the likely effectiveness of their management in face-to-face (73% (very) confident, 95% CI 71% to 76%) than in virtual consultations (69%, 95% CI 67% to 71%). Conclusions Despite between-country variation in consultation characteristics, access to SARS-CoV-2 laboratory testing and medication prescribing, GPs report

Published
2021

46. Direct and Indirect Costs of Influenza-Like Illness Treated with and Without Oseltamivir in 15 European Countries:A Descriptive Analysis Alongside the Randomised Controlled ALIC(4)E Trial

Author

Li, Xiao, Bilcke, Joke, van der Velden, Alike W., Bongard, Emily, Bruyndonckx, Robin, Sundvall, Par-Daniel, Harbin, Nicolay J., Coenen, Samuel, Francis, Nick, Bruno, Pascale, Garcia-Sangenis, Ana, Glinz, Dominik, Kosiek, Katarzyna, Miko-Pauer, Reka, Radzeviciene Jurgute, Ruta, Seifert, Bohumil, Tsakountakis, Nikolaos, Aabenhus, Rune, Butler, Christopher C., Beutels, Philippe, Li, Xiao, Bilcke, Joke, van der Velden, Alike W., Bongard, Emily, Bruyndonckx, Robin, Sundvall, Par-Daniel, Harbin, Nicolay J., Coenen, Samuel, Francis, Nick, Bruno, Pascale, Garcia-Sangenis, Ana, Glinz, Dominik, Kosiek, Katarzyna, Miko-Pauer, Reka, Radzeviciene Jurgute, Ruta, Seifert, Bohumil, Tsakountakis, Nikolaos, Aabenhus, Rune, Butler, Christopher C., and Beutels, Philippe

Abstract

Background and Objective Influenza-like illness (ILI) leads to a substantial disease burden every winter in Europe; however, oseltamivir is not frequently prescribed to ILI patients in the primary-care setting. An open-label, multi-country, multi-season, randomised controlled trial investigated the effectiveness of oseltamivir for treating ILI in 15 European countries. We aimed to evaluate whether patients presenting with ILI in primary care and being managed with the addition of oseltamivir to usual care had lower average direct and indirect costs compared to patients with usual care alone. Methods Resource use data were extracted from participants' daily diaries. Itemised country-specific unit costs were collected through official tariffs, pharmacies or literature. Costs were converted to 2018 values. The null hypothesis was tested based on one-sided credible intervals (CrIs) obtained by bootstrapping. Base-case analysis estimated direct cost and productivity losses using itemised costed resource use and the human capital approach. Scenario analyses with self-reported spending rather than itemised costing were also performed. Results Patients receiving oseltamivir (N = 1306) reported fewer healthcare visits, medication uses, hospital attendances and paid-work hours lost than the other patients (N = 1298). Excluding the oseltamivir cost, the average direct costs were lower in patients treated with oseltamivir from all perspectives, but these differences were not statistically significant (perspective of patient: euro17 [0-95% Crl: 16-19] vs. euro24 [5-100% Crl: 18-29]; healthcare provider: euro37 [28-67] vs. euro44 [25-55]; healthcare payers: euro54 [45-85] vs. euro68 [45-81]; and society: euro423 [399-478] vs. euro451 [390-478]). Scenario and age-group analyses confirmed these findings, but with some between-country differences. Conclusion The average direct and indirect costs were consistently lower in patients treated with oseltamivir than in patients without

Published
2021

47. Common infections and antibiotic prescribing during the first year of the covid-19 pandemic: A primary care-based observational cohort study

Author

HAG Zorginnovatieonderzoek, Huisartsopleiding, HAG Infectieziekten, Infection & Immunity, JC onderzoeksprogramma Infectieziekten, General Practice & Nursing Science, Other research (not in main researchprogram), JC Overig onderzoek, Child Health, HAG Onderzoek, Boeijen, Josi A., van der Velden, Alike W., Hullegie, Saskia, Platteel, Tamara N., Zwart, Dorien L.M., Damoiseaux, Roger A.M.J., Venekamp, Roderick P., van de Pol, Alma C., HAG Zorginnovatieonderzoek, Huisartsopleiding, HAG Infectieziekten, Infection & Immunity, JC onderzoeksprogramma Infectieziekten, General Practice & Nursing Science, Other research (not in main researchprogram), JC Overig onderzoek, Child Health, HAG Onderzoek, Boeijen, Josi A., van der Velden, Alike W., Hullegie, Saskia, Platteel, Tamara N., Zwart, Dorien L.M., Damoiseaux, Roger A.M.J., Venekamp, Roderick P., and van de Pol, Alma C.

Published
2021

48. Does C-reactive protein predict time to recovery and benefit from oseltamivir treatment in primary care patients with influenza-like illness?: A randomized controlled trial secondary analysis

Author

HAG Infectieziekten, Infection & Immunity, JC onderzoeksprogramma Infectieziekten, Harbin, Nicolay Jonassen, Rystedt, Karin, Lindbaek, Morten, Radzeviciene, Ruta, Westin, Johan, Gunnarsson, Ronny, Butler, Christopher C, van der Velden, Alike W, Verheij, Theo J, Sundvall, Pär-Daniel, HAG Infectieziekten, Infection & Immunity, JC onderzoeksprogramma Infectieziekten, Harbin, Nicolay Jonassen, Rystedt, Karin, Lindbaek, Morten, Radzeviciene, Ruta, Westin, Johan, Gunnarsson, Ronny, Butler, Christopher C, van der Velden, Alike W, Verheij, Theo J, and Sundvall, Pär-Daniel

Published
2021

49. Diagnostic performance of the IdyllaTM respiratory panel for molecular detection of influenza A/B in patients presenting to primary care with influenza-like illness during 3 consecutive influenza seasons

Author

HAG Infectieziekten, Infection & Immunity, JC onderzoeksprogramma Infectieziekten, Matheeussen, Veerle, Loens, Katherine, Kuijstermans, Mandy, Jacobs, Kevin, Coenen, Samuel, van der Velden, Alike W, Bongard, Emily, Butler, Chris C, Verheij, Theo Jm, Goossens, Herman, Ieven, Margareta, HAG Infectieziekten, Infection & Immunity, JC onderzoeksprogramma Infectieziekten, Matheeussen, Veerle, Loens, Katherine, Kuijstermans, Mandy, Jacobs, Kevin, Coenen, Samuel, van der Velden, Alike W, Bongard, Emily, Butler, Chris C, Verheij, Theo Jm, Goossens, Herman, and Ieven, Margareta

Published
2021

50. A Strong Decline in the Incidence of Childhood Otitis Media During the COVID-19 Pandemic in the Netherlands

Author

Infection & Immunity, HAG Infectieziekten, Child Health, JC onderzoeksprogramma Infectieziekten, Huisartsopleiding, HAG Onderzoek, Hullegie, Saskia, Schilder, Anne G.M., Marchisio, Paola, de Sévaux, Joline L.H., van der Velden, Alike W., van de Pol, Alma C., Boeijen, Josi A., Platteel, Tamara N., Torretta, Sara, Damoiseaux, Roger A.M.J., Venekamp, Roderick P., Infection & Immunity, HAG Infectieziekten, Child Health, JC onderzoeksprogramma Infectieziekten, Huisartsopleiding, HAG Onderzoek, Hullegie, Saskia, Schilder, Anne G.M., Marchisio, Paola, de Sévaux, Joline L.H., van der Velden, Alike W., van de Pol, Alma C., Boeijen, Josi A., Platteel, Tamara N., Torretta, Sara, Damoiseaux, Roger A.M.J., and Venekamp, Roderick P.

Published
2021

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