Publications by authors named "Barbara C Van Munster"

Objective: This review provides an overview of the literature on shared decision making (SDM) in patients with abdominal aortic aneurysm (AAA) or peripheral artery disease (PAD) and identifies barriers and facilitators.

Methods: A systematic scoping review was conducted in which four databases were systematically searched for the period January 2007 to November 2024. All articles were reviewed by two independent authors and asses for quality using the Mixed Methods Appraisal Tool (MMAT).

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Background: As the population is aging, multimorbidity has become an increasingly important global health challenge. Clinical practice guidelines are essential references to guide daily practice for health care providers. This systematic review aims to assess whether existing multimorbidity guidelines adhered to the principles outlined in a previously developed framework for multimorbidity management recommendations, Ariadne, and evaluate their methodological and reporting quality.

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Aim: To investigate the additional value of geriatric parameters such as physical impairment to the quick Sequential Organ Failure Assessment (qSOFA) tool for predicting clinical deterioration in older ED patients with a suspected infection and to validate the final prediction model.

Methods: Post-hoc multivariable regression analysis from a prospective observational cohort study of adult patients visiting the ED of a university hospital to develop a prediction model. External validation of the prediction model was performed using the prospective data-biobank Acutelines.

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Article Synopsis
  • The study evaluates the Glasgow Prognostic Score (GPS), which combines albumin and C-reactive protein levels, as a tool for assessing health issues and mortality in older cancer patients.
  • It finds that older patients with abnormal GPS are more likely to be frail and have higher one-year mortality rates compared to those with normal GPS.
  • The GPS also enhances the predictive accuracy for mortality risk when combined with other clinical factors, indicating its potential usefulness in cancer treatment decisions for older adults.
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Objective: To investigate whether referrals of general practitioners (GPs) to the memory clinic align with the regional and national dementia guidelines.

Design: For this single center retrospective study, data was collected from electronic patient files.

Method: GP referrals to the memory clinic over a 1-year period were categorized and evaluated according to the regional and national guidelines.

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Objectives: Timely detection and diagnosis of dementia are beneficial for providing appropriate, anticipatory care and preventing acute situations. However, initiating diagnostic testing is a complex and dynamic process that requires general practitioners (GPs) to balance competing priorities. Previously identified barriers, such as a lack of time, knowledge, and resources, may not fully represent the challenges involved in this process.

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Prognostic information is needed to balance benefits and risks of cancer treatment in older patients. Metabolomics-based scores were previously developed to predict 5- and 10-year mortality (MetaboHealth) and biological age (MetaboAge). This study aims to investigate the association of MetaboHealth and MetaboAge with 1-year mortality in older patients with solid tumors, and to study their predictive value for mortality in addition to established clinical predictors.

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Purpose: Viral mutations and improved prevention or treatment options may have changed the association of frailty with mortality throughout the COVID-19 pandemic. We investigated how associations of frailty with in-hospital mortality changed throughout the pandemic in older people hospitalised for COVID-19.

Methods: The COVID-OLD study included COVID-19 patients aged ≥ 70 years hospitalised during the first (early 2020), second (late 2020), third (late 2021) or fourth wave (early 2022).

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Background: Cognitive impairment affects nearly half of vascular surgery patients, but its association with postoperative outcomes remains poorly understood. This study explores the link between preoperative cognitive performance and postoperative complications, including postoperative delirium, in vascular surgery patients.

Methods: A prospective cohort study was conducted on vascular surgery patients aged ≥65.

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Background: To estimate whether the benefits of aortic aneurysm repair will outweigh the risks, determining individual risks is essential. This single-center prospective cohort study aimed to compare the association of functional tools with postoperative complications in older patients undergoing aortic aneurysm repair.

Methods: Ninety-eight patients (≥65 years) who underwent aortic aneurysm repair were included.

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Interdisciplinary communication and collaboration are crucial in the care of people with multiple long-term conditions (MLTCs) yet are often experienced as insufficient. Through the lens of complexity science, this study aims to explain how healthcare professionals (HCPs) adapt to emerging situations in the care of patients with MLTC by examining interdisciplinary communication and collaboration in the outpatient hospital setting. We used the constant comparative method to analyze transcribed data from seven focus groups with twenty-one HCPs to generate a constructivist grounded theory of 'interdisciplinary communication and collaboration in the outpatient setting of the hospital for patients with multiple long-term conditions'.

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Article Synopsis
  • The study evaluated the cost-effectiveness of the FindMyApps intervention for people with dementia and their caregivers, comparing it to standard digital care.
  • The research involved a randomized controlled trial with participants having mild cognitive impairment or mild dementia, measuring outcomes like quality of life and caregiver competence through various assessments and economic data.
  • Results indicated that while the FindMyApps group showed improved caregiver competence, overall costs and most other outcomes did not significantly differ from those receiving standard care.
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Kidney transplantation is the best treatment for kidney failure in older patients. However, little is known regarding changes in health-related quality of life (HRQoL) from before to after transplantation and determinants of HRQoL in older kidney transplant recipients (KTR). We studied both, using data of older (≥65 years) patients waitlisted for kidney transplantation and older KTR 1 year after transplantation from the TransplantLines Biobank and Cohort Study.

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Background: Dutch hospitals are required to screen older patients for the risk of developing functional decline using the Safety Management System (VMS) which assesses four domains associated with functional decline; fall risk, risk of delirium, malnutrition, and physical impairment.

Purpose: The aim is twofold, first to compare the VMS frailty instrument as a frailty screener with existing frailty instruments and second to provide an overview of the available evidence.

Methods: We performed a literature search to identify studies that used the VMS instrument as frailty screener to asses frailty or to predict adverse health outcomes in older hospitalized patients.

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Aim: Gain insight into the process of shared decision-making (SDM) in daily hospital care for patients with dementia from nurses' perspectives.

Design: Explorative qualitative design.

Methods: In-depth digital interviews were conducted with 14 registered nurses between June and November 2022.

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Objective: This scoping review summarises health literacy and disease knowledge in patients with abdominal aortic aneurysm (AAA) or peripheral arterial disease (PAD) and the influencing factors.

Data Sources: A systematic search was conducted in PubMed, Embase, PsychINFO, and CINAHL covering the period January 2012 to October 2022.

Review Methods: This scoping review was undertaken in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR).

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Background: Postoperative cognitive dysfunction (POCD) is a common complication in older patients with cancer and is associated with decreased quality of life and increased disability and mortality rates. Systemic inflammation resulting in neuroinflammation is considered important in the pathogenesis of POCD. The aim of this study was to explore the association between the early surgery-induced inflammatory response and POCD within 3 months after surgery in older cancer patients.

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Objectives: This study aims to determine how prevalent suspected cognitive impairment is in older people visiting hearing aid dispensers, and to assess whether hearing aid dispensers' judgment on cognition was in accordance with the outcome of a cognitive screening.

Design: This observational study was conducted between April and May 2022.

Setting And Participants: Four private hearing aid retail stores in the Netherlands, where cognitive impairment was screened in people aged ≥60 years.

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Delirium is common in hospitalised patients, and there is currently no specific treatment. Identifying and treating underlying somatic causes of delirium is the first priority once delirium is diagnosed. Several international guidelines provide clinicians with an evidence-based approach to screening, diagnosis and symptomatic treatment.

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Objective: To provide a literature overview of characteristics of Shared Decision Making (SDM) with specific importance to the older adult population with cancer and to tailor an existing model of SDM in patients with cancer to the needs of older adults.

Methods: A systematic search of several databases was conducted. Eligible studies described factors influencing SDM concerning cancer treatment with adults aged 65 years or above, with any type of cancer.

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Article Synopsis
  • Postoperative delirium (POD) is a frequent issue in elderly patients after hip fracture surgery, leading to adverse outcomes, and this study aimed to find links between biomarkers and POD development.
  • Sixty patients were observed for signs of POD after spinal anesthesia, using daily assessments to classify them into POD and non-POD groups, with blood and cerebrospinal fluid (CSF) samples collected for analysis.
  • Results showed that 35% of patients developed POD, with a notable correlation between lower levels of the cytokine CXCL9 in both serum and CSF and the incidence of POD, suggesting that these biomarkers could help create predictive models for delirium.
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Background: It is important that healthcare professionals recognise cognitive dysfunction in hospitalised older patients in order to address associated care needs, such as enhanced involvement of relatives and extra cognitive and functional support. However, studies analysing medical records suggest that healthcare professionals have low awareness of cognitive dysfunction in hospitalised older patients. In this study, we investigated the prevalence of cognitive dysfunction in hospitalised older patients, the percentage of patients in which cognitive dysfunction was recognised by healthcare professionals, and which variables were associated with recognition.

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Background: Because of perioperative splanchnic hypoperfusion, the gut wall becomes more permeable for intraluminal microbes to enter the splanchnic circulation, possibly contributing to development of complications. Hypoperfusion-related injured enterocytes release intestinal fatty acid binding protein (I-FABP) into plasma, which is used as proxy of intestinal integrity. This study investigates the occurrence of intestinal integrity loss during oncologic surgery, measured by I-FABP change.

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Article Synopsis
  • DeltaScan is a special tool that helps doctors quickly find out if a patient has delirium, which is a type of confusion that can happen when someone is very sick.
  • The study tested DeltaScan on 494 patients in different hospitals and found that it was very accurate, with a success rate of 99% in detecting brain issues.
  • The researchers want to learn more about how well DeltaScan can predict future problems related to delirium in patients.
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