Early intervention with inhaled corticosteroids in subjects with rapid decline in lung function and signs of bronchial hyperresponsiveness: results from the DIMCA programme.

Background: Asthma is generally accepted as an inflammatory disease that needs steroid treatment. However, when to start with inhaled steroids remains unclear. A study was undertaken to determine when inhaled corticosteroids should be introduced as the first treatment step.

Quality of life of patients with irritable bowel syndrome is low compared to others with chronic diseases.

Background: Irritable bowel syndrome (IBS) is a prevalent functional gastrointestinal dysmotility disorder. This study aimed to estimate the burden of illness of a Dutch population of community dwelling patients suffering from IBS.

Methods: Patients identified at community pharmacies, using mebeverine as a proxy for IBS, were administered a questionnaire regarding (1) the Rome II criteria for IBS, (2) predominant type of stool during complaints, (3) severity of symptoms (abdominal pain and discomfort), (4) generic and disease-specific quality of life, (5) current health status (utilities), and (6) loss of productivity.

Differences in antihypertensive drug persistence associated with drug class and gender: a PHARMO study.

Objective: The objective of the study is to investigate factors related to treatment persistence among users of antihypertensive (AHT) drugs in daily practice.

Methods: Data for this study were obtained from the PHARMO database including pharmacy records and hospitalizations in the Netherlands (n=950,000). Patients who newly received AHT therapy (n=17,113) between 1997 and 2001 were selected.

Efficacy of inhaled steroids in undiagnosed subjects at high risk for COPD: results of the detection, intervention, and monitoring of COPD and asthma program.

Background And Aim: COPD leads to a progressive decline of pulmonary function. Family physicians treat a substantial number of patients with COPD and are encouraged to start treatment at as early a stage as is possible. This study analyzed the effectiveness of early inhaled corticosteroid treatment on the decline of pulmonary function in COPD patients.

Treatment patterns and health care costs of mebeverine-treated IBS patients: a case-control study.

Background: Irritable bowel syndrome (IBS) is a functional disorder affecting the quality of life of patients. In the Netherlands, mebeverine is currently the only medical treatment registered for IBS, although its efficacy is considered disputable.

Objective: To assess treatment patterns and associated health care cost in mebeverine users relative to matched controls.

Short- and long-term efficacy of fluticasone propionate in subjects with early signs and symptoms of chronic obstructive pulmonary disease. Results of the DIMCA study.

Background: Early treatment with inhaled corticosteroids may prevent progression of irreversible obstruction in COPD, especially in patients with bronchial hyperresponsiveness. We investigated the clinical effects of early introduction of inhaled steroids in subjects showing early signs and symptoms of COPD without a prior clinical diagnosis.

Methods: Study subjects were detected in a general population screening and monitoring program.

Randomized controlled economic evaluation of asthma self-management in primary health care.

In this randomized controlled economic evaluation we compared guided asthma self-management with usual asthma care according to guidelines for Dutch family physicians. Nineteen family practices were randomized, and 193 adults with stable asthma (98 self-management, 95 usual care) were included and monitored for 2 years. We hypothesized that introducing self-management would not compromise asthma control and cost would be equal to or lower than in usual care.