Routine primary care data for scientific research, quality of care programs and educational purposes: the Julius General Practitioners' Network (JGPN).

Background: General Practitioners (GPs) in the Netherlands routinely register all patient contacts electronically. These records include longitudinally gathered clinical information of the patient contacts in coded data and free text.

Methods: Diagnoses are coded according to the International Coding of Primary Care (ICPC).

Economic Consequences and Potentially Preventable Costs Related to Osteoporosis in the Netherlands.

Background: Osteoporosis often does not involve symptoms, and so the actual number of patients with osteoporosis is higher than the number of diagnosed individuals. This underdiagnosis results in a treatment gap.

Objectives: To estimate the total health care resource use and costs related to osteoporosis in the Netherlands, explicitly including fractures, and to estimate the proportion of fracture costs that are linked to the treatment gap and might therefore be potentially preventable; to also formulate, on the basis of these findings, strategies to optimize osteoporosis care and treatment and reduce its related costs.

Local Geographical Distribution of Acute Involuntary Psychiatric Admissions in Subdistricts In and Around Utrecht, the Netherlands.

Background: Acute involuntary psychiatric admissions (AIPA) tend to be applied more often in urban areas.

Objective: The current study aims to describe AIPA prevalence differences between the subdistricts in an urban area, and to identify which district characteristics are associated with a higher AIPA district density.

Methods: Information was collected on consecutive AIPAs over a 64-month period (2005-2010) in 49 subdistricts in and around the city of Utrecht, the Netherlands, including 1098 AIPAs.

Frequent Use of Antibiotics Is Associated with Colorectal Cancer Risk: Results of a Nested Case-Control Study.

Background: Microbiotical dysbiosis induced by a Western diet seems to be associated with an increased risk of developing colorectal cancer (CRC). Few other factors with an effect on the colonic microbiota and their association with CRC have been evaluated.

Aim: We investigated whether the use of antibiotics is associated with CRC risk.

Effectiveness of pharmacotherapy in behavioural therapeutic smoking cessation programmes.

Background: In 2011, pharmacotherapy as a part of smoking cessation treatment was reimbursed through the basic health insurance in the Netherlands. We examine the (cost)-effectiveness of pharmacotherapy added to behavioural therapy.

Methods: An observational study was conducted using data from the suppliers of the smoking cessation programmes together with information on costs from health insurance company Achmea.

Constipation-related direct medical costs in 16 887 patients newly diagnosed with chronic constipation.

Background: Chronic constipation is a common condition, but the exact impact on healthcare budgets in Western Europe is poorly documented.

Objectives: The aim of this study was to (a) investigate chronic constipation-related direct medical costs in patients with newly diagnosed chronic constipation and (b) study differences in costs according to natural history.

Patients And Methods: We identified 16 887 patients newly diagnosed with chronic constipation in a Dutch health insurance database (∼1.

Neighborhood ethnic density and psychotic disorders among ethnic minority groups in Utrecht City.

Purpose: Recent studies have shown increased incidence of non-affective psychotic disorders (NAPD) among ethnic minorities compared to the native population, but not, or less so, in areas with a high own-group proportion. The aim is to investigate this ethnic density effect in Utrecht and whether this effect is due to higher rates of NAPD among Dutch persons in areas with high minority proportions. We also explore the geographical scale at which this effect occurs and the influence of social drift prior to NAPD.

Effect of aging on healthcare costs of inflammatory bowel disease: a glimpse into the future.

Background: Population aging is expected to result in a substantial additional burden on healthcare resources in the near future. We aimed to assess the current and future impact of aging on direct healthcare costs (DHC) attributed to inflammatory bowel disease (IBD).

Methods: Patients with IBD from a Dutch multicenter cohort filled out 3-monthly questionnaires for 2 years.

Morbidity and doctor characteristics only partly explain the substantial healthcare expenditures of frequent attenders: a record linkage study between patient data and reimbursements data.

Background: Frequently attending patients to primary care (FA) are likely to cost more in primary care than their non-frequently attending counterparts. But how much is spent on specialist care of FAs? We describe the healthcare expenditures of frequently attending patients during 1, 2 or 3 years and test the hypothesis that additional costs can be explained by FAs' combined morbidity and primary care physicians' characteristics.

Methods: Record linkage study.

Cause-specific mortality among patients with psychosis: disentangling the effects of age and illness duration.

Background: There is a large mortality gap between patients with a nonaffective psychotic disorder and those in the general population, is associated with both natural and nonnatural death causes.

Objective: This study aims to assess whether mortality risks vary for different causes of death according to the duration since diagnosis and age in a large sample of patients with nonaffective psychotic disorder.

Methods: Data of patients with nonaffective psychotic disorder (n = 12,580) from 3 Dutch psychiatric registers were linked to the cause of death register of Statistics Netherlands and compared with personally matched controls (n = 124,143) from the population register.

Infection load as a predisposing factor for somatoform disorders: evidence from a Dutch General Practice Registry.

Objective: Somatoform disorders (SDs) are characterized by chronic multiple functional somatic (FS) symptoms. It has been suggested that infections may be triggers for FS symptoms to occur, pointing to the immune system as a pathogenic factor in their development. The current study aimed to compare the prevalence of infections (i.

Mortality and psychiatric disorders among public mental health care clients in Utrecht: a register-based cohort study.

Background: Different studies have shown similar or even lower mortality among homeless persons with compared to homeless persons without a severe mental disorder.

Aims: To clarify the association between presence of a psychiatric diagnosis and mortality among the socially marginalized.

Methods: The Public Mental health care (PMHc) is a legal task of the municipal authority aiming at prevention and intervention in case of (imminent) homelessness among persons with a serious shortage of self-sufficiency.

Primary non-variceal upper gastrointestinal bleeding in NSAID and low-dose aspirin users: development and validation of risk scores for either medication in two large Dutch cohorts.

Background: Non-steroidal anti-inflammatory drugs (NSAIDs) and low-dose acetylsalicylic acid (ASA) have several adverse gastrointestinal (GI) effects, including upper GI bleeding. We aimed to develop a simple risk score to identify high risk NSAID and ASA users for primary upper GI bleeding.

Methods: Using data from two large anonymized health insurance databases, we defined a development and validation cohort with NSAID and ASA users which were followed-up for the occurrence of a primary upper GI bleeding.

Cancer mortality in patients with psychiatric diagnoses: a higher hazard of cancer death does not lead to a higher cumulative risk of dying from cancer.

Purpose: Both increased as well as decreased cancer mortality among psychiatric patients has been reported, but competing death causes were not included in the analyses. This study aims to investigate whether observed cancer mortality in patients with psychiatric disorders might be biased by competing death causes.

Method: In this retrospective cohort study on data from the Psychiatric Case Register Middle Netherlands linked to the death register of Statistics Netherlands, the risk of cancer death among patients with schizophrenia (N = 4,590), bipolar disorder (N = 2,077), depression (N = 15,130) and their matched controls (N = 87,405) was analyzed using a competing risk model.

Prescription patterns for psychotropic drugs in cancer patients; a large population study in the Netherlands.

Background: Psychotropic drugs are commonly prescribed for various psychological complaints in cancer patients. We aim to examine the prescription pattern in cancer patients of three common psychotropic drugs: benzodiazepine, antidepressant and antipsychotic.

Methods: This is a retrospective case-control study.

Familial clustering of schizophrenia, bipolar disorder, and major depressive disorder.

Purpose: To investigate familial clustering of schizophrenia, bipolar disorder, and major depressive disorder.

Methods: Combining data from a psychiatric case registry and Statistics Netherlands provided information on 4,673 affected probands and 18,692 matched population controls.

Results: Probands with schizophrenia had relative risks (RRs) for having a sibling with schizophrenia of 3.

A comorbid anxiety disorder does not result in an excess risk of death among patients with a depressive disorder.

Background: Several studies have demonstrated increased mortality associated with depression and with anxiety. Mortality due to comorbidity of two mental disorders may be even more increased. Therefore, we investigated the mortality among patients with depression, with anxiety and with both diagnoses.

The psychiatric case register middle Netherlands.

Background: The Psychiatric Case Register Middle Netherlands (PCR-MN) registers the mental healthcare consumption of over Dutch 760,000 inhabitants in the centre of the Netherlands. In 2010 the follow-up period was over ten years. In this paper we describe the content, aims and research potential of this case register.

A health insurance company-initiated practice support intervention for optimizing acid-suppressing drug prescriptions in primary care.

Background: A health insurance-initiated programme to improve cost-effectiveness of acid-suppressing drugs (ASDs).

Aim: To evaluate the effect of two different interventions of general practitioner support in reducing drug prescription.

Materials And Methods: A sequential cluster randomized controlled trial with 90 participating general practitioners in a telephone support (TS) group or practice visit (PV) group.

Thiopurines prevent advanced colorectal neoplasia in patients with inflammatory bowel disease.

Background And Aims: Previous studies have suggested a chemopreventive effect of 5-aminosalicylic acid (5-ASA) therapy in patients with inflammatory bowel disease (IBD). This effect has not been reported in IBD patients using thiopurines. We investigated the association between thiopurine or 5-ASA use and the risk of advanced neoplasia (AN), including high-grade dysplasia and colorectal cancer, in a large cohort of patients with IBD in the Netherlands.