Transmural collaborative care model for the review of antipsychotics: a feasibility study of a complex intervention.

General practitioners (GPs) are often unaware of antipsychotic (AP)-induced cardiovascular risk (CVR) and therefore patients using atypical APs are not systematically monitored. We evaluated the feasibility of a complex intervention designed to review the use of APs and advise on CVR-lowering strategies in a transmural collaboration. A mixed methods prospective cohort study in three general practices in the Netherlands was conducted in 2021.

Cardiovascular risk management in patients with severe mental illness or taking antipsychotics: A qualitative study on barriers and facilitators among dutch general practitioners.

Background: Patients with severe mental illness (SMI) or receiving treatment with antipsychotics (APs) have an increased risk of cardiovascular disease. Cardiovascular risk management (CVRM) increasingly depends on general practitioners (GPs) because of the shift of mental healthcare from secondary to primary care and the surge of off-label AP prescriptions. Nevertheless, the uptake of patients with SMI/APs in CVRM programmes in Dutch primary care is low.

Effectiveness of a Pharmacist-Led Web-Based Medication Adherence Tool With Patient-Centered Communication: Results of a Clustered Randomized Controlled Trial.

Background: Growing numbers of people use medication for chronic conditions; nonadherence is common, leading to poor disease control. A web-based tool to identify an increased risk for nonadherence with related potential individual barriers might facilitate tailored interventions and improve adherence.

Objective: This study aims to assess the effectiveness of a newly developed tool aimed at improving medication adherence.

Cooperation networks of ambulatory health care providers: exploration of mechanisms that influence coordination and uptake of recommended cardiovascular care (ExKoCare): a mixed-methods study protocol.

Background: As the number of elderly and multimorbid patients increases, healthcare has become more complex. This requires good coordination of treatment and care given the various  health care professionals involved (e.g.

The decline in physical activity in aging people is not modified by gender or the presence of cardiovascular disease.

Background: A physically active lifestyle decreases the progression of atherosclerosis and consequently reduces cardiovascular mortality. However, activity levels are hampered by aging. The association between aging and physical inactivity might be gender-specific or be modified by the presence of cardiovascular disease (CVD).

Symptoms of depression are associated with physical inactivity but not modified by gender or the presence of a cardiovascular disease; a cross-sectional study.

Background: Depressive symptomatology may act as a barrier to enhance physical activity. This phenomenon is predominantly found in patients with an established cardiovascular disease (CVD) and in female patients. This cross-sectional study investigated (1) the association between symptoms of depression and physical inactivity, and (2) whether this association is different between primary and secondary prevention patients, and between men and women.

Patient cardiovascular risk self-management: results from a randomized trial of motivational interviewing delivered by practice nurses.

Background: To enhance cardiovascular risk management and patients' self-management, a tailored programme to improve cardiovascular risk management was tested in a randomized trial. The presented study concerned secondary analysis.

Objectives: To explore the correlations of practice nurses' counselling skills at baseline on chronic illness care (measured with Patient Assessment of Chronic Illness Care questionnaire) and patients' self-management (assessed with Patient Activation Measure) at follow-up and to examine the effect of the tailored implementation programme on chronic illness care and patients' self-management.

Laxative co-medication and changes in defecation patterns during opioid use.

Introduction: Opioid-induced constipation is a clinically relevant side effect and a cause of potentially avoidable drug-related hospital admissions.

Objectives: To describe the presence of laxative co-medication, the reasons for not starting laxatives and to evaluate changes in stool patterns of opioid initiators.

Methods: In this observational study community pharmacists evaluated the availability of laxative co-medication in starting opioid users and registered reasons for non-use.

Novel oral anticoagulants in primary care in patients with atrial fibrillation: a cross-sectional comparison before and after their introduction.

Background: Novel oral anticoagulation (NOAC) has been introduced in recent years, but data on use in atrial fibrillation (AF) in primary care setting is scarce. In Germany, General Practitioners are free to choose type of oral anticoagulation (OAC) in AF. Our aim was to explore changes in prescription-rates of OAC in German primary care before and after introduction of NOAC on the market.

α-Blockers for uncomplicated ureteric stones: a clinical practice guideline.

Objective: To develop an evidence-based recommendation concerning the use of α-blockers for uncomplicated ureteric stones based on an up-to-date Cochrane review, as the role of medical expulsive therapy for uncomplicated ureteric stones remains controversial in the light of new contradictory trial evidence.

Methods: We applied the Rapid Recommendations approach to guideline development, which represents an innovative approach by an international collaborative network of clinicians, researchers, methodologists and patient representatives seeking to rapidly respond to new, potentially practice-changing evidence with recommendations developed according to standards for trustworthy guidelines.

Results: The panel suggests the use of α-blockers in addition to standard care over standard care alone in patients with uncomplicated ureteric stones (weak recommendation based on low-quality evidence).

Social network composition of vascular patients and its associations with health behavior and clinical risk factors.

Background: This study aimed to explore linkages of patients' social network composition with health behaviors and clinical risk factors.

Methods/design: This observational study was embedded in a project aimed at improving cardiovascular risk management (CRVM) in primary care. 657 vascular patients (227 with cardiovascular disease, 380 at high vascular risk), mean age 72.

Information exchange networks of health care providers and evidence-based cardiovascular risk management: an observational study.

Background: Although a wide range of preventive and clinical interventions has targeted cardiovascular risk management (CVRM), outcomes remain suboptimal. Therefore, the question is what additional determinants of CVRM and outcomes can be identified and addressed to optimize CVRM. In this study, we aimed to identify new perspectives for improving healthcare delivery and explored associations between information exchange networks of health care providers and evidence-based CVRM.

Tailored implementation of cardiovascular risk management in general practice: a cluster randomized trial.

Background: Counselling on health-related lifestyles is key to the prevention and management of chronic diseases. After comprehensive study of determinants of its delivery in general practice and strategies to improve, we composed a tailored improvement program, which included communication skills training, online patient information, and a clinical protocol for managing depressive symptoms. Our aim was to assess the effectiveness of this program on professional performance and outcomes in cardiovascular patients.

Medication management strategy for older people with polypharmacy in general practice: a qualitative study on prescribing behaviour in primary care.

Background: For older patients with polypharmacy, medication management is a process of careful deliberation that needs periodic adjustment based on treatment effects and changing conditions. Because of the heterogeneity of the patient group, and limited applicability of current guidelines, it is difficult for GPs to build up a routine.

Aim: To gain insight into GPs' medication management strategies for patients with polypharmacy, and to explore the GPs' perspectives and needs on decision-making support to facilitate this medication management.

Effectiveness of a medication-adherence tool: study protocol for a randomized controlled trial.

Background: Research shows that more than half of the people taking medication for a chronic condition are non-adherent. Nonadherence hinders disease control with a burden on patient quality of life and healthcare systems. We developed a tool that provides insight into nonadherence risks and barriers for medication-adherence including an intervention strategy to overcome those barriers.

Efficiency of the implementation of cardiovascular risk management in primary care practices: an observational study.

Background: This study aimed to document the variation in technical efficiency of primary care (PC) practices in delivering evidence-based cardiovascular risk management (CVRM) and to identify associated factors.

Methods: This observational study was based on the follow-up measurements in a cluster randomized trial. Patients were recruited from 41 general practices in the Netherlands, involving 106 GPs and 1671 patients.

Effectiveness of personalised support for self-management in primary care: a cluster randomised controlled trial.

Background: Self-management support is an important component of the clinical management of many chronic conditions. The validated Self-Management Screening questionnaire (SeMaS) assesses individual characteristics that influence a patient's ability to self-manage.

Aim: To assess the effect of providing personalised self-management support in clinical practice on patients' activation and health-related behaviours.

Validation of Self-Management Screening (SeMaS), a tool to facilitate personalised counselling and support of patients with chronic diseases.

Background: A rising number of people with chronic conditions is offered interventions to enhance self-management. The responsiveness of individuals to these interventions depends on patient characteristics. We aimed to develop and validate a tool to facilitate personalised counselling and support for self-management in patients with chronic diseases in primary care.

Social support and self-management capabilities in diabetes patients: An international observational study.

Objective: The objective of this study was to explore which aspects of social networks are related to self-management capabilities and if these networks have the potential to reduce the adverse health effects of deprivation.

Methods: In a cross-sectional study we recruited type 2 diabetes patients in six European countries. Data on self-management capabilities was gathered through written questionnaires and data on social networks characteristics and social support through subsequent personal/telephone interviews.

Social Support and Health in Diabetes Patients: An Observational Study in Six European Countries in an Era of Austerity.

Introduction: Support from individual social networks, community organizations and neighborhoods is associated with better self-management and health outcomes. This international study examined the relative impact of different types of support on health and health-related behaviors in patients with type 2 diabetes.

Methods: Observational study (using interviews and questionnaires) in a sample of 1,692 type 2 diabetes patients with 5,433 connections from Bulgaria, Greece, Netherlands, Norway, Spain, and the United Kingdom.

Determinants of impact of a practice accreditation program in primary care: a qualitative study.

Background: Practice accreditation is a widely used method to assess and improve the quality of healthcare services. In the Netherlands, a practice accreditation program was implemented in primary medical care. We aimed to identify determinants of impact of a practice accreditation program, building on the experiences of primary care professionals who had participated in this program.

Higher monetary incentives led to a lowered response rate in ambulatory patients: a randomized trial.

Objectives: Monetary incentives can increase response rate in patient surveys, but calibration of the optimal incentive level is required. Our aim was to assess the effect of different monetary incentives on response rates to calibrate the optimal monetary incentive for ambulatory patients.

Study Design And Setting: A patient-randomized trial was performed in which targeted individuals received different gift vouchers (€5.

Tailored interventions to address determinants of practice.

Background: Tailored intervention strategies are frequently recommended among approaches to the implementation of improvement in health professional performance. Attempts to change the behaviour of health professionals may be impeded by a variety of different barriers, obstacles, or factors (which we collectively refer to as determinants of practice). Change may be more likely if implementation strategies are specifically chosen to address these determinants.

Improving participation rates by providing choice of participation mode: two randomized controlled trials.

Background: Low participation rates reduce effective sample size, statistical power and can increase risk for selection bias. Previous research suggests that offering choice of participation mode can improve participation rates. However, few head-to-head trials compared choice of participation mode using telephone interviews and postal questionnaires as modes of interest.