Publications by authors named "Marijke M Kuyvenhoven"
Background And Objectives: Poor performance among trainees is an important issue, for patient safety and economic reasons. While early identification might enhance remediation measures, we explored the frequency, nature, and risk factors of poor performance in a Dutch postgraduate general practitioner (GP) training program.
Methods: All trainees who started the GP training between 2005 and 2007 were included.
Objectives: Antibiotic overprescribing is a significant problem. Multifaceted interventions improved antibiotic prescribing quality; their implementation and sustainability, however, have proved difficult. We analysed the effectiveness of an intervention embedded in the quality cycle of primary care practice accreditation on quantity and quality of antibiotic prescribing for respiratory tract and ear infections (RTIs).
View Article and Find Full Text PDFUnlabelled: Abstract Background: Historically, semi-structured interviews (SSI) have been the core of the Dutch selection for postgraduate general practice (GP) training. This paper describes a pilot study on a newly designed competency-based selection procedure that assesses whether candidates have the competencies that are required to complete GP training.
Objectives: The objective was to explore reliability and validity aspects of the instruments developed.
Background: Semi- structured interviews are the core of the Dutch selection procedure for postgraduate general practice (GP) training. A staff member, trainer and trainee independently assess personal qualities. Aiming to improve the selection procedure we were interested in the reliability aspects of these interviews.
View Article and Find Full Text PDFBackground: Antibiotic use and concomitant resistance are increasing. Literature reviews do not unambiguously indicate which interventions are most effective in improving antibiotic prescribing practice.
Aim: To assess the effectiveness of physician-targeted interventions aiming to improve antibiotic prescribing for respiratory tract infections (RTIs) in primary care, and to identify intervention features mostly contributing to intervention success.
Background: In the Netherlands we select candidates for the postgraduate GP training by assessing personal qualities in interviews. Because of differences in the ratio of number of candidates and number of vacancies between the eight departments of GP training we questioned whether the risk of being rejected diverged amongst them.
Objective: The research question of this study was to which degree department of choice, candidates' characteristics and qualities assessed during interviews explain admission into GP training.
Background: A supportive patient safety culture is considered to be an essential condition for improving patient safety. Assessing the current safety culture in general practice may be a first step to target improvements. To that end, we studied internal consistency and construct validity of a safety culture questionnaire for general practice (SCOPE) which was derived from a comparable questionnaire for hospitals (Dutch-HSOPS).
View Article and Find Full Text PDFObjective: To investigate which determinants are related to poor performance and forced attrition in the first year residency in general practice (GP).
Design: Observational retrospective cohort study.
Method: We collected data relating to personal characteristics such as age, sex and clinical experience from residents who started the GP training in Utrecht, the Netherlands, in the period March 2005-August 2007.
Antibiotics for respiratory, ear and urinary tract disorders and consistency among GPs.
J Antimicrob Chemother
September 2008
Objectives: To describe specific diagnoses for which systemic antibiotics are prescribed, to assess adherence of antibiotic choice to national guidelines and to assess consistency among general practitioners (GPs) in prescribed volumes of antibiotics for respiratory, ear and urinary tract disorders.
Methods: The cross-sectional study included 174 GPs from 89 general practices. Data were derived from the Second Dutch National Survey of General Practice (DNSGP-2) in 2001.
Background: GPs are often consulted for respiratory tract symptoms in children.
Aim: To explore characteristics of children, their parents, and their GPs that are correlated with consulting a GP for cough, sore throat, or earache.
Design Of Study: Second Dutch National Survey of General Practice (DNSGP-2) with a health interview and an additional questionnaire.
Purpose: In order to assess whether different databases generate information which can be reliable compared with each other, this study aimed to assess to which degree prescribing rates for systemic antibiotics from a nationwide electronic general practitioner (GP) database correspond with national reimbursement rates, and to investigate for which indications antibiotics are prescribed.
Methods: Nationwide GP prescribing data were collected from the Second Dutch National Survey of General Practice (DNSGP-2) based on 90 general practices serving 358 008 patients in 2001. Dutch national reimbursement rates for GPs were derived from claims data of the Dutch Drug Information System/Health Care Insurance Board (GIP/CVZ) from 2001.
Background: Next to other GP characteristics, diagnostic labelling (the proportion of acute respiratory tract (RT) episodes to be labelled as infections) probably contributes to a higher volume of antibiotic prescriptions for acute RT episodes. However, it is unknown whether there is an independent association between diagnostic labelling and the volume of prescribed antibiotics, or whether diagnostic labelling is associated with the number of presented acute RT episodes and consequently with the number of antibiotics prescribed per patient per year.
Methods: Data were used from the Second Dutch National Survey of General Practice (DNSGP-2) with 163 GPs from 85 Dutch practices, serving a population of 359,625 patients.
Background: Although the vast majority of respiratory tract symptoms are self-limiting, many patients visit their GP for these symptoms and antibiotics are over-prescribed.
Aim: To explore determinants of patients visiting GPs for recent cough, sore throat, or earache; for being prescribed antibiotics; and for patients' satisfaction with visiting the GP.
Design Of The Study: Second Dutch National Survey of General Practice (DNSGP-2) with a health interview and an additional questionnaire.
Background: The Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification of severity of chronic obstructive pulmonary disease (COPD) is based solely on obstruction and does not capture physical functioning. The hypothesis that the Medical Research Council (MRC) dyspnoea scale would correlate better with quality of life than the level of airflow limitation was examined.
Aim: To study the associations between quality of life in smokers and limitations in physical functioning (MRC dyspnoea scale) and, quality of life and airflow limitation (GOLD COPD stages).
Objectives: To explore views on respiratory tract symptoms (cough, sore throat and earache) and antibiotics of GPs, practice staff, and patients.
Methods: In a nationwide study, 181 GPs, 204 practice staff members and 1250 patients from 90 practices participated by answering 14 items relating to views on respiratory tract symptoms and antibiotics in a written questionnaire. Differences in means were compared.
Objectives: To assess determinants of antibiotic overprescribing in patients with sinusitis, tonsillitis and bronchitis in Dutch general practice.
Patients And Methods: A total of 146 general practitioners (GPs) from The Netherlands included all patients with sinusitis, tonsillitis and bronchitis during a 4 week period in the winter of 2002/2003, and recorded patient characteristics, clinical presentation and management. Overprescribing of antibiotics was assessed using the recommendations of the Dutch national guidelines as a benchmark.
Objectives: To assess clinical determinants of under- and overprescribing of antibiotics according to the Dutch national guideline for patients with acute otitis media (AOM) in general practice.
Patients And Methods: A total of 146 general practitioners (GPs) from the Netherlands included all patients with AOM during a 4 week period in winter, and recorded patient characteristics, clinical presentation and management. Under- and overprescribing of antibiotics in AOM was assessed using the Dutch national guideline.
Objectives: The aim of this study was to assess the association between general practitioners' (GPs') characteristics and the volume of second-choice antibiotics for acute respiratory tract (RT) episodes by GPs.
Methods: Morbidity and antibiotic prescription data originated from the Second Dutch National Survey of General Practice (DNSGP-2). GPs' characteristics, including professional activities and views on RT symptoms and antibiotics, were measured by a written questionnaire.
Objectives: In Europe there are large variations in overall outpatient antibiotic use, even between two neighbouring countries as Belgium and the Netherlands. We aimed to compare the management of acute cough between Belgian and Dutch general practitioners (GPs).
Methods: In cross-sectional studies in Belgium and the Netherlands, 71 Belgian and 84 Dutch GPs included adult patients consulting for acute cough.
Background: Due to clinical and non-clinical factors, considerable variation exists in the prescribing of antibiotics for respiratory tract infections (RTIs) by GPs based in the Netherlands.
Aim: To assess, in patients with RTIs in Dutch general practice: the prescribing rates of antibiotics; the relationship between GP characteristics and antibiotic prescribing; and the type of antibiotics prescribed.
Design Of Study: Descriptive and prognostic.
Objectives: To obtain detailed information on current prescribing rates of antibiotics for respiratory tract infections (RTIs) in Dutch general practice and its relation with age and respiratory tract clinical entities.
Methods: We assessed the mean proportion of antibiotics prescribed for RTIs per age group, contact-based and population-based using all patient contacts concerning RTIs in the year 2000 selected from the IPCI database, containing information on general practice consultations of 235,290 patients.
Results: In one-third of all contacts concerning RTIs, antibiotics were prescribed, with much variation between age groups and clinical entities.
Objectives: To assess the effectiveness of a multiple intervention aimed at reducing antibiotic prescription rates for symptoms of the respiratory tract in primary care.
Design: Randomised controlled trial.
Subjects: Twelve peer review groups including 100 general practitioners with their collaborating pharmacists in the region of Utrecht, Netherlands.
Objective: The aim of this study was to determine the notification by general practitioners (GPs) to the Municipal Health Service (MHS) and the presentation of measles complaints by patients to the GP during a measles epidemic in a 78% vaccinated population.
Study Design And Setting: Measles cases in children under 13 years were identified via questionnaires, GPs' records, and MHS's records. Consultation rate, notification rate, and completeness of notification were determined.