Factors associated with excessive polypharmacy in older people.

Background: Older people are a growing population. They live longer, but often have multiple chronic diseases. As a consequence, they are taking many different kind of medicines, while their vulnerability to pharmaceutical products is increased.

The Belgian Health System Performance Report 2012: snapshot of results and recommendations to policy makers.

Following the commitments of the Tallinn Charter, Belgium publishes the second report on the performance of its health system. A set of 74 measurable indicators is analysed, and results are interpreted following the five dimensions of the conceptual framework: accessibility, quality of care, efficiency, sustainability and equity. All domains of care are covered (preventive, curative, long-term and end-of-life care), as well as health status and health promotion.

Belgian health-related data in three international databases.

Aims Of The Study: This study wants to examine the availability of Belgian healthcare data in the three main international health databases: the World Health Organization European Health for All Database (WHO-HFA), the Organisation for Economic Co-operation and Development Health Data 2009 and EUROSTAT.

Methods: For the indicators present in the three databases, the availability of Belgian data and the source of these data were checked.

Main Findings: The most important problem concerning the availability of Belgian health-related data in the three major international databases is the lack of recent data.

The added value of the registration of home accidents in general practice.

Objectives: To determine the number, the nature and the circumstances of home accidents managed in general practices, and to compare the results with the European Home and Leisure Accidents Surveillance System (EHLASS) data.

Design: A prospective population survey of all domestic accidents managed in 138 sentinel general practices during 1995/96.

Setting: Primary health care.

High incidence of primary pulmonary hypertension associated with appetite suppressants in Belgium.

Primary pulmonary hypertension is a rare, progressive and incurable disease, which has been associated with the intake of appetite suppressant drugs. The importance of this association was evaluated in Belgium while this country still had no restriction on the prescription of appetite suppressants. Thirty-five patients with primary pulmonary hypertension and 85 matched controls were recruited over 32 months (1992-1994) in Belgium.

Mortality in the elderly and ambient ozone concentration during the hot summer, 1994, in Belgium.

Extensive investigations were carried out to study the relationship between daily mortality in the elderly, outdoor air temperature, and ozone concentration observed in Belgium during the hot summer, 1994. The two environmental variables were assessed through mean daily temperature and 24-hr ozone concentration, both measured the day before and averaged over the country. Data were stratified by terciles of mean daily temperature in order to reduce the degree of collinearity between the investigated environmental variables.

Results of an epidemiological study on drug-treated intraocular hypertension in Belgium.

Some epidemiological aspects of drug-treated intraocular hypertension in Belgium were established in 1992 from questionnaires filled in by 1513 patients who attended a sample of 209 pharmacies open to the public. The mean age of the patients was 67 years (range: 3-95). After standardization for age, the prevalence of diabetes mellitus among patients was found to be 1.

Temperature, ambient ozone levels, and mortality during summer 1994, in Belgium.

The number of daily deaths, temperature, relative humidity, and 24-hr concentrations of main air pollutants observed during a heat wave (June 27-August 7, 1994) in Belgium were compared with those recorded before and after this heat wave. All these variables were averaged over the country. Expected mortality was calculated from daily deaths observed during the summers of 1985-1993.

Estimate of disease prevalence using drug consumption data.

A simple method is presented to estimate the prevalence for chronic diseases treated with drugs that are specific to the disease and must be taken continuously. Data required for the computations involve the total amount of drugs sold in a given region and the mean intake of these drugs, which can be based on the defined daily doses, the prescribed daily doses, or the consumed daily doses. The prevalence of the studied disease is the most accurate using the consumed daily doses estimated in a sample of patients with the disease of interest.

[Epidemiological study on neonatal septicemia and meningitis in Belgium].

Epidemiological data were collected for 219 cases of neonatal septicaemia and/or meningitis. In two thirds of the cases the diagnosis was made in newborns aged 4 days or less. Risk factors related to the delivery, to the health status of the infant at birth and to pregnancy were mentioned respectively in 74, 63 and 36% of the cases.

Pharmacoeconomics of immunisation: a review.

The effects of immunisation programmes that have existed for several decades in developed countries are demonstrated by the decrease and even eradication of smallpox, poliomyelitis, measles, mumps and hepatitis B. Cost, health policy and spontaneous evolution in the incidence of communicable diseases have a decisive influence on the use of a vaccine. Investment in vaccination policy has to be encouraged to maintain this progress made in the control of infectious diseases and to meet new challenges.

[Trends in pneumococcal infections in Belgium from 1986 to 1991].

Streptococcus pneumoniae is one of the most frequent causes of pneumonia, meningitis, and otitis media. Persons at high risk are young children, elderly, and individuals with immunodeficiency or with an underlying disease. Thanks to a network ot 111 laboratories spread all over Belgium, the evolution of the number of deep isolates of S.

Prevalence of drug-treated diabetes mellitus in Belgium. Results of a study with the collaboration of a network of pharmacies.

Within the framework of a European concerted action on diabetes mellitus (EURODIAB SubArea C), an epidemiological study was established in Belgium in 1990 in order to estimate the prevalence of drug-treated diabetes mellitus. An assessment was made of the sales of insulin and oral antidiabetic drugs and the average daily dose used. A sample of people with diabetes, clients of 107 pharmacies, provided the data to establish average daily doses.

Sero epidemiological characteristics of hepatitis C encountered in general practice in Belgium.

A study carried out between 1982 and 1984 established by exclusion diagnosis that 35% of viral hepatitis cases registered in Belgium were due to non A, non B (NANB) viruses. Recently, a new anti-hepatitis C virus (HCV) detection test was used to analyse the sera of patients in whom NANB hepatitis was diagnosed in that study. Using this new serological test for HCV, 29% of the NANB group was found to be positive for anti-HCV.

Declining trends in some sexually transmitted diseases in Belgium between 1983 and 1989.

Objective: To examine trends in some sexually transmitted diseases in Belgium and to discuss them in the light of the European background.

Design: Analysis of the time trends of C trachomatis and N gonorrhoeae infections diagnosed by a network of microbiological laboratories, and of male urethritis diagnosed by a network of general practitioners.

Setting: Belgium.

A sentinel network of microbiological laboratories as a tool for surveillance of infectious diseases in Belgium.

In the development of a surveillance programme for infectious diseases in Belgium, a national network of microbiological laboratories has been responsible, since February 1983, for the weekly registration of certain pathogenic agents. Thus, the main epidemiological features of a selected number of infections in Belgium can be characterized.

[Epidemiological aspects of Campylobacter infections in Belgium].

In the context of a surveillance programme for infectious diseases in Belgium, a network of microbiological laboratories, since February 1983, weekly registers the isolation of a number of pathogenic agents, among which Campylobacter. Some epidemiological characteristics of Campylobacter in Belgium are discussed. Between 54 and 58% of the isolations are reported from males.

[Study of neonatal septicemia and meningitis].

Departments of pediatrics and hospital laboratories gather, since September 1986, epidemiological data about babies with bacterial septicaemia and/or meningitis in the first 27 days of life. About 30 hospitals are at present participating to the program on a voluntary basis. The present study was undertaken to determine the factors predisposing to the development of these serious infections, in order to help identify infants at high risk of infection.

[Epidemiologic aspects of infections due to Neisseria gonorrhoea in Belgium].

In the context of a surveillance programme for communicable diseases in Belgium, a network of microbiological laboratories has, since February, 1983, made weekly registrations of a number of pathogenic agents, among them, N. gonorrhoeae. Some epidemiological characteristics of N.

[Various sero-epidemiological characteristics of viral hepatitis in general medicine: results of a pilot survey performed in Belgium].

A study was made of 110 cases of viral hepatitis diagnosed by general practitioners between 31 May 1982 and 30 June 1984. Hepatitis A was diagnosed in 53 patients, hepatitis B in 18 patients, hepatitis of both types A and B in one patient, and--by exclusion--hepatitis non-A non-B in 38 patients. Hepatitis A appears to be generally acquired by contact with infected persons or by travelling in endemic regions.

Tool for validation of the network of sentinel general practitioners in the Belgian health care system.

Morbidity registration by a network of sentinel general practitioners (SGPs) in Belgium raises a number of problems related to possible biases in the network procedure, such as unequal geographical distribution, non-participation of a segment of the target population of practitioners and difficulties in the estimation of the denominator population at risk for the health problems under study. Through the application of two hierarchical clustering procedures, the initial number of 43 districts in the country has been reduced to 15 homogeneous district clusters. These represent the new geographical framework from which the geographical spread of the network is checked.

Epidemiological surveillance of measles through a network of sentinel general practitioners in Belgium.

Measles morbidity data were collected during 1982-1983 through a network of sentinel general practitioners. The annual incidence rate of the disease in the country was 80.3 per 1000 population with most of the cases seen between 2 and 6 years of age.