Is a 1-year course of methotrexate in patients with arthralgia at-risk for rheumatoid arthritis cost-effective? A cost-effectiveness analysis of the randomised, placebo-controlled TREAT EARLIER trial.

Objectives: Rheumatoid arthritis (RA) has a considerable disease burden with life-long physical limitations, reduced work productivity and high societal costs. Trials on arthralgia at-risk for RA are therefore conducted, aiming to intercept evolving RA and reduce the disease burden. A 1-year course of methotrexate in patients with clinically suspect arthralgia (CSA) caused sustained improvements in subclinical joint inflammation and physical impairments.

Nationwide guideline implementation: a qualitative study of barriers and facilitators from the perspective of guideline organizations.

Background: Although the number of Dutch guidelines is growing, their uptake and impact in clinical practice lag behind. Dutch guideline organizations, including guideline developers, governmental agencies, health insurers and other national organizations, play a crucial role in developing, authorizing and/or supporting the use of guidelines. They influence end users' awareness, accessibility, understanding, acceptability and applicability of guidelines.

Public Reason in Times of Corona: Countering Disinformation in the Netherlands.

Who should decide what passes for disinformation in a liberal democracy? During the COVID-19 pandemic, a committee set up by the Dutch Ministry of Health was actively blocking disinformation. The committee comprised civil servants, communication experts, public health experts, and representatives of commercial online platforms such as Facebook, Twitter, and LinkedIn. To a large extent, vaccine hesitancy was attributed to disinformation, defined as misinformation (or data misinterpreted) with harmful intent.

The effect of sleep disturbances on the incidence of dementia for varying lag times.

Background: Few studies have addressed the association of sleep disturbances with incident dementia with long lag times. We add to this literature by investigating how lag times varying from 2.2 to 23.

Ecopsychosocial strategies for the self-exploration of professional family caregivers to manage the behavioural and psychological symptoms of Alzheimer patients in Iran: a qualitative study.

Objective: The aim of the present study was to explore the experiences and viewpoints of professional family caregivers in the management of behavioural and psychological symptoms of dementia (BPSDs) to identify the ecopsychosocial strategies applied by them.

Design: Qualitative study.

Setting: Kerman, Iran.

Cost-effectiveness of monitoring and liver cancer surveillance among patients with inactive chronic hepatitis B.

Patients with chronic hepatitis B infection (CHB) have an increased risk for death from liver cirrhosis and hepatocellular carcinoma (HCC). In the United States, only an estimated 37% of adults with chronic hepatitis B diagnosis without cirrhosis receive monitoring with at least an annual alanine transaminase (ALT) and hepatitis B deoxyribonucleic acid (DNA), and an estimated 59% receive antiviral treatment when they develop active hepatitis or cirrhosis. A Markov model was used to calculate the costs, health impact and cost-effectiveness of increased monitoring of adults with HBeAg negative inactive or HBeAg positive immune tolerant CHB who have no cirrhosis or significant fibrosis and are not recommended by the current American Association for the Study of Liver Diseases (AASLD) clinical practice guidelines to receive antiviral treatment, and to assess whether the addition of HCC surveillance would be cost-effective.

Perspectives of physicians on risk factors for patient aggression and violence against physicians in Chinese hospitals: a Q-methodology study.

Background: The prevalence of patient (and their relatives/friends) aggression and violence against healthcare professionals in general, and physicians in particular, is a recognized problem worldwide. While numerous risk factors for such aggression and violence from patients (and their relatives/friends) have been identified, little is known about which risk factors are perceived as relatively most important in a specific context and among a particular group, and about the potentially differing views on the relative importance. This lack of insight prohibits preventive measures being tailored to address the main risk factors.

Approaches to Incorporation of Preferences into Health Economic Models of Genomic Medicine: A Critical Interpretive Synthesis and Conceptual Framework.

Introduction: Genomic medicine has features that make it preference sensitive and amenable to model-based health economic evaluation. Preferences of patients, caregivers, and clinicians related to the uptake and delivery of genomic medicine technologies and services that are not captured in health state utility weights can affect the intervention's cost-effectiveness and budget impact. However, there is currently no established or agreed-on approach for integrating preference information into economic evaluations.

PCSK9 inhibitor experiences and preferences of patients and healthcare professionals in decision-making: A mixed methods study.

Background And Aims: This study investigated how patients experience and which outcomes matter to patients and healthcare professionals in the decision to initiate proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) as add-on lipid-lowering treatment (LLT).

Methods: We performed a mixed methods study: very high-risk patients qualifying for PCSK9i reimbursement were interviewed about their experiences and preferences. Subsequently, patients using PCSK9i completed an anonymous online survey about their experiences.

Frontline professionals' experiences of navigating boundaries in a layered care and support system for individuals with complex care needs in the Netherlands.

Fragmented care systems, characterized by horizontal and vertical boundaries, hinder interprofessional collaboration for individuals with complex care needs. This study explores how frontline professionals navigate these boundaries to foster collaboration within a national program promoting integrated care for individuals with 'misunderstood behaviour' in the Netherlands. Using a boundary work lens, we analysed 44 semi-structured interviews with frontline professionals from the social, care, and safety domains.

Gains and pains: a qualitative study on the implications of value-based health care for professionals.

Background: While aiming to optimize patient value, the shift towards Value-Based Health Care (VBHC) in hospitals worldwide has been argued to benefit healthcare professionals as well. However, robust evidence regarding VBHC's workforce implications is lacking. This gap is problematic, as the motivation and health of healthcare professionals are central to the quality of care and crucial amidst contemporary workforce challenges.

Enhancing work environments and reducing turnover intention: a multicenter longitudinal cohort study on differentiated nursing practices in Dutch hospitals.

Background: Addressing the growing challenge of nurse retention requires coordinated actions at national and global levels to improve recruitment, retention policies, and investments in the nursing work environment. The nursing work environment, defined as the "organizational characteristics of a work setting that facilitate or constrain professional nursing practice", is critical in influencing whether nurses decide to leave their jobs. This study investigates the impact of differentiated nursing practices - which involved tailoring roles and responsibilities based on nurses' training, skills, and experience in Dutch hospitals - and investigated their impact on the nursing work environment and turnover intention (i.

Prediction accuracy of discrete choice experiments in health-related research: a systematic review and meta-analysis.

Background: Discrete choice experiments (DCEs) are increasingly used to inform the design of health products and services. It is essential to understand the extent to which DCEs provide reliable predictions outside of experimental settings in real-world decision-making situations. We aimed to compare the prediction accuracy of stated preferences with real-world choices, as modelled from DCE data.

Transforming dementia research into practice: a multiple case study of academic research utilization strategies in Dutch Alzheimer Centres.

Background: Non-pharmacological dementia research products, such as social and behavioural interventions, are generated in traditional university settings. These often experience challenges to impact practices that they were developed for. The Netherlands established five specialized academic health science centres, referred to as Alzheimer Centres, to structurally coordinate and facilitate the utilization of dementia research knowledge.

The complexity of home-based rehabilitation technology implementation for post-stroke motor rehabilitation in the Netherlands.

Background: Rehabilitation technology is a growing field, but the sustainable implementation of these technologies, particularly in home settings, is lacking. The aim of this study was to explore the factors influencing the uptake of stroke rehabilitation technology among various stakeholders, including developers, healthcare professionals, individuals who had strokes, strategic experts, management and innovation staff, health insurers, and the National Health Care Institute.

Methods: In total, 22 semi-structured interviews were conducted with a purposive stakeholder sample.

Women's preferences for care delivery during labour and birth in Dutch hospitals: A Q-methodology study.

Problem: Women's preferences regarding care delivery during labour and birth remain insufficiently understood. Obtaining a clear understanding of these is important to realise a maternity care system that is future-proof and person-centred.

Background: Dutch maternity care deals with capacity issues due to staff shortages.

Exploring Motives Behind Ideal Melanoma Survivorship Care Plans With Multiple Stakeholders: A Cocreation Study.

Background: Survivorship care plans (SCPs), ie, personalized health care plans for cancer survivors, can be used to support the growing group of melanoma survivors throughout their disease trajectory. However, implementation and effectiveness of SCPs are suboptimal and could benefit from the involvement of stakeholders in developing a user-centered design.

Objective: The aim of this study was to identify the ideal SCP for patients with melanoma in terms of functions and features to be included according to different stakeholders and to explore their underlying motives.

Tackling the primary healthcare workforce crisis: time to talk about health systems and governance-a comparative assessment of nine countries in the WHO European region.

Background: Primary healthcare has emerged as a powerful global concept, but little attention has been directed towards the pivotal role of the healthcare workforce and the diverse institutional setting in which they work. This study aims to bridge the gap between the primary healthcare policy and the ongoing healthcare workforce crisis debate by introducing a health system and governance approach to identify capacities that may help respond effectively to the HCWF crisis in health system contexts.

Methods: A qualitative comparative methodology was employed, and a rapid assessment of the primary healthcare workforce was conducted across nine countries: Denmark, Germany, Kazakhstan, Netherlands, Portugal, Romania, Serbia, Switzerland, and the United Kingdom/ England.

What Does Pharmaceutical 3D Printing Cost? A Framework and Case Study with Hydrocortisone for Adrenal Insufficiency.

Background: Pharmaceutical three-dimensional printing (3DP) technology offers an automated platform that can be utilized to manufacture personalized medicine, improving pharmacotherapy. Although 3D-printed products have entered clinical trials, no costing studies have been performed yet. Cost insights can aid researchers and industry in making informed decisions about the feasibility and scalability of 3DP.

Factors associated with patients' demand for low-value care: a scoping review.

Background: Low-value care is unnecessary care that contributes to inefficient use of health resources and constitutes a considerable proportion of healthcare expenditures worldwide. Factors contributing to patients' demand for low-value care have often been overlooked and are dispersed in the literature. Therefore, the current study aimed to systematically summarize factors associated with patients' demand for low-value care.

Toward value-based care using cost mining: cost aggregation and visualization across the entire colorectal cancer patient pathway.

Background: The aim of this study is to develop a method we call "cost mining" to unravel cost variation and identify cost drivers by modelling integrated patient pathways from primary care to the palliative care setting. This approach fills an urgent need to quantify financial strains on healthcare systems, particularly for colorectal cancer, which is the most expensive cancer in Australia, and the second most expensive cancer globally.

Methods: We developed and published a customized algorithm that dynamically estimates and visualizes the mean, minimum, and total costs of care at the patient level, by aggregating activity-based healthcare system costs (e.

Patient-level cost analysis of subfertility pathways in the Dutch healthcare system.

Background: Health economic evaluations require cost data as a key input, and reimbursement policies and systems should incentivize valuable care. Subfertility is a growing global phenomenon, and Dutch per-treatment DRGs alone do not support value-based decision-making because they don't reflect patient-level variation or the impact of technologies on costs across entire patient pathways.

Methods: We present a real-world micro-costing analysis of subfertility patient pathways (n = 4.