Seasonal patterns of initiating antidepressant therapy in general practice in the Netherlands during 2002–2007

In diagnosing depression, the most important maxim is to remember its existence. Depression may present overtly or covertly; it may be associated with suicide, alcoholism, or addiction to amphetamines. Perhaps half the depressions seen in general practice require specific treatment, of which a quarter may need referral to a psychiatrist or a psychiatric hospital. If left untreated about 1 in 7 severe depressives die, commit suicide, or become chronic invalids. About these observations there is general agreement. Unfortunately, views about treatment are more diverse, and it is impossible to discuss all of them in a short article, especially if the conclusions are to be firm enough for general use. What follows, therefore, does not represent a consensus of psychiatric opinion, for this does not exist. It is an account of a consistent approach to therapy well supported by experimental evidence and found useful in practice.

Download Full-text

Handling of Confidentiality in General Practice: A Survey Among General Practitioners in the Netherlands

Family Practice ◽

10.1093/fampra/7.1.34 ◽

1990 ◽

Vol 7 (1) ◽

pp. 34-38 ◽

Cited By ~ 2

Author(s):

C J LAKO ◽

FJA HUYGEN ◽

JJ LINDENTHAL ◽

JMG PERSOON

Keyword(s):

General Practice ◽

The Netherlands ◽

General Practitioners

Download Full-text

Datasets collected in general practice: an international comparison using the example of obesity

Australian Health Review ◽

10.1071/ah17157 ◽

2018 ◽

Vol 42 (5) ◽

pp. 563 ◽

Cited By ~ 1

Author(s):

Elizabeth Sturgiss ◽

Kees van Boven

Keyword(s):

Primary Care ◽

General Practice ◽

The Netherlands ◽

Care Management ◽

Clinical Care ◽

International Comparisons ◽

Health Condition ◽

Practice Management ◽

Number Of Patients ◽

Primary Care Management

International datasets from general practice enable the comparison of how conditions are managed within consultations in different primary healthcare settings. The Australian Bettering the Evaluation and Care of Health (BEACH) and TransHIS from the Netherlands collect in-consultation general practice data that have been used extensively to inform local policy and practice. Obesity is a global health issue with different countries applying varying approaches to management. The objective of the present paper is to compare the primary care management of obesity in Australia and the Netherlands using data collected from consultations. Despite the different prevalence in obesity in the two countries, the number of patients per 1000 patient-years seen with obesity is similar. Patients in Australia with obesity are referred to allied health practitioners more often than Dutch patients. Without quality general practice data, primary care researchers will not have data about the management of conditions within consultations. We use obesity to highlight the strengths of these general practice data sources and to compare their differences. What is known about the topic? Australia had one of the longest-running consecutive datasets about general practice activity in the world, but it has recently lost government funding. The Netherlands has a longitudinal general practice dataset of information collected within consultations since 1985. What does this paper add? We discuss the benefits of general practice-collected data in two countries. Using obesity as a case example, we compare management in general practice between Australia and the Netherlands. This type of analysis should start all international collaborations of primary care management of any health condition. Having a national general practice dataset allows international comparisons of the management of conditions with primary care. Without a current, quality general practice dataset, primary care researchers will not be able to partake in these kinds of comparison studies. What are the implications for practitioners? Australian primary care researchers and clinicians will be at a disadvantage in any international collaboration if they are unable to accurately describe current general practice management. The Netherlands has developed an impressive dataset that requires within-consultation data collection. These datasets allow for person-centred, symptom-specific, longitudinal understanding of general practice management. The possibilities for the quasi-experimental questions that can be answered with such a dataset are limitless. It is only with the ability to answer clinically driven questions that are relevant to primary care that the clinical care of patients can be measured, developed and improved.

Download Full-text

A comparison of disease prevalence in general practice in the Netherlands and in England and Wales

Morbidity, Performance and Quality in Primary Care ◽

10.1201/9781315383248-8 ◽

2018 ◽

pp. 45-56

Author(s):

Douglas Fleming ◽

François Schellevis ◽

Michiel van der Linden ◽

Gert Westert

Keyword(s):

General Practice ◽

The Netherlands ◽

Disease Prevalence ◽

England And Wales

Download Full-text

PNS190 BUSINESS MODELS SUPPORTING THE INTEGRATION OF POINT-OF-CARE TESTING AT THE GENERAL PRACTICE: A COMPARISON OF ENGLAND AND THE NETHERLANDS

Value in Health ◽

10.1016/j.jval.2019.09.2090 ◽

2019 ◽

Vol 22 ◽

pp. S793

Author(s):

D. Lingervelder ◽

E. Koffijberg ◽

G.C.M. Kusters ◽

M. IJzerman

Keyword(s):

General Practice ◽

The Netherlands ◽

Business Models ◽

Point Of Care ◽

Point Of Care Testing

Download Full-text

Spread of the epidemic European fusidic acid-resistant impetigo clone (EEFIC) in general practice patients in the south of The Netherlands

Journal of Antimicrobial Chemotherapy ◽

10.1093/jac/dkr590 ◽

2012 ◽

Vol 67 (5) ◽

pp. 1176-1180 ◽

Cited By ~ 14

Author(s):

M. I. A. Rijnders ◽

P. F. G. Wolffs ◽

R. M. Hopstaken ◽

M. den Heyer ◽

C. A. Bruggeman ◽

...

Keyword(s):

General Practice ◽

The Netherlands ◽

Fusidic Acid ◽

The South

Download Full-text

Treatment success of internet-based vestibular rehabilitation in general practice: development and internal validation of a prediction model

BMJ Open ◽

10.1136/bmjopen-2020-038649 ◽

2020 ◽

Vol 10 (10) ◽

pp. e038649

Author(s):

Vincent A van Vugt ◽

Martijn W Heymans ◽

Johannes C van der Wouden ◽

Henriëtte E van der Horst ◽

Otto R Maarsingh

Keyword(s):

General Practice ◽

The Netherlands ◽

Prediction Model ◽

Predictive Models ◽

Prediction Models ◽

Short Form ◽

Treatment Success ◽

Vestibular Rehabilitation ◽

Internal Validation ◽

Vestibular Symptoms

ObjectivesTo develop and internally validate prediction models to assess treatment success of both stand-alone and blended online vestibular rehabilitation (VR) in patients with chronic vestibular syndrome.DesignSecondary analysis of a randomised controlled trial.Setting59 general practices in The Netherlands.Participants202 adults, aged 50 years and older with a chronic vestibular syndrome who received either stand-alone VR (98) or blended VR (104). Stand-alone VR consisted of a 6-week, internet-based intervention with weekly online sessions and daily exercises. In blended VR, the same intervention was supplemented with physiotherapy support.Main outcome measuresSuccessful treatment was defined as: clinically relevant improvement of (1) vestibular symptoms (≥3 points improvement Vertigo Symptom Scale—Short Form); (2) vestibular-related disability (>11 points improvement Dizziness Handicap Inventory); and (3) both vestibular symptoms and vestibular-related disability. We assessed performance of the predictive models by applying calibration plots, Hosmer-Lemeshow statistics, area under the receiver operating characteristic curves (AUC) and applied internal validation.ResultsImprovement of vestibular symptoms, vestibular-related disability or both was seen in 121, 81 and 64 participants, respectively. We generated predictive models for each outcome, resulting in different predictors in the final models. Calibration for all models was adequate with non-significant Hosmer-Lemeshow statistics, but the discriminative ability of the final predictive models was poor (AUC 0.54 to 0.61). None of the identified models are therefore suitable for use in daily general practice to predict treatment success of online VR.ConclusionIt is difficult to predict treatment success of internet-based VR and it remains unclear who should be treated with stand-alone VR or blended VR. Because we were unable to develop a useful prediction model, the decision to offer stand-alone or blended VR should for now be based on availability, cost effectiveness and patient preference.Trial registration numberThe Netherlands Trial Register NTR5712.

Download Full-text