%0 Journal Article %J BMJ Open %D 2019 %T Care of general practice patients preceding and following a suicide attempt: observational study in Flemish general practices %A Nicole Boffin %A Viviane Van Casteren %A Karin De Ridder %B BMJ Open %V 9 %8 May-05-2019 %G eng %N 5 %R 10.1136/bmjopen-2018-028546 %0 Journal Article %J BMJ Open %D 2019 %T Care of general practice patients preceding and following a suicide attempt: observational study in Flemish general practices. %A Nicole Boffin %A Viviane Van Casteren %A Karin De Ridder %X

OBJECTIVES: First, to examine general practitioner (GP) knowledge about the care (needs) of their patients; second, to examine the quality of GP follow-up care; third, to examine the transmission of patient care information from hospitals/emergency services (ES) to GPs.

SETTING: 105 general practices from the representative Belgian Network of Sentinel General Practices (SGP) in Flanders, the largest region of Belgium, during 2013-2016.

PARTICIPANTS: 245 suicide attempts by regular patients.

OUTCOMES MEASURES: Ten care-related measures, including three indicators of quality of follow-up care, were based on data reported by the SGP on structured forms at baseline and at two follow-up points in time.

RESULTS: As for GP knowledge, 10.5% of SGP failed to report whether suicidal risk was noticed in patients seen in the month preceding the attempt; 9.0% whether there were previous attempts; 22.5% whether the patient was receiving mental health treatment at follow-up and 22.0% whether suicidal behaviour was repeated at follow-up. Relatively more patients≥65 years had no suicide risk evaluation (OR 3.54; 95% CI 1.11 to 11.26). As for quality of follow-up care, there was a GP-patient contact following 90.5% of the attempts, follow-up appointments were planned following 43.4% of the attempts and there was a GP contact with patient proxies following 62.8% of the attempts. Patient age ≥65 years (OR 4.09; 95% CI 1.79 to 9.33), a recent GP-patient contact preceding the attempt (OR 1.97; 95% CI 1.13 to 3.43), depression of patient (OR 1.96; 95% CI 1.14 to 3.37) and a suburban SGP area (OR 2.34; 95% CI 1.13 to 4.82) were determinants of an increased quality of care sum. GPs received patient care information from a hospital (ES) for 67.8% of eligible attempts, with SGP practice location being a determinant.

CONCLUSIONS: GPs are highly involved in the care of suicide attempters but there is room for improvement, also in informational continuity from hospital (ES) to GPs.

%B BMJ Open %V 9 %8 2019 May 05 %G eng %N 5 %R 10.1136/bmjopen-2018-028546 %0 Journal Article %J BMJ Open %D 2019 %T Care of general practice patients preceding and following a suicide attempt: observational study in Flemish general practices %A Nicole Boffin %A Viviane Van Casteren %A Karin De Ridder %K care %K GENERAL PRACTITIONER %K observational study %K suicide %B BMJ Open %V 9 %8 May-05-2019 %G eng %N 5 %R 10.1136/bmjopen-2018-028546 %0 Journal Article %J BMJ Open %D 2019 %T Care of general practice patients preceding and following a suicide attempt: observational study in Flemish general practices. %A Nicole Boffin %A Viviane Van Casteren %A Karin De Ridder %X

OBJECTIVES: First, to examine general practitioner (GP) knowledge about the care (needs) of their patients; second, to examine the quality of GP follow-up care; third, to examine the transmission of patient care information from hospitals/emergency services (ES) to GPs.

SETTING: 105 general practices from the representative Belgian Network of Sentinel General Practices (SGP) in Flanders, the largest region of Belgium, during 2013-2016.

PARTICIPANTS: 245 suicide attempts by regular patients.

OUTCOMES MEASURES: Ten care-related measures, including three indicators of quality of follow-up care, were based on data reported by the SGP on structured forms at baseline and at two follow-up points in time.

RESULTS: As for GP knowledge, 10.5% of SGP failed to report whether suicidal risk was noticed in patients seen in the month preceding the attempt; 9.0% whether there were previous attempts; 22.5% whether the patient was receiving mental health treatment at follow-up and 22.0% whether suicidal behaviour was repeated at follow-up. Relatively more patients≥65 years had no suicide risk evaluation (OR 3.54; 95% CI 1.11 to 11.26). As for quality of follow-up care, there was a GP-patient contact following 90.5% of the attempts, follow-up appointments were planned following 43.4% of the attempts and there was a GP contact with patient proxies following 62.8% of the attempts. Patient age ≥65 years (OR 4.09; 95% CI 1.79 to 9.33), a recent GP-patient contact preceding the attempt (OR 1.97; 95% CI 1.13 to 3.43), depression of patient (OR 1.96; 95% CI 1.14 to 3.37) and a suburban SGP area (OR 2.34; 95% CI 1.13 to 4.82) were determinants of an increased quality of care sum. GPs received patient care information from a hospital (ES) for 67.8% of eligible attempts, with SGP practice location being a determinant.

CONCLUSIONS: GPs are highly involved in the care of suicide attempters but there is room for improvement, also in informational continuity from hospital (ES) to GPs.

%B BMJ Open %V 9 %8 2019 May 05 %G eng %N 5 %R 10.1136/bmjopen-2018-028546 %0 Report %D 2019 %T De zorgtrajecten diabetes mellitus type 2 en chronische nierinsufficiëntie en kwaliteit van zorg (EVACQ) %A Maria Goossens %A Chrysostomos Kalyvas %A Titouan Kennel %A Viviane Van Casteren %A Kris Doggen %X

Huisartsen kunnen hun geïndividualiseerd feedbackrapport hier raadplegen. Hieronder vindt u de samenvatting van het nationaal rapport.

Deze tweede evaluatie van de doeltreffendheid van de zorgtrajecten (ZT) diabetes type 2 (DM2) en chronische nierinsufficiëntie (CNI) in termen van de kwaliteit van zorgprocessen en intermediaire gezondheidsuitkomsten voor de patiënten opgenomen in een ZT kadert in de onderzoeksopdracht EVACQ (Evaluation of Ambulatory Care Quality), vastgelegd in een conventie tussen het Rijksinstituut voor Ziekte- en Invaliditeitsverzekering (RIZIV) en Sciensano (september 2017 - februari 2019)[1].

In deze tweede evaluatie werd de kwaliteit van de zorg geëvalueerd aan de hand van de parameters opgenomen in het ZT-contract. Voor het ZT DM2 was dit het bepalen van het geglyceerd hemoglobine A1c (HbA1c) en het low density lipoprotein (LDL)-cholesterol, opvolging van de bloeddruk en de body mass index (BMI). Voor het ZT CNI was dit hemoglobine (Hb), de geschatte glomerulaire filtratiesnelheid (eGFR) en opvolging van de bloeddruk. Voor de evaluatie van de kwaliteit van de zorgprocessen konden we gebruik maken van de gegevens die door de huisartsen aangeleverd werden op basis van het elektronisch medisch dossier (EMD), hetzij via automatische extractie, hetzij via manuele invoer, en van de gegevens van het Intermutualistisch Agentschap (IMA). De gezondheidsuitkomsten konden geëvalueerd worden aan de hand van de gegevens door de huisartsen aangeleverd. Voor het ZT DM2 werd gekeken naar het percentage patiënten dat de streefwaarden voor HbA1c en LDL-cholesterol behaalden en het percentage van patiënten die de streefwaarden voor de bloeddruk behaalden. Voor het ZT CNI berekenden we het percentage patiënten dat de streefwaarde voor Hb behaalde over de verschillende jaren, de opvolging van de nierfunctie aan de hand van de eGFR-waarde, en het percentage van patiënten dat de streefwaarden voor de bloeddruk behaalde. De contacten met de verschillende zorgverleners werden geëvalueerd aan de hand van de IMA-gegevens.

Zorgtraject diabetes mellitus type 2

De studiepopulatie op basis van de IMA-gegevens bestond in het totaal uit 40.963 patiënten met een ZT DM2 gestart in de periode 01/09/2009 - 31/12/2015. De EMD-gegevens waren beschikbaar voor 21.373 patiënten met een ZT DM2 gestart in de periode 01/09/2009 tot 30/09/2016.

Het opstarten van het ZT DM2 leidt tot een frequenter contact van de patiënt met de zorgverleners, zowel huisarts als specialist, maar ook met de podoloog, diabeteseducator/diëtist en de oogarts voor de oogfundoscopie.

De geanalyseerde parameters uit het EMD (HbA1c, LDL-cholesterol, bloeddruk en BMI) laten zien dat er een significante toename is van het percentage patiënten met deze parameters in het EMD over de jaren heen na inclusie in het ZT. De IMA-gegevens bevestigen dat na inclusie in het ZT bijna alle patiënten (>97%) over de jaren heen minstens éénmaal per jaar een HbA1c-, cholesterol-, of creatininebepaling kregen. We zagen ook een significante stijging in de jaarlijkse bepalingen van urinaire creatinine en albumine.

De kwaliteit van zorg voor DM2-patiënten die geëvalueerd werd aan de hand van de intermediaire gezondheidsuitkomstparameters nam toe. We merken dat een hoger percentage patiënten een gecontroleerde bloeddruk, een lagere LDL-cholesterol en HbA1c hebben na inclusie in het ZT DM2.

Zorgtraject chronische nierinsufficiëntie

De studiepopulatie op basis van de IMA-gegevens bestond in het totaal uit 21.373 patiënten met een ZT CNI gestart in de periode 01/06/2009 - 31/12/2015. De EMD-gegevens waren beschikbaar voor 15.313 patiënten met een ZT CNI gestart in de periode 01/06/2009 tot 30/09/2016.

Het opstarten van het ZT CNI leidt tot een frequenter contact van de patiënt met de zorgverleners, zowel huisarts als specialist. Het contact met de diëtist neemt toe maar is vooral beperkt tot het eerste jaar na inclusie in het ZT CNI.

De geanalyseerde parameters uit het EMD (HB, eGFR en bloeddruk) laten zien dat er een significante toename is van het percentage patiënten met deze parameters in het EMD over de jaren heen na inclusie in het ZT. De IMA-gegevens bevestigen dat na inclusie in het ZT bijna alle patiënten (>97%) over de jaren heen minstens éénmaal per jaar een Hb-, cholesterol-, of creatininebepaling kregen. We zagen ook een significante stijging in de jaarlijkse bepalingen van urinaire proteïne en albumine.

De kwaliteit van zorg voor CNI-patiënten die geëvalueerd werd aan de hand van de intermediaire gezondheidsuitkomstparameters nam toe. We merken dat een hoger percentage patiënten een gecontroleerde bloeddruk hebben in het ZT CNI. Bovendien zien we dat de daling van de nierfunctie over de jaren heen trager verloopt dan een jaarlijkse daling van de nierfunctie gedefinieerd in een vergelijkbare cohorte als ≥3 ml/min/1.73 m2/jaar.

Algemeen besluit

Het programma “zorgtraject” van het RIZIV dat een complexe interventie omvat, was doeltreffend in de periode 2009-2016 om voor patiënten met DM2 of CNI een betere opvolging te verzekeren. We zagen een toename in de frequentie van de contacten tussen patiënt en zorgverleners in vergelijking met de periode vóór de inclusie in het ZT en de evaluatie van de intermediaire gezondheidsuitkomstparameters liet een duidelijke verbetering zien van de kwaliteit van de zorg.

 

[1] Overeenkomst tussen het Comité van de Verzekering voor Geneeskundige Verzorging van het RIZIV en het WIV-ISP tot realisatie van beleidsondersteunend onderzoek, in het kader van de zorgtrajecten en de voortrajecten.

%I Sciensano %C Brussel, België %8 11/2019 %G eng %R https://doi.org/10.25608/34ka-c432 %0 Report %D 2019 %T Les trajets de soins diabète de type 2 et insuffisance rénale chronique et la qualité des soins (EVACQ) %A Maria Goossens %A Chrysostomos Kalyvas %A Titouan Kennel %A Viviane Van Casteren %A Kris Doggen %X

Les médecins-généralistes peuvent consulter leur rapport de feed-back individualisé ici. Ci-dessous, vous trouverez le résumé du rapport nationale.

Cette deuxième évaluation de l’efficacité des trajets de soins (TS) du diabète sucré de type 2 (DS2) et de l’insuffisance rénale chronique (IRC) en termes de qualité des processus de soins et de résultats intermédiaires de santé pour les patients pris en charge dans un TS s’inscrit dans la demande d’étude EVACQ (Evaluation of Ambulatory Care Quality), définie dans une convention conclue entre l’Institut National d’Assurance Maladie-Invalidité (INAMI) et Sciensano (septembre 2017 - février 2019)[1].

Cette deuxième évaluation consistait à évaluer la qualité des soins à l’aide des paramètres qui ont été fixés dans le contrat de TS. Le TS DS2 avait pour but d’évaluer les taux d’hémoglobine glyquée A1c (HbA1c) et de cholestérol des lipoprotéines de basse densité (LDL), ainsi que de suivre l’évolution de la pression artérielle (PA) et de l’indice de masse corporelle (IMC). Le TS IRC avait pour but d’évaluer le taux d’hémoglobine (Hb) et la valeur du débit de filtration glomérulaire estimé (DFGe), ainsi que de suivre l’évolution de la PA. Pour l’évaluation de la qualité des processus de soins, on a pu utiliser les données qui nous ont été communiquées par les médecins généralistes (MG) sur la base du dossier médical informatisé (DMI), soit par extraction automatique, soit via saisie manuelle, ainsi que les données de l’Agence Intermutualiste (AIM). Les résultats de santé ont pu être évalués à l’aide des données qui nous ont été fournies par les MG. Pour le TS DS2, on s’est concentré sur le pourcentage de patients qui ont atteint les valeurs cibles pour l’HbA1c et le cholestérol LDL et le pourcentage de patients qui ont obtenu les valeurs cibles pour la PA. Pour le TS IRC, on a calculé le pourcentage de patients qui ont atteint la valeur cible pour l’Hb sur plusieurs années, le suivi de la fonction rénale à l’aide de la valeur du DFGe et le pourcentage de patients qui ont atteint les valeurs cibles pour la PA. Les contacts avec les différents prestataires de soins ont été évalués à l’aide des données de l’AIM.

Trajet de soins du diabète sucré de type 2

La population d’étude évaluée sur la base des données de l’AIM comprenait au total 40 963 patients débutant un TS DS2 au cours de la période allant du 01/09/2009 au 31/12/2015. Les données des DMI étaient disponibles pour 21 373 patients avec un TS DS2 débutant au cours de la période allant du 01/09/2009 au 30/09/2016.

Le démarrage du TS DS2 permet d’obtenir un contact plus fréquent entre le patient et les prestataires de soins, c.-à-d. aussi bien les MG que les spécialistes, mais aussi avec le podologue, l’éducateur en diabétologie/diététicien et l’ophtalmologue pour l’examen du fond d’œil.

Les paramètres du DMI (HbA1c, cholestérol LDL, PA et IMC) qui ont été analysés nous montrent une augmentation significative du pourcentage de patients avec ces paramètres dans le DMI au fil des années après inclusion dans le TS. Les données de l’AIM confirment que quasiment tous les patients (> 97 %), après l’inclusion dans le TS, ont été soumis au fil des années au moins une fois par an à un dosage de l’HbA1c, du cholestérol ou de la créatinine. Une augmentation significative des dosages annuels de la créatininurie et de l’albuminurie a également été constatée.

La qualité de soins des patients avec le DS2 qui a été évalué sur la base des paramètres des résultats intermédiaires de santé s’améliorait. Nous remarquons un pourcentage plus élevé de patients présentent une PA contrôlée, un taux de cholestérol LDL et d’HbA1c plus faibles après inclusion dans le TS DS2.

Trajet de soins de l’insuffisance rénale chronique

La population d’étude évaluée sur la base des données de l’AIM comprenait au total 21 373 patients débutant un TS IRC au cours de la période allant du 01/06/2009 au 31/12/2015. Les données des DMI étaient disponibles pour 15 313 patients avec un TS IRC débutant au cours de la période allant du 01/06/2009 au 30/09/2016.

Le démarrage du TS IRC permet d’obtenir un contact plus fréquent entre le patient et les prestataires de soins, c.-à-d. aussi bien les MG que les spécialistes. Les consultations avec le diététicien augmentent, mais se limitent principalement à la première année après inclusion dans le TS IRC.

Les paramètres du DMI (Hb, DFGe et PA) qui ont été analysés nous montrent une augmentation significative du pourcentage de patients avec ces paramètres dans le DMI au fil des années après inclusion dans le TS. Les données de l’AIM confirment que quasiment tous les patients (> 97 %), après l’inclusion dans le TS, ont été soumis au fil des années au moins une fois par an à un dosage de l’Hb, du cholestérol ou de la créatinine. Une augmentation significative des dosages annuels de la protéinurie et de l’albuminurie a également été constatée.

La qualité de soins des patients avec l’IRC qui a été évalué sur la base des paramètres des résultats intermédiaires de santé s’est améliorée. Nous remarquons un pourcentage plus élevé de patients dont la PA est contrôlée dans le TS IRC. En outre, il apparaît que la diminution de la fonction rénale ralentit au fil des ans, par rapport à la baisse annuelle de la fonction rénale définie par ≥ 3 ml/min/1,73 m²/an dans une cohorte similaire.

Conclusion générale

Le programme « trajet de soins » de l’INAMI qui comporte une intervention complexe s’est révélé efficace au cours de la période allant de 2009 à 2016 afin de garantir un meilleur suivi des patients atteints d’un DS2 ou d’une IRC. Nous avons constaté une amélioration de la fréquence des contacts entre le patient et le prestataire de soins en comparaison avec la période précédant l’inclusion dans le TS et l’évaluation des paramètres des résultats intermédiaires de santé ont montré une nette amélioration de la qualité des soins.

 

[1] Convention conclue entre le Comité de l’assurance soins de santé de l’INAMI et le WIV-ISP en vue d’une recherche stratégique dans le cadre des trajets de soins et des prétrajets.

%I Sciensano %C Bruxelles, Belgique %8 11/2019 %G eng %R https://doi.org/10.25608/jwcc-5n94 %0 Report %D 2018 %T Belgisch register van neuromusculaire aandoeningen, jaarverslag 2016 %A Corinne Bleyenheuft %A Marjan Cosyns %A Viviane Van Casteren %X

De doelstellingen van het Belgisch register van neuromusculaire aandoeningen zijn: het faciliteren van klinisch, epidemiologisch en etiologisch onderzoek binnen het domein van de neuromusculaire aandoeningen, het ondersteunen en bevorderen van de kwaliteit van zorg in de neuromusculaire referentiecentra (NMRC), het verstrekken van informatie aan volksgezondheidsoverheden voor het beheer van de overeenkomst en de planning van de zorg en het vergemakkelijken van de werving van patiënten voor onderzoek naar nieuwe behandelingen.

Sinds de oprichting van het register in 2008 is het aantal geïncludeerde patiënten jaar na jaar toegenomen. Voor 2016 werden in totaal 5.381 patiënten geregistreerd. Wat dit register van neuromusculaire aandoeningen zo bijzonder maakt ten opzichte van andere gezondheidszorgregisters is dat de patiëntenpopulatie helemaal niet homogeen is. De term "neuromusculaire aandoeningen" groepeert immers verschillende zeldzame ziekten die hetzij de voorste hoorncellen van het ruggenmerg, hetzij de perifere zenuwen, hetzij de spieren, hetzij de neuromusculaire verbindingen aantasten. Een aantal van deze ziekten zijn genetisch, andere niet. De meeste ervan zijn degeneratief, met soms een fatale afloop op korte of lange termijn. Sommige ziekten doen zich voor vanaf de vroege kinderjaren, terwijl andere zich manifesteren vanaf de volwassen leeftijd. Gezien de heterogeniteit van de patiëntengroep is het dus moeilijk een algemeen overzicht te geven.

Uit de algemene demografische gegevens van het register blijkt dat er iets meer mannen dan vrouwen met een neuromusculaire aandoening zijn (respectievelijk n = 2.940 versus n = 2.438). Momenteel worden er meer patiënten in het noorden dan in het zuiden van het land gerekruteerd. Dit valt wellicht te verklaren door de geografische spreiding van de NMRC, die de gegevens inzamelen. Het verschil tussen de twee landsdelen neemt echter jaar na jaar af. In 2016 werden 230 overlijdens gerapporteerd, waarvan 161 (70%) bij patiënten met amyotrofische lateraal sclerose.

De tien meest voorkomende aandoeningen in het register waren voor 2016: hereditaire motorische en sensorische neuropathie, myotone dystrofie type 1, amyotrofische lateraal sclerose, hereditaire spastische paraparese, spierdystrofie van Duchenne, bekkengordeldystrofie, chronische inflammatoire demyeliniserende polyneuropathie, facioscapulohumerale dystrofie, spinocerebellaire ataxie en postpoliosyndroom. Deze tien aandoeningen worden in dit verslag in detail geanalyseerd.

Voor twee ziektegroepen, met name spierdystrofie van Duchenne en spinale musculaire atrofie, zamelt het register ook bijkomende gegevens in voor het internationale TREAT-NMD-netwerk (Translational Research in Europe – Assessment and Treatment of NeuroMuscular Diseases). Deze specifieke gegevens worden ook in dit verslag geanalyseerd.

In de toekomst zou de mogelijkheid om sommige gegevens rechtstreeks in te voeren via een tablet, die ter beschikking zou worden gesteld van de patiënt in de wachtzaal, kunnen bijdragen tot een vermindering van de werklast van de data providers in de NMRC. De kwaliteit van de gegevens bij invoer zal in de loop van de datacollectie van 2017 opnieuw worden geëvalueerd.

%I Sciensano %C Brussel, België %P 80 %G eng %M D/2018/14470/18 %0 Journal Article %J Int J Environ Res Public Health %D 2018 %T General Practice Care for Patients with Rare Diseases in Belgium. A Cross-Sectional Survey. %A Nicole Boffin %A Elfriede Swinnen %A Wens, Johan %A Montse Urbina Paz %A Johan Van der Heyden %A Viviane Van Casteren %K family practice;chronic disease; epidemiology; referral and consultation; health surveys; workload %X

There are almost no studies about rare diseases in general practice. This study examined care characteristics of active rare disease patients in the Belgian Network of Sentinel General Practices (SGP) and the importance of rare diseases in general practice by its caseload, general practitioner (GP)⁻patient encounter frequency and nationwide prevalence. The SGP reported data about: (i) the number of active rare disease patients in 2015; and (ii) characteristics of one to three most recently seen patients. Rare diseases were matched against Orphanet (www.orpha.net). GP encounter frequency and patients' age were compared to the total general practice population. Details from 121 active patients (median age: 44, interquartile range (IQR) 24⁻60) showed that for 36.9% the GP had been the first caregiver for the rare disease and for 35.8% the GP established a diagnostic referral. GPs rated their knowledge about their patients' disease as moderate and used Orphanet for 14.9% of patients. Any active rare disease patients (median: 1, IQR 0⁻2) were reported by 66 of 111 SGP. Compared to the total general practice population, the mean GP encounter frequency was higher (7.3; 95% confidence intervals (CI) 6.1⁻8.5 versus 5.4; 95% CI 5.4⁻5.4). The prevalence of rare diseases in the Belgian general practice population was estimated at 12.0 (95% CI 10.3⁻13.9) per 10,000. This study acknowledges the important role of GPs in rare disease care. Knowledge and use of Orphanet by GPs could be improved.

%B Int J Environ Res Public Health %V 15 %8 2018 06 05 %G eng %N 6 %R 10.3390/ijerph15061180 %0 Report %D 2018 %T Registre belge des maladies neuromusculaires, rapport annuel 2016 %A Corinne Bleyenheuft %A Marjan Cosyns %A Viviane Van Casteren %X

Les objectifs du registre belge des maladies neuromusculaires sont : de faciliter la recherche clinique, épidémiologique et étiologique dans le domaine des maladies neuromusculaires, de soutenir et de promouvoir la qualité des soins dans les centres de références pour les maladies neuromusculaires (CRNM), de fournir des informations aux autorités de santé publique pour la gestion de la convention et la planification des soins, et de faciliter le recrutement de patients pour la recherche sur les nouveaux traitements.

Depuis la création du registre en 2008, le nombre de patients inclus a augmenté d’année en année. Pour l’année 2016, un nombre total de 5381 patients ont été enregistrés. La particularité d’un registre dédié aux maladies neuromusculaires par rapport à d’autres registres de soins de santé, est que la population de patients n’est absolument pas homogène. Le terme "maladie neuromusculaire" regroupe en effet différentes maladies rares qui touchent soit les nerfs périphériques, soit les muscles, soit la jonction neuromusculaire, soit les cellules de la corne antérieure de la moelle épinière. Certaines de ces maladies sont génétiques, d’autre pas. La grande majorité d’entre elles sont dégénératives, avec parfois une issue fatale à brève ou longue échéance. Certaines de ces maladies se manifestent dès la petite enfance, d’autres surviennent à l’âge adulte. Il est donc difficile de fournir un aperçu général d’un groupe de patients aussi hétérogène.

Les données démographiques générales du registre font état d’un nombre d’hommes légèrement plus élevé que de femmes (N = 2940 versus N = 2438). Le recrutement des patients est pour l’instant plus important au nord qu’au sud du pays, vraisemblablement en raison de la répartition géographique des CRNM qui collectent les données. Néanmoins, l’écart entre ces deux régions tend à se réduire d’année en année. 230 décès ont été rapportés en 2016, dont 161 (70%) survenus chez des patients atteints de sclérose latérale amyotrophique.

Les dix maladies les plus prévalentes au sein du registre sont pour l’année 2016 : la neuropathie sensitive et motrice, la dystrophie myotonique de type 1, la sclérose latérale amyotrophique, la paraplégie spastique héréditaire, la dystrophie musculaire de Duchenne, la dystrophie musculaire des ceintures, la polyneuropathie démyélinisante inflammatoire chronique, la dystrophie facio-scapulo-humérale, l’ataxie spino-cérébelleuse, et le syndrome post-poliomyélite. Ces dix maladies font l’objet d’une analyse plus détaillée au sein de ce rapport.

Le registre collecte également des données spécifiques au réseau international « TREAT-NMD », pour 2 groupes de maladies spécifiques : les dystrophies musculaires de Duchenne et de Becker, et les amyotrophies spinales. Ces données spécifiques sont également analysées au sein de ce rapport.

Dans les perspectives futures, la possibilité de collecter certaines données directement sur une tablette qui serait mise à disposition du patient dans la salle d’attente pourrait contribuer à diminuer la charge de travail des data providers au sein des CRNM. La qualité des données à l’encodage sera réévaluée au cours de la collecte de données de 2017.

%I Sciensano %C Bruxelles, Belgique %P 80 %G eng %M D/2018/14470/17 %0 Report %D 2018 %T Virological Surveillance of Influenza in Belgium Season 2017-2018 %A Isabelle Thomas %A Cyril Barbezange %A Steven Van Gucht %A Jeannine Weyckmans %A Ilham Fdillate %A Reinout Van Eycken %A Assia Hamouda %A Nathalie Bossuyt %A Sophie Quoilin %A Viviane Van Casteren %A Yolande Pirson %V ISSN number: D/2018/14.440/40 %G eng %0 Report %D 2017 %T Belgisch register van neuromusculaire aandoeningen, jaarverslag 2015 %A Corinne Bleyenheuft %A Viviane Van Casteren %X

Het doel van het Belgisch register van neuromusculaire aandoeningen bestaat erin om het klinische,
epidemiologische en etiologische onderzoek op het gebied van neuromusculaire aandoeningen te vergemakkelijken,
de kwaliteit van de zorg in de neuromusculaire referentiecentra (NMRC) te verbeteren,
informatie te verstrekken aan de volksgezondheidsoverheden voor het beheer van de overeenkomst en
de planning van de zorg en de werving van patiënten te bevorderen met het oog op het onderzoek naar
nieuwe behandelingen.
Sinds de oprichting van het register in 2008 is het aantal opgenomen patiënten jaar na jaar toegenomen.
Voor 2015 werden in totaal 4.670 patiënten geregistreerd. Wat dit register van neuromusculaire aandoeningen
zo bijzonder maakt ten opzichte van andere gezondheidszorgregisters is dat de patiëntenpopulatie
helemaal niet homogeen is. De term “neuromusculaire aandoening” groepeert immers verschillende
zeldzame ziekten die een impact hebben op hetzij de perifere zenuwen, hetzij de spieren, hetzij de neuromusculaire
verbindingen, hetzij de voorste hoorncellen van het ruggenmerg. Een aantal van deze aandoeningen
zijn genetisch, andere niet. De meeste ervan zijn degeneratief en hebben soms een fatale afloop
op korte of lange termijn. Sommige van deze aandoeningen doen zich voor vanaf de vroege kinderjaren,
terwijl andere zich manifesteren vanaf de volwassen leeftijd. Het is dus moeilijk om een algemeen overzicht
te geven, gezien de heterogeniteit van deze groep van patiënten.
Uit de algemene demografische gegevens van het register blijkt dat er iets meer mannen dan vrouwen
met een neuromusculaire aandoening zijn (n = 2.610 versus n = 2.043). Momenteel worden er meer
patiënten gerekruteerd in het noorden van het land dan in het zuiden. Dit valt wellicht te verklaren door
de geografische spreiding van de NMRC die de gegevens inzamelen. Het verschil tussen deze twee regio’s
neemt echter jaar na jaar af. In 2015 werden 152 overlijdens gerapporteerd, waarvan 96 bij patiënten met
amyotrofe laterale sclerose.
De tien meest voorkomende aandoeningen in het register zijn voor 2015: hereditaire motorische en sensorische
neuropathie, myotone dystrofie type 1, amyotrofe laterale sclerose, spierdystrofie van Duchenne,
hereditaire spastische paraplegie, bekkengordeldystrofie, chronische inflammatoire demyeliniserende
polyneuropathie, facioscapulohumerale dystrofie, spinocerebellaire ataxie en postpoliosyndroom. Deze
tien aandoeningen worden in dit verslag in detail geanalyseerd.
Het register zamelt ook specifieke gegevens in van het internationaal netwerk “TREAT-MND” voor 2 bijzondere
groepen van aandoeningen: de spierdystrofie van Duchenne en van Becker, en de spinale atrofieën.
Deze specifieke gegevens worden ook geanalyseerd in dit verslag.
De kwaliteit van de gegevens bij de invoer werd tot slot beoordeeld in de loop van deze inzameling, door
5% van de ingevoerde dossiers te vergelijken met het oorspronkelijke dossier. Uit de resultaten blijkt dat
in bepaalde NMRC vooruitgang is geboekt op het vlak van de kwaliteit van de ingevoerde gegevens. De
mogelijkheid om sommige gegevens rechtstreeks via een tablet in te zamelen die ter beschikking zou worden
gesteld van de patiënt in de wachtzaal, zou in de toekomst kunnen bijdragen tot een vermindering
van de werklast van de dataleveranciers in de NMRC.

%I Wetenschappelijk Instituut Volksgezondheid %C Brussel, België %P 75 %G eng %M D/2017/2505/09 %0 Journal Article %J BMJ Open %D 2017 %T Four sexually transmitted infections (STIs) in Belgian general practice: first results (2013-2014) of a nationwide continuing surveillance study. %A Boffin, N %A Moreels, S %A Deblonde, J %A Viviane Van Casteren %K Adult %K Belgium %K Chlamydia Infections %K Condylomata Acuminata %K Contact Tracing %K Female %K General practice %K Gonorrhea %K HIV Infections %K Humans %K Logistic Models %K Male %K middle aged %K Practice Guidelines as Topic %K Retrospective Studies %K Sexual Behavior %K Sexually Transmitted Diseases %K Syphilis %K Young adult %X

OBJECTIVES: To describe and explore data from the surveillance of chlamydia, syphilis, gonorrhoea and genital warts by the Belgian Network of Sentinel General Practices (SGP) over the first 2 years (2013 and 2014) and to estimate the incidence of these 4 sexually transmitted infections (STIs). A special focus is put on data quality.

DESIGN: Retrospective observational study.

SETTING: General practices from the nationwide representative SGP network.

OUTCOME MEASURES: Agreement between data distributions by year, agreement between SGP-based incidence and incidence based on mandatory notification, missingness of patient age or gender and incompleteness of sexual risk history of patients.

RESULTS: 306 new STI episodes were reported from 298 patients, corresponding with an episode-based incidence of 91.9/100 000 (95% CI 81.9 to 102.8) general practice patients, with almost half of it due to chlamydia. The incidence of chlamydia in men was significantly higher in 2014 than in 2013. Population characteristics were similarly distributed in 2013 and 2014. The SGP-based incidence of gonorrhoea and syphilis in Flanders were in agreement with the incidence based on mandatory notification of cases. Patient age or gender was missing from 35 episodes (11.4%). Independent determinants of missingness of patient age or gender were the Flemish region (OR 3.46; 95% CI 1.02 to 11.73) and genital warts infection (OR 2.23; 95% CI 1.07 to 4.63). An incomplete sexual risk history was reported for 54.6% STI episodes. The odds for an incomplete sexual history were higher for older patients (OR 1.72; 95% CI 1.06 to 2.76) and for patients infected with syphilis, gonorrhoea or co-infection(s) (OR 1.71; 95% CI 1.03 to 2.83).

CONCLUSIONS: Incompleteness of reports about patients with STI sexual risk histories is important from the perspective of quality of data and of quality of care. Together with the low rates of both HIV testing and discussion of partner notification, this suggests that a general practice guideline is needed.

%B BMJ Open %V 7 %P e012118 %8 2017 Jan 27 %G eng %N 1 %1 https://www.ncbi.nlm.nih.gov/pubmed/28131995?dopt=Abstract %R 10.1136/bmjopen-2016-012118 %0 Report %D 2017 %T Initiatief voor Kwaliteitsbevordering en Epidemiologie bij Kinderen en Adolescenten met Diabetes - Resultaten 2015 %A Suchsia Chao %A Kris Doggen %A Astrid Lavens %A Viviane Van Casteren %K diabetes %X

In dit rapport worden de resultaten beschreven van de vijfde audit bij de erkende pediatrische diabetescentra (hierna de PDC’s genoemd). In de audit werden gegevens verzameld van 2880 patiënten met type 1-diabetes, jonger dan 19 jaar, die in 14 PDC’s werden behandeld. De gegevens hebben betrekking op de zorg in 2015. In dit rapport wordt gefocust op trends in de zorgkwaliteit en kenmerken van de studiepopulatie in de periode 2008-2015.
De voornaamste bevindingen waren:
••
Een aantal aspecten van de zorgkwaliteit, zoals gemeten met een brede set van proces- en uitkomstindicatoren, verbeterde in de periode 2008-2015: er was een stijging van het aantal bloeddrukmetingen en van het aantal patiënten dat het therapiedoel van HbA1c < 7,5% haalde. De meting van het HbA1c (één of drie keer), van de BMI en de screening voor coeliakie en schildklierauto- immuniteit was consistent hoog (> 80%) in alle audits.
••
De verbetering van het HbA1c werd vastgesteld in 13 van de 14 PDC’s en was voornamelijk onafhankelijk van de kenmerken van de patiënt (geslacht, kerngezinstatus...) en het insulineschema: uit de gegevens bleek dat de verbetering van het HbA1c meestal voorkwam bij patiënten boven de 10 jaar oud en ook bij patiënten van wie minstens één ouder de Kaukasische etniciteit had.
••
In de periode 2008-2015 bleef het niveau van de acute en chronische complicaties en cardiovasculaire risicofactoren stabiel.
In conclusie, ondanks de beperkingen van het transversale karakter van de studie en de beperkte follow-up, bleek uit de vijfde IKEKAD-audit dat er een gunstige evolutie is op het vlak van het HbA1c, een belangrijke indicator van de zorgkwaliteit. Uit toekomstige audits zal moeten blijken of deze evolutie aanhoudt. Omdat sinds 2013 extra gegevens worden verzameld (alle patiënten die in aanmerking komen worden in de steekproef opgenomen, en niet slechts bij helft) zal het ook mogelijk worden om het HbA1c-traject van individuele patiënten en de bepalende factoren te analyseren, waardoor we meer aanwijzingen zullen hebben over de factoren waarop we ons het meeste moeten richten wanneer we de zorgkwaliteit bij pediatrische diabetespatiënten willen verbeteren.

%I WIV-ISP %C Brussel %P 54 %8 12/2017 %G eng %M D/2017/2505/25 %0 Report %D 2017 %T Initiatief voor Kwaliteitsbevordering en Epidemiologie bij multidisciplinaire Diabetes Voetklinieken (IKED-Voet) - Samenvatting van de resultaten van de 4de gegevensverzameling (auditjaren 2013-2014) %A Kris Doggen %A Sophie Deweer %A Isabelle Dumont %A Vera Eenkhoorn %A Patricia Félix %A Patrick Lauwers %A Giovanni Matricali %A Caren Randon %A Kristien Van Acker %A Michel Vandenbroucke %A Eric Weber %A Viviane Van Casteren %A Frank Nobels %K audit %K charcot foot %K diabetes %K Diabetic Foot %K diabetic foot ulcer %K feedback %K quality improvement %K quality of care %X

Dit rapport beschrijft de resultaten van de vierde audit bij de erkende diabetesvoetklinieken in België (hierna “centra” genoemd). De resultaten worden vergeleken met die van eerdere audits. Tussen 2005 en 2014 werden vier audits georganiseerd. In alle audits werden in 20 tot 34 centra 5.510 diabetesvoetproblemen geregistreerd bij 4.917 unieke patiënten. De voetproblemen waren ofwel een diabetesvoetwonde van minstens Wagner-graad 2 en/of een actieve charcotvoet. De gegevens hadden betrekking op de kenmerken bij de aanvang van de opvolging en op de behandeling en de uitkomsten in de loop van 6 tot 12 maanden. Na de audit kregen de centra een feedbackrapport met benchmarking van hun prestaties op het vlak van een aantal kwaliteitsindicatoren. Het volledige rapport kan men downloaden via volgende link: https://rebrand.ly/iqedfootfullreport

 

Met betrekking tot diabetesvoetwonden kunnen de volgende conclusies worden getrokken:

 

 

Met betrekking tot actieve charcotvoet kunnen de volgende conclusies worden getrokken:

 

%I WIV-ISP %C Brussel, België %P 96 %8 02/2017 %G eng %M D/2017/2505/03 %0 Report %D 2017 %T Initiative for Quality Improvement and Epidemiology in Multidisciplinary Diabetic Foot Clinics (IQED-Foot) - Results of the 4th data collection (audit years 2013-2014) %A Kris Doggen %A Sophie Deweer %A Isabelle Dumont %A Vera Eenkhoorn %A Patricia Félix %A Patrick Lauwers %A Giovanni Matricali %A Caren Randon %A Kristien Van Acker %A Michel Vandenbroucke %A Eric Weber %A Viviane Van Casteren %A Frank Nobels %K charcot foot %K diabetes %K Diabetic Foot %K diabetic foot ulcer %K feedback %K quality improvement %K quality of care %X

This report describes the results of the fourth audit among the recognized diabetic foot clinics in Belgium (hereafter referred to as “centres”). The results are compared to those from previous audits. Four audits have been organised between 2005 and 2014. Across all audits, 5,510 diabetic foot problems of 4,917 unique patients were sampled in 20-34 centres. Foot problems were either a diabetic foot ulcer of at least Wagner grade 2 and/or an active Charcot foot. Data pertained to characteristics at intake and the treatment and outcomes over the course of 6-12 months. After the audit, centres received a feedback report including benchmarking of their performance with regard to a number of quality indicators.

 

With regard to diabetic foot ulcers, the following conclusions can be drawn:

 

 

With regard to active Charcot foot, the following conclusions can be drawn:

 

%I WIV-ISP %C Brussels, Belgium %P 289 %8 02/2017 %G eng %M D/2017/2505/01 %0 Report %D 2017 %T Initiative pour la Promotion de la Qualité et l’Epidémiologie chez les Enfants et les Adolescents atteints du Diabète sucré - Résultats 2015 %A Suchsia Chao %A Kris Doggen %A Astrid Lavens %A Viviane Van Casteren %K diabetes %X

Ce rapport décrit les résultats du cinquième audit auquel ont participé les centres de diabétologie pédiatrique agréés (dénommés ci-après CDP). Cet audit a permis de collecter les données concernant 2 880 patients atteints d’un diabète de type 1 âgés de moins de 19 ans et traités dans 14 CDP. Les données étaient relatives aux soins prodigués en 2015. Le rapport explore les tendances concernant la qualité des soins et étudie les caractéristiques de la population dans la période comprise entre 2008 et 2015.
Les principaux résultats étaient les suivants :
••
Certains aspects de la qualité des soins, mesurés par une série d’indicateurs de processus et de résultats, se sont améliorés entre 2008 et 2015 : le nombre de déterminations de la tension artérielle et la proportion de patients ayant atteint l’ objectif thérapeutique de l’HbA1c de 7,5 % ont augmenté, tandis que le nombre de déterminations de l’HbA1c (une et trois), la détermination de l’indice de masse corporelle (IMC) et le dépistage de la coeliaquie et de l’auto-immunité thyroïdienne se sont maintenus à un niveau élevé (> 80 %) pour tous les audits.
••
L’amélioration du taux d’HbA1c a été constatée dans 13 CDP sur 14, en grande partie indépendamment des caractéristiques des patients (sexe, statut de la famille nucléaire...) et du schéma insulinique : d’après les données, l’amélioration du taux d’HbA1c concernait principalement les patients âgés de plus de 10 ans ainsi que les patients ayant au moins un parent d’origine ethnique caucasienne.
••
Les taux de complications aigües et chroniques et les niveaux des facteurs de risque cardiovasculaires sont restés stables pendant la période 2008-2015.
En conclusion, malgré les limites inhérentes à la nature transversale de l’étude et son suivi restreint, le cinquième audit du projet IPQE-EAD a mis en lumière l’évolution favorable de l’HbA1c, l’un des indicateurs essentiels de la qualité des soins. Les futurs audits auront pour tâche de montrer si cette évolution se confirme. Par ailleurs, grâce à la collecte de données supplémentaires depuis 2013 (obtenues par l’échantillonnage de tous les patients éligibles au lieu de 50 % seulement), il sera désormais possible d’analyser l’évolution de l’HbA1c pour chaque patient individuellement et ses déterminants, et ainsi de repérer les facteurs auxquels nous devons apporter une attention accrue afin d’améliorer la qualité des soins de diabétologie pédiatrique.

%I WIV-ISP %C Bruxelles %P 54 %8 12/2017 %G eng %M D/2017/2505/26 %0 Report %D 2017 %T Initiative pour la Promotion de la Qualité et l'Epidémiologie dans les Cliniques multidisciplinaires du Pied Diabétique (IPQED-Pied) - Résumé des résultats de la 4ième collecte de données (années d'audit 2013-2014) %A Kris Doggen %A Sophie Deweer %A Isabelle Dumont %A Vera Eenkhoorn %A Patricia Félix %A Patrick Lauwers %A Giovanni Matricali %A Caren Randon %A Kristien Van Acker %A Michel Vandenbroucke %A Eric Weber %A Viviane Van Casteren %A Frank Nobels %K audit %K charcot foot %K diabetes %K Diabetic Foot %K diabetic foot ulcer %K feedback %K quality improvement %K quality of care %X

Ce rapport présente les résultats du quatrième audit réalisé dans les cliniques du pied diabétique agréées en Belgique (ci-après dénommées « centres »). Ces résultats sont comparés à ceux des audits précédents. Quatre audits ont été réalisés entre 2005 et 2014. Pour l’ensemble des audits, 5 510 problèmes diabétiques du pied sur 4 917 patients uniques ont été échantillonnés dans les 20 à 34 centres. Ces problèmes au pied étaient une lésion diabétique du pied de grade de Wagner égal ou supérieur à 2 et/ou un pied de Charcot actif. Les données recueillies portaient sur les caractéristiques lors de la première consultation, ainsi que sur les soins prodigués et les résultats obtenus sur une période de six à douze mois. À l’issue de cet audit, les centres ont obtenu un rapport de feed-back leur permettant de comparer leurs résultats pour plusieurs indicateurs de qualité. Le rapport complet peut être téléchargé du lien suivant : https://rebrand.ly/iqedfootfullreport

 

Pour ce qui concerne les lésions diabétiques du pied, les conclusions suivantes peuvent être tirées :

 

 

Pour ce qui concerne le pied de Charcot actif, les conclusions suivantes peuvent être tirées :

 

%I WIV-ISP %C Bruxelles, Belgique %P 96 %G eng %M D/2017/2505/02 %0 Report %D 2017 %T Jaarverslag Belgisch register van neuromusculaire aandoeningen (BNMDR) 2015 %A Corinne Bleyenheuft %A Viviane Van Casteren %K BNMDR %K neuromusculaire ziekten %K Register %X

The goals of the Belgian neuromuscular diseases registry are to enable epidemiological research to evaluate the importance of the diseases and the patient characteristics, to provide information to the public health authorities for planning of health care in Belgium, to promote health services for patients having a neuromuscular disease and to improve recruitment for clinical trials.

The patients’ recruitment increases every year since the registry’s creation in 2008. In 2015, a total number of 4670 patients were registered. The particularity of a registry dedicated to neuromuscular disorders (compared to other health care registries) is that the patients’ population is heterogeneous. Neuromuscular disorders comprise indeed different rare diseases affecting the peripheral nerves, or the muscles, or the neuromuscular junction, or anterior horn cells. Some of those diseases are genetic, while others are not. The vast majority of them are degenerative, and sometimes result in death in the short or in the long term. Some of those diseases occur during the childhood, and others occur during the adulthood. It is thus difficult to give a general overview of such a heterogeneous group of patients.

General demographic data show a slightly higher number of males than females (N = 2610 versus N = 2043). The patients’ recruitment is currently better in the north than in the south of the country. This is presumably due to the geographical repartition of the reference centers collecting the data. Nevertheless, the gap between those two regions tends to decrease year after year. 152 deaths occurred in 2015. Amongst them, 96 occurred in patients suffering from amyotrophic lateral sclerosis.

For the year 2015, the ten most prevalent diseases in the registry are: hereditary motor and sensory neuropathy, myotonic dystrophy type 1, amyotrophic lateral sclerosis, Duchenne muscular dystrophy, hereditary spastic paraplegia, limb girdle muscular dystrophy, chronic inflammatory demyelinating polyneuropathy, facioscapulohumeral dystrophy, spinocerebellar ataxias, and postpolio syndrome. Those ten diseases are more specifically analyzed in the present report.

The registry also collects specific data relative to the international “TREAT-NMD” network, for two defined groups of diseases: Duchenne and Becker muscular dystrophies, and spinal muscular atrophies. Those specific data are also analyzed in the present report.

The procedure for entry of data was assessed during this data collection. 5% of the registered files were compared to the original patient file in every reference center. The results show that some centers should improve the quality of the registration process. In the future, some of the data may directly be registered by the patient through a tablet in the waiting room.

%I WIV-ISP %C Brussels %P 81 %8 04/2017 %G eng %M D/2017/2505/09 %0 Report %D 2017 %T Rapport annuel - registre belge des maladies neuromusculaires 2015 %A Corinne Bleyenheuft %A Viviane Van Casteren %K BNMDR %K Maladies neuromusculaires %K registre %X

The goals of the Belgian neuromuscular diseases registry are to enable epidemiological research to evaluate the importance of the diseases and the patient characteristics, to provide information to the public health authorities for planning of health care in Belgium, to promote health services for patients having a neuromuscular disease and to improve recruitment for clinical trials.

The patients’ recruitment increases every year since the registry’s creation in 2008. In 2015, a total number of 4670 patients were registered. The particularity of a registry dedicated to neuromuscular disorders (compared to other health care registries) is that the patients’ population is heterogeneous. Neuromuscular disorders comprise indeed different rare diseases affecting the peripheral nerves, or the muscles, or the neuromuscular junction, or anterior horn cells. Some of those diseases are genetic, while others are not. The vast majority of them are degenerative, and sometimes result in death in the short or in the long term. Some of those diseases occur during the childhood, and others occur during the adulthood. It is thus difficult to give a general overview of such a heterogeneous group of patients.

General demographic data show a slightly higher number of males than females (N = 2610 versus N = 2043). The patients’ recruitment is currently better in the north than in the south of the country. This is presumably due to the geographical repartition of the reference centers collecting the data. Nevertheless, the gap between those two regions tends to decrease year after year. 152 deaths occurred in 2015. Amongst them, 96 occurred in patients suffering from amyotrophic lateral sclerosis.

For the year 2015, the ten most prevalent diseases in the registry are: hereditary motor and sensory neuropathy, myotonic dystrophy type 1, amyotrophic lateral sclerosis, Duchenne muscular dystrophy, hereditary spastic paraplegia, limb girdle muscular dystrophy, chronic inflammatory demyelinating polyneuropathy, facioscapulohumeral dystrophy, spinocerebellar ataxias, and postpolio syndrome. Those ten diseases are more specifically analyzed in the present report.

The registry also collects specific data relative to the international “TREAT-NMD” network, for two defined groups of diseases: Duchenne and Becker muscular dystrophies, and spinal muscular atrophies. Those specific data are also analyzed in the present report.

The procedure for entry of data was assessed during this data collection. 5% of the registered files were compared to the original patient file in every reference center. The results show that some centers should improve the quality of the registration process. In the future, some of the data may directly be registered by the patient through a tablet in the waiting room.

%I WIV-ISP %C Brussels %P 81 %8 04/2017 %G eng %M D/2017/2505/08 %0 Report %D 2017 %T Seasonal influenza surveillance (Belgique/België/Belgium) : Résumé saison 2016-2017 - Overzicht seizoen 2016-2017 - Overview season 2016-2017 %A Isabelle Thomas %A Cyril Barbezange %A Steven Van Gucht %A Nathalie Bossuyt %A Natalia Bustos Sierra %A Sophie Quoilin %A Viviane Van Casteren %A Y. Pirson %K 2016 %K 2017 %K Belgium %K overview season %K Seasonal influenza surveillance %I WIV-ISP %C Brussels, Belgium %P 27 %8 06/2017 %G eng %M D/2017/2505/11 %0 Journal Article %J BMC Health Serv Res %D 2016 %T Clinical action measures improve the reliability of feedback on quality of care in diabetes centres: a retrospective cohort study. %A Astrid Lavens %A Kris Doggen %A Chantal Mathieu %A Frank Nobels %A Evy Vandemeulebroucke %A Michel Vandenbroucke %A Ann Verhaegen %A Viviane Van Casteren %K Aged %K Cholesterol %K Diabetes Mellitus %K feedback %K Female %K Humans %K Male %K middle aged %K Quality Indicators, Health Care %K Quality of Health Care %K Reproducibility of Results %K Retrospective Studies %X

BACKGROUND: Assessment of quality of care using classical threshold measures (TM) is open to debate. Measures that take into account the clinician's actions and the longitudinal nature of chronic care are more reliable, although their major limitation is that they require more sophisticated electronic health records. We created a clinical action measure (CAM) for the control of LDL and non-HDL cholesterol from low-complexity data, and investigated how quality of care in individual diabetes centres based on the CAM is related to that based on the classical TM.

METHODS: Data was used from 3421 diabetes patients treated in 95 centres, collected in two consecutive retrospective data collections. Patients met the TM when their index value was below target. Patients met the CAM when their index value was below target or above target but for whom treatment initiation or intensification, or possible contraindication, was indicated.

RESULTS: Based on the TM, 60-70 % of the patients received good care. This percentage increased significantly using the CAM (+5 %, p < 0.001). At the centre level, the CAM was associated with a higher median score, and a change in position among centres ('poor', 'good' or 'excellent' performer) for 5-10 % of the centres.

CONCLUSIONS: Judging quality of diabetes care of a centre based on a TM may be misleading. Low-complexity data available from a quality improvement initiative can be used to construct a more fair and feasible measure of quality of care.

%B BMC Health Serv Res %V 16 %P 424 %8 2016 Aug 23 %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/27553193?dopt=Abstract %R 10.1186/s12913-016-1670-5 %0 Journal Article %J BMC Public Health %D 2016 %T General practice patients treated for substance use problems: a cross-national observational study in Belgium. %A Nicole Boffin %A Jérôme Antoine %A S Moreels %A Simeon Wanyama %A Karin De Ridder %A Peremans, Lieve %A Vanmeerbeek, Marc %A Viviane Van Casteren %K Adult %K Belgium %K Female %K General practice %K general practitioners %K Humans %K Male %K Methadone %K middle aged %K Prescription Drugs %K Substance-Related Disorders %X

BACKGROUND: General Practitioners (GPs) are well placed to care for patients with (chronic) substance use problems. This pilot was carried out to study the feasibility and usefulness of a continuous surveillance of substance use problems among general practice patients. The objectives were (i) to describe variables with missing values exceeding 1% and whether patients were reported without substance-related problems; (ii) the profile and the magnitude of the patient population that is treated for substance use problems.

METHODS: Observational study by the Belgian Network of Sentinel General Practices (SGP) in 2013. Baseline (at the first encounter) and 7-month follow-up data were reported of all patients treated for substance use problems. Two main measurements were type of substance use and patient status at follow-up. Multiple logistic regression analysis was used to examine patient status at follow-up.

RESULTS: Of 479 patients, 47.2% had problems with alcohol alone, 20.3% with prescription drugs, 16.7% with illicit drugs other than heroin or methadone and 15.9% with heroin or methadone. Problems with alcohol alone were more prevalent in Flanders (53.0%; 95% confidence interval (CI) 46.8-59.1%) than in Wallonia-Brussels (39.8%; 95% CI 33.1-46.8%), while problems with heroin or methadone were more prevalent in Wallonia-Brussels (27.0%; 95% CI 21.1-33.5%) than in Flanders (7.1%; 95% CI 4.3-10.9%). At follow-up, 32.8% of the patients had dropped out, 29.0% had discontinued GP treatment and 38.2% had continued GP treatment. Overall, 32.4% of 479 patients had continued GP treatment for substance use problems during the study period. In Wallonia-Brussels, this proportion was higher (42.7%; 95% CI 35.9-49.6%) than in Flanders (24.3%; 95% CI 19.2-29.8%).

CONCLUSIONS: A continuous surveillance of the general practice population treated for substance use problems seems to be feasible and useful. The latter is suggested by the specific profile and the relative magnitude of the population. Inter-regional health system differences should be taken into account to estimate the epidemiology of substance use problems among general practice patients.

%B BMC Public Health %V 16 %P 1235 %8 2016 Dec 08 %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/27927240?dopt=Abstract %R 10.1186/s12889-016-3885-0 %0 Report %D 2016 %T Infectieziekten bij kinderen, die voorkomen kunnen worden door vaccinatie. Jaarrapport 2015 %A Mendes da Costa,E. %A Tine Grammens %A Amber Litzroth %A Virginie Maes %A Gaetan Muyldermans %A Sophie Quoilin %A Martine Sabbe %A Sophie Bertrand %A Marie-Luce Delforge %A I Desombere %A Veronik Hutse %A Helena Martini %A Martiny, Delphine %A Wesley Mattheus %A S Moreels %A Denis Piérard %A Carole Schirvel %A Béatrice Swennen %A Heidi Theeten %A Geert Top %A Jean-Marie Tremerie %A Viviane Van Casteren %A Steven Van Gucht %A Van Ranst, M %A Jan Verhaegen %K 2015 %K Infectieziekten %K kinderen %K vaccinatie %I WIV-ISP %C Brussel, België %P 108 %8 dec 2016 %@ 2507-0274 %G eng %M D/2016/2505/47 %0 Report %D 2016 %T Infectieziekten bij kinderen die voorkomen kunnen worden door vaccinatie. Jaarrapport 2014 %A Martine Sabbe %A Mendes da Costa,E. %A Sophie Quoilin %A Sophie Bertrand %A Dediste,A. %A Marie-Luce Delforge %A Heymans,C. %A K Huygen %A Veronik Hutse %A Stéphanie Jacquinet %A Mak,R. %A Wesley Mattheus %A S Moreels %A Muyldermans,C. %A Denis Piérard %A Carole Schirvel %A Béatrice Swennen %A Heidi Theeten %A Geert Top %A Jean-Marie Tremerie %A Viviane Van Casteren %A Marc Van Ranst %A Jan Verhaegen %A Zinnen,V. %K Infectieziekten %K kinderen %K vaccinatie %I Johan Peeters/WIV-ISP %C Bruxelles %P . %8 0/0/2016 %@ D/2015/2505/75 %G eng %1 37182 %0 Report %D 2016 %T Initiatief voor kwaliteitsbevordering en epidemiologie bij diabetes (IKED) - Rapport resultaten 2014 %A Astrid Lavens %A Suchsia Chao %A M. Buysschaert %A G. Krzentowski %A C. Mathieu %A F. Nobels %A E. Vandemeulebroucke %A A. Verhaegen %A Kris Doggen %A Viviane Van Casteren %I Wetenschappelijk Instituut Volksgezondheid – Institut Scientifique de Santé Publique %C Brussel, België %G eng %M D/2016/2505/10 %0 Report %D 2016 %T Initiative pour la promotion de la qualité et de l'épidemiologie du diabète sucré (IPQED)- Rapport résultats 2014 %A Astrid Lavens %A Suchsia Chao %A M. Buyssaert %A G. Krzentowski %A C. Mathieu %A F. Nobels %A E. Vandemeulebroucke %A A. Verhaegen %A Kris Doggen %A Viviane Van Casteren %I Wetenschappelijk Instituut Volksgezondheid – Institut Scientifique de Santé Publique %C Brussel, België %G eng %M D/2016/2505/09 %0 Report %D 2016 %T Initiative pour la Promotion de la Qualité et l’Epidémiologie du Diabète sucré - Rapport résultats 2014 %A Astrid Lavens %A Suchsia Chao %A M. Buysschaert %A G. Krzentowski %A C. Mathieu %A F. Nobels %A E. Vandemeulebroucke %A A. Verhaegen %A Kris Doggen %A Viviane Van Casteren %K diabetes %X

L’Initiative pour la Promotion de la Qualité et l’Épidémiologie du Diabète sucré (IPQED) est un programme
à grande échelle, unique en son genre au niveau national, permettant de mesurer périodiquement et de
promouvoir la qualité des soins apportés dans le cadre d’une convention de l’INAMI aux patients adultes
diabétiques.
Le rapport actuel présente une vue d’ensemble de la collecte des données ayant débuté en décembre
2014 jusqu’en mars 2015 (période de la collecte). Il porte sur les données des patients, enregistrées
durant les 15 mois précédant cette collecte des données (période d’audit). Ces données concernent un
échantillon de plus de 12 000 patients, qui représente 10 % des patients conventionnés parmi une population
totale de ±105 000, issus de 100 centres de diabétologie conventionnés, en Wallonie, à Bruxelles et
en Flandre. L’encodage de ces données a été effectué au moyen d‘une application web, comportant une
série d’information à remplir, accessible par chaque centre à l’aide de la plate-forme publique eHealth.
Les patients de l’échantillon ont été sélectionnés sur base d’un ordre alphabétique, en commençant par
la lettre « D ».
Le présent rapport décrit, sur base de l’échantillon de 3750 patients diabétiques de type 1 et de
8552 patients diabétiques de type 2, les caractéristiques générales des patients, les injections d’insuline
et la thérapie antidiabétique, la fréquence de l’autocontrôle de la glycémie, le contrôle métabolique, le
surpoids et l’obésité, la tension artérielle et la prévalence de complications aiguës et chroniques au sein
de la population étudiée. La qualité des soins apportés aux patients diabétiques est évaluée sur base (1)
de la mise en application de divers processus de mesure ou de soins (2) et sur base l’obtention ou non
(au moyen de la thérapie) de valeurs cibles prédéfinies. Les résultats sont comparés avec les collectes
précédentes.
Les patients diabétiques conventionnés présentent une pathologie complexe, caractérisée par une forte
morbidité et la nécessité d’un traitement intensif, tant pour la régulation de la glycémie qu’en ce qui
concerne les complications du diabète. Le présent rapport montre et confirme que les soins prodigués
aux patients traités dans le cadre de la Convention Diabète sont de bonne qualité, et que cette qualité
est en augmentation constante depuis la création de l’IPQED.

%I WIV-ISP %C Bruxelles %P 114 %8 06/2016 %G eng %M D/2016/2505/09 %0 Report %D 2016 %T Maladies infectieuses pédiatriques à prévention vaccinale. Rapport annuel 2015 %A Mendes da Costa,E. %A Tine Grammens %A Amber Litzroth %A Virginie Maes %A Gaetan Muyldermans %A Sophie Quoilin %A Martine Sabbe %A Sophie Bertrand %A Marie-Luce Delforge %A I Desombere %A Veronik Hutse %A Helena Martini %A Martiny, Delphine %A Wesley Mattheus %A S Moreels %A Denis Piérard %A Carole Schirvel %A Béatrice Swennen %A Heidi Theeten %A Geert Top %A Jean-Marie Tremerie %A Viviane Van Casteren %A Steven Van Gucht %A Van Ranst, M %A Jan Verhaegen %K 2015 %K Maladies infectieuses pédiatriques %K Vaccination %I WIV-ISP %C Bruxelles, Belgique %P 108 %8 12/2016 %@ 2507-0266 %G eng %M D/2016/2505/46 %0 Generic %D 2016 %T Pediatric diabetes centres rated parental responsibility and family support as most important determinants of HbA1c using a 17-item questionnaire: a pilot study %A Suchsia Chao %A Robin Van Vreckem %A Véronique Beauloye %A Casteels,K. %A Coeckelberghs, M %A Dooms, L %A Logghe, K %A P Collin %A K Poschet %A Viviane Van Casteren %A Kris Doggen %K diabetes %K family support %K HbA1c %K parental responsibility %K pediatric %X

In the last decades, HbA1c levels in young diabetic patients have decreased. However differences in metabolic control still exists between pediatric diabetes centers (PDC) [1-2].

Few studies have been undertaken to explain the between-center HbA1c differences. Nevertheless we know that the metabolic control is not only dependent on the treatment prescribed but also on other factors such as biological, socio-demographic and psychosocial factors which are beyond the control of care providers and may be different between centers [3].

Thus a "simple" comparison of HbA1c does not reflect the real differences of the quality of care given by different centers. In order to have a proper comparison, consideration must be taken for those external factors’ impact on HbA1c levels (i.e. risk-adjustment).

Based on a pilot project, we wanted to identify psychosocial factors of which PDCs thought that they can positively or negatively influence the level of HbA1c in type 1 diabetes during childhood and adolescence. The factors that PDCs scored highly are potential factors which should be corrected for when mean HbA1c is compared between centers.

High parental responsability and family support were scored as the most important contributing factors for EH. - A wider set of factors scored highly with regard to PH. But parental responsibility and family support remained among the highest ranking contributors, together with adolescence. - When a known risk factor for PH was present (e.g. adolescence), PDCs also scored this factor highly. - A qualitative analysis of free-text reasons for EH and PH provided information on how to improve the questionnaire for future studies (items on motivation and comorbidities). - There is evidence that due to the relatively low participation rate, the results may not be representative for all Belgian patients.

%B ISPAD 2016 %I ISPAD %C Valencia, Spain %8 26/10/2016 %G eng %0 Journal Article %J Neurol Int %D 2016 %T Results of the Belgian Sentinel Network of General Practitioners on the Involvement of Therapists in Stroke Rehabilitation. %A Francois, Silke %A Viviane Van Casteren %A Vanthomme, Katrien %A Borgermans, Liesbeth %A Devroey, Dirk %X

This study examines which therapists are involved in the rehabilitation of stroke survivors in Belgium at different points in time. A nationwide registration of stroke patients was provided by 199 and 189 family physicians working in sentinel practices for the years 2009 and 2010 respectively. 326 patients who were diagnosed with stroke were included. Patients with paralysis/paresis received significant more physiotherapy after one month (63%) compared to non-paralysed patients (38%) (P = 0.005). Residing in a nursing home was associated with higher proportions of patients receiving physiotherapy, both after one (P = 0.003) and six (P = 0.002) months. 31% of patients with aphasia were treated by a speech and language therapist after one month, which decreased after six months to 20%. After six months, the patients in a nursing home received significant more often speech and language therapy (P = 0.004), compared to patients living at home. The proportion of patients receiving stroke rehabilitation services provided by physiotherapists, speech/language therapists and occupational therapists is rather low, especially 6 months after the critical event.

%B Neurol Int %V 8 %P 5846 %8 2016 Nov 02 %G eng %N 4 %1 http://www.ncbi.nlm.nih.gov/pubmed/28217267?dopt=Abstract %R 10.4081/ni.2016.5846 %0 Report %D 2016 %T Virological surveillance of influenza in Belgium season 2015-2016 %A Isabelle Thomas %A Cyril Barbezange %A Hombrouck,A. %A Steven Van Gucht %A Weyckmans,J. %A Ullens,L. %A Abady,M. %A Fdillate,I. %A Nathalie Bossuyt %A Viviane Van Casteren %A Y. Pirson %K Belgium %K INFLUENZA %K Surveillance %I Johan Peeters/WIV-ISP %C Bruxelles %P . %8 0/0/2016 %@ D/2016/2505/40 %G eng %1 37183 %0 Report %D 2016 %T Zorg aan het levenseinde in het Vlaamse Gewest in de periode 2005-2014 %A S Moreels %E Van den Block, Lieve %Y Pivodic, Lara %? Nicole Boffin %? Yolanda Wh Penders %K België %K end of life care %K palliatieve %K Vlaanderen %K Zorg aan het levenseinde %X

Rapport ten behoeve van het Agentschap Zorg en Gezondheid

%I WIV-ISP %C Brussel, Belgium %V D/2016/2505/12 %P 52 %8 2016 %G eng %M D/2016/2505/12 %6 PHS Report 2016-014 %& 1 %0 Report %D 2015 %T Belgian Neuromuscular Disease Registry (BNMDR) - Resultaten van 2014 en Trends sinds 2010. %A A. Roy %A Viviane Van Casteren %K 2010 %K Belgian %K disease %K EN %K Neuromuscular disease %K REGISTRIES %K Registry %K result %K results %K trend %K trends %I WIV-ISP %C Brussels/Belgium %P 50 %8 0/0/2015 %@ 2466-5991 %G eng %1 253 %& 1 %0 Journal Article %J Prim Care Diabetes %D 2015 %T Care trajectories are associated with quality improvement in the treatment of patients with uncontrolled type 2 diabetes: A registry based cohort study. %A Goderis, Geert %A Viviane Van Casteren %A Declercq, Etienne %A Nathalie Bossuyt %A Van Den Broeke, Carine %A Vanthomme, Katrien %A S Moreels %A Nobels, Frank %A Mathieu, Chantal %A Buntinx, Frank %K Aged %K Angiotensin II Type 1 Receptor Blockers %K Angiotensin-Converting Enzyme Inhibitors %K Belgium %K Biomarkers %K Blood Glucose %K Cholesterol, LDL %K Critical Pathways %K Diabetes Mellitus, Type 2 %K Diabetic Angiopathies %K Female %K General practice %K Glucagon-Like Peptide 1 %K Hemoglobin A, Glycosylated %K Humans %K Hydroxymethylglutaryl-CoA Reductase Inhibitors %K Hypoglycemic Agents %K Incretins %K Insulin %K Linear Models %K Logistic Models %K Male %K ODDS RATIO %K quality improvement %K Quality Indicators, Health Care %K REGISTRIES %K Retrospective Studies %K Risk Factors %K Time Factors %K Treatment Outcome %X

AIMS: To analyse whether care trajectories (CT) were associated with increased prevalence of parenteral hypoglycemic treatment (PHT=insulin or GLP-1 analogues), statin therapy or RAAS-inhibition. Introduced in 2009 in Belgium, CTs target patients with type 2 diabetes mellitus (T2DM), in need for or with PHT.

METHODS: Retrospective study based on a registry with 97 general practitioners. The evolution in treatment since 2006 was compared between patients with vs. without a CT, using longitudinal logistic regression.

RESULTS: Comparing patients with (N=271) vs. without a CT (N=4424), we noted significant differences (p<0.05) in diabetes duration (10.1 vs. 7.3 years), HbA1c (7.5 vs. 6.9%), LDL-C (85 vs. 98mg/dl), microvascular complications (26 vs. 16%). Moreover, in 2006, parenteral treatment (OR 52.1), statins (OR 4.1) and RAAS-inhibition (OR 9.6) were significantly more prevalent (p<0.001). Between 2006 and 2011, the prevalence rose in both groups regarding all three treatments, but rose significantly faster (p<0.05) after 2009 in the CT-group.

CONCLUSIONS: Patients enrolled in a CT differ from other patients even before the start of this initiative with more intense hypoglycemic and cardiovascular treatment. Yet, they presented higher HbA1c-levels and more complications. Enrolment in a CT is associated with additional treatment intensification.

%B Prim Care Diabetes %V 9 %P 354-61 %8 2015 Oct %G eng %N 5 %1 http://www.ncbi.nlm.nih.gov/pubmed/25709079?dopt=Abstract %R 10.1016/j.pcd.2015.01.008 %0 Generic %D 2015 %T Comparison between non-general practice patients and general practice patients treated for substance use problems %A Jérôme Antoine %A Nicole Boffin %A Karin De Ridder %A L. Gremeaux %A Viviane Van Casteren %K addiction %K Belgium %K Comparison %K conference %K drug addiction %K general %K General practice %K General-practice %K Patient %K patients %K Practice %K problems %K Substance use %K use %B Addictions Conference %C Lisbon %8 0/0/2015 %G eng %N ? %1 37604 %2 01/07/2015 %0 Journal Article %J Arch Public Health %D 2015 %T Does the Belgian diabetes type 2 care trajectory improve quality of care for diabetes patients? %A Viviane Van Casteren %A Nathalie Bossuyt %A S Moreels %A Goderis, Geert %A Vanthomme, Katrien %A Wens, Johan %A De Clercq, Etienne W %K 2009 %K ACHIL %K aims %K ALL %K Ambulatory Care %K an %K analysi %K analysis %K article %K AS %K at %K Belgian %K Belgium %K Brussels %K care %K chronic %K confounder %K Control %K cross sectional %K Cross-sectional %K data %K data sources %K de %K diabete %K diabetes %K Diabetes Mellitus %K Diabetes type 2 %K effect %K electronic %K end %K ET %K evidence based %K evidence-based %K Follow %K Follow up %K FOLLOW-UP %K Frequency %K general %K GENERAL PRACTITIONER %K general practitioners %K GP %K Group %K HbA1c %K health %K Health information %K implementation %K improve %K Improvement %K INFORMATION %K Institute %K IS %K journal %K Laboratories %K longitudinal %K management %K method %K methods %K MODEL %K Monitoring %K multilevel %K national %K Network %K ON %K outcome %K outcomes %K parameters %K past %K Patient %K patients %K period %K practitioner %K Practitioners %K Print %K PROCESSES %K programme %K Project %K proportion %K public %K public health %K Public-health %K Quality %K quality of care %K regional %K Research %K result %K results %K Sample %K study %K Surveillance %K time %K Type %K uptake %K WHO %X

BACKGROUND: The Belgian care trajectory (CT) for diabetes mellitus type 2 (T2DM), implemented in September 2009, aims at providing integrated, evidence-based, multidisciplinary patient- centred care, based on the chronic care model. The research project ACHIL (Ambulatory Care Health Information Laboratory) studied the adherence of CT patients, in the early phases of CT programme implementation, with CT obligations, their uptake of incentives for self-management, whether the CT programme was targeting the appropriate group of patients, how care processes for these patients evolved over time and whether CT start led to better quality in the processes and outcomes of care.

METHODS: This observational study took place in the period 2006-2011 and covered T2DM patients who started a CT between 01/09/2009 and 31/12/2011. Four data sources were used: outcome data, from electronic patient records (EPRs) on all CT patients, provided by general practitioners (GPs); reimbursement process data on all CT patients and clinically comparable patients; and data from a sample of CT patients and clinically comparable patients from an EPR-based regional GP network and a paper-based national GP network, respectively. Through multilevel analysis of cross-sectional and longitudinal data, the effect of CT inclusion on processes and outcome was estimated, controlling for potential confounders.

RESULTS: By the end of 2011, data on 18,250 CT patients had been collected. Approximately 50 % of these CT patients had received reimbursement for a glucometer and nearly 60 % had had at least one encounter with a diabetes educator. The CT programme recruited T2DM patients who had been difficult to control in the past. In the years prior to CT start, there had been a gradual improvement in the follow up of these patients. Moreover, compared to non-CT patients, the proportion of CT patients adhering to the recommended frequency for monitoring of parameters, such as HbA1c, increased significantly around CT start. Some data sources, albeit not all, suggested there had been an improvement in certain outcomes, such as HbA1c, after CT inclusion.

CONCLUSIONS: According to this study, CT enrolment is associated with better quality of care processes compared to non-CT patients. This improvement was found in several of the data sources used in this study. However, results on outcome parameters remain inconclusive.

%B Arch Public Health %V 73 %P 31 %8 2015 %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/26171143?dopt=Abstract %& 31 %R 10.1186/s13690-015-0080-1 %0 Journal Article %J Acta Neurol Belg %D 2015 %T Early stages of building a rare disease registry, methods and 2010 data from the Belgian Neuromuscular Disease Registry (BNMDR). %A Roy, Anna J %A Van den Bergh, Peter %A Van Damme, Philip %A Kris Doggen %A Viviane Van Casteren %K Adult %K Belgium %K cross-sectional studies %K Female %K Humans %K Male %K middle aged %K Neuromuscular Diseases %K Online Systems %K prevalence %K Rare diseases %K REGISTRIES %K Retrospective Studies %X

The Belgian Neuromuscular Disease Registry, commissioned in 2008, aims to collect data to improve knowledge on neuromuscular diseases and enhance quality health services for neuromuscular disease patients. This paper presents a clear outline of the strategy to launch a global national registry. All patients diagnosed with one of the predefined 62 neuromuscular disease groups and living in Belgium may be included in the yearly updated Registry. Basic core data is harvested through a newly designed web application by the six accredited neuromuscular reference centres. In 2010, 3,424 patients with a neuromuscular disorder were registered. The most prevalent disease group in the Registry is Hereditary Motor and Sensory Neuropathy, as similarly stated by other studies, albeit the prevalence in Belgium is five times lower: 6.5 per 100,000 in the north of Belgium, versus 17.0-41.0 per 100,000 in other areas of Europe. Very few patients were captured in the south of the country. With the aim to collect valuable epidemiological data, the registry targets to gather high quality data, that the sample to be representative of the population and that it be complete. The past 5 years of building the registry have improved its quality, albeit the consistent gap in data from the south of the country prevails, influencing the estimated prevalence of these diseases. To this day, the true burden of neuromuscular diseases in Belgium is not known but actions have been undertaken to address these issues.

%B Acta Neurol Belg %V 115 %P 97-104 %8 2015 Jun %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/24957677?dopt=Abstract %R 10.1007/s13760-014-0320-0 %0 Generic %D 2015 %T Identification of rare disease codes in ICD-9-CM and exploration of Belgian Minimal Hospital Data %A Montse Urbina Paz %A A. D'Hav %A Viviane Van Casteren %A Mertens,I. %A Elfriede Swinnen %E European Society of Human Genetics %K a %K accuracy %K admission %K ALL %K Analyses %K Area %K AS %K at %K Belgian %K care %K CODING %K conference %K data %K disease %K Diseases %K European %K Exploration %K Genetic %K genetics %K health %K health care %K HEALTH-CARE %K hospital %K hospital admission %K hospitals %K Human %K ICD %K identification %K identify %K INFORMATION %K Information system %K IS %K IT %K LEVEL %K List %K mapping %K methodology %K need %K ON %K Order %K Orphanet %K Patient %K questions %K Rare disease %K Rare diseases %K registration %K result %K results %K System %K Systems %K Term %K use %X For financial reimbursement, Belgian hospitals need to comply with compulsory registration of the Minimal Hospital Data (MHD). These comprise various data on all hospital admissions at patient level. Our ultimate goal is to query this comprehensive repository to answer various health care related questions in the area of rare diseases (80% of which are genetic diseases). Unfortunately, such analyses are hampered by lack of a suitable codification/classification system in the hospital information systems. Although efforts are being made to introduce the ORPHA rare disease codes, diagnostic information in the MHD was coded with ICD-9-CM. Since January 2015, ICD-10-CM is in use .In order to investigate the problem of rare disease coding more thoroughly and to enable the exploitation of historical data, we aimed to identify all codes of interest in the ICD-9-CM and ICD-10-CM. Mapping and linearization of the ORPHA codes to ICD-10-CM codes is done by Orphanet (INSERM) and available at orphadata.org. ICD-9-CM/ ICD-10-CM conversion tables were created by the FPS. By standardizing and combining these lists we distilled a final set of ICD9-CM codes for rare diseases of equivalent, broader as well as narrower terms.We conclude that for rare diseases, the transition to ICD-10-CM was indispensable due to a higher degree of granularity. We will discuss the mapping methodology, its accuracy and results. In addition, we will illustrate the value of MHD analyses for identification of rare diseases by presenting information derived from MHD for a representative rare disease. %B The EUROPEAN HUMAN GENETICS CONFERENCE 2015 %S Identification of rare disease codes in ICD-9-CM and exploration of Belgian Minimal Hospital Data %8 6/6/2015 %G eng %N European Society of Human Genetics %1 38008 %2 6-9/06/2015 %0 Report %D 2015 %T Infectieziekten bij kinderen, die voorkomen kunnen worden door vaccinatie. Jaaroverzicht 2014 %A Martine Sabbe %A Tine Grammens %A Toon Braeye %A Corinne Bleyenheuft %A Mendes da Costa, Elise %A Sophie Quoilin %A Sophie Bertrand %A Dediste, Anne %A Delforge, Marie-Luce %A Heymans,C. %A Huygen, Kris %A Veronik Hutse %A Stéphanie Jacquinet %A Mak, Ruud %A Wesley Mattheus %A S Moreels %A Gaetan Muyldermans %A Denis Piérard %A Carole Schirvel %A Béatrice Swennen %A Heidi Theeten %A Top, Geert %A Jean-Marie Tremerie %A Viviane Van Casteren %A Van Ranst, M %A Verhaegen, J. %A Zinnen,V. %K 2014 %K Infectieziekten %K kinderen %K vaccinatie %I WIV-ISP %C Brussel, België %P 62 %8 dec 2015 %G eng %M D/2015/2505/75 %0 Report %D 2015 %T Infectieziekten bij kinderen die voorkomen kunnen worden door vaccinatie. Jaarrapport 2013 %A Tine Grammens %A Toon Braeye %A Corinne Bleyenheuft %A Sophie Quoilin %A Sophie Bertrand %A Dediste,A. %A Detemmerman,L. %A K. De Schrijver %A Goubert,P. %A Heymans,C. %A K Huygen %A Veronik Hutse %A Stéphanie Jacquinet %A Mak,R. %A Wesley Mattheus %A S Moreels %A Gaetan Muyldermans %A Denis Piérard %A Carole Schirvel %A Béatrice Swennen %A Heidi Theeten %A Geert Top %A Jean-Marie Tremerie %A Viviane Van Casteren %A Steven Van Gucht %A Marc Van Ranst %A Jan Verhaegen %A Waegenaere,J. %A Zinnen,V. %K Infectieziekten %K kinderen %I WIV-ISP %C Brussel %P 156 %8 0/0/2015 %@ D/2015/2505/05 %G eng %1 39200 %0 Report %D 2015 %T Influenza virological surveillance in Belgium season 2014-2015. %A Hombrouck,A. %A Nathalie Bossuyt %A Viviane Van Casteren %A Steven Van Gucht %A Isabelle Thomas %K Belgium %K INFLUENZA %K Surveillance %I WHO %C . %P . %8 0/0/2015 %G eng %1 39174 %0 Generic %D 2015 %T Low prevalence of previous lower limb revascularisation in patients with diabetes and acute Charcot foot: results from a case-control study. %A Kris Doggen %A Hilde Beele %A Kevin Deschamps %A Isabelle Dumont %A Astrid Lavens %A Viviane Van Casteren %A Giovanni Matricali %K charcot foot %K diabetes %K lower-limb revascularization %X

Aim: Charcot foot is a rare but devastating complication of diabetes, leading to uncontrolled inflammation and high risk of osteolysis in its acute phase. Preserved local perfusion is a hypothesized prerequisite for the detrimental inflammatory response. We sought support for this hypothesis by studying the prevalence of previous lower limb revascularisation (LLR), as a marker of peripheral macroangiopathy, in patients with diabetes and Charcot foot.

Methods: Patients with diabetes and incident acute Charcot foot, but without a history of diabetic foot ulcers (DFU) (Charcot group, N=50) were retrospectively identified in a database used for quality of care monitoring in 36 Belgian specialized diabetic foot clinics in the period 2005-2011. [1] Patients without Charcot foot, but who had diabetic foot ulcers (DFU), served as controls (DFU group, N=3,147). Prevalence of previous LLR was compared between both groups using logistic regression.

Results: The Charcot group was significantly younger than the DFU group (59.1 vs. 69.1 years, P<0.001). Age-adjusted prevalence of previous LLR was significantly lower in the Charcot group than in the DFU group (3.5 vs. 29.8%, P<0.05), while the age-adjusted prevalence of coronary artery disease and stroke did not significantly differ (41.7 vs. 38.3%, P>0.05).

Conclusions: Charcot foot in diabetes only seems to occur in patients without a history of LLR. Despite the limitation of the cross-sectional nature of this study, our findings support the hypothesis that among patients with diabetes, Charcot foot occurs preferentially when lower limb perfusion is preserved.

 

[1] Doggen K, Diabetes Metab Res Rev. 2014;30(5):435-43.

%B 7th International Symposium on the Diabetic Foot %I International Working Group on the Diabetic Foot %C The Hague, Netherlands %8 2015 %G eng %N International Working Group on the Diabetic Foot %1 1049 %2 20/05/2015 %0 Report %D 2015 %T Maladies infectieuses pédiatriques à prévention vaccinale. Synthèse annuelle 2014 %A Martine Sabbe %A Tine Grammens %A Toon Braeye %A Corinne Bleyenheuft %A Mendes da Costa,E. %A Sophie Quoilin %A Sophie Bertrand %A Dediste,A. %A Marie-Luce Delforge %A Heymans,C. %A K Huygen %A Veronik Hutse %A Stéphanie Jacquinet %A Mak,R. %A Wesley Mattheus %A S Moreels %A Gaetan Muyldermans %A Denis Piérard %A Carole Schirvel %A Béatrice Swennen %A Heidi Theeten %A Geert Top %A Jean-Marie Tremerie %A Viviane Van Casteren %A Van Ranst, M %A Jan Verhaegen %A Zinnen,V. %K 2014 %K Maladies infectieuses pédiatriques %K Vaccination %I WIV-ISP %C Bruxelles, Belgique %P 63 %8 12/2015 %G eng %M D/2015/2505/76 %0 Generic %D 2015 %T Negative determinants of diabetic foot ulcer healing: 6-month follow-up of a large multicentre cohort %A Kris Doggen %A Dimitri Aerden %A Hilde Beele %A Kevin Deschamps %A Isabelle Dumont %A Patricia Félix %A Patrick Lauwers %A Astrid Lavens %A Giovanni Matricali %A Caren Randon %A Eric Weber %A Viviane Van Casteren %K diabetes %K Diabetic Foot %K diabetic foot ulcer %K wound healing %X

Aim: Knowing the determinants that negatively influence diabetic foot ulcer (DFU) healing is crucial for improving DFU care. We identified negative determinants of DFU healing in diabetic foot clinics (DFC) participating in a quality improvement (QI) initiative with periodical audits and feedback (anonymous benchmarking). [1]

Methods: In 2011, 32 Belgian DFCs followed 1528 patients with a DFU of Wagner grade 2 or more for six months or until healing, major amputation or death, whichever occurred first. Cumulative incidence functions were studied and Cox proportional hazards regression was used to identify determinants of healing by using a forward selection method, taking into account competing risks (major amputation and death), missingness of covariates and clustering of outcomes in DFCs.

Results: At 6 months, the overall probability of healing, major amputation and death was 60.1, 4.3 and 4.4% respectively. 31.3% of patients had a DFU that was not healed. Multivariate analysis identified 6 significant (P<0.05) negative determinants of healing: presence of contralateral ulcer(s) at presentation reduced predicted 6-month healing probability by 27.1%, presence of peripheral artery disease by 21.1%, presence of midfoot/heel ulcers (vs. toe) by 19.7%, presence of additional ipsilateral ulcer(s) by 14.4%, presence of renal insufficiency by 13.5% and referral delay by 5.6% per additional 3 month delay. Notably, plantar vs. dorsal location was not significantly associated with DFU healing.

Conclusions: Presence of bilateral DFUs is particularly detrimental for healing. Compared to previous observational studies and especially Eurodiale [2], our data, collected routinely for QI purposes, yielded a similar set of negative determinants of healing, thus highlighting their external validity. Our findings could be incorporated in a useful QI tool in which risk-adjusted outcomes of DFCs are benchmarked to each other and over time.

 

[1] Doggen K, Diabetes Metab Res Rev. 2014;30:435-443.

[2] Pickwell K, Diabetes Metab Res Rev. 2013;29:377-383.

%B 7th International Symposium on the Diabetic Foot %I International Working Group on the Diabetic Foot %C The Hague, Netherlands %8 2015 %G eng %N International Working Group on the Diabetic Foot %1 1048 %2 20/05/2015 %0 Journal Article %J Stud Health Technol Inform %D 2015 %T Public Health Triangulation to inform decision-making in Belgium. %A Nathalie Bossuyt %A Viviane Van Casteren %A Goderis, G %A Wens, J %A S Moreels %A Vanthomme, K %A De Clercq, E %K Ambulatory Care %K Belgium %K Clinical Decision-Making %K Data Mining %K Diabetes Mellitus, Type 2 %K Electronic Health Records %K Humans %K Kidney Failure, Chronic %K Medical Record Linkage %K Outcome Assessment (Health Care) %K REGISTRIES %X

We assessed the impact of a nation-wide ambulatory care complex intervention (the "care trajectory program") on quality of care in Belgium. We used the three-step public health triangulation method described in this paper and data from four different data sources: a national reimbursement database, an electronic patient record-based general practitioner network, the Belgian general practitioner sentinel network, and a new national registry for care trajectory patients. By applying our method and using the available evidence, we identified key findings that have been accepted by experts and stakeholders. We also produced timely recommendations for the decision-making process, four years after the start of the care trajectory program.

%B Stud Health Technol Inform %V 210 %P 855-9 %8 2015 %G eng %1 http://www.ncbi.nlm.nih.gov/pubmed/25991276?dopt=Abstract %0 Report %D 2015 %T Registre des Maladies Neuromusculaires (BNMDR) - Résultats 2014 et Tendances depuis 2010. %A A. Roy %A Viviane Van Casteren %K 2010 %K de %K disease %K ET %K Neuromuscular disease %K registre %K REGISTRIES %K Registry %K result %K results %K trend %K trends %I WIV-ISP %C Brussels/Belgium %P 50 %8 0/0/2015 %@ 2466-6017 %G eng %1 254 %& 1 %0 Journal Article %J BMJ Open %D 2015 %T Trends from the surveillance of suicidal behaviour by the Belgian Network of Sentinel General Practices over two decades: a retrospective observational study. %A Nicole Boffin %A S Moreels %A Viviane Van Casteren %K Aged %K Belgium %K Databases, Factual %K Female %K Forecasting %K General practice %K general practitioners %K Humans %K incidence %K Logistic Models %K Male %K middle aged %K Retrospective Studies %K Risk Factors %K suicide %K Suicide, Attempted %X

OBJECTIVES: First, we describe trends in characteristics of suicidal events using new (2011-2012) and previous (1993-1995, 2000-2001 and 2007-2008) data reported by the Belgian Network of Sentinel General Practices (SGP); second, we examine patient age-related trends in on-site attendance of sentinel general practitioners (GPs) as first professional caregivers following suicidal behaviour; third, we investigate the accuracy of suicide incidence estimates derived from the SGP data.

DESIGN: Retrospective observational study.

SETTING: General practices from the nationwide representative Belgian Network of SGP.

OUTCOME MEASURES: Patient gender and age, suicide methods, whether the patient was new, whether the GP was the first caregiver on-site, and the outcome of the suicidal behaviour (fatal or not) were recorded on standard registration forms. The accuracy of suicide incidence estimates was tested against suicide mortality data.

RESULTS: Over the four time periods, 1671 suicidal events were reported: 275 suicides, 1287 suicide attempts and 109 events of suicidal behaviour of unknown outcome. In 2011-2012, sentinel GPs' on-site attendance following the suicidal behaviour of patients <65 years had continued to decrease (from 71% in 1993-1995 to 58% in 2000-2001, 39% in 2007-2008 and 25% in 2011-2012). In 2011-2012, it had also decreased steeply in the population ≥65 years (from 70% in 1993-1995, 76% in 2000-2001 and 79% in 2007-2008 to 35% in 2011-2012). No significant differences were found between the SGP-based suicide incidence estimates for 2011-2012 and the available suicide mortality rates for people <65 and ≥65 years.

CONCLUSIONS: GPs' on-site attendance as first professional caregivers following suicidal behaviour continues to decline since 2011-2012 also in the population ≥65 years. Unawareness of patients' suicidal behaviour endangers both care for surviving patients and the completeness of SGP surveillance data. Yet, the incidence of suicide for 2011-2012 was estimated accurately by the SGP.

%B BMJ Open %V 5 %P e008584 %8 2015 Nov 27 %G eng %N 11 %1 http://www.ncbi.nlm.nih.gov/pubmed/26614619?dopt=Abstract %R 10.1136/bmjopen-2015-008584 %0 Generic %D 2015 %T Vaccine effectiveness estimates in preventing laboratory-confirmed mild and moderate-to-severe influenza in the Belgian population during the last 3 seasons. %A Hombrouck,A. %A Viviane Van Casteren %A Steven Van Gucht %A Sophie Quoilin %A Françoise Wuillaume %A Isabelle Thomas %A Nathalie Bossuyt %K Belgian %K Belgian population %K de %K ET %K INFLUENZA %K Laboratory-confirmed %K Maladies infectieuse %K Mild %K POPULATION %K Seasons %K Surveillance %K vaccine %B Séminaire Diagnostic et surveillance des maladies infectieuses. %I NA %C NA %8 0/0/2015 %G eng %N WIV-ISP %1 38230 %2 21/05/2015 %0 Report %D 2015 %T Virological Surveillance of Influenza in Belgium Season 2014-2015. %A Isabelle Thomas %A Hombrouck,A. %A Steven Van Gucht %A Weyckmans,J. %A K. El Kadaani %A Abady,M. %A Fdillate,I. %A Nathalie Bossuyt %A Viviane Van Casteren %A Y. Pirson %K Belgium %K INFLUENZA %K Surveillance %I WIV-ISP %C Brussels %P . %8 0/0/2015 %@ D/2015/2505/60 %G eng %1 37049 %0 Journal Article %J Stud Health Technol Inform %D 2014 %T Belgian primary care EPR: assessment of nationwide routine data extraction. %A De Clercq, Etienne %A Viviane Van Casteren %A Nathalie Bossuyt %A Goderis, Geert %A S Moreels %K Belgium %K Electronic Health Records %K Health Records, Personal %K Information Storage and Retrieval %K Internet %K Primary Health Care %K Utilization Review %X

Starting in 2009, the first ever Belgian nationwide data collection network using routine data extracted from primary care EPR (upload method) has been built from scratch. The network also uses a manual web-based data collection method. This paper compares these two methods by analysing missing and most recent values for certain parameters. We collected data from 4954 practices, pertaining to 29,180 patients. Mean values for the most recent parameters were similar regardless of which data collection method was used. Many missing recent values (>46%) were found for all of the parameters when using the upload method. It seems that, in Belgium, uploading routine data from primary care EPR on a large scale is suitable and allows the collection of chronological retrospective data. However, the method still requires major, carefully controlled improvements.

%B Stud Health Technol Inform %V 197 %P 85-9 %8 2014 %G eng %1 http://www.ncbi.nlm.nih.gov/pubmed/24743083?dopt=Abstract %0 Journal Article %J Stud Health Technol Inform %D 2014 %T EPR-based, quality-related process parameters: a nationwide assessment. %A De Clercq, E %A Viviane Van Casteren %A Nathalie Bossuyt %A Goderis, G %A S Moreels %K Belgium %K Electronic Health Records %K General practice %K Guideline Adherence %K Health Records, Personal %K Practice Guidelines as Topic %K Quality Assurance, Health Care %X

The aim of the study was to determine whether or not primary care EPR-based data can be used to measure specific process parameters that can then, in turn, be used to assess the quality of care provided to chronic patients. We analysed data from a large research network that collects data from all Belgian GP practices through both manual and automatic extraction procedures. We built a number of quality-related process parameters and observed the concordance of our results with two external databases: a nationwide reimbursement database and a regional EPR-based network. We found that only the automatic data extraction method was suitable for building process parameters. The current research network may lead to an underestimation of the quality of care processes. We suggested ways to improve this network.

%B Stud Health Technol Inform %V 205 %P 121-5 %8 2014 %G eng %1 http://www.ncbi.nlm.nih.gov/pubmed/25160158?dopt=Abstract %0 Journal Article %J Fam Pract %D 2014 %T Falls among older general practice patients: a 2-year nationwide surveillance study. %A Nicole Boffin %A S Moreels %A Vanthomme, Katrien %A Viviane Van Casteren %K Accidental Falls %K Age factors %K Aged %K Aged, 80 and over %K Belgium %K comorbidity %K Female %K Humans %K incidence %K Male %K Mobility Limitation %K Polypharmacy %K Primary Health Care %K Public Health Surveillance %K Risk Factors %K Self-Help Devices %K Wounds and Injuries %X

BACKGROUND: Falling among older persons is a multifactorial health condition needing multifactorial care. Several targeted preventive interventions and their coordination are considered to be general practitioner (GP)-specific tasks.

OBJECTIVES: To estimate the incidence of falls among older non-institutionalized general practice patients in Belgium (2009-10) and to describe the main characteristics of falls, fallers and fall risks; factors associated with multiple fall risks and the co-occurrence of fall risks; patient status 3 months later and care delivery.

METHODS: A 2-year nationwide cross-sectional study based on data collected by the Belgian network of Sentinel General Practices on all non-institutionalized persons aged ≥65 years consulting their GP for new fall-related injuries.

RESULTS: Baseline data were collected on 1503 persons and valid follow-up data were available on 715 persons (79%). The yearly incidence of older persons with fall-related injuries was estimated at 2.5% of the older general practice population; 39% of patients had also received hospital care, physician-specialist or nursing home care. A multifactorial risk profile was observed in 59% and associated with increasing age, recurrent falling, falling at home and during lower level activity. The clustering of frailty-specific fall risks was higher than expected by chance. At follow-up, 46% of at-risk patients had received physical therapy, 47% were using assistive devices, and medication had been reviewed in 28% of patients taking psychopharmacy and 17% of patients with polypharmacy.

CONCLUSIONS: Our study shows a high burden of care for fall-related injuries in older general practice patients and provides baseline data for its future monitoring.

%B Fam Pract %V 31 %P 281-9 %8 2014 Jun %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/24532609?dopt=Abstract %R 10.1093/fampra/cmu002 %0 Journal Article %J Diabetes Metab Res Rev %D 2014 %T Implementation of a quality improvement initiative in Belgian diabetic foot clinics: feasibility and initial results. %A Kris Doggen %A Kristien Van Acker %A Hilde Beele %A Isabelle Dumont %A Patricia Félix %A Patrick Lauwers %A Astrid Lavens %A Giovanni A Matricali %A Caren Randon %A Eric Weber %A Viviane Van Casteren %A Nobels, Frank %K Aged %K Ambulatory Care Facilities %K Amputation %K Belgium %K Diabetic Foot %K Diabetic Neuropathies %K feedback %K Female %K Foot Ulcer %K Humans %K Male %K Medical Audit %K middle aged %K Pilot Projects %K quality improvement %K Surveys and Questionnaires %X

BACKGROUND: This article aims to describe the implementation and initial results of an audit-feedback quality improvement initiative in Belgian diabetic foot clinics.

METHODS: Using self-developed software and questionnaires, diabetic foot clinics collected data in 2005, 2008 and 2011, covering characteristics, history and ulcer severity, management and outcome of the first 52 patients presenting with a Wagner grade ≥ 2 diabetic foot ulcer or acute neuropathic osteoarthropathy that year. Quality improvement was encouraged by meetings and by anonymous benchmarking of diabetic foot clinics.

RESULTS: The first audit-feedback cycle was a pilot study. Subsequent audits, with a modified methodology, had increasing rates of participation and data completeness. Over 85% of diabetic foot clinics participated and 3372 unique patients were sampled between 2005 and 2011 (3312 with a diabetic foot ulcer and 111 with acute neuropathic osteoarthropathy). Median age was 70 years, median diabetes duration was 14 years and 64% were men. Of all diabetic foot ulcers, 51% were plantar and 29% were both ischaemic and deeply infected. Ulcer healing rate at 6 months significantly increased from 49% to 54% between 2008 and 2011. Management of diabetic foot ulcers varied between diabetic foot clinics: 88% of plantar mid-foot ulcers were off-loaded (P10-P90: 64-100%), and 42% of ischaemic limbs were revascularized (P10-P90: 22-69%) in 2011.

CONCLUSIONS: A unique, nationwide quality improvement initiative was established among diabetic foot clinics, covering ulcer healing, lower limb amputation and many other aspects of diabetic foot care. Data completeness increased, thanks in part to questionnaire revision. Benchmarking remains challenging, given the many possible indicators and limited sample size. The optimized questionnaire allows future quality of care monitoring in diabetic foot clinics.

%B Diabetes Metab Res Rev %V 30 %8 2014 Jul %G eng %N 5 %R 10.1002/dmrr.2524 %0 Journal Article %J J Clin Epidemiol %D 2014 %T The right indicator for the job: different levels of rigor may be appropriate for the development of quality indicators. Comment on Stelfox and Straus. %A Kris Doggen %A Astrid Lavens %A Viviane Van Casteren %K Humans %K Needs Assessment %K Quality Indicators, Health Care %B J Clin Epidemiol %V 67 %P 963-4 %8 2014 Sep %G eng %N 9 %1 http://www.ncbi.nlm.nih.gov/pubmed/24786596?dopt=Abstract %R 10.1016/j.jclinepi.2014.03.001 %0 Report %D 2014 %T Virological Surveillance of Influenza in Belgium Season 2013-2014. National influenza Centre (WHO). %A Isabelle Thomas %A Hombrouck,A. %A Steven Van Gucht %A Weyckmans,J. %A Bauwens,D. %A K. El Kadaani %A Abady,M. %A Fdillate,I. %A Nathalie Bossuyt %A Viviane Van Casteren %A Y. Pirson %K Belgium %K INFLUENZA %K national %K Surveillance %K WHO %X NA %I WIV-ISP %C Brussels %P 23 %8 0/0/2014 %@ D/2014/2505/65 %G eng %1 39214 %0 Journal Article %J Arch Public Health %D 2014 %T What determines inclusion in the early phase of the type 2 diabetes care trajectory in Belgium? %A Vanthomme, Katrien %A Bossuyt, Nathalie %A S Moreels %A Boffin, Nicole %A De Clercq, Etienne %A Goderis, Geert %A Viviane Van Casteren %X

BACKGROUND: In 2009, the Belgian National Institute of Health and Disability Insurance established a care trajectory (CT) for a subgroup of type 2 diabetes mellitus patients (T2DM) based on Wagner's chronic care model. The goal of this CT is to optimise the quality of care using an integrated multidisciplinary approach. This study aims to identify patient-related factors associated with inclusion in a CT and to determine the most frequent reasons for non-inclusion.

METHODS: In 2010, the Belgian Sentinel Network of General Practices conducted a prevalence study of type 2 diabetes. The surveillance study carried out by this nationwide, representative network collected unique information about eligibility for the CT, inclusion in the CT and reasons for non-inclusion. Based on the official inclusion and exclusion criteria, we first identified a group of eligible patients. Within this group, we then calculated the proportion of patients included in a CT as well as the prevalence of reasons for non-inclusion as reported by GPs. Furthermore, bivariate associations between patient-level parameters and inclusion were analysed. Finally, any patient-level parameters found to be statistically significant were included in a multivariate logistic regression model.

RESULTS: The 2010 study recorded 4600 Belgian type 2 diabetes patients. According to the official criteria, 589 patients were eligible for inclusion in a CT T2DM. By the end of August 2011, 95 patients had been included in a CT T2DM. Our findings reveal that the younger the eligible patient was, the more likely he or she was to be included in a CT. Patients living in Flanders were more likely to be included in the CT than were patients living in Wallonia. Motivated patients with specific plans to change their diets were also more likely to be included in a CT. The two most frequently reported reasons for non-inclusion were participation in another diabetes care programme and the timing of this surveillance study (inclusion will take place in the near future).

CONCLUSIONS: Eligible diabetes patients who were admitted to a CT T2DM during the early phases of CT implementation were mainly found to be those who are able to make progress in their disease trajectories. In the future, more attention could be paid to also include more high-risk patients.

%B Arch Public Health %V 72 %P 29 %8 2014 %G eng %N 1 %1 https://www.ncbi.nlm.nih.gov/pubmed/25232479?dopt=Abstract %R 10.1186/2049-3258-72-29 %0 Journal Article %J Eur.J.Cancer %D 2013 %T Awareness of general practitioners concerning cancer patients' preferences for place of death: Evidence from four European countries %A Ko,W. %A Beccaro,M. %A Miccinesi,G. %A Viviane Van Casteren %A G.A. Donker %A B.D. Onwuteaka-Philipsen %A M.T. Miralles Espi %A Deliens,L. %A Costantini,M. %A Van den Block,L. %K 2010 %K ALL %K article %K at %K Awareness %K Belgium %K cancer %K care %K CONTACT %K Countries %K data %K Death %K Design %K electronic %K End-of-life %K European %K European countries %K evidence %K general %K GENERAL PRACTITIONER %K general practitioners %K GP %K healthcare %K Improvement %K IS %K ITALY %K journal %K LEVEL %K MEDV %K method %K methods %K Netherlands %K Network %K networks %K ON %K Palliative Care %K Patient %K patients %K Practice %K PRACTICES %K practitioner %K Practitioners %K regional %K registration %K result %K results %K Retrospective Studies %K Role %K Sample %K SENTI-MELC %K Spain %K study %K study design %K System %K The Netherlands %X BACKGROUND: General Practitioners (GPs) are at the first level of contact in many European healthcare systems and they supposedly have a role in supporting cancer patients in achieving their desired place of death. A four-country (Belgium, the Netherlands, Italy and Spain) study was carried out exploring current practices. PATIENTS AND METHODS: EURO SENTI-MELC adopted a retrospective study design and data for this study were collected in 2010 through representative GPs' networks in four countries. In the current study all non-sudden cancer deaths were included with weekly GP registrations. RESULTS: The main study sample included 930 deceased cancer patients: preference for place of death was known by GPs for only 377. GP awareness on the preferred place of death varied across countries, 27% in Italy, 36% in Spain, 45% in Belgium and 72% in the Netherlands (p<0.01). The general level of preferences met was high, from 68% (Italy) to 92% (Spain). CONCLUSIONS: Despite the importance of being able to die in a preferred location, GPs were often unaware about patient preferences, especially in Italy and Spain. If GPs were informed, the preference was often met in all countries, indicating room for improvement in end-of-life care %B Eur.J.Cancer %V 49 %P 1967 - 1974 %8 14/2/2013 %G eng %N 8 %1 35342 %& 1967 %R http://dx.doi.org/10.1016/j.ejca.2013.01.006 %0 Report %D 2013 %T The Belgian network of Sentinel General Practices between 2007 and 2012: a short report %A Nicole Boffin %A S Moreels %A Viviane Van Casteren %K 2007 %K 2012 %K Belgian %K general %K General practice %K Network %K Practice %K PRACTICES %K report %K sentinel %I WIV-ISP %C Brussels %P 10 %8 0/0/2013 %G eng %1 1066 %0 Journal Article %J J Diabetes Complications %D 2013 %T Cardiovascular risk factors and complications associated with albuminuria and impaired renal function in insulin-treated diabetes. %A Kris Doggen %A Nobels, Frank %A Scheen, André J %A Van Crombrugge, Paul %A Viviane Van Casteren %A Mathieu, Chantal %K Adult %K Aged %K Albuminuria %K Cardiovascular Diseases %K cross-sectional studies %K Diabetes Mellitus, Type 1 %K Diabetes Mellitus, Type 2 %K Diabetic Nephropathies %K Glomerular Filtration Rate %K Humans %K Hypoglycemic Agents %K Insulin %K middle aged %K Risk Factors %K Surveys and Questionnaires %X

AIMS: To establish the association between albuminuria and cardiovascular risk factors as well as micro- and macrovascular complications in type 1 and insulin-treated type 2 diabetes, both in the presence and in the absence of reduced estimated glomerular filtration rate (eGFR).

METHODS: Cross-sectional study including 7640 insulin-treated diabetic patients (33% type 1) treated in specialist diabetes centers. Albuminuria was defined as ≥30 mg/g, 20 mg/L, 20 μg/min or 30 mg/24 h. Reduced eGFR was defined as <60 mL/min/1.73 m(2) (CKD-EPI equations).

RESULTS: Albuminuria, reduced eGFR or a combination was more prevalent in type 2 (21.5%, 15.9% and 16.5%) than in type 1 diabetes (16.1%, 4.7% and 4.0%, all P < 0.001 vs. type 2). Albuminuria was associated with poorer control of blood pressure, blood lipids and glycemia as well as higher prevalence of retinopathy and macrovascular disease, regardless of preserved/reduced eGFR or diabetes type. Reduced eGFR was associated with higher prevalence of micro- and macrovascular complications especially in type 2 diabetes. Combined presence of albuminuria and reduced eGFR was associated with the worst cardiovascular outcomes.

CONCLUSIONS: Albuminuria and impaired renal function are prevalent in type 1 and insulin-treated type 2 diabetes. Albuminuria, but also normoalbuminuric renal impairment, is associated with micro- and macrovascular complications.

%B J Diabetes Complications %V 27 %P 370-5 %8 2013 Jul-Aug %G eng %N 4 %1 http://www.ncbi.nlm.nih.gov/pubmed/23537603?dopt=Abstract %R 10.1016/j.jdiacomp.2013.02.008 %0 Report %D 2013 %T De zorgtrajecten diabetes mellitus type 2 en chronische nierinsufficiëntie: impact op de kwaliteit van zorg. - Achil Phase 1 (2009-2013). Ambulatory Care Health Information Laboratory. %A Viviane Van Casteren %A Nathalie Bossuyt %A S Moreels %A Vanthomme,K. %A Goderis,G. %A De Clercq,E. %K care trajectories %K chronic renal failure %K diabetes mellitus type 2 %K quality of care %I WIV-ISP %C Brussels %P 125 %8 2013/// %G eng %M D/2013/2505/24 %0 Generic %D 2013 %T Do the national care trajectories diabetes and chronic care management in various European countries. %A Viviane Van Casteren %E European Public Health Association (EUPHA) %K 2009 %K ACHIL %K aims %K ALL %K an %K Analyses %K analysi %K analysis %K Belgian %K Belgium %K Brussels %K care %K chronic %K Chronic disease %K chronic diseases %K Clinical %K Comparison %K conditions %K conference %K confounder %K CONTACT %K Control %K Countries %K cross sectional %K cross sectional studies %K Cross-sectional %K cross-sectional studies %K data %K data sources %K de %K diabete %K diabetes %K Diabetes Mellitus %K disabilities %K DISABILITY %K disability insurance %K disease %K Diseases %K e %K effect %K electronic %K European %K European countries %K factors %K Geographical %K GP %K health %K improve %K INFORMATION %K Institute %K insurance %K IS %K Kidney %K Laboratories %K Lead %K longitudinal %K management %K method %K methods %K multilevel %K national %K Network %K Observation %K ON %K Order %K outcome %K outcomes %K Paper %K parameters %K Patient %K patients %K period %K primary care %K PROCESSES %K public %K public health %K Public-health %K Quality %K quality of care %K registration %K result %K results %K S %K Sample %K sentinel %K SPECIALIST %K study %K time %K Type %K WHO %X In order to improve quality of care for chronic conditions, in 2009 the National Institute for Health and Disability Insurance in Belgium created care trajectories (CTs) for diabetes mellitus type 2 (T2DM) and chronic kidney disease (CKD). A CT, formalised by a contract between patient, GP and specialist, aims to ensure integrated, evidence-based, multidisciplinary and structured care for chronic diseases in primary care.The ACHIL (Ambulatory Care Health Information Laboratory) study assesses whether inclusion in a CT leads to better quality of care for chronic disease, both over time and in comparison with other clinically comparable patients. %B 6th European Public Health Conference "Health in Europe:are we there yet?" %8 0/0/2013 %G eng %N European Public Health Association %1 2536 %2 13-16 November 2013 %0 Journal Article %J PLoS ONE %D 2013 %T End-of-life decisions: a cross-national study of treatment preference discussions and surrogate decision-maker appointments %A Evans,N. %A Pasman,H.R. %A T. Vega Alonso %A Van den Block,L. %A Miccinesi,G. %A Viviane Van Casteren %A G.A. Donker %A Bertolissi,S. %A Zurriaga,O. %A Deliens,L. %A B.D. Onwuteaka-Philipsen %K an %K article %K AS %K Belgian %K Belgium %K care %K CONTACT %K Countries %K cross sectional %K cross-national %K Cross-sectional %K Death %K Decision %K Decision Making %K Dementia %K Diagnosis %K differences %K Discussion %K electronic %K End-of-life %K European %K European countries %K factors %K GP %K health %K im %K Institute %K IS %K ITALY %K journal %K Life %K Logistic %K logistic regression %K Logistic-regression %K medical %K method %K methods %K Netherlands %K Network %K networks %K OCCUPATIONAL %K Occupational Health %K Participation %K Patient %K patients %K Planning %K prevalence %K public %K regression %K Research %K Research Support %K result %K results %K SB - IM %K Spain %K study %K surrogate %K survey %K The Netherlands %K treatment %K Universities %K university %K WHO %X BACKGROUND: Making treatment decisions in anticipation of possible future incapacity is an important part of patient participation in end-of-life decision-making. This study estimates and compares the prevalence of GP-patient end-of-life treatment discussions and patients' appointment of surrogate decision-makers in Italy, Spain, Belgium and the Netherlands and examines associated factors. METHODS: A cross-sectional, retrospective survey was conducted with representative GP networks in four countries. GPs recorded the health and care characteristics in the last three months of life of 4,396 patients who died non-suddenly. Prevalences were estimated and logistic regressions were used to examine between country differences and country-specific associated patient and care factors. RESULTS: GP-patient discussion of treatment preferences occurred for 10%, 7%, 25% and 47% of Italian, Spanish, Belgian and of Dutch patients respectively. Furthermore, 6%, 5%, 16% and 29% of Italian, Spanish, Belgian and Dutch patients had a surrogate decision-maker. Despite some country-specific differences, previous GP-patient discussion of primary diagnosis, more frequent GP contact, GP provision of palliative care, the importance of palliative care as a treatment aim and place of death were positively associated with preference discussions or surrogate appointments. A diagnosis of dementia was negatively associated with preference discussions and surrogate appointments. CONCLUSIONS: The study revealed a higher prevalence of treatment preference discussions and surrogate appointments in the two northern compared to the two southern European countries. Factors associated with preference discussions and surrogate appointments suggest that delaying diagnosis discussions impedes anticipatory planning, whereas early preference discussions, particularly for dementia patients, and the provision of palliative care encourage participation %B PLoS ONE %V 8 %P e57965 %8 30/6/2013 %G eng %N 3 %1 35339 %& e57965 %R http://dx.doi.org/10.1371/journal.pone.0057965 %0 Journal Article %J B.M.J.Support.Palliat.Care %D 2013 %T End-of-life medical treatment preference discussions and surrogate decision-maker appointments: evidence from Italy, Spain, Belgium and the Netherlands %A Evans,N. %A Pasman,H.R. %A T. Vega Alonso %A Van den Block,L. %A Miccinesi,G. %A Viviane Van Casteren %A G.A. Donker %A Bertolissi,S. %A Zurriaga,O. %A Deliens,L. %A B.D. Onwuteaka-Philipsen %K ALL %K an %K article %K AS %K Belgian %K Belgium %K Bt %K care %K Cognitive %K CONTACT %K Countries %K cross sectional %K Cross-sectional %K Death %K Decision %K Decision Making %K Decline %K Dementia %K Diagnosis %K differences %K Discussion %K electronic %K End-of-life %K European %K European countries %K evidence %K expertise %K factors %K GP %K health %K Institute %K IS %K ITALY %K journal %K Life %K Logistic %K logistic regression %K Logistic-regression %K medical %K method %K methods %K Netherlands %K Network %K networks %K OCCUPATIONAL %K Occupational Health %K Palliative Care %K Participation %K Patient %K Patient Participation %K patients %K Planning %K prevalence %K public %K regression %K Research %K result %K results %K Spain %K study %K surrogate %K survey %K The Netherlands %K treatment %K Universities %K university %K WHO %X BACKGROUND: Making treatment decisions in anticipation of possible future incapacity is an important part of patient participation in end-of-life decision-making. AIM: To compare the prevalence of GP-patient end-of-life treatment discussions and patient surrogate appointments in Italy, Spain, Belgium and the Netherlands and examine associated factors. METHODS: A cross-sectional, retrospective survey was conducted with representative GP networks in four countries. GPs recorded the health and care characteristics in the last 3 months of life of patients who died non-suddenly. Prevalences were estimated and between country differences, and country-specific associated patient and care factors, were examined using logistic regressions. RESULTS: 4396 non-sudden deaths were included. GP-patient discussion of treatment preferences occurred for 10%, 7%, 25% and 47% of Italian, Spanish, Belgian and of Dutch patients respectively. Furthermore, 6%, 5%, 16% and 29% of Italian, Spanish, Belgian and Dutch patients had a surrogate decision-maker. Despite some country-specific differences, previous GP-patient diagnosis discussions, more frequent GP contact, GP provision of palliative care, the importance of palliative care as a treatment aim and place of death were positively associated with preference discussions or surrogate appointments. A diagnosis of dementia was negatively associated with preference discussions and surrogate appointments. The single most important factor was prior GP-patient diagnosis discussion. DISCUSSION: The study revealed a higher prevalence of treatment preference discussions and surrogate appointments in the two northern European countries. CONCLUSION: Delaying diagnosis discussions impedes anticipatory planning, whereas early discussions for all patients, particularly those with cognitive decline, and palliative care provision support patients' participation in decision-making %B B.M.J.Support.Palliat.Care %V 3 %P 235 %8 1/6/2013 %G eng %N 2 %1 456 %& 235 %R http://dx.doi.org/10.1136/bmjspcare-2013-000491.28 %0 Government Document %D 2013 %T Epidemiologie van windpokken en zona vastgesteld door huisartsen : 2006-2010 %A Vanthomme,K. %A Geert Top %A Viviane Van Casteren %K 2006 %K 2010 %K age %K Age-group %K ALL %K an %K Case %K Chickenpox %K Development %K EN %K epidemiology %K Flanders %K general %K General practice %K GP %K incidence %K IS %K Light %K MEDV %K need %K Network %K old %K ON %K Practice %K sentinel %K Vaccination %K windpokken %K WIV-ISP %K zona %X In the light of new developments on vaccination we studied the epidemiology of chickenpox (varicella) and shingles (herpes zoster). We studied the number of cases of chickenpox and shingles through the network of sentinel GP's from 2006 to 2010. The incidence in general practice in Flanders for chickenpox varied between 28,8 and 35,7/10, 000. Highest incidence was noted in the age group 1-4 years old with an average of 495/10,000 in 2006-2010. Out of all cases 91% of the cases was younger than 10 years. Consultation-incidence for shingles varied from 38.3 to 46.4/10, 000, with highest incidence in 70-79 years old. Insight into the epidemiology of chickenpox and shingles is important to evaluate the need for a generalized vaccination. %B Vlaams infectieziektebulletin %V 4 %P 5 - 10 %8 0/0/2013 %G eng %1 35598 %& 5 %0 Generic %D 2013 %T First nationwide data collection from the medical patient record (2008-2011) in Belgium. %A S Moreels %A Nathalie Bossuyt %A Vanthomme,K. %A Goderis,G. %A Wens,J. %A Viviane Van Casteren %E European Public Health Association (EUPHA) %K Belgium %K conference %K data %K Data collection %K Europe %K European %K health %K medical %K Patient %K public %K public health %K Public-health %B 6th European Public Health Conference "Health in Europe: are we there yet?" %8 0/11/2013 %G eng %N European Public Health Association %1 2538 %2 13-16 November 2013 %0 Journal Article %J Stud.Health Technol.Inform. %D 2013 %T Global quality indicators for primary care electronic patient records %A E. De Clercq %A S Moreels %A Viviane Van Casteren %A Nathalie Bossuyt %A Goderis,G. %K an %K article %K AS %K assessment %K at %K Belgium %K care %K CONTACT %K CONTACTS %K data %K Database %K Decision %K disease %K DRUG %K electronic %K GP %K health %K Indicator %K Indicators %K INFORMATION %K Institute %K IS %K journal %K measuring %K medical %K Monitoring %K parameters %K Patient %K patients %K Practice %K PRACTICES %K Prescription %K primary care %K Print %K Quality %K quality of care %K questions %K Research %K result %K results %K SENSITIVITY %K Societies %K Society %K study %K System %K use %X Electronic Patient Records can be interfaced with medical decision support systems and quality of care assessment tools. An easy way of measuring the quality of EPR data is therefore essential. This study identified a number of global quality indicators (tracers) that could be easily calculated and validated them by correlating them with the Sensitivity and Positive Predictive Value (PPV) of data extracted from the EPR. Sensitivity and PPV of automatically extracted data were calculated using a gold standard constructed using answers to questions GPs were asked at the end of each contact with a patient. These properties were measured for extracted diagnoses, drug prescriptions, and certain parameters. Tracers were defined as drug-disease pairs (e.g. insulin-diabetes) with the assumption that if the patient is taking the drug, then the patient is suffering from the disease. Four tracers were identified that could be used for the ResoPrim primary care research database, which includes data from 43 practices, 10,307 patients, and 13,372 contacts. Moderately positive correlations were found between the 4 tracers and between the tracers and the sensitivity of automatically extracted diagnoses. For some purposes, these results may support the potential use of tracers for monitoring the quality of information systems such as EPRs %B Stud.Health Technol.Inform. %V 186 %P 66 - 70 %8 30/6/2013 %G eng %1 35330 %& 66 %R http://dx.doi.org/ %0 Government Document %D 2013 %T IKED-Voet: implementatie van een kwaliteitsbevorderend initiatief in de Belgische diabetische voetklinieken %A Kris Doggen %A Kristien Van Acker %A Hilde Beele %A Isabelle Dumont %A Patricia Félix %A Patrick Lauwers %A Astrid Lavens %A Giovanni Matricali %A Caren Randon %A Eric Weber %A Viviane Van Casteren %A Frank Nobels %X

Diabetische voetwonden zijn een vaak voorkomende complicatie van diabetes. Tot 25% van de diabetespatiënten krijgt te maken met (terugkerende) voetwonden. De impact op de levenskwaliteit en de kosten voor de maatschappij zijn hoog (1).Terwijl het uitvoeren van een voetonderzoek een gebruikelijke kwaliteitsindicator is wat betreft preventie van nieuwe diabetische voetwonden, is er geen consensus over indicatoren wat betreft de behandeling van bestaande voetwonden in gespecialiseerde diabetische voetklinieken. De resultaten van Eurodiale, een prospectieve studie omtrent de behandeling en uitkomsten van diabetische voetwonden in 14 Europese diabetische voetklinieken, wezen op een mismatch tussen wat de richtlijnen voorschrijven en de praktijk (2). Mogelijk zijn de richtlijnen te vaag waardoor het behandelende team vaak vertrouwt op eigen behandelingsprotocollen waarvan de klinische effectiviteit onvoldoende bewezen is.Een manier om de kwaliteit van zorg te verbeteren bestaat uit het periodiek meten van de kwaliteit (audit) gevolgd door benchmarking van (teams van) gezondheidszorgwerkers (feedback). Dit principe wordt sinds 2001 toegepast in de diabetes conventiecentra onder de vorm van IKED en ging gepaard met verbeteringen van de kwaliteit van zorg, vooral op het vlak van zorgprocessen. In 2005 werd een gelijkaardig kwaliteitsbevorderend initiatief opgestart in de door het RIZIV erkende diabetische voetklinieken (hierna centra genaamd): IKED-Voet. In dit artikel beschrijven we de implementering van IKED-Voet en de evolutie in methodologie en resultaten.

%B Vlaams tijdschrift voor Diabetologie %V 2013 %8 0/0/2013 %G eng %N 2 %1 1041 %0 Generic %D 2013 %T Impact of a Belgian nationwide diabetes care programme on the evolution of process indicators between 2006 and 2010: a longitudinal study based on administrative reimbursement data. %A Nathalie Bossuyt %A S Moreels %A Vanthomme,K. %A Goderis,G. %A Wens,J. %A Viviane Van Casteren %E European Public Health Association (EUPHA) %K 2006 %K 2010 %K Belgian %K care %K conference %K data %K diabete %K diabetes %K Europe %K European %K Evolution %K health %K Impact %K Indicator %K Indicators %K longitudinal %K Longitudinal Studies %K ON %K PROCESSES %K programme %K public %K public health %K Public-health %K study %B 6th European Public Health Conference "Health in Europe: are we there yet?" %8 0/10/2013 %G eng %N European Public Health Association %1 2537 %2 13-16 November 2013 %0 Report %D 2013 %T Incidentie, risicofactoren en risicobeleid bij oudere slachtoffers van valincidenten in de huisartspraktijk in het Vlaamse gewest. Resultaten van een surveillance door het Belgische netwerk van Huisartsenpeilpraktijken in 2009-2010 [intern rapport] %A Nicole Boffin %A Vanthomme,K. %A Viviane Van Casteren %K Belgische %K de %K EN %K Huisartsenpeilpraktijken %K huisartspraktijk %K Surveillance %K vlaamse %I WIV-ISP %C Brussel %P 30 %8 0/0/2013 %G eng %1 1107 %0 Report %D 2013 %T Initiatief voor kwaliteitsbevordering en epidemiologie bij diabetes - IKED - Rapport resultaten 2011 %A Astrid Lavens %A G. Krzentowski %A C. Mathieu %A F. Nobels %A A. Scheen %A A. Verhaegen %A Kris Doggen %A Viviane Van Casteren %I Wetenschappelijk Instituut Volksgezondheid – Institut Scientifique de Santé Publique %C Brussel, België %G eng %M D/2013/2505/06 %0 Report %D 2013 %T Initiatief voor kwaliteitsbevordering en epidemiologie bij kinderen en adolescenten met diabetes (IKEKAD) - Resultaten 2011. %A Kris Doggen %A Viviane Van Casteren %K diabete %K diabetes %K EN %K IKEKAD %K pediatric %K quality of care %I WIV-ISP %C Brussel %P 44 %8 0/0/2013 %@ D/2013/2505/01 %G eng %1 35335 %0 Report %D 2013 %T Initiatief voor kwaliteitsbevordering en epidemiologie bij multidisciplinaire diabetes voetklinieken (IKED-Voet) - Resultaten 2011 %A Kris Doggen %A Sophie Deweer %A Isabelle Dumont %A Mercedes Heureux %A Patrick Lauwers %A Astrid Lavens %A Giovanni Matricali %A Frank Nobels %A Caren Randon %A Kristien Van Acker %A Eric Weber %A Viviane Van Casteren %K audit %K charcot foot %K diabetes %K Diabetic Foot %K diabetic foot ulcer %K feedback %K quality improvement %K quality of care %X

Dit rapport beschrijft de resultaten van de derde audit bij de erkende diabetische voetklinieken in België (hierna “centra” genaamd). De audit verzamelde gegevens van 1.600 unieke patiënten die in 2011 voor een diabetische voetwonde van ten minste Wagner-graad 2 en/of een actieve Charcot-voet behandeld werden in één van de 32 deelnemende centra. De gegevens hadden betrekking op de karakteristieken bij de 1ste consultatie en de behandeling en uitkomsten over een periode van 6 maanden. Na de audit ontvingen de centra een feedbackrapport met benchmarking van hun performantie voor een aantal kwaliteitsindicatoren.

 

De belangrijkste resultaten waren:

 

 

De volgende conclusies kunnen geformuleerd worden:

 

%I WIV-ISP %C Brussel, België %P 60 %8 09/2013 %G eng %M D/2013/2505/33 %1 1038 %2 D/2013/2505/33 %0 Report %D 2013 %T Initiative pour la promotion de la qualité et epidémiologie chez les enfants et les adolescents atteints du diabète sucré (IPQE-EAD) - Résultats 2011. %A Kris Doggen %A Viviane Van Casteren %K ADOLESCENT %K Adolescents %K de %K diabete %K diabetes %K ET %K LE %K pediatric %K promotion %K qualité %K quality of care %I Institut Scientifique de Santé Publique %C Bruxelles %P 44 %8 0/0/2013 %@ D/2013/2505/02 %G eng %1 35336 %0 Report %D 2013 %T Initiative pour la promotion de la qualité et epidémiologie dans les cliniques multidisciplinaires du pied diabétique (IPQED-Pied) - Résultats 2011 %A Kris Doggen %A Sophie Deweer %A Isabelle Dumont %A Mercedes Heureux %A Patrick Lauwers %A Astrid Lavens %A Giovanni Matricali %A Frank Nobels %A Caren Randon %A Kristien Van Acker %A Eric Weber %A Viviane Van Casteren %K audit %K charcot foot %K diabetes %K Diabetic Foot %K diabetic foot ulcer %K feedback %K quality improvement %K quality of care %X

Ce rapport présente les résultats du troisième audit réalisé dans les cliniques du pied diabétique agréées en Belgique (ci-après dénommées « centres »). Pour cet audit, ont été collectées des données relatives à quelque 1.600 patients uniques qui se sont présentés dans l’un des 32 centres participants pour une lésion diabétique du pied de degré égal ou supérieur à 2 selon la classification de Wagner et/ou un pied de Charcot actif. Les données recueillies portaient sur les caractéristiques lors de la première consultation, ainsi que sur les soins prodigués et les résultats obtenus sur une période de six mois. À l’issue de cet audit, les centres ont obtenu un rapport de feedback, leur permettant de comparer leurs résultats avec ceux des autres centres pour plusieurs indicateurs de qualité (benchmarking).

 

On peut retenir les résultats suivants :

 

On peut tirer les conclusions suivantes :

%I WIV-ISP %C Bruxelles, Belgique %P 60 %8 9/2013 %G eng %M N° de dépôt : D/2013/2505/34 %1 1039 %2 D/2013/2505/33 %0 Report %D 2013 %T Initiative pour la promotion de la qualité et epidémiologie du diabète sucré IPQED - Rapport résultats 2011. %A Astrid Lavens %A G. Krzentowski %A C. Mathieu %A F. Nobels %A A. Scheen %A A. Verhaegen %A Kris Doggen %A Viviane Van Casteren %I Wetenschappelijk Instituut Volksgezondheid – Institut Scientifique de Santé Publique %C Brussel, België %P 94 %8 0/0/2013 %G eng %M D/2013/2505/07 %1 35595 %2 D/2013/2505/07 %0 Journal Article %J Huisarts Nu %D 2013 %T Nationaal onderzoeksnetwerk in de eerstelijnsgezondheidszorg. Een evaluatie van de privacybescherming. %A Viviane Van Casteren %A Nathalie Bossuyt %A S Moreels %A Goderis,G. %A Bartholomeeusen,S. %A Bonte,P. %A Bangels,M. %K * %K AAN %K België %K de %K EN %K MODEL %X De laatste tien jaar zijn in België meerdere specifieke onderzoeksnetwerken, permanent of tijdelijk, gelanceerd. In dit onderzoeksrapport wordt een generiek model van gegevensstroom voor een onderzoeksnetwerk beschreven en getoetst aan het nationale privacysysteem. %B Huisarts Nu %V 42 %P 43 - 45 %8 0/0/2013 %G eng %N 1 %1 35332 %& 43 %0 Journal Article %J B.M.C.Fam.Pract. %D 2013 %T Nationwide continuous monitoring of end-of-life care via representative networks of general practitioners in Europe %A Van den Block,L. %A B.D. Onwuteaka-Philipsen %A Meeussen,K. %A G.A. Donker %A F. Giusti %A Miccinesi,G. %A Viviane Van Casteren %A T. V. Alonso %A Zurriaga,O. %A Deliens,L. %K Aged %K ALL %K an %K article %K AS %K at %K Belgium %K cancer %K care %K Case %K cause %K Cause of Death %K Clinical %K Control %K Countries %K data %K Database %K Death %K disease %K Diseases %K electronic %K End-of-life %K EU %K Europe %K European %K European countries %K Female %K general %K GENERAL PRACTITIONER %K general practitioners %K GP %K health %K identify %K IS %K ITALY %K journal %K Life %K measure %K measurement %K measures %K measuring %K method %K methodology %K methods %K Monitoring %K Netherlands %K Network %K networks %K older %K ON %K Patient %K patients %K POPULATION %K population based %K population-based %K Populations %K Practice %K practitioner %K Practitioners %K public %K public health %K Public-health %K Quality %K Quality Control %K region %K registration %K Research %K result %K results %K SENTI-MELC %K sentinel %K Spain %K study %K Surveillance %K System %K The Netherlands %K time %K use %K WHO %X BACKGROUND: Although end-of-life care has become an issue of great clinical and public health concern in Europe and beyond, we lack population-based nationwide data that monitor and compare the circumstances of dying and care received in the final months of life in different countries. The European Sentinel GP Networks Monitoring End of Life Care (EURO SENTIMELC) study was designed to describe and compare the last months of life of patients dying in different European countries. We aim to describe how representative GP networks in the EURO SENTIMELC study operate to monitor end of life care in a country, to describe used methodology, research procedures, representativity and characteristics of the population reached using this methodology. METHODS: Nationwide representative Networks of General Practitioners (GPs) -- ie epidemiological surveillance systems representative of all GPs in a country or large region of a country -- in Belgium, the Netherlands, Italy and Spain continuously registered every deceased patient (>18 year) in their practice, using weekly standardized registration forms, during two consecutive years (2009--2010).All GPs were asked to identify patients who had died "non-suddenly". The last three months of these patients' lives was surveyed retrospectively. Several quality control measures were used to ensure data of high scientific quality. RESULTS: A total of 6858 deaths were registered of which two thirds died non-suddenly (from 62% in the Netherlands to 69% in Spain), representative for the GP populations in the participating countries. Of all non-sudden deaths, between 32% and 44% of deaths were aged 85 or older; between 46% and 54% were female, and between 23% and 49% died at home. Cancer was cause of death in 37% to 53% of non-sudden death cases in the four participating countries. CONCLUSION: Via the EURO SENTI-MELC methodology, we can build a descriptive epidemiological database on end-of-life care provision in several EU countries, measuring across setting and diseases. The data can serve as baseline measurement to compare and monitor end-of-life care over time. The use of representative GP networks for end-of-life care monitoring has huge potential in Europe where several of these networks are operational %B B.M.C.Fam.Pract. %V 14 %P 73 - 73 %8 3/6/2013 %G eng %N 1 %1 35614 %& 73 %R http://dx.doi.org/10.1186/1471-2296-14-73 %0 Journal Article %J PLoS One %D 2013 %T Palliative care service use in four European countries: a cross-national retrospective study via representative networks of general practitioners. %A Pivodic, Lara %A Pardon, Koen %A Van den Block, Lieve %A Viviane Van Casteren %A Miccinesi, Guido %A Donker, Gé A %A Tomás Vega Alonso %A José Lozano Alonso %A Pierangelo Lora Aprile %A Onwuteaka-Philipsen, Bregje D %A Deliens, Luc %K Age factors %K Delivery of Health Care %K Europe %K Female %K general practitioners %K Humans %K Male %K Neoplasms %K Palliative Care %K Retrospective Studies %X

BACKGROUND: Due to a rising number of deaths from cancer and other chronic diseases a growing number of people experience complex symptoms and require palliative care towards the end of life. However, population-based data on the number of people receiving palliative care in Europe are scarce. The objective of this study is to examine, in four European countries, the number of people receiving palliative care in the last three months of life and the factors associated with receiving palliative care.

METHODS: Cross-national retrospective study. Over two years (2009-2010), GPs belonging to representative epidemiological surveillance networks in Belgium, the Netherlands, Italy, and Spain registered weekly all deaths of patients (≥ 18 years) in their practices and the care they received in the last three months of life using a standardized form. Sudden deaths were excluded.

RESULTS: We studied 4,466 deaths. GPs perceived to have delivered palliative care to 50% of patients in Belgium, 55% in Italy, 62% in the Netherlands, and 65% in Spain (p<.001). Palliative care specialists attended to 29% of patients in the Netherlands, 39% in Italy, 45% in Spain, and 47% in Belgium (p<.001). Specialist palliative care lasted a median (inter-quartile range) of 15 (23) days in Belgium to 30 (70) days in Italy (p<.001). Cancer patients were more likely than non-cancer patients to receive palliative care in all countries as were younger patients in Italy and Spain with regard to specialist palliative care.

CONCLUSIONS: Although palliative care is established in the countries studied, there are considerable differences in its provision. Two potentially underserved groups emerge non-cancer patients in all countries and older people in Italy and Spain. Future research should examine how differences in palliative care use relate to both patient characteristics and existing national health care policies.

%B PLoS One %V 8 %P e84440 %8 2013 %G eng %N 12 %1 http://www.ncbi.nlm.nih.gov/pubmed/24386381?dopt=Abstract %R 10.1371/journal.pone.0084440 %0 Journal Article %J Stud.Health Technol.Inform. %D 2013 %T Routinely-collected general practice data from the electronic patient record and general practitioner active electronic questioning method: A comparative study %A S Moreels %A Nathalie Bossuyt %A Vanthomme,K. %A Goderis,G. %A Viviane Van Casteren %K Agreement %K ALL %K an %K approach %K approaches %K article %K AS %K Belgian %K Belgium %K blood %K Blood Pressure %K Blood-pressure %K BODY MASS %K Body Mass Index %K Body-mass %K Brussels %K cardiovascular %K care %K Cholesterol %K Clinical %K Comparative Study %K Comparison %K Computerized patient record %K conditions %K data %K Data collection %K de %K diabete %K diabetes %K DRUG %K drugs %K electronic %K ET %K general %K General practice %K GENERAL PRACTITIONER %K general practitioners %K GP %K healthcare %K Hypertension %K improve %K index %K INFORMATION %K IS %K IT %K journal %K Mass %K Mass index %K method %K methods %K Network %K networks %K observed %K Paper %K parameters %K past %K Patient %K patients %K Practice %K practitioner %K Practitioners %K Prescription %K Pressure %K prevalence %K Primary Health Care %K Print %K proxies %K Proxy %K Quality %K Questionnaire %K Research %K study %K System %K use %X The numerous existing primary care-based research networks currently use various data collection methods. In this paper, we compared routine data extracted from general practitioners' (GPs') electronic patient records (EPRs) and GPs' answers to an electronic questionnaire. We investigated for 10,307 Belgian patients 10 healthcare conditions using clinical and biological parameters (cholesterol, blood pressure, and body mass index), diagnoses (hypertension, diabetes, and personal past cardiovascular event(s)), and drug prescriptions (antidiabetic drugs, aspirin, statins, and antihypertensive drugs). We found a relatively fair agreement (Kappa>/=0.40) between the two data collection methods for 7 healthcare conditions, but no agreement for the biological parameters. When EPR data was used and compared with the questioning method, the prevalence of diagnoses and drug prescriptions was relatively lower and the prevalence of clinical and biological parameters was relatively higher (all missing data excluded) in the EPR data than in the data collected using the questioning method. Using EPR data, we calculated an acceptable proxy for the prevalence as observed using the questioning method. The comparison of the two data collection methods was a worthwhile approach, in that it could highlight potential ways to improve both care quality and information systems %B Stud.Health Technol.Inform. %V 192 %P 510 - 514 %8 30/6/2013 %G eng %1 2523 %& 510 %R http://dx.doi.org/ %0 Generic %D 2013 %T Starting a care trajectory precedes improved glucaemic control in patients with formerly uncontrolled Diabetes Mellitus Type 2: results from a retrospective registry based study in Belgium. %A Goderis,G. %A Viviane Van Casteren %A Nathalie Bossuyt %A S Moreels %A Vanthomme,K. %A Wens,J. %A Bartholomeeusen,S. %A F.J. Buntinx %E European Public Health Association (EUPHA) %K Belgium %K care %K conference %K Control %K data %K Data collection %K diabete %K diabetes %K Diabetes Mellitus %K Europe %K European %K health %K medical %K Patient %K patients %K public %K public health %K Public-health %K REGISTRIES %K Registry %K result %K results %K study %K Type %B 6th European Public Health Conference "Health in Europe: are we there yet?" %8 0/11/2013 %G eng %N European Public Health Association %1 2539 %2 13-16 November 2013 %0 Report %D 2013 %T Trajets de soins diabète sucré de type 2 et insuffisance rénale chronique: impact sur la qualité des soins. Achil Phase 1 (2009-2013). Ambulatory Care Health Information Laboratory. %A Viviane Van Casteren %A Nathalie Bossuyt %A S Moreels %A Vanthomme,K. %A Goderis,G. %A De Clercq,E. %K ACHIL %K care %K chronique %K de %K health %K Impact %K INFORMATION %K Laboratories %K Type %I WIV-ISP %C Bruxelles, Belgique %P 127 %8 0/11/2013 %G eng %M D/2013/2505/25 %0 Journal Article %J Huisarts Nu %D 2013 %T Zijn de peilartsen klaar om gegevens te leveren uit hun EMD? %A Nicole Boffin %A Nathalie Bossuyt %A Vanthomme,K. %A Viviane Van Casteren %K 2009 %K age %K ALL %K Belgian %K challenge %K compliance %K criteria %K data %K de %K electronic %K Family Practice %K Gender %K general %K General practice %K GP %K health %K IS %K language %K Logistic %K logistic regression %K Logistic-regression %K Medical Records Systems,Computerized %K method %K methods %K Network %K ON %K Order %K Paper %K PARTICIPANTS %K Physician's Practice Patterns %K Practice %K Prescription %K Quality %K registration %K regression %K Research %K response %K response rate %K result %K results %K sentinel %K Sentinel Surveillance %K SOFTWARE %K Still %K Surveillance %K survey %K surveys %K System %K use %X BACKGROUND: In order to proceed from a paper based registration to a surveillance system that is based on extraction of electronic health records (EHR), knowledge is needed on the number and representativeness of sentinel GPs using a government-certified EHR system and the quality of EHR data for research, expressed in the compliance rate with three criteria: recording of home visits, use of prescription module and diagnostic subject headings. METHODS: Data were collected by annual postal surveys between 2005 and 2009 among all sentinel GPs. We tested relations between four key GP characteristics (age, gender, language community, practice organisation) and use of a certified EHR system by multivariable logistic regression. The relation between EHR software package, GP characteristics and compliance with three quality criteria was equally measured by multivariable logistic regression. RESULTS: A response rate of 99% was obtained. Of 221 sentinel GPs, 55% participated in the surveillance without interruption from 2005 onwards, i.e. all five years, and 78% were participants in 2009. Sixteen certified EHR systems were used among 91% of the Dutch and 63% of the French speaking sentinel GPs. The EHR software package was strongly related to the community and only one EHR system was used by a comparable number of sentinel GPs in both communities. Overall, the prescription module was always used and home visits were usually recorded. Uniform subject headings were only sometimes used and the compliance with this quality criterion was almost exclusively related to the EHR software package in use. CONCLUSIONS: The challenge is to progress towards a sentinel network of GPs delivering care-based data that are (partly) extracted from well performing EHR systems and still representative for Belgian general practice %B Huisarts Nu %V 40 %P 150 - 151 %8 0/0/2013 %G eng %1 961 %& 150 %0 Government Document %D 2013 %T Zorgkwaliteit bij type 2 diabetici behandeld in de eerste lijn: resultaten uit de GUIDANCE-studie %A Kris Doggen %A Astrid Lavens %A Viviane Van Casteren %X

Wetenschappelijke richtlijnen en aanbevelingen ondersteunen gezond-heidswerkers bij het verlenen van kwaliteitsvolle zorg aan patiënten met type 2 diabetes (T2D). Een aantal factoren belemmert echter de imple-mentatie : 1. Op internationaal vlak zijn er verschillen tussen de kwaliteit en de in-houd van richtlijnen, wat hun geloofwaardigheid en doeltreffendheid ondermijnt; 2. Verbeteringen op vlak van zorgprocessen reflecteren zich niet noodza-kelijk in zorguitkomsten; 3. Het "one-size-fits-all" karakter van veel richtlijnen strookt niet met de groeiende aandacht voor gepersonaliseerde zorg en zorgdoelstellingen. Desondanks kunnen richtlijnen wel helpen de praktijk te oriënteren naar evidence based zorg en kunnen ze gebruikt worden als referentie om de kwaliteit van zorg te evalueren. In de Guideline Adherence to Enhance Care (GUIDANCE)-studie werd de kwaliteit en inhoud van Europese T2D-richtlijnen geëvalueerd. In tweede instantie werd de zorgkwaliteit bij T2D-patiënten in Europa gemeten met als uiteindelijk doel de hindernissen te begrijpen die artsen en patiënten ervaren bij de toepassing van de bestaande richtlijnen. In onderstaand artikel wordt de zorgkwaliteit van de Belgische T2D-patiënten in de GUI-DANCE-studie beschreven en worden deze resultaten in de bredere Euro-pese context van de studie geplaatst.

%B Vlaams tijdschrift voor Diabetologie %V 2013 %8 2013 %G eng %N 2 %1 1040 %0 Government Document %D 2012 %T ACHIL en de RIZIV-zorgtrajecten diabetes mellitus type 2 en chronische nierinsufficiëntie %A Viviane Van Casteren %A Goderis,G. %A Wens,J. %A S Moreels %A Vanthomme,K. %A Bartholomeeusen,S. %A Nathalie Bossuyt %K ACHIL %K de %K diabetes %K Diabetes Mellitus %K RIZIV %K Type %K zorgtraject %B Medi-Sfeer %V 387 %P 14 - 16 %8 0/2/2012 %G eng %1 401 %& 14 %0 Government Document %D 2012 %T ACHIL et les trajets de soins INAMI pour le diabète de type 2 et l'insuffisance rénale chronique %A Viviane Van Casteren %A Goderis,G. %A Wens,J. %A S Moreels %A Vanthomme,K. %A Bartholomeeusen,S. %A Nathalie Bossuyt %K ACHIL %K chronique %K de %K INAMI %K LE %K trajet de soins %K Type %B Medi-Sfeer %V 387 %P 14 - 16 %8 0/2/2012 %G eng %1 409 %& 14 %0 Journal Article %J Eur J Pediatr %D 2012 %T Care delivery and outcomes among Belgian children and adolescents with type 1 diabetes. %A Kris Doggen %A Debacker, N %A Beckers, D %A Casteels, K %A Coeckelberghs, M %A Dooms, L %A Dorchy, H %A Lebrethon, M %A Logghe, K %A Maes, M %A Massa, G %A Mouraux, T %A Rooman, R %A Thiry-Counson, G %A Van Aken, S %A Vanbesien, J %A Viviane Van Casteren %K ADOLESCENT %K Belgium %K Biomarkers %K Child %K Child, Preschool %K cross-sectional studies %K Delivery of Health Care %K Diabetes Mellitus, Type 1 %K Female %K Health Care Surveys %K Hemoglobin A, Glycosylated %K Humans %K Hypoglycemic Agents %K Infant %K Infant, Newborn %K Linear Models %K Male %K Outcome and Process Assessment (Health Care) %K Poisson Distribution %K quality improvement %K Retrospective Studies %K Surveys and Questionnaires %X

We aimed to investigate care processes and outcomes among children and adolescents with type 1 diabetes treated in hospital-based multidisciplinary paediatric diabetes centres. Our retrospective cross-sectional study among 12 Belgian centres included data from 974 patients with type 1 diabetes, aged 0-18 years. Questionnaires were used to collect data on demographic and clinical characteristics, as well as process of care completion and outcomes of care in 2008. Most patients lived with both biological or adoption parents (77 %) and had at least one parent of Belgian origin (78 %). Nearly all patients (≥95 %) underwent determination of HbA(1c) and BMI. Screening for retinopathy (55 %) and microalbuminuria (73 %) was less frequent, but rates increased with age and diabetes duration. Median HbA(1c) was 61 mmol/mol (7.7 %) [interquartile range 54-68 mmol/mol (7.1-8.4 %)] and increased with age and insulin dose. HbA(1c) was higher among patients on insulin pump therapy. Median HbA(1c) significantly differed between centres [from 56 mmol/mol (7.3 %) to 66 mmol/mol (8.2 %)]. Incidence of severe hypoglycaemia was 30 per 100 patient-years. Admissions for ketoacidosis had a rate of 3.2 per 100 patient-years. Patients not living with both biological or adoption parents had higher HbA(1c) and more admissions for ketoacidosis. Parents' country of origin was not associated with processes and outcomes of care.

CONCLUSION: Outcomes of care ranked well compared to other European countries, while complication screening rates were intermediate. The observed centre variation in HbA(1c) remained unexplained. Outcomes were associated with family structure, highlighting the continuing need for strategies to cope with this emerging challenge.

%B Eur J Pediatr %V 171 %P 1679-85 %8 2012 Nov %G eng %N 11 %1 http://www.ncbi.nlm.nih.gov/pubmed/22875314?dopt=Abstract %R 10.1007/s00431-012-1809-2 %0 Generic %D 2012 %T Contribution of respiratory pathogens to consultations of influenza-like illness %A Bollaerts,K. %A Jérôme Antoine %A Viviane Van Casteren %A Ducoffre,G. %A Sophie Quoilin %K Activity %K analysis %K Belgian %K Belgium %K consultation %K contribution %K data %K illness %K illnesses %K INFLUENZA %K IS %K Laboratories %K measure %K measures %K MODEL %K models %K Objective %K ON %K parameters %K pathogen %K POISSON %K Poisson regression %K Ratio %K regression %K relative %K Respiratory %K seasonal %K seasonality %K series %K time %K Time series %K Time-series %K Underreporting %K variation %K VIRUS %K Viruses %X

Objective

%B 3rd SIMID workshop %I NA %C NA %8 0/4/2012 %G eng %N UHasselt %1 33050 %2 25-27/04/2012 %0 Journal Article %J Epidemiol.Infect. %D 2012 %T Contribution of respiratory pathogens to influenza-like illness consultations %A Bollaerts,K. %A Jérôme Antoine %A Viviane Van Casteren %A Ducoffre,G. %A N. Hens %A Sophie Quoilin %K Activity %K article %K Belgian %K Belgium %K Clinical %K consultation %K contribution %K data %K electronic %K health %K illness %K illnesses %K INFLUENZA %K Institute %K IS %K journal %K Laboratories %K measure %K measures %K MEDV %K method %K methods %K MODEL %K models %K ON %K Paper %K parameters %K pathogen %K POISSON %K Poisson regression %K public %K public health %K Public-health %K Ratio %K Ratios %K regression %K relative %K Respiratory %K result %K results %K seasonal %K seasonal variation %K seasonality %K series %K summary %K Surveillance %K time %K Time series %K Time-series %K Underreporting %K variation %K VIRUS %K Viruses %K WIV-ISP %X SUMMARY Influenza-like illnesses (ILIs) are caused by several respiratory pathogens. These pathogens show weak to strong seasonal activity implying seasonality in ILI consultations. In this paper, the contribution of pathogens to seasonality of ILI consultations was statistically modelled. Virological count data were first smoothed using modulation models for seasonal time series. Second, Poisson regression was used regressing ILI consultation counts on the smoothed time series. Using ratios of the estimated regression parameters, relative measures of the underreporting of pathogens were obtained. Influenza viruses A and B, parainfluenza virus and respiratory syncytial virus (RSV) significantly contributed to explain the seasonal variation in ILI consultations. We also found that RSV was the least and influenza virus A is the most underreported pathogen in Belgian laboratory surveillance. The proposed methods and results are helpful in interpreting the data of clinical and laboratory surveillance, which are the essential parts of influenza surveillance %B Epidemiol.Infect. %V 141 %P 2196 - 2204 %8 6/12/2012 %G eng %N 10 %1 437 %& 2196 %R http://dx.doi.org/10.1017/S0950268812002506 %0 Government Document %D 2012 %T Datacollectie: de ACHIL-leshiel van de zorgtrajecten? %A Viviane Van Casteren %E Domus Medica %K ACHIL %K de %X Not available %8 4/4/2012 %G eng %1 35613 %0 Journal Article %J Vlaams tijdschrift voor Diabetologie %D 2012 %T Diabetesprevalentie in België: vergelijking van beschikbare data %A Johan Van der Heyden %A Mimilidis,H. %A Bartholomeeusen,S. %A Vanthomme,K. %A Viviane Van Casteren %A Jean Tafforeau %K België %K Belgium %K data %K diabetes %K morbidity %K prevalence %K Register %B Vlaams tijdschrift voor Diabetologie %V 2 %P 6 - 8 %8 0/0/2012 %G eng %1 36412 %& 6 %0 Journal Article %J Vlaams infectieziektebulletin %D 2012 %T Epidemiologie van windpokken en zona vastgesteld door huisartsen: 2006-2010 %A Vanthomme,K. %A Geert Top %A Viviane Van Casteren %K 2006 %K AAN %K de %K EN %K IS %K zona %X In het kader van nieuwe ontwikkelingen op het vlak van vaccinatie werd de epidemiologie van windpokken (varicella) en zona (herpes zoster) onderzocht. Via de huisartsenpeilpraktijken werd tussen 2006 en 2010 het aantal gevallen van deze aandoeningen opgevolgd. De consultatie-incidentie voor windpokken in de huisartsenpraktijken in Vlaanderen varieerde tussen 28,8 en 35,7 gevallen per 10.000 personenjaren. De hoogste incidentie werd gezien bij de 1-4 jarigen met een gemiddelde van 495/10.000 in de periode 2006-2010 en 91% was jonger dan 10 jaar. De consultatie-incidentie van zona varieerde tussen 38,3 en 46,4 gevallen per 10.000 personenjaren, met de hoogste incidentie bij de 70-79 jarigen. Een goed inzicht in de epidemiologie van windpokken en zona is belangrijk om de noodzaak aan een eventuele veralgemeende vaccinatie te kunnen evalueren. %B Vlaams infectieziektebulletin %V 4 %P 5 - 11 %8 1/12/2012 %G eng %1 30319 %& 5 %0 Government Document %D 2012 %T Griepsurveillance door de huisartsenpeilpraktijken : surveillance van de klinische parameters tijdens 3 griepepidemieën. %A Françoise Wuillaume %A Viviane Van Casteren %E Johan Peeters %K de %K Griep %K Grippe %K Huisartsenpeilpraktijken %K MEDV %K parameters %K Surveillance %X not available %B Senti-Bul %C Brussel %V 2012 %P 1 - 4 %8 0/1/2012 %@ 2032-2283 %G eng %N 1 %1 35621 %& 1 %0 Journal Article %J Eur J Clin Microbiol Infect Dis %D 2012 %T Incidence and management of presumption of Lyme borreliosis in Belgium: recent data from the sentinel network of general practitioners. %A Vanthomme, K %A Nathalie Bossuyt %A Nicole Boffin %A Viviane Van Casteren %K ADOLESCENT %K Adult %K Aged %K Aged, 80 and over %K Belgium %K Child %K Child, Preschool %K Female %K general practitioners %K Guideline Adherence %K Humans %K incidence %K Infant %K Lyme Disease %K Male %K middle aged %K Sentinel Surveillance %K Young adult %X

An increasing incidence of tick bites and Lyme disease has been noticed internationally. The aims of this study are threefold: to estimate the incidence of tick bites and erythema migrans, to assess the compliance of the general practitioners (GPs) with the recommendations about the management of tick bites and erythema migrans, and finally, to have a look at the evolution over time, both on incidence and management. We used data of the Belgian network of sentinel general practitioners (SGP) to study the incidence rates in Belgium, the trend over time, and the degree of compliance of the SGP. The overall Belgian incidence rates in the SGP practice in 2008-2009 were 18.65 (95% CI 17.29-20.08) per 10,000 persons for tick bites and 9.02 (95% CI 8.08-10.03) for erythema migrans. The diagnostic management of patients with an asymptomatic tick bite has worsened over time, while the therapeutic management of erythema migrans has improved over time. The international increasing trend of the incidence was not observed in the SGP. There is still room for improvement concerning the approach of the GPs. Recommendations could help to improve their approach.

%B Eur J Clin Microbiol Infect Dis %V 31 %P 2385-90 %8 2012 Sep %G eng %N 9 %1 http://www.ncbi.nlm.nih.gov/pubmed/22391757?dopt=Abstract %R 10.1007/s10096-012-1580-3 %0 Journal Article %J Fam Pract %D 2012 %T Incidence, patient characteristics and treatment initiated for GP-diagnosed depression in general practice: results of a 1-year nationwide surveillance study. %A Nicole Boffin %A Nathalie Bossuyt %A Declercq, Tom %A Vanthomme, Katrien %A Viviane Van Casteren %K ADOLESCENT %K Adult %K Antidepressive Agents %K Belgium %K dépression %K Female %K General practice %K Humans %K incidence %K Male %K middle aged %K Population Surveillance %K Practice Patterns, Physicians' %K Suicidal Ideation %K Young adult %X

BACKGROUND: Despite its public health significance, data about depression in general practice are often unavailable.

OBJECTIVE: To study (i) the incidence of GP-diagnosed depression during 2008, (ii) associations between patient characteristics, appraised severity and initiated treatment, (iii) GPs' usual care compared to diagnostic criteria from Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition guidelines and the newly developed practice guideline of the Society of Flemish GPs (2008) and (iv) GPs' initiated treatments compared to the Flemish Guideline.

METHODS: General practice-based data were collected on all patients of ≥18 years who were diagnosed by their GP with a new episode of depression in Belgian sentinel general practices (SGP) during 2008.

RESULTS: Data on 1739 persons were recorded by 172 sentinel general practices. Incidence rates for GP-diagnosed depression were estimated at 719/100 000 men and 1440/100 000 women. Thirty-one per cent of patients had mild, 50% had moderate and 19% had severe GP-diagnosed depression. Although only 43% of the patients at risk for suicide were considered to have severe depression, having thoughts of death or suicide was the main factor associated with increased severity of depression. Seventy-five per cent of patients received a prescription for an antidepressive agent; 29% received a prescription for another psychoactive agent; in 36%, non-pharmaceutical support was initiated by the GP and 25% received a referral. In contrast with the Flemish GP guideline criteria: (i) 69% of patients with a new episode of mild or a first episode of moderate depression were prescribed an antidepressive agent and (ii) only 39% of the patients with severe depression were both prescribed an antidepressive agent and referred to a mental health service.

CONCLUSIONS: This study has yielded original data on the incidence and management of depression in Belgian general practice. Our findings show that efforts are needed to improve depression management in Belgian general practice.

%B Fam Pract %V 29 %P 678-87 %8 2012 Dec %G eng %N 6 %1 http://www.ncbi.nlm.nih.gov/pubmed/22523390?dopt=Abstract %R 10.1093/fampra/cms024 %0 Report %D 2012 %T Infectieziekten bij kinderen die voorkomen kunnen worden door vaccinatie. Trends en Ontwikkelingen in België en de Gemeenschappen, 2011. %A Toon Braeye %A D Hue %A Tine Grammens %A Sophie Quoilin %A Sophie Bertrand %A Bots,J. %A Ducoffre,G. %A Goubau,P. %A Heymans,C. %A Denis Piérard %A Carole Schirvel %A Béatrice Swennen %A Geert Top %A Viviane Van Casteren %A Vandenberg,O. %A Steven Van Gucht %A Marc Van Ranst %A Vanthomme,K. %A Jan Verhaegen %A Françoise Wuillaume %K België %K de %K EN %K trend %K trends %I WIV-ISP %C Brussel %P 84 %8 1/12/2012 %@ D/2012/2050/80 %G eng %1 30418 %0 Report %D 2012 %T Initiatief voor kwaliteitsbevordering en epidemiologie bij kinderen en adolescenten met diabetes (IKEKAD) - Resultaten 2010. %A Kris Doggen %A Viviane Van Casteren %K 2010 %K diabete %K diabetes %K EN %K IKEKAD %K pediatric %K quality of care %X Not available %I WIV-ISP %C Brussel %P 44 %8 0/0/2012 %@ D/2012/2505/15 %G eng %1 1034 %0 Generic %D 2012 %T Initiative for quality improvement and epidemiology among children and adolescents with diabetes (IQECAD) %A Kris Doggen %A Debacker,N. %A Viviane Van Casteren %X

Introduction

 

The importance of quality of care monitoring, allowing identification of shortcomings in care, is increasingly recognized among health care practitioners. It is especially important among children with chronic illness, such as type 1 diabetes, as high care quality in childhood might prevent long-term complications. Several national and international systems of audit and feedback have been established, aimed at improving care quality in hospital-based multidisciplinary paediatric diabetes centres (HBMC).

 

Aims

 

To study and improve the processes and outcomes of care by implementing a system of audit and feedback in Belgian HBMCs. To identify risk factors of poor care delivery and outcomes.

 

Methods

 

In 2009, twelve HBMCs transmitted data on a random sample (N=976) of type 1 diabetic patients aged 0-18 years (representing about one third of all Belgian patients) to the Scientific Institute of Public Health (IPH) using an on-line secured questionnaire. Data pertained to demographic and clinical characteristics, as well as process of care completion and outcomes of care in 2008. Outcomes were studied for patients with diabetes duration exceeding 1 year (N=861). Quality of care indicators were defined using international recommendations.

 

Results

 

Following the audit, the IPH provided each HBMC with a quality indicator feedback report of the individual scores as well as caterpillar plots allowing the comparison of individual scores to anonymised scores of the other HBMCs (benchmarking). Next, a global description of care delivery and barriers to successful outcomes was undertaken (available at: http://www.wiv-isp.be/epidemio/). Nearly all patients (≥95%) underwent determination of glycated haemoglobin (HbA1c) and BMI. Screening for retinopathy (55%) and microalbuminuria (73%) was less frequent, but rates increased with age and diabetes duration, consistent with the observed absence of complications in young patients. Median HbA1c was 7.7% (interquartile range: 7.1-8.4%) and increased with age and insulin dose. HbA1c was higher among patients on insulin pump therapy. Median HbA1c significantly differed between centres (from 7.3% to 8.2%). Incidence of severe hypoglycemia was 30 per 100 patient-years. Admissions for ketoacidosis had a rate of 3.2 per 100 patient-years. Most patients lived with both biological or adoption parents (77%) and had at least one parent of Belgian origin (78%). Patients not living with both biological or adoption parents had higher HbA1c and more admissions for ketoacidosis. Parents’ country of origin was not associated with processes and outcomes of care.

 

Conclusions

 

The IQECAD Study Group successfully implemented a system of audit and feedback in Belgian HBMCs. Future cycles will indicate whether feedback leads to quality improvement. At baseline, outcomes of care ranked well compared to other European countries, while screening rates for complications were intermediate. Centre variation in HbA1c remained unexplained. Outcomes were associated with family structure, highlighting the continuing need for strategies to cope with this emerging challenge.

%B 40ste Jaarlijkse Congres van de Belgische Vereniging voor Kindergeneeskunde %I BVK-SBP %C Brussels, Belgium %8 2012 %G eng %N BVK-SBP %1 1030 %2 24/03/2012 %0 Report %D 2012 %T Initiative pour la promotion de la qualité et epidémiologie chez les enfants et les adolescents atteints du diabète sucré (IPQE-EAD) - Résultats 2010. %A Kris Doggen %A Viviane Van Casteren %K 2010 %K ADOLESCENT %K Adolescents %K de %K diabete %K diabetes %K ET %K LE %K pediatric %K promotion %K qualité %K quality of care %X Not available %I WIV-ISP %C Bruxelles %P 44 %8 0/0/2012 %@ D/2012/2505/16 %G eng %1 1032 %0 Report %D 2012 %T Maladies infectieuses pédiatriques à prévention vaccinale. Tendances et évolutions en Belgique et dans les Communautés, 2011. %A Toon Braeye %A D Hue %A Tine Grammens %A Sophie Quoilin %A Sophie Bertrand %A Bots,J. %A Ducoffre,G. %A Goubau,P. %A Heymans,C. %A Denis Piérard %A Carole Schirvel %A Béatrice Swennen %A Geert Top %A Viviane Van Casteren %A Vandenberg,O. %A Steven Van Gucht %A Marc Van Ranst %A Vanthomme,K. %A Jan Verhaegen %A Françoise Wuillaume %K Belgique %K EN %K ET %K LE %K Maladies infectieuse %K pédiatrique %K trends %I WIV-ISP %C Bruxelles %V 2012-44 %P 84 %8 1/12/2012 %@ D/2012/2050/81 %G eng %1 30419 %0 Generic %D 2012 %T Methodology of the evaluation of the national care trajectoires diabetes and chronic kidney disease. %A Nathalie Bossuyt %A Goderis,G. %A Wens,J. %A S Moreels %A Vanthomme,K. %A Bartholomeeusen,S. %A Viviane Van Casteren %K care %K chronic %K diabete %K diabetes %K disease %K European %K EVALUATION %K general %K General practice %K Kidney %K meeting %K methodology %K national %K Network %K Practice %X Not available %B Annual Meeting European General Practice Reasearch Network %C Brussels/Belgium %8 0/10/2012 %G eng %N E.G.P.R.N. %1 2447 %2 18-21 October 2012 %0 Generic %D 2012 %T Methodology of the evaluation of the national care trajectory diabetes. %A Wens,J. %A Nathalie Bossuyt %A Goderis,G. %A S Moreels %A Vanthomme,K. %A Bartholomeeusen,S. %A Viviane Van Casteren %K care %K chronic %K conference %K diabete %K diabetes %K disease %K Europe %K European %K EVALUATION %K general %K General practice %K International %K Kidney %K methodology %K national %K Network %K Practice %K primary care %X Not available %B XIIth International Primary Care Diabetes Europe Conference %C Brussels/Belgium %8 0/10/2012 %G eng %N I.D.F. %1 2448 %2 26-27 October 2012 %0 Journal Article %J Stud.Health Technol.Inform. %D 2012 %T Nation-wide primary healthcare research network: a privacy protection assessment %A Viviane Van Casteren %A Nathalie Bossuyt %A S Moreels %A Goderis,G. %A Bartholomeeusen,S. %A Bonte,P. %A Bangels,M. %K an %K analysis %K assessment %K Belgian %K Belgium %K care %K Countries %K Efficiency %K health %K healthcare %K Institute %K IS %K journal %K LEVEL %K management %K MODEL %K Network %K Paper %K Primary Health Care %K Print %K Research %K Service %K Services %K Societies %K Society %X Efficiency and privacy protection are essential when setting up nationwide research networks. This paper investigates the extent to which basic services developed to support the provision of care can be re-used, whilst preserving an acceptable privacy protection level, within a large Belgian primary care research network. The generic sustainable confidentiality management model used to assess the privacy protection level of the selected network architecture is described. A short analysis of the current architecture is provided. Our generic model could also be used in other countries %B Stud.Health Technol.Inform. %V 174 %P 23 - 28 %8 0/4/2012 %@ 978-1-61499-051-2 %G eng %1 420 %& 23 %R http://dx.doi.org/ %0 Journal Article %J Int.Psychogeriatr. %D 2012 %T Older people dying with dementia: a nationwide study %A Meeussen,K. %A Van den Block,L. %A Echteld,M. %A Nicole Boffin %A Bilsen,J. %A Viviane Van Casteren %A Deliens,L. %K 2008 %K Aged %K ALL %K an %K approach %K approaches %K Area %K Areas %K article %K AS %K Belgium %K Brussels %K care %K Cognitive %K Common %K Communication %K Components %K data %K Death %K Decision Making %K Dementia %K Diagnosis %K distress %K ELDERLY %K elderly people %K electronic %K End-of-life %K general %K GENERAL PRACTITIONER %K general practitioners %K GP %K IS %K IT %K journal %K Less %K Life %K MEDV %K Mild %K mortality %K Network %K older %K ON %K Palliative Care %K Paper %K Patient %K patients %K People %K physical %K practitioner %K Practitioners %K PROCESSES %K proxies %K Proxy %K PSYCHOLOGICAL %K PSYCHOLOGICAL DISTRESS %K registration %K Research %K Sample %K study %K Symptom %K Symptoms %K Term %K treatment %K Universities %K university %X ABSTRACTBackground: Large-scale nationwide data describing the end-of-life characteristics of older people with dementia are lacking. This paper describes the dying process and end-of-life care provided to elderly people with mild or severe dementia in Belgium. It compares with elderly people dying without dementia.Methods: A nationwide retrospective mortality study was conducted, via representative network of general practitioners (GPs) in 2008 in Belgium, with weekly registration of all deaths (aged >/= 65) using a standardized form. GPs reported on diagnosis and severity of dementia, aspects of end-of-life care and communication, and on the last week of life in terms of symptoms that caused distress as judged by the GP, and the patients' physical and cognitive abilities.Results: Thirty-one percent of our sample (1,108 deaths) had dementia (43% mildly, 57% severely). Of those, 26% died suddenly, 59% in care home, and 74% received palliative treatment, versus 37%, 19%, and 55% in people without dementia. GP-patient conversations were less frequent among those with (45%) than those without (73%) dementia, and 11% of both groups had a proxy decision-maker. During the last week of life, physical and psychological distress was common in both groups. Of older people with dementia, 83% were incapable of decision-making and 83% were bedridden; both significantly higher percentages than found in the group without dementia (24% and 52%).Conclusions: Several areas of end-of-life care provision could be improved. Early communication and exploration of wishes and appointment of proxy decision-makers are important components of an early palliative care approach which appears to be initiated too infrequently %B Int.Psychogeriatr. %V 24 %P 1581 - 1591 %8 30/5/2012 %G eng %1 431 %& 1581 %R http://dx.doi.org/10.1017/S1041610212000865 %0 Generic %D 2012 %T Problématique du dépistage systématique de la mucoviscidose. Données du registre Belge de la Mucoviscidose. %A Muriel Thomas %A Simeon Wanyama %A Jansen,H. %A Viviane Van Casteren %K Belge %K de %K mucoviscidose %X

Not available

%B Séminaire de concertation "problématique du dépistage néonatal systématique de la mucoviscidose" %I NA %C NA %8 0/3/2012 %G eng %N Fédération Wallonie-Bruxelles %1 35609 %2 Mars 2012 %0 Journal Article %J Stud.Health Technol.Inform. %D 2012 %T Quality assessment of automatically extracted data from GPs' EPR %A S Moreels %A Viviane Van Casteren %A Nathalie Bossuyt %A Goderis,G. %A Bartholomeeusen,S. %K an %K article %K AS %K assessment %K Belgian %K Belgium %K Benefit %K benefits %K care %K data %K DRUG %K electronic %K GP %K health %K Institute %K IS %K journal %K method %K need %K Network %K networks %K Paper %K parameters %K Patient %K patients %K Practice %K PRACTICES %K Prescription %K primary care %K Print %K Quality %K Questionnaire %K referral %K Research %K result %K results %K Secondary %K SENSITIVITY %K Societies %K Society %K SOFTWARE %K System %X There are many secondary benefits to collecting routine primary care data, but we first need to understand some of the properties of this data. In this paper we describe the method used to assess the PPV and sensitivity of data extracted from Belgian GPs' EPR (diagnoses, drug prescriptions, referrals, and certain parameters), using data collected through an electronic questionnaire as a gold standard. We describe the results of the ResoPrim phase 2 project, which involved 4 software systems and 43 practices (10,307 patients). This method of assessment could also be applied to other research networks %B Stud.Health Technol.Inform. %V 180 %P 726 - 730 %8 0/0/2012 %G eng %1 2437 %& 726 %R http://dx.doi.org/ %0 Journal Article %J Stud Health Technol Inform %D 2012 %T Quality assessment of automatically extracted data from GPs' EPR. %A De Clercq, Etienne %A S Moreels %A Viviane Van Casteren %A Nathalie Bossuyt %A Goderis, Geert %A Stefaan Bartholomeeusen %K Belgium %K Data Mining %K Electronic Health Records %K General practice %K Guideline Adherence %K Health Records, Personal %X

There are many secondary benefits to collecting routine primary care data, but we first need to understand some of the properties of this data. In this paper we describe the method used to assess the PPV and sensitivity of data extracted from Belgian GPs' EPR (diagnoses, drug prescriptions, referrals, and certain parameters), using data collected through an electronic questionnaire as a gold standard. We describe the results of the ResoPrim phase 2 project, which involved 4 software systems and 43 practices (10,307 patients). This method of assessment could also be applied to other research networks.

%B Stud Health Technol Inform %V 180 %8 2012 %G eng %R https://www.ncbi.nlm.nih.gov/pubmed/?term=22874287 %0 Journal Article %J Fam Pract %D 2012 %T Short-term follow-up of patients diagnosed by their GP with mild depression or first-time moderate depression. Results of a 1-year nationwide surveillance study. %A Nicole Boffin %A Nathalie Bossuyt %A Vanthomme, Katrien %A Van Audenhove, Chantal %A Viviane Van Casteren %K Adult %K Aged %K Belgium %K Confidence Intervals %K dépression %K Female %K Follow-Up Studies %K general practitioners %K Humans %K Male %K middle aged %K ODDS RATIO %K Outcome Assessment (Health Care) %K Population Surveillance %K public health %X

BACKGROUND: Despite its public health significance, data about depression in general practice are often unavailable or incomplete.

OBJECTIVE: To study half-year follow-up data on patients diagnosed by their GP with a new episode of mild or a first episode of moderate depression, specifically: (i) treatment continuation, (ii) remission and, in ongoing episodes, suicidal behaviour and inability to work and (iii) the match between treatments initiated and delivered as well as the determinants of actual delivery of non-pharmacological support initiated by the GP for patients with ongoing depression.

METHODS: General practice-based data were collected on all patients aged ≥18 years who were diagnosed by their GP with a new episode of depression in Belgian sentinel general practices during 2008.

RESULTS: Follow-up data were available for 900 of 1048 patients. Complete treatment dropout was found in 9%, treatment discontinuation in 40% and a GP visit ≤8 weeks preceding the follow-up in 51%. Of the latter 457 patients, 60% were still depressed. Among these, one suicide attempt was reported and 24% were unable to work for ≥1 month. While 91% of the patients who received psychoactive agents at diagnosis had actually taken them, and 62% of the referred patients actually received treatment from another caregiver, non-pharmacological support by the GP was delivered in only 43% of patients for whom it was initiated.

CONCLUSIONS: Half a year after diagnosis, half of patients continue to visit their GP and 60% of those patients remain depressed. The delivery of non-pharmacological GP support takes place for less than half of the patients for whom that intervention is initiated. Our follow-up findings reinforce the policy recommendations made by stakeholders, i.e. the introduction and reimbursement of a mental health consultation in family practice and integration of primary care psychologists. Quality improvement interventions may be a strategy to overcome premature discontinuation of non-pharmacological support by GPs.

%B Fam Pract %V 29 %P 688-95 %8 2012 Dec %G eng %N 6 %1 http://www.ncbi.nlm.nih.gov/pubmed/22523392?dopt=Abstract %R 10.1093/fampra/cms032 %0 Government Document %D 2012 %T Surveillance de la grippe par les médecins vigies : paramètres cliniques de surveillance pendant trois épidémies de grippe. %A Françoise Wuillaume %A Viviane Van Casteren %E Johan Peeters %K de %K Griep %K Grippe %K LE %K MEDV %K PAR %K Surveillance %X not available %B Senti-Bul %C Bruxelles %V 2012 %P 1 - 4 %8 0/1/2012 %@ 2032-2283 %G eng %N 1 %1 35620 %& 1 %0 Generic %D 2012 %T Towards a central registry for rare disease patients in Belgium %A Elfriede Swinnen %A Jansen,H. %A Viviane Van Casteren %K 2009 %K additional %K AS %K at %K Belgian %K Belgium %K calculation %K care %K Caregivers %K Common %K data %K disease %K Diseases %K DRUG %K drugs %K European %K European Commission %K general %K genetics %K health care %K HEALTH-CARE %K healthcare %K Human %K implementation %K improve %K incidence %K Indicator %K Indicators %K IS %K IT %K LEVEL %K measure %K measures %K methodology %K Monitoring %K need %K needs %K Nomenclature %K ON %K orphan %K Orphanet %K Patient %K Patient Care %K patients %K Planning %K prevalence %K public %K Quality %K Rare disease %K Rare diseases %K recommendation %K Recommendations %K registration %K REGISTRIES %K Registry %K Research %K result %K State %K Statistical %K Strategies %K Strategy %K survival %K use %K work %X In 2009 the European Commission asked the Member States to develop a strategy to improve the care of rare disease patients by 2013 (2009/C 151/02). In Belgium, recommendations for measures to fill unmet needs of rare disease patients were formulated by the Fund of Rare Diseases and Orphan Drugs at the King Baudouin Foundation. As a result, for 2012-2013, the government provides a budget to work out the implementation of a central rare disease registry collecting a minimum common dataset. Indeed, registration of rare diseases would be highly beneficial to patients, caregivers, authorities, researchers and the general public. Registries can be used e.g. for epidemiological research; incidence, prevalence and survival calculations; quality of patient care, health-care planning and monitoring.Belgian data on rare disease patients are scarce and fragmented. The primary goal is to bring together already existing data (e.g. by extraction from established registries), to harmonize the different initiatives and to start up registration of core data for additional rare diseases. The Orphanet nomenclature of rare diseases will be used as this will allow mapping to the ICD11 in the future.The core dataset will serve epidemiological purposes, including some quality indicators. In the future, also data on orphan drug use will be collected and other administrative or dossier functionalities might be implemented. %B European Human Genetics Conference %8 0/10/2012 %G eng %N E.S.H.G. %1 35603 %2 23-26 June 2012 %0 Journal Article %J Eur J Clin Microbiol Infect Dis %D 2012 %T Viral aetiology of influenza-like illness in Belgium during the influenza A(H1N1)2009 pandemic. %A Hombrouck, A %A Martine Sabbe %A Viviane Van Casteren %A Françoise Wuillaume %A D Hue %A Reynders, M %A Gérard, C %A Bernard Brochier %A Van Eldere, J %A Van Ranst, M %A Isabelle Thomas %K ADOLESCENT %K Adult %K Age Distribution %K Aged %K Aged, 80 and over %K Belgium %K Child %K Child, Preschool %K Female %K Humans %K Infant %K Infant, Newborn %K Male %K middle aged %K Respiratory Tract Diseases %K Virus Diseases %K Viruses %K Young adult %X

The purpose of this investigation was to determine the proportion of influenza-like illness (ILI) attributable to specific viruses during the influenza A(H1N1)2009 pandemic and to describe the demographic and clinical characteristics of ILI due to respiratory viruses in Belgium. Nasopharyngeal swabs were collected from ILI patients by general practitioners (GPs) and paediatricians (PediSurv) and analysed for viruses. Of 139 samples collected from children <5 years of age by PediSurv, 86 were positive, including 28 influenza (20%), 27 respiratory syncytial virus (RSV) (19%), 21 rhinovirus (17%), 12 human metapneumovirus (hMPV) (9%) and ten parainfluenza virus (PIV) (7%). Of 810 samples received from GPs, 426 were influenza (53%). Of 312 influenza-negative samples, 41 were rhinovirus (13%), 13 RSV (4%), 11 PIV (4%) and three hMPV (1%). Influenza mostly affected the 6-15 years old age group. Other respiratory viruses were commonly detected in the youngest patients. Similar clinical symptoms were associated with different respiratory viruses. Influenza A(H1N1)2009 was the most detected virus in ILI patients during the 2009-2010 winter, suggesting a good correlation between ILI case definition and influenza diagnosis. However, in children under 5 years of age, other respiratory viruses such as RSV were frequently diagnosed. Furthermore, our findings do not suggest that the early occurrence of the influenza A(H1N1)2009 epidemic impacted the RSV epidemic in Belgium.

%B Eur J Clin Microbiol Infect Dis %V 31 %P 999-1007 %8 2012 Jun %G eng %N 6 %1 http://www.ncbi.nlm.nih.gov/pubmed/21901635?dopt=Abstract %& 999 %R 10.1007/s10096-011-1398-4 %0 Journal Article %J Vlaams infectieziektebulletin %D 2011 %T Eliminatie van Mazelen en Rubella in 2010: halen we de doelstelling?36571 %A Veronik Hutse %A Viviane Van Casteren %A Geert Top %A E. Padalko %A Goubau,P. %K 2009 %K 2010 %K AAN %K België %K de %K EN %K Infectieziekten %K IS %K Mazelen %K Rubella %K Surveillance %X Mazelen is één van de meest besmettelijke infectieziekten waarbij tot in 30% van de gevallen complicaties optreden. Het congenitaal rubellasyndroom is een verzamelnaam voor de afwijkingen die kunnen optreden bij een kind waarvan de moeder tijdens de zwangerschap besmet werd met rubella. Het Regionaal Bureau voor Europa van de Wereldgezondheidsorganisatie gaf in 2010 prioriteit aan de eliminatie van mazelen en het congenitaal rubellasyndroom. Dit artikel beschrijft de belangrijkste klinische en diagnostische aspecten van mazelen en van het congenitaal rubellasyndroom. Vervolgens wordt een overzicht gegeven van de surveillance van mazelen en rubella in België. Hieruit blijkt dat ook in 2009 er nog verschillende gevallen van mazelen voorkwamen. De eliminatiedoelstelling kan bereikt worden maar vraagt een blijvende inspanning van alle gezondheidswerkers. %B Vlaams infectieziektebulletin %V 76 %P 4 - 9 %8 0/0/2011 %G eng %N 2 %1 36571 %& 4 %0 Journal Article %J J Palliat Med %D 2011 %T Is individual educational level related to end-of-life care use? Results from a nationwide retrospective cohort study in Belgium. %A Nathalie Bossuyt %A Van den Block, Lieve %A Cohen, Joachim %A Meeussen, Koen %A Bilsen, Johan %A Echteld, Michael %A Deliens, Luc %A Viviane Van Casteren %K ADOLESCENT %K Adult %K Aged %K Aged, 80 and over %K Attitude to Death %K Belgium %K Child %K Child, Preschool %K Educational Measurement %K Educational Status %K Female %K HEALTH POLICY %K Health Services Accessibility %K Humans %K Infant %K Male %K middle aged %K Models, Psychological %K Multivariate Analysis %K ODDS RATIO %K Palliative Care %K Practice Patterns, Physicians' %K Retrospective Studies %K Terminal Care %K Young adult %X

BACKGROUND: Educational level has repeatedly been identified as an important determinant of access to health care, but little is known about its influence on end-of-life care use.

OBJECTIVES: To examine the relationship between individual educational attainment and end-of-life care use and to assess the importance of individual educational attainment in explaining differential end-of-life care use.

RESEARCH DESIGN: A retrospective cohort study via a nationwide sentinel network of general practitioners (GPs; SENTI-MELC Study) provided data on end-of-life care utilization. Multilevel analysis was used to model the association between educational level and health care use, adjusting for individual and contextual confounders based upon Andersen's behavioral model of health services use.

SUBJECTS: A Belgian nationwide representative sample of people who died not suddenly in 2005-2007.

RESULTS: In comparison to their less educated counterparts, higher educated people equally often had a palliative treatment goal but more often used multidisciplinary palliative care services (odds ratios [OR] for lower secondary education 1.28 [1.04-1.59] and for higher [secondary] education: 1.31 [1.02-1.68]), moved between care settings more frequently (OR: 1.68 [1.13-2.48] for lower secondary education and 1.51 [0.93-2.48] for higher [secondary] education) and had more contacts with the GP in the final 3 months of life.

CONCLUSIONS: Less well-educated people appear to be disadvantaged in terms of access to specialist palliative care services, and GP contacts at the end of life, suggesting a need for empowerment of less well-educated terminally ill people regarding specialist palliative and general end-of-life care use.

%B J Palliat Med %V 14 %P 1135-41 %8 2011 Oct %G eng %N 10 %1 http://www.ncbi.nlm.nih.gov/pubmed/21815816?dopt=Abstract %R 10.1089/jpm.2011.0045 %0 Report %D 2011 %T Initiatief voor Kwaliteitsbevordering en Epidemiologie bij Diabetes (IKED) - Rapport resultaten 2009 %A N. Debacker %A G. Krzentowski %A C. Mathieu %A J. Ruige %A A. Scheen %A J. Tits %A Viviane Van Casteren %A S. Van Imschoot %A F. Nobels %I Wetenschappelijk Instituut Volksgezondheid – Institut Scientifique de Santé Publique %C Brussel, België %G eng %M D/2011/2505/6 %0 Report %D 2011 %T Initiatief voor Kwaliteitsbevordering en Epidemiologie bij Multidisciplinaire Diabetes Voetklinieken IKED-voet - Resultaten 2008 %A Mandy Claessens %A Frank Nobels %A N. Debackere %A Hilde Beele %A Sophie Deweer %A Isabelle Dumont %A Patricia Félix %A M. Flour %A Patrick Lauwers %A Giovanni Matricali %A Caren Randon %A A. Spijker %A Viviane Van Casteren %A Kristien Van Acker %K audit %K charcot foot %K diabetes %K Diabetic Foot %K diabetic foot ulcer %K feedback %K quality improvement %K quality of care %I WIV-ISP %C Brussel, België %P 64 %8 03/2011 %G eng %M D/2011/2505/4 %0 Report %D 2011 %T Initiative pour la Promotion de la Qualité et Epidémiologie dans les Cliniques multidisciplinaires du pied Diabétique IPQED-Pied - Résultats 2008 %A Mandy Claessens %A Frank Nobels %A N. Debacker %A Hilde Beele %A Sophie Deweer %A Isabelle Dumont %A Patricia Félix %A M. Flour %A Patrick Lauwers %A Giovanni Matricali %A Caren Randon %A A. Spijker %A Viviane Van Casteren %A Kristien Van Acker %K audit %K charcot foot %K diabetes %K Diabetic Foot %K diabetic foot ulcer %K feedback %K quality improvement %K quality of care %I WIV-ISP %C Bruxelles, Belgique %P 64 %8 03/2011 %G eng %M D/2011/2505/5 %0 Report %D 2011 %T IPQED: Initiative pour la Promotion de la Qualité et l’Epidémiologie du Diabète sucré - Rapport résultats 2009 %A N. Debacker %A G. Krzentowski %A C. Mathieu %A J. Ruige %A A. Scheen %A J. Tits %A Viviane Van Casteren %A P. Van Crombrugge %A S. Van Imschoot %A F. Nobels %I Wetenschappelijk Instituut Volksgezondheid – Institut Scientifique de Santé Publique %C Brussel, België %G eng %M D/2011/2505/7 %0 Report %D 2011 %T Prevention of Cervical Cancer in Belgium: Anno 2011 %A M. Arbyn %A Viviane Van Casteren %A Van Hoof,E. %K Belgium %K cancer %K cervical cancer %K cervix %K HPV %K incidence %K mortality %K prevention %K SCREENING %K Vaccination %I WIV-ISP %C Brussels %V 2010/010 %P 118 %8 0/0/2011 %@ D/2011/2505/79 %G eng %1 35170 %& 1 %0 Journal Article %J Vasc Health Risk Manag %D 2011 %T Signs for early diagnosis of heart failure in primary health care. %A Devroey, Dirk %A Viviane Van Casteren %K Adult %K Aged %K Aged, 80 and over %K Belgium %K Chi-Square Distribution %K Early Diagnosis %K Edema %K Exercise Test %K Female %K Health Care Surveys %K Heart Failure %K Heart Function Tests %K Humans %K Logistic Models %K Male %K middle aged %K Predictive Value of Tests %K Primary Health Care %K Prospective Studies %K Respiration Disorders %K Respiratory Sounds %K Risk Assessment %K Risk Factors %K Time Factors %X

OBJECTIVE: The current guidelines for the diagnosis of heart failure (HF) are based on studies of hospital-based patients. The aim of this study is to describe the symptoms, clinical signs, and diagnostic procedures confirming the diagnosis of HF in primary health care.

MATERIALS/SUBJECTS AND METHODS: Data were prospectively collected during a 2-year period by a nationwide network of sentinel practices. All adult patients without known HF, for which the diagnosis of HF was clinically suspected for the first time, were registered. When diagnosed, HF was confirmed after 1 month.

RESULTS: 754 patients with a suspicion of HF were recorded. The diagnosis of HF was confirmed for 74% of the patients. The average age of the patients with confirmed HF was 77.7 years, and for those without HF 75.6 years (P = 0.018). From a logistic regression, breathlessness on exercise (P < 0.001), limitations of physical activity (P = 0.003), and orthopnea (P = 0.040) were the symptoms most associated with HF. The clinical signs most associated with HF, were pulmonary rales (P < 0.001), peripheral edema (P < 0.001), and raised jugular venous pressure (P = 0.039). An electrocardiogram was performed in 75% of the cases, blood analyses in 68%, echocardiogram in 63%, chest X-ray in 61%, and determination of natriuretic peptides in 11% of the cases.

CONCLUSION: Many clinical signs may occur in patients with HF. However, the occurrence of peripheral edema, breathlessness on exercise, or pulmonary rales, are highly suggestive for HF when diagnosed in primary health care, as is the case in hospital-admitted patients. The diagnosis of HF was often left unconfirmed by an echocardiogram and/or an electrocardiogram.

%B Vasc Health Risk Manag %V 7 %P 591-6 %8 2011 %G eng %1 http://www.ncbi.nlm.nih.gov/pubmed/21966224?dopt=Abstract %R 10.2147/VHRM.S24476 %0 Journal Article %J Archives of Public Health %D 2010 %T Clinical influenza surveillance of Influenza A(H1N1) 2009 pandemic through the network of Sentinel General Practitioners36890 %A Viviane Van Casteren %A Karl Mertens %A Jérôme Antoine %A Simeon Wanyama %A Isabelle Thomas %A Nathalie Bossuyt %K 2009 %K Clinical %K general %K GENERAL PRACTITIONER %K general practitioners %K INFLUENZA %K Network %K pandemic %K practitioner %K Practitioners %K sentinel %K Surveillance %X Not available %B Archives of Public Health %V 68 %P 62 - 67 %8 0/0/2010 %G eng %1 36890 %& 62 %R http://dx.doi.org/10.1186%2F0778-7367-68-2-62 %0 Journal Article %J Int J Clin Pract %D 2010 %T The incidence and first-year mortality of heart failure in Belgium: a 2-year nationwide prospective registration. %A Devroey, D %A Viviane Van Casteren %K Adult %K Age Distribution %K Aged %K Aged, 80 and over %K Belgium %K Diagnosis, Differential %K Female %K Heart Failure %K Hospitalization %K Humans %K incidence %K Male %K middle aged %K Physical Examination %K Prospective Studies %K Sex Distribution %X

AIMS: The aim of this study is to determine the incidence and mortality of heart failure (HF) in Belgium.

METHODS: Data were prospectively collected during a 2-year period by a nationwide network of sentinel practices. All adult patients for whom, for the first time the diagnosis of HF was clinically suspected were registered. Patients were finally included if the diagnosis of HF was confirmed after 1 month.

RESULTS: The yearly incidence of confirmed HF in the Belgian adult population was estimated to be 194 patients per 100,000 inhabitants (95% CI: 172-218). At diagnosis, the median age of the patients with confirmed HF was 79 years: 82 years for women and 76 years for men (p < 0.0001). For the population aged 55 years or more, the yearly incidence of HF was 502 (95% CI: 444-565) with no significant difference between men and women. At diagnosis, most of the patients were classified as NYHA III (50%), 27% as NYHA IV and 20% as NYHA II. Six months after the initial diagnosis, the mortality was 19% and after 12 months it was 26%.

CONCLUSION: In Belgium, yearly 15,643 new patients of HF are diagnosed (95% CI: 13,861-17,590). HF is fatal for more than one quarter of the patients in the first year after the diagnosis.

%B Int J Clin Pract %V 64 %P 330-5 %8 2010 Feb %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/20456173?dopt=Abstract %R 10.1111/j.1742-1241.2009.02212.x %0 Journal Article %J BMC Fam Pract %D 2010 %T Readiness of the Belgian network of sentinel general practitioners to deliver electronic health record data for surveillance purposes: results of survey study. %A Nicole Boffin %A Nathalie Bossuyt %A Vanthomme, Katrien %A Viviane Van Casteren %K Belgium %K Electronic Health Records %K Family Practice %K Female %K Guideline Adherence %K Health Care Surveys %K Humans %K Male %K Medical Records Systems, Computerized %K middle aged %K Population Surveillance %K Practice Patterns, Physicians' %K Sentinel Surveillance %K Surveys and Questionnaires %X

BACKGROUND: In order to proceed from a paper based registration to a surveillance system that is based on extraction of electronic health records (EHR), knowledge is needed on the number and representativeness of sentinel GPs using a government-certified EHR system and the quality of EHR data for research, expressed in the compliance rate with three criteria: recording of home visits, use of prescription module and diagnostic subject headings.

METHODS: Data were collected by annual postal surveys between 2005 and 2009 among all sentinel GPs. We tested relations between four key GP characteristics (age, gender, language community, practice organisation) and use of a certified EHR system by multivariable logistic regression. The relation between EHR software package, GP characteristics and compliance with three quality criteria was equally measured by multivariable logistic regression.

RESULTS: A response rate of 99% was obtained. Of 221 sentinel GPs, 55% participated in the surveillance without interruption from 2005 onwards, i.e. all five years, and 78% were participants in 2009. Sixteen certified EHR systems were used among 91% of the Dutch and 63% of the French speaking sentinel GPs. The EHR software package was strongly related to the community and only one EHR system was used by a comparable number of sentinel GPs in both communities. Overall, the prescription module was always used and home visits were usually recorded. Uniform subject headings were only sometimes used and the compliance with this quality criterion was almost exclusively related to the EHR software package in use.

CONCLUSIONS: The challenge is to progress towards a sentinel network of GPs delivering care-based data that are (partly) extracted from well performing EHR systems and still representative for Belgian general practice.

%B BMC Fam Pract %V 11 %P 50 %8 2010 Jun 25 %G eng %1 http://www.ncbi.nlm.nih.gov/pubmed/20579350?dopt=Abstract %R 10.1186/1471-2296-11-50 %0 Journal Article %J Cent Eur J Public Health %D 2010 %T Symptoms and clinical signs associated with hospital admission and mortality for heart failure. %A Devroey, Dirk %A Viviane Van Casteren %K Adult %K Aged %K Aged, 80 and over %K Female %K Heart Failure %K hospitals %K Humans %K Male %K middle aged %K Patient Admission %K prevalence %K Prospective Studies %K Sentinel Surveillance %K Time Factors %X

Little information is available on the predicting factors for hospitalisation and mortality in heart failure. The aim of this study was to determine the symptoms and clinical signs at the time of the diagnosis of heart failure that predict hospitalisation within the first month after diagnosis and mortality within the first six months after diagnosis. Data were prospectively collected during a two-year period by a nationwide network of sentinel family practices. All adult patients for whom the first time the diagnosis of heart failure was clinically suspected were registered. One, six and twelve months after the initial diagnosis, the family physicians completed a follow-up form with questions about the final diagnosis, evolution and outcome. In total 557 patients with confirmed heart failure were recorded (median age = 78 years). Hospitalisation within the first month after the diagnosis was best predicted by peripheral oedema (p = 0.001), nocturnal dyspnoea (p = 0.022) and pleural effusion (p = 0.032) at the time of the diagnosis. Six months after the initial diagnosis the mortality was 19% and after 12 months it was 26%. Mortality within the first six months after the diagnosis was best predicted by age (p < 0.001) and pulmonary rales (p = 0.001). Peripheral oedema appeared more among the survivors (p = 0.035). Peripheral oedema, nocturnal dyspnoea and pleural effusion are highly associated with hospitalisation within the first month after diagnosis.

%B Cent Eur J Public Health %V 18 %P 209-14 %8 2010 Dec %G eng %N 4 %1 http://www.ncbi.nlm.nih.gov/pubmed/21361105?dopt=Abstract %0 Journal Article %J Archives of Public Health %D 2010 %T Virological surveillance of the Influenza A (H1N1)2009 pandemic: the role of the Belgian National Influenza Centre %A Gerard,C. %A Bernard Brochier %A Sophie Quoilin %A Françoise Wuillaume %A Viviane Van Casteren %A Isabelle Thomas %K a %K Belgian %K INFLUENZA %K Influenza A Virus,H1N1 Subtype %K national %K pandemic %K Role %K Surveillance %X

Not available

%B Archives of Public Health %V 68 %P 68 - 75 %8 0/0/2010 %G eng %N 2 %1 31233 %& 68 %R http://dx.doi.org/10.1186%2F0778-7367-68-2-68 %0 Journal Article %J Int J Public Health %D 2009 %T Domestic violence: variation in case-management by the general practitioner in Belgium. %A Nathalie Bossuyt %A Viviane Van Casteren %K Adjustment Disorders %K ADOLESCENT %K Adult %K Age factors %K Aged %K Belgium %K Case Management %K Coercion %K cross-sectional studies %K Family Practice %K Female %K Humans %K Male %K middle aged %K Pregnancy %K Referral and Consultation %K Sentinel Surveillance %K sex factors %K Sex Offenses %K Spouse Abuse %K Wounds and Injuries %K Young adult %X

OBJECTIVES: to describe the medical interventions and referrals carried out by the general practitioner (GP) when taking care of victims and to quantify the between-physician variability in management of domestic violence.

METHODS: A nationwide sentinel network of 150 general practitioners, covering 1.5 % of the Belgian population, registered in 2002-2004 all episodes of domestic violence for which they were consulted, via paper registration forms. A multilevel analysis was carried out by fitting a random effects logistic regression model for every intervention/referral.

RESULTS: The most frequent interventions of the GP were providing a certificate of injury (54 %), and making an appointment for a next visit (33 %). Half of the patients were referred or hospitalised upon the first consultation, most frequently they were advised to go to the police (17 %) or referred to a psychologist or psychiatrist (11 %). The intra cluster correlation coefficient (ICC) of the interventions varied between 11 % and 39 % and the median odds ratios between 1,82 and 3,96.

CONCLUSIONS: GP consultations for domestic violence are frequent and involve considerable between-physician variability in care.

%B Int J Public Health %V 54 %P 106-11 %8 2009 %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/19288287?dopt=Abstract %R 10.1007/s00038-009-7074-0 %0 Report %D 2009 %T Initiatief voor Kwaliteitsbevordering en Epidemiologie bij Diabetes (IKED) - Rapport resultaten 2007 %A N. Debacker %A G. Krzentowski %A C. Mathieu %A F. Nobels %A J. Ruige %A A. Scheen %A J. Tits %A Viviane Van Casteren %A P. Van Crombrugge %A S. Van Imschoot %I Wetenschappelijk Instituut Volksgezondheid – Institut Scientifique de Santé Publique %C Brussel, België %G eng %M D/2009/2505/14 %0 Report %D 2009 %T Initiatief voor Kwaliteitsbevordering en Epidemiologie bij Diabetes (IKED) - rapport resultaten 2007 %A N. Debacker %A G. Krzentowski %A C. Mathieu %A F. Nobels %A J. Ruige %A A. Scheen %A J. Tits %A Viviane Van Casteren %A P. Van Crombrugge %A S. Van Imschoot %I Wetenschappelijk Instituut Volksgezondheid – Institut Scientifique de Santé Publique %C Brussel, België %G eng %M D/2009/2505/14 %0 Report %D 2009 %T Initiative pour la Promotion de la Qualité et Epidémiologie du Diabète sucré (IPQED) - Rapports résultats 2007 %A N. Debacker %A G. Krzentowski %A C. Mathieu %A F. Nobels %A J. Ruige %A A. Scheen %A J. Tits %A Viviane Van Casteren %A P. Van Crombrugge %A S. Van Imschoot %I Wetenschappelijk Instituut Volksgezondheid – Institut Scientifique de Santé Publique %C Brussel, België %G eng %M D/2009/2505/15 %0 Journal Article %J Bull.Mem.Acad.R.Med.Belg. %D 2009 %T Virologic surveillance of influenza, and of influenza A/H1N1 in particular, in Belgium36843 %A Isabelle Thomas %A Gerard,C. %A Françoise Wuillaume %A Viviane Van Casteren %A Bernard Brochier %K abstract %K Animals %K article %K Belgium %K Bruxelles %K de %K epidemiology %K Grippe %K History,21st Century %K Humans %K im %K INFLUENZA %K Influenza A Virus,H1N1 Subtype %K Influenza A Virus,H3N2 Subtype %K Influenza,Human %K IS %K journal %K national %K pathogenicity %K Print %K SB - IM %K Seasons %K Surveillance %K Swine %K Swine Diseases %K virology %X abstract %B Bull.Mem.Acad.R.Med.Belg. %V 164 %P 268 - 274 %8 0/0/2009 %G eng %N 10 %1 38397 %& 268 %0 Report %D 2008 %T La grippe en Belgique: importance de la surveillance %A Isabelle Thomas %A Viviane Van Casteren %A Gerard,C. %A Bernard Brochier %K Belgique %K de %K EN %K Grippe %K Surveillance %I WIV-ISP %C Brussels %P 4 %8 0/0/2008 %@ D/2009/2505/55 %G eng %1 38396 %0 Journal Article %J Diabet Med %D 2008 %T Organization of a quality-assurance project in all Belgian multidisciplinary diabetes centres treating insulin-treated diabetes patients: 5 years' experience. %A Debacker, N %A Nobels, F %A Vandenberghe, H %A Van Crombrugge, P %A Scheen, A %A Viviane Van Casteren %K ADOLESCENT %K Adult %K Aged %K Belgium %K Diabetes Mellitus, Type 1 %K Diabetes Mellitus, Type 2 %K Epidemiologic Methods %K Female %K Humans %K Male %K middle aged %K Quality Assurance, Health Care %X

AIMS: To describe the IQED, a quality-assurance system started in 2001 in Belgian hospital-based multidisciplinary diabetes centres, and its effects on the quality of care.

METHODS: The study was conducted through four data collections (in 2001, 2002, 2004 and 2006). Approximately 120 diabetes centres provided data on a systematic random sample of 10% of their adult diabetic patients on at least two daily insulin injections. Data on patient characteristics, glycaemic control, cardiovascular risk, diabetes complications, follow-up procedures and treatment were obtained. Local quality promotion was encouraged by returning comprehensive feedback (benchmarks) and during information meetings.

RESULTS: Nearly all diabetes centres (98-100%) participated. The pooled sample consisted of 9194 (32%) Type 1 and 19 828 (68%) Type 2 diabetes patients, with mean diabetes duration of 17 years and 14 years, prevalence of microvascular complications of 23% and 38% and prevalence of macrovascular complications of 9% and 26%, respectively. At the start, the quality of care was good in terms of risk-factor testing rates and moderate in terms of patients meeting goals for risk-factor management. At least 50% of the centres initiated quality-promoting initiatives. After 5 years, significant improvements were seen in risk-factor testing rates, apart from renal screening. Improvements in intermediate outcomes were less obvious, apart from an increase in patients reaching the targets for blood pressure and LDL cholesterol.

CONCLUSIONS: It is feasible to implement a continuous quality-improvement project on a nationwide scale, with improvements particularly in process indicators.

%B Diabet Med %V 25 %P 179-85 %8 2008 Feb %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/18290859?dopt=Abstract %R 10.1111/j.1464-5491.2007.02378.x %0 Journal Article %J Int J Public Health %D 2007 %T Epidemiology of suicide and suicide attempts in Belgium: results from the sentinel network of general practitioners. %A Nathalie Bossuyt %A Viviane Van Casteren %K ADOLESCENT %K Adult %K Age factors %K Aged %K Aged, 80 and over %K Belgium %K Data Interpretation, Statistical %K Family Practice %K Female %K Humans %K incidence %K Male %K middle aged %K Sentinel Surveillance %K sex factors %K suicide %K Suicide, Attempted %X

OBJECTIVES: To estimate the evolution of incidence of (attempted) suicide between 1993 and 2001 in Belgium and to examine trends in methods, first caretaker and aspects of seasonality.

METHODS: In 1993-1995 and 2000-2001, the national sentinel network of general practitioners registered, for each case of (attempted) suicide, age, sex, date, place of the event, first caretaker, method, and survival.

RESULTS: Between 1993-1995 and 2000-2001, the incidence of suicide increased among men from 29/ 100,000 to 35/ 100,000, and decreased among women from 14/ 100,000 to 11/ 100,000. The incidence of attempted suicide increased among men (from 67/ 100,000 to 71/ 100,000) and women (from 131/ 100,000 to 141/ 100,000). None of the above mentioned changes were statistically significant however. The use of violent methods as opposed to non-violent methods remained unchanged in women (OR: 0.95 [0.63-1.41]).

CONCLUSIONS: No statistically significant trends were observed in the incidence of suicide, the fraction of cases with fatal outcome and the use of violent methods.

%B Int J Public Health %V 52 %P 153-7 %8 2007 %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/17958281?dopt=Abstract %0 Report %D 2007 %T Initiatief voor Kwaliteitsbevordering en Epidemiologie bij Diabetes (IKED) - Rapport resultaten 2005-2006 %A N. Debacker %A C. Mathieu %A F. Nobels %A A. Scheen %A Viviane Van Casteren %A P. Van Crombrugge %I Wetenschappelijk Instituut Volksgezondheid – Institut Scientifique de Santé Publique %C Brussel, België %G eng %M D/2007/2505/2 %0 Report %D 2007 %T Initiatief voor Kwaliteitsbevordering en Epidemiologie bij Multidisciplinaire Diabetes Voetklinieken - Jaren 2005-2006 %A A. Biliet %A N. Debacker %A Frank Nobels %A Kristien Van Acker %A Viviane Van Casteren %K audit %K charcot foot %K diabetes %K Diabetic Foot %K diabetic foot ulcer %K feedback %K quality improvement %K quality of care %I WIV-ISP %C Brussel, België %P 76 %8 07/2007 %G eng %M D/2007/2505/22 %0 Report %D 2007 %T Initiative pour la Promotion de la Qualité et Epidémiologie dans les cliniques multidisciplinaires du pied Diabétique - Années 2005-2006 %A A. Biliet %A N. Debacker %A Frank Nobels %A Kristien Van Acker %A Viviane Van Casteren %K audit %K charcot foot %K diabetes %K Diabetic Foot %K diabetic foot ulcer %K feedback %K quality improvement %K quality of care %I WIV-ISP %C Bruxelles, Belgique %P 75 %8 07/2007 %G eng %M D/2007/2505/23 %0 Report %D 2007 %T Initiative pour la Promotion de la Qualité et Epidémiologie du Diabète sucré (IPQED) - Rapport résultats 2005-2006 %A N. Debacker %A C. Mathieu %A F. Nobels %A A. Scheen %A Viviane Van Casteren %A P. Van Crombrugge %I Wetenschappelijk Instituut Volksgezondheid – Institut Scientifique de Santé Publique %C Brussel, België %G eng %M D/2007/2505/3 %0 Journal Article %J Int J Med Inform %D 2005 %T Collecting information on the quality of prescribing in primary care using semi-automatic data extraction from GPs' electronic medical records. %A Vandenberghe, H E E %A Viviane Van Casteren %A Jonckheer, P %A Bastiaens, H %A Johan Van der Heyden %A Lafontaine, M-F %A De Clercq, E %K Aged %K Aged, 80 and over %K Anti-Inflammatory Agents, Non-Steroidal %K Belgium %K Data collection %K Drug Prescriptions %K Female %K Humans %K Male %K Medical Audit %K Medical Records Systems, Computerized %K middle aged %K Osteoarthritis %K Physicians, Family %K Practice Patterns, Physicians' %K Quality of Health Care %X

OBJECTIVES: To evaluate a semi-automatic data extraction from the electronic medical record (EMR) of general practitioners (GPs) through a comparison with a paper sheets data collection simultaneously used in a primary care research project on the quality of prescribing for osteoarthritis in the elderly.

SUBJECTS: One hundred and fifty-two GPs using five different EMR-software systems participated with the semi-automatic data extraction from the EMR and 233 GPs collected data with paper registration sheets.

METHODS: The proportion of patients with respectively a drug prescription, paracetamol, a non-steroidal anti-inflammatory drug (NSAID) and ibuprofen were compared between the semi-automatic extraction and the paper data collection and among the EMR-software systems.

RESULTS: Using the semi-automatic data extraction, a significantly lower proportion of patients on drugs was obtained compared to the paper data collection (adjusted OR: 0.31; 95% CI 0.25-0.39). However, the proportion of patients on a specific type of drug was comparable. Within the results from the semi-automatic extraction, the results were heterogeneous among the different EMR-software systems.

CONCLUSIONS: The semi-automatic data extraction with multiple EMR-software systems proposed in this study seems suitable for quality of prescribing assessment in primary care. However, it may be less reliable when only a single EMR-software is used.

%B Int J Med Inform %V 74 %P 367-76 %8 2005 Jun %G eng %N 5 %1 http://www.ncbi.nlm.nih.gov/pubmed/15893259?dopt=Abstract %R 10.1016/j.ijmedinf.2005.02.004 %0 Report %D 2005 %T Initiatief voor Kwaliteitsbevordering en Epidemiologie bij Diabetes (IKED) - Rapport resultaten 2003-2004 %A N. Debacker %A F. Nobels %A A. Scheen %A Viviane Van Casteren %A P. Van Crombrugge %A H. Vandenberghe %I Wetenschappelijk Instituut Volksgezondheid – Institut Scientifique de Santé Publique %C Brussel, België %G eng %M D/2005/2505/06 %0 Report %D 2005 %T Initiative pour la Promotion de la Qualité et Epidémiologie du Diabète sucré (IPQED) - Rapport résultats 2003-2004 %A N. Debacker %A F. Nobels %A A. Scheen %A Viviane Van Casteren %A P. Van Crombrugge %A H. Vandenberghe %I Wetenschappelijk Instituut Volksgezondheid – Institut Scientifique de Santé Publique %C Brussel, België %G eng %M D/2005/2505/07 %0 Journal Article %J J Public Health (Oxf) %D 2004 %T An 8 year nationwide prospective registration of non-consented HIV testing in Belgium. %A Viviane Van Casteren %A Devroey, Dirk %A André Sasse %A Wallyn, Solvejg %K ADOLESCENT %K Adult %K Aged %K AIDS Serodiagnosis %K Belgium %K Family Practice %K Female %K Health Care Surveys %K HIV Infections %K Humans %K Informed Consent %K Male %K middle aged %K Practice Patterns, Physicians' %K REGISTRIES %K Risk-Taking %K Sentinel Surveillance %K Truth Disclosure %X

BACKGROUND: Little information is available on the number of HIV tests that are carried out without the patient's consent. The aim of this study was to find out about the number of HIV tests for which the specific consent of the patient was not obtained and to describe the circumstances in which these tests were carried out.

METHODS: Since 1993 a representative network of sentinel general practitioners (GPs) has recorded data about requests for HIV tests, risk behaviour and the patient's awareness about the test.

RESULTS: In total 11,660 HIV tests were recorded and for 3628 tests the question about patient awareness was completed. Although non-consensual HIV testing (NHT) is against European guidelines on informed consent, 453 tests were performed without informed consent. Of the 292 participating GPs, 17.5 per cent never completed the question about the patient's awareness and 35.6 per cent performed at least one non-consensual HIV test. For 28.9 per cent of NHT, no risk behaviour for HIV infection was identified and for 43.4 per cent the risk behaviour was unknown. NHT was recurrent for patients with suggestive symptoms (22.7 per cent), patients consulting for a check-up (21.1 per cent) and women consulting for antenatal care (12.8 per cent).

CONCLUSION: Never before have figures been available about NHT forthcoming from a prospective registration including such a large number of tested subjects. Physicians should be reminded once more about the unacceptability of NHT. Instead of performing a non-consensual HIV test, physicians should invest more time in pre-test counselling, especially in those patients with a higher risk or with suggestive symptoms for HIV.

%B J Public Health (Oxf) %V 26 %P 72-6 %8 2004 Mar %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/15044578?dopt=Abstract %0 Journal Article %J Stud Health Technol Inform %D 2004 %T Quality of care assessment using GPs' electronic patient records: do we need data from home visits? %A Vandenberghe, Hans %A Viviane Van Casteren %A Jonckheer, Pascale %A Lafontaine, Marie-France %A De Clercq, Etienne %K Belgium %K Data collection %K Family Practice %K House Calls %K Medical Records Systems, Computerized %K Quality Indicators, Health Care %X

The paper tackles the topic of collecting data from home visits using the electronic patient record (EPR) of general practitioners (GPs), in a context with a high proportion of home visits in primary care. Since data from home visits, representing about 40% of GPs' consultations in Belgium, are rather scarcely recorded in the EPR, we wanted to study the impact of not taking into account home visits for quality assessment in primary care. Five quality indicators, which measured the accordance of the delivered care with guidelines on the management of osteoarthritis, were compared between a pooled database (consultations and home visits) and a restricted database (after removal of home visits). Our findings suggest that removing home visits from a database collected from primary care may provide a slight modification of the estimate of the quality of care, whereas conclusions on quality improvement remain relatively stable. Quality of care assessment with the EPR of GPs seems not to be dramatically hampered by the poor recording rate of home visits in the EPR.

%B Stud Health Technol Inform %V 110 %P 35-41 %8 2004 %G eng %1 http://www.ncbi.nlm.nih.gov/pubmed/15853249?dopt=Abstract %0 Report %D 2003 %T Initiatief voor Kwaliteitsbevordering en Epidemiologie bij Diabetes (IKED) - Rapport resultaten 2002 %A N. Debacker %A F. Nobels %A P. Van Crombrugge %A H. Vandenberghe %A Viviane Van Casteren %I Wetenschappelijk Instituut Volksgezondheid – Institut Scientifique de Santé Publique %C Brussel, België %G eng %M D/2003/2505/45 %0 Report %D 2003 %T Initiative pour la Promotion de la Qualité et Épidémiologie du Diabète sucré (IPQED) - Rapport résultats 2002 %A N. Debacker %A F. Nobels %A P. Van Crombrugge %A H. Vandenberghe %A Viviane Van Casteren %I Wetenschappelijk Instituut Volksgezondheid – Institut Scientifique de Santé Publique %C Brussel, België %G eng %M D/2003/2505/46 %0 Journal Article %J Fam Pract %D 2002 %T How are patients informed about their HIV test results? %A Devroey, Dirk %A Viviane Van Casteren %A André Sasse %K Belgium %K Chi-Square Distribution %K Family Practice %K HIV Infections %K Humans %K Informed Consent %K Sentinel Surveillance %K Truth Disclosure %X

BACKGROUND: AIDS and HIV are hot topics in public health nowadays, but little information is available about the way in which HIV test results are communicated to patients.

OBJECTIVE: Our aim was to find out about the way in which patients are informed about their HIV test results and the delay they experience.

METHOD: Since 1996, a representative network of sentinel GPs has recorded data about requests for HIV tests, risk factors and the way in which and the delay with which patients are informed about their HIV test results.

RESULTS: Between 1996 and 1999, 4807 requests for an HIV test were recorded. Test results were given mostly by phone (41.9%). Patients at risk were informed more often during a planned follow-up. Anxious patients were informed more often about the results by phone, and in 61.2% test results were communicated during the first week following the test. Results were given earlier if patients were anxious or had themselves asked for the test. Although non-consensual HIV testing is against the European guidelines on informed consent, 102 tests (2.2%) were performed without informed consent.

CONCLUSIONS: Even though notification by phone decreases the delay, physicians should be encouraged to make follow-up appointments to inform the patient about the test results. A face-to-face conversation is the only way in which physicians can offer valuable post-test counselling. Physicians should be informed about the unlawfulness of non-consensual HIV testing.

%B Fam Pract %V 19 %P 125-7 %8 2002 Apr %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/11906975?dopt=Abstract %0 Journal Article %J Aging Ment Health %D 2002 %T Placements in psychiatric institutions, nursing homes, and homes for the elderly by Belgian general practitioners. %A Devroey, D %A Viviane Van Casteren %A De Lepeleire, J %K Adult %K Aged %K Aged, 80 and over %K Belgium %K Chronic disease %K Family Practice %K Female %K Home Care Services %K Homes for the Aged %K Hospitals, Psychiatric %K Humans %K long-term care %K Male %K middle aged %K nursing homes %K Patient Admission %K Population Surveillance %K Referral and Consultation %K Utilization Review %K Waiting Lists %X

This research is an epidemiological study of long-term care facility admissions to various types of institutions (homes for the elderly, nursing homes, psychiatric institutions) during 1994 in Belgium. Data were obtained from a network of 143 general practitioners, which acts as a reliable surveillance system for health-related data. For every patient who was institutionalized, physicians were asked to record the following information: (1) type of institution in which the patient was placed; (2) medical conditions; (3) current living situation; (4) reason for institutionalization; (5) length of the waiting time for institutionalization, and (6) whether or not the patient was hospitalized prior to the institutionalization. The overall incidence for institutionalization among older patients was 1%. The most common medical conditions upon placement were functional impairments and dementia. Over half the patients lived alone just prior to the placement and family members made the majority of requests for placements. Compared to placements in other types of institutions, those to psychiatric facilities were more likely to be 'urgent' and waiting times for admission to these institutions were shorter. Over half of all placements were preceded by an admission to a medical hospital. Few placements (16%) were made with the consultation of home care services. Finally, in about two thirds of the cases, patients were cared for by their general practitioner while they were institutionalized.

%B Aging Ment Health %V 6 %P 286-92 %8 2002 Aug %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/12217098?dopt=Abstract %R 10.1080/13607860220142404 %0 Journal Article %J Fam Pract %D 2001 %T Revealing regional differences in the institutionalization of adult patients in homes for the elderly and nursing homes: results of the Belgian network of sentinel GPs. %A Devroey, D %A Viviane Van Casteren %A De Lepeleire, J %K Aged %K Aged, 80 and over %K Belgium %K Female %K Home Care Services %K Homes for the Aged %K Hospitalization %K Humans %K Institutionalization %K Male %K nursing homes %K Physicians, Family %K Sentinel Surveillance %K Waiting Lists %X

OBJECTIVES: The aim of this study was, firstly, to determine the number of institutionalizations in homes for the elderly and nursing homes and, secondly, to learn about regional differences in the placement procedure and the pre-existing problems and diseases.

METHODS: Data were recorded during 1994 by the 143 GPs of the network of sentinel practices, which is representative of Belgian GPs. All placements of adult patients in homes for the elderly and nursing homes were registered.

RESULTS: During 1994, Belgian sentinel GPs placed 297 patients in a nursing home or a home for the elderly. Most of them were women and patients who lived alone. At the time of institutionalization, motor function impairment and dementia were the most common diseases. The institutionalizations were motivated mostly by a need for assistance with daily living activities and nursing assistance. An interim hospitalization was necessary in 60% of all institutionalizations. Two-thirds of all patients were on a waiting list. The average length of these waiting lists was shorter in the southern (Walloon) region than in the northern (Flemish) region. Home care services were consulted in 16% of all institutionalizations. In the southern region, home care services were consulted more often than in the northern region.

CONCLUSIONS: Motor function impairment and dementia were the most common pre-existing impairments. Placements were often hampered by long waiting lists and interim hospitalization. In the southern region, waiting lists were shorter and home care services consulted more often. Some placements could be avoided or delayed by a better organization and promotion of the possibilities of professional home care services.

%B Fam Pract %V 18 %P 39-41 %8 2001 Feb %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/11145626?dopt=Abstract %0 Journal Article %J Euro Surveill %D 1997 %T Changing patterns in acute clinical viral hepatitis encountered by Belgian general practitioners. %A Devroey, D %A Viviane Van Casteren %A Vranckx, R %B Euro Surveill %V 2 %P 53-6 %8 1997 Jul 01 %G eng %N 7 %1 http://www.ncbi.nlm.nih.gov/pubmed/12631807?dopt=Abstract %0 Journal Article %J Archives of Public Health %D 1997 %T Epidemiology of measles and mumps in Belgium, 1994-1995 %A Viviane Van Casteren %K General practice %K Measles %K Mumps %K Surveillance %X

Since 1982, the sentinel network of general practitioners registers all new cases of measles and mumps clinically diagnosed in their practice.  This network provides the only ongoing surveillance of both diseases.

In 1994-1995, measles incidence in the Flemish Region was comparable with the level in 1991-1993 (87/100 000 inhabitants).  In the Walloon Region the incidence was significantly higher in 1994-1995 (177/100 000) inhabitants) compared with the period 1991-1993 and compared with the incidence in the Flemish Region in 1994-1995.  The proportion of cases in children aged 10 years and older increased significantly over time in both Regions.  Complications were notified in 19% of the
cases, with pneumonia as leading type of complication (43%);

In 1994-1995, the incidence of mumps in the Flemish Region (49/100 000 inhabitants) was significantly lower than in 1991-1993.  The incidence of mumps in the Walloon Region in 1994-1995 (207/100 000 inhabitants) was comparable with the incidence in 1991-1993, but was significantly higher than in the Flemish Region.  As for measles, the proportion of cases in children aged 10 years and older increased significantly over time in both Regions.

The sentinel network of GPs is still a useful tool for monitoring changes in the epidemiology of measles and mumps.  Data from this network must be tested by information on vaccination coverage in both Regions

%B Archives of Public Health %V 55 %8 1997 %G eng %N 1-2 %& 15 %0 Journal Article %J Methods Inf Med %D 1992 %T Eurosentinel: development of an international sentinel network of general practitioners. %A Viviane Van Casteren %A Leurquin, P %K Computer Communication Networks %K Epidemiologic Methods %K Europe %K Health Services Research %K health surveys %K HIV Infections %K Humans %K Physicians, Family %X

The Eurosentinel project was a European concerted action. It started in June 1988 and ended in June 1991. Its purpose was to coordinate activities in the field of sentinel practices with GPs and the ultimate goal was to establish a real European network of sentinel practices. This paper deals with the purposes of the project, the studies carried out in the frame of the project, and an evaluation of three years Eurosentinel.

%B Methods Inf Med %V 31 %P 147-52 %8 1992 Jun %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/1635466?dopt=Abstract %0 Report %D 0 %T The Belgian Neuromuscular Disease Registry (BNMDR) 2013 | Results and Trends since 2010 %A A. Roy %E Viviane Van Casteren %K BNMDR %K Neuromuscular Diseases %K Registry %X

The Belgian Neuromuscular Disease Registry (BNMDR) was set up at the initiative of the National Institute of Health and Disability Insurance of Belgium (NIHDI) and comes under the rehabilitation convention relating to the care of patients suffering from neuromuscular diseases (NMD). Since the first of January 2008, the Scientific Institute for Public Health (WIV-ISP) and the Reference Centres for Neuromuscular Diseases (NMRC) have joint responsibility for “drawing up a national neuromuscular disease registry … with the aim of facilitating research (clinical, epidemiological, and aetiological) in the field of neuromuscular diseases”.
This report provides an overview of the data harvested for the year 2013 and outlines the trend identified in the data over the last four years, from 2010 to 2013. The data is entered into the web application by the specialists of the six neuromuscular disease reference centres. The data gathered are descriptive in nature and broken down into two sections: socio-demographic and pathological.
Four thousand and sixty six (4,066) patients were entered into the BNMDR in 2013. The distribution of these patients among the 62 groups of neuromuscular diseases was similar to that of previous years. The distribution of patients by postal code is still imbalanced, with under-representation in the south of the country and regional differences for other patient characteristics.
We can conclude that this study offers an initial insight into neuromuscular diseases through reference centres in Belgium. The analyses point to a bias in geographical distribution, as well as in other patient characteristics, thereby limiting extrapolations to the target population of patients with NMD in Belgium. Significant disparity still persists between the study population and the target population. However, since its inception, the BNMDR continues each year to improve data quality and the completeness of the registry and to track the evolution of NMD over time.

%I Wetenschappelijk Instituut Volksgezondheid %C Brussels, Belgium %P 43 %8 nov 2014 %G eng %0 Report %D 0 %T The Belgian Neuromuscular Disease Registry (BNMDR) 2014 | Results and Trends since 2010 %A A. Roy %E Viviane Van Casteren %K BNMDR %K Neuromuscular Diseases %K Registry %X

The Belgian Neuromuscular Disease Registry (BNMDR) was set up at the initiative of the National Institute of Health and Disability Insurance of Belgium (NIHDI) and comes under the rehabilitation convention relating to the care of patients suffering from neuromuscular diseases (NMD). Since the first of January 2008, the Scientific Institute for Public Health (WIV-ISP) and the Reference Centres for Neuromuscular Diseases (NMRC) have joint responsibility for “drawing up a national neuromuscular disease registry …with the aim of facilitating research (clinical, epidemiological, and etiological) in the field of neuromuscular diseases” [4,5].

This report provides an overview of the data harvested for the year 2014 and outlines the trends identified in the data for the past five years, from 2010 to 2014. The data is entered into a web application by the specialists of the seven neuromuscular disease reference centres. The data gathered are descriptive in nature and broken down into two sections: socio-demographic and pathological.

This year, four thousand, three hundred and seventeen (4,317) patients were entered into the BNMDR in 2014. The distribution of these patients among the 62 groups of neuromuscular diseases was similar to that of previous years. The distribution of patients by postal code is still imbalanced, with under-representation in the south of the country, but a slight increase in data from the east of the country.

We can conclude that this study offers an insight into neuromuscular disease through reference centres in Belgium. The analyses point to a bias in geographical distribution, as well as in other patient characteristics, thereby limiting extrapolation of the registry information to the target population of patients with NMD in Belgium. Significant disparity still persists between the study population and the target population.

%I Wetenschappelijk Instituut Volksgezondheid %C Brussels, Belgium %P 52 %8 aug 2015 %G eng %0 Report %D 0 %T Belgisch register van neuromusculaire aandoeningen (BNMDR) 2013 | Resultaten en trends sinds 2010 %A A. Roy %A Viviane Van Casteren %K BNMDR %K neuromusculaire ziekten %K Register %X

Het Belgian NeuroMuscular Disease Registry (BNMDR) is in het leven geroepen op initiatief van het RIZIV en ligt in de lijn van de revalidatie-overeenkomst met betrekking tot de behandeling van patiënten lijdend aan een neuromusculaire ziekte (NMZ). Sinds 1 januari 2008 zijn het WIV-ISP en de neuromusculaire referentiecentra (NMRC) samen belast met de realisatie van een nationaal register voor neuromusculaire ziekten met als doel het (klinisch, epidemiologisch, etiologisch) onderzoek op het gebied van neuromusculaire ziekten te bevorderen.

Dit rapport biedt een overzicht van de verzamelde gegevens voor 2013 alsook van de trends van de gegevens in de afgelopen 4 jaar, meer bepaald van 2010 tot 2013. De invoering in de webapplicatie gebeurt door de experts van de 6 neuromusculaire referentiecentra. De verzamelde gegevens zijn descriptief en ingedeeld in twee secties: een sociaal-demografische en een pathologie-gerelateerde sectie.

In 2013 telde het BNMDR 4066 patiënten. De verdeling van de patiënten over de 62 groepen van neuromusculaire ziekten is vergelijkbaar met de voorgaande jaren. De verdeling van de patiënten per postcode is nog altijd onevenwichtig met een ondervertegenwoordiging in het zuiden van het land en met gewestelijke verschillen voor andere karakteristieken van de patiënten.

We kunnen hieruit besluiten dat deze studie een eerste beeld van de neuromusculaire ziekten via de referentiecentra in België geeft. De analysen wijzen op een vertekening in de geografische spreiding en in andere karakteristieken van de patiënten waardoor extrapolaties naar de doelpopulatie van de patiënten getroffen door NMZ in België beperkt zijn. Er is nog een groot verschil tussen de bestudeerde populatie en de doelpopulatie. Sinds zijn oprichting verbetert het BNMDR niettemin elk jaar opnieuw de kwaliteit van de gegevens alsook de volledigheid van het register en het biedt de gelegenheid om de evolutie van de NMZ met de jaren op te volgen.

%I Wetenschappelijk Instituut Volksgezondheid %C Brussels, Belgium %P 43 %8 nov 2014 %G eng %0 Report %D 0 %T Belgisch register van neuromusculaire aandoeningen (BNMDR) 2014 | Resultaten en trends sinds 2010 %A A. Roy %E Viviane Van Casteren %K BNMDR %K neuromusculaire ziekten %K Register %X

Het Belgian NeuroMuscular Disease Registry (BNMDR) is in het leven geroepen op initiatief van het Rijksinstituut voor Ziekte- en Invaliditeitsverzekering (RIZIV) en ligt in de lijn van de revalidatie-overeenkomst met betrekking tot de behandeling van patiënten lijdend aan een neuromusculaire ziekte (NMZ). Sinds 1 januari 2008 zijn het Wetenschappelijk Instituut Volksgezondheid (WIV-ISP) en de neuromusculaire referentiecentra (NMRC) samen belast met de realisatie van een nationaal register voor neuromusculaire ziekten met als doel het (klinisch, epidemiologisch, etiologisch) onderzoek op het gebied van neuromusculaire ziekten te bevorderen [4,5].

Dit rapport biedt een overzicht van de verzamelde gegevens voor 2014 en belicht de trends van de gegevens in de afgelopen 5 jaar (2010-2014). De invoering van de gegevens in de webapplicatie gebeurt door experts van de 7 neuromusculaire referentiecentra. De verzamelde gegevens zijn descriptief en kunnen in twee secties worden ingedeeld met enerzijds, sociaal-demografische gegevens en anderzijds, pathologie-gerelateerde gegevens.

In 2014 telde het BNMDR 4317 patiënten. De verdeling van de patiënten over 62 groepen van neuromusculaire ziekten is vergelijkbaar met voorgaande jaren. De verdeling van de patiënten per postcode is nog altijd onevenwichtig. Er is een ondervertegenwoordiging in het zuiden van het land. Het aantal gegevens uit het oosten van het land neemt echter toe.

We kunnen besluiten dat deze studie een overzicht biedt van de neuromusculaire ziekten waargenomen in de verschillende referentiecentra in België. De analyses wijzen op een vertekening in de geografische spreiding en in andere karakteristieken van de patiënten waardoor extrapolaties van de gegevens van het register naar de doelpopulatie van patiënten getroffen door NMZ in België beperkt zijn. Er is nog een groot verschil tussen de bestudeerde populatie en de doelpopulatie.

%I Wetenschappelijk Instituut Volksgezondheid %C Brussels, Belgium %P 52 %8 aug 2015 %G eng %0 Report %D 0 %T Rapport annuel registre belge des maladies neuromusculaires (BNMDR) 2015 %A Corinne Bleyenheuft %A Viviane Van Casteren %K BNMDR %K Maladies neuromusculaires %K registre %X

Les objectifs du registre belge des maladies neuromusculaires sont : de faciliter la recherche clinique, épidémiologique et étiologique dans le domaine des maladies neuromusculaires, de soutenir et de promouvoir la qualité des soins dans les centres de références pour les maladies neuromusculaires (CRNM), de fournir des informations aux autorités de santé publique pour la gestion de la convention et la planification des soins, et de faciliter le recrutement de patients pour la recherche sur les nouveaux traitements.
Depuis la création du registre en 2008, le nombre de patients inclus a augmenté d’année en année. Pour l’année 2015, un nombre total de 4670 patients ont été enregistrés. La particularité d’un registre dédié aux maladies neuromusculaires par rapport à d’autres registres de soins de santé, est que la population de patients n’est absolument pas homogène. Le terme “maladie neuromusculaire” regroupe en effet différentes maladies rares qui touchent soit les nerfs périphériques, soit les muscles, soit la jonction neuromusculaire, soit les cellules de la corne antérieure de la moelle épinière. Certaines de ces maladies sont génétiques, d’autre pas. La grande majorité d’entre elles sont dégénératives, avec parfois une issue fatale à brève ou longue échéance. Certaines de ces maladies se manifestent dès la petite enfance, d’autres surviennent à l’âge adulte. Il est donc difficile de fournir un aperçu général d’un groupe de patients aussi hétérogène.
Les données démographiques générales du registre font état d’un nombre d’hommes légèrement plus élevé que de femmes (N = 2610 versus N = 2043). Le recrutement des patients est pour l’instant plus important au nord qu’au sud du pays, vraisemblablement en raison de la répartition géographique des CRNM qui collectent les données. Néanmoins, l’écart entre ces deux régions tend à se réduire d’année en année. 152 décès ont été rapportés en 2015, dont 96 survenus chez des patients atteints de sclérose latérale amyotrophique.
Les dix maladies les plus prévalentes au sein du registre sont pour l’année 2015 : la neuropathie sensitive et motrice, la dystrophie myotonique de type 1, la sclérose latérale amyotrophique, la dystrophie musculaire de Duchenne, la paraplégie spastique héréditaire, la dystrophie musculaire des ceintures, la polyneuropathie démyélinisante inflammatoire chronique,  la dystrophie facio-scapulo-humérale, l’ataxie spino-cérébelleuse, et le syndrome post-poliomyélite. Ces dix maladies font l’objet d’une analyse plus détaillée au sein de ce rapport.
Le registre collecte également des données spécifiques au réseau international « TREAT-NMD », pour 2 groupes de maladies spécifiques : les dystrophies musculaires de Duchenne et de Becker, et les amyotrophies spinales. Ces données spécifiques sont également analysées au sein de ce rapport.
La qualité des données à l’encodage a enfin été évaluée au cours de cette collecte, en comparant 5% des dossiers encodés au dossier d’origine. Les résultats mettent en évidence le fait qu’il existe au sein de certains CRNM une marge de progression concernant la qualité de l’encodage. Dans les perspectives futures, la possibilité de collecter certaines données directement sur une tablette qui serait mise à disposition du patient dans la salle d’attente pourrait contribuer à diminuer la charge de travail des data managers au sein des CRNM.
 

%I Institut Scientifique de Santé Publique %C Brussels %P 81 %8 4/2017 %G eng %0 Report %D 0 %T Registre belge des maladies neuromusculaires (BNMDR) 2013 | Résultats et tendances depuis 2010 %A A. Roy %E Viviane Van Casteren %K BNMDR %K Maladies neuromusculaires %K registre %X

Le Registre des Maladies Neuromusculaires belge (BNMDR) a été conçu à l'initiative de l'INAMI et s'inscrit dans la convention de rééducation relative à la prise en charge de patients souffrant de maladies neuromusculaires (MNM). Depuis le premier janvier 2008, le WIV-ISP et les Centres de maladies neuromusculaires (CRNM) sont conjointement chargés de « réaliser un registre national sur les maladies neuromusculaires … dans le but de faciliter la recherche (clinique, épidémiologique, étiologique) dans le domaine des maladies neuromusculaires ».

Ce rapport présente une vue d’ensemble de la collecte de données pour l’année 2013 ainsi que la tendance des données à travers les quatre dernières années, de 2010 à 2013. L’encodage dans l’application web se fait par les spécialistes des 6 centres de référence des maladies neuromusculaires. Les données récoltées sont de nature descriptive et divisées en deux sections, sociodémographiques et sur la pathologie.

Le nombre de patients inscrits dans le BNMDR en 2013 était de 4066 patients. La distribution des patients dans les 62 groupes de maladies neuromusculaires était similaire aux années précédentes. La distribution des patients par code postal est toujours déséquilibrée avec une sous-représentation dans le sud du pays et avec des différences régionales pour d’autres caractéristiques des patients.

Nous pouvons conclure que la présente étude fournit un premier aperçu des maladies neuromusculaires à travers les centres de référence en Belgique. Les analyses indiquent un biais dans la répartition géographique, ainsi que dans d’autres caractéristiques des patients et limitant de ce fait les extrapolations au niveau de la population cible des patients atteints de MNM en Belgique. Il y a encore une grande disparité entre la population étudiée et la population cible. Néanmoins, depuis sa création, le BNMDR continue chaque année à améliorer la qualité des données et l’exhaustivité du registre et permet de suivre l’évolution des MNM dans le temps.

%I Wetenschappelijk Instituut Volksgezondheid %C Brussels, Belgium %P 43 %8 nov 2014 %G eng %0 Report %D 0 %T Registre belge des maladies neuromusculaires (BNMDR) 2014 | Résultats et tendances depuis 2010 %A A. Roy %E Viviane Van Casteren %K BNMDR %K Maladies neuromusculaires %K registre %X

Le Registre belge des maladies neuromusculaires (BNMDR) a été conçu à l’initiative de l’Institut national d’assurance maladie-invalidité (INAMI) et s’inscrit dans le cadre de la convention de rééducation relative à la prise en charge de patients souffrant de maladies neuromusculaires (MNM). Depuis le 1er janvier 2008, l’Institut Scientifique de Santé Publique (WIV-ISP) et les centres de référence des maladies neuromusculaires (CRMN) sont conjointement chargés de « réaliser un registre national sur les maladies neuromusculaires (…) dans le but de faciliter la recherche (clinique, épidémiologique, étiologique) dans le domaine des maladies neuromusculaires » [4,5].

Ce rapport présente un aperçu des données recueillies pour l’année 2013 et met en avant les tendances relevées dans les données des cinq dernières années (2010-2014). Ce sont les spécialistes des sept centres de référence des maladies neuromusculaires qui se chargent de l’encodage des données dans l’application web. Les données récoltées sont de nature descriptive et peuvent être divisées en deux sections, les données sociodémographiques, d’une part, et les données relatives à la pathologie, d’autre part.

En 2014, 4317 patients ont fait l’objet d’une inscription dans le BNMDR. La distribution des patients dans les 62 groupes de maladies neuromusculaires s’est révélée similaire à celle des années précédentes. La distribution des patients par code postal est toujours déséquilibrée, avec une sous-représentation dans le sud du pays. On observe toutefois une augmentation de la quantité de données provenant de l’est du pays.

On peut conclure que la présente étude fournit un aperçu des maladies neuromusculaires observées dans les différents centres de référence en Belgique. Les analyses mettent en évidence un biais dans la répartition géographique, ainsi que dans d’autres caractéristiques des patients. Ce biais limite l’extrapolation des données du registre à la population cible de patients atteints de MNM en Belgique. On observe encore une grande disparité entre la population étudiée et la population cible.

%I Wetenschappelijk Instituut Volksgezondheid %C Brussels, Belgium %P 52 %8 aug 2015 %G eng