1
|
Driessen HPA, Busschbach JJV, Blokhuis M, Kranenburg LW. The effectiveness of Eye Movement Desensitization and Reprocessing (EMDR)-therapy on Posttraumatic Stress Disorder (PTSD) symptoms and quality of life in patients with cancer. Gen Hosp Psychiatry 2024; 88:83-85. [PMID: 38369435 DOI: 10.1016/j.genhosppsych.2024.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 02/14/2024] [Accepted: 02/14/2024] [Indexed: 02/20/2024]
Affiliation(s)
- Helen P A Driessen
- Department of Psychiatry, Section of Medical Psychology and Psychotherapy, Erasmus Medical Center, Rotterdam, the Netherlands.
| | - Jan J V Busschbach
- Department of Psychiatry, Section of Medical Psychology and Psychotherapy, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Marijke Blokhuis
- Department of Psychiatry, Section of Medical Psychology and Psychotherapy, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Leonieke W Kranenburg
- Department of Psychiatry, Section of Medical Psychology and Psychotherapy, Erasmus Medical Center, Rotterdam, the Netherlands
| |
Collapse
|
2
|
Driessen HPA, Busschbach JJV, Elfrink EJ, van der Rijt CCD, Paardekooper GMRM, den Hollander CJ, Kranenburg LW. Cancer centre information and support services and patient needs: participatory action research study. BMJ Support Palliat Care 2024:spcare-2023-004464. [PMID: 38471789 DOI: 10.1136/spcare-2023-004464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 02/03/2024] [Indexed: 03/14/2024]
Abstract
OBJECTIVES Clear information and supportive care are necessary for oncology patients and their relatives to manage the disease (trajectory). Centres for information and support aim to address their needs by offering informal and non-medical formal services. This study evaluated whether the centres' services offered meet the needs of its visitors, and whether there is interest for these among oncology patients treated at affiliated hospitals. METHODS In this participatory action research, interviews were conducted among visitors of two centres (Patient Information Center Oncology (PATIO) and IntermeZZo) and among patients treated at the affiliated hospitals. Visitors were interviewed to share their experiences regarding the centres' services offered. Patients from the hospitals were interviewed about their interest in such support. Data were collected during three different periods and adjustments were made to the centres' services between measurements. RESULTS 111 (PATIO) and 123 visitors (IntermeZZo) were interviewed, and 189 and 149 patients at the respective hospitals. Reasons to visit PATIO/IntermeZZo were to relax (93.1%), seek professional advice (54.6%) and meet peers (36.3%). Visitors indicated that the visits met their needs (99.1%), citing the accessible support and the expertise in oncology. 20% of patients interviewed at the hospitals expressed interest in visiting PATIO/IntermeZZo. The majority of patients (89.6%) considered these centres an integral part of their treatment process. These findings were stable over time. CONCLUSIONS Patients and their relatives highly value the services of hospital-affiliated centres for information and support. Future research should address how such centres best be integrated in the Dutch healthcare system.
Collapse
Affiliation(s)
- Helen P A Driessen
- Department of Psychiatry, Section of Medical Psychology and Psychotherapy, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Jan J V Busschbach
- Department of Psychiatry, Section of Medical Psychology and Psychotherapy, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Erna J Elfrink
- Erasmus MC Cancer Institute, Erasmus Medical center, Rotterdam, The Netherlands
| | | | | | | | - Leonieke W Kranenburg
- Department of Psychiatry, Section of Medical Psychology and Psychotherapy, Erasmus Medical Center, Rotterdam, The Netherlands
| |
Collapse
|
3
|
Smits ML, Feenstra DJ, Blankers M, Kamphuis JH, Bales DL, Dekker JJM, Verheul R, Busschbach JJV, Luyten P. Impact of clinical severity on treatment response in a randomized controlled trial comparing day hospital and intensive outpatient mentalization-based treatment for borderline personality disorder. Personal Ment Health 2024. [PMID: 38298020 DOI: 10.1002/pmh.1603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 10/23/2023] [Accepted: 01/02/2024] [Indexed: 02/02/2024]
Abstract
This study examined the impact of clinical severity on treatment outcome in two programs that differ markedly in treatment intensity: day hospital mentalization-based treatment (MBT-DH) and intensive outpatient mentalization-based treatment (MBT-IOP) for borderline personality disorder (BPD). A multicenter randomized controlled trial was conducted. Participants include the full intention-to-treat sample of the original trial of N = 114 randomized BPD patients (MBT-DH n = 70, MBT-IOP n = 44), who were assessed at baseline and subsequently every 6 up to 36 months after start of treatment. Outcomes were general symptom severity, borderline features, and interpersonal functioning. Clinical severity was examined in terms of severity of BPD, general symptom severity, comorbid symptom disorders, comorbid personality disorders, and cluster C personality features. None of the severity measures was related to treatment outcome or differentially predicted treatment outcome in MBT-DH and MBT-IOP, with the exception of a single moderating effect of co morbid symptom disorders on outcome in terms of BPD features, indicating less improvement in MBT-DH for patients with more symptom disorders. Overall, patients with varying levels of clinical severity benefited equally from MBT-DH and MBT-IOP, indicating that clinical severity may not be a useful criterion to differentiate in treatment intensity.
Collapse
Affiliation(s)
| | | | - Matthijs Blankers
- Department of Research, Arkin Mental Health Care, Amsterdam, Netherlands
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, Netherlands
- Amsterdam UMC, Location AMC, Department of Psychiatry, University of Amsterdam, Amsterdam, Netherlands
| | - Jan H Kamphuis
- Department of Psychology, University of Amsterdam, Amsterdam, Netherlands
| | - Dawn L Bales
- GGZ Breburg, Breda, Netherlands
- MBT-Expertise, Breda, Netherlands
| | - Jack J M Dekker
- Department of Research, Arkin Mental Health Care and Department of Clinical Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | | | - Jan J V Busschbach
- Department of Psychiatry, Section of Medical Psychology and Psychotherapy, Erasmus MC, Rotterdam, Netherlands
| | - Patrick Luyten
- Faculty of Psychology and Educational Sciences, University of Leuven, Leuven, Belgium
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| |
Collapse
|
4
|
Driessen HPA, van der Rijt CCD, Busschbach JJV, Elfrink EJ, Kranenburg LW. Psychosocial screening instruments to assist support consultants in patients with cancer. BMJ Support Palliat Care 2024:spcare-2023-004733. [PMID: 38191273 DOI: 10.1136/spcare-2023-004733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 12/09/2023] [Indexed: 01/10/2024]
Abstract
OBJECTIVES Around 30% of patients with cancer suffer from psychosocial problems requiring formal care; however, these problems are often not identified. Support consultants may play a role in identifying these problems. This study investigates the feasibility of using validated screening instruments to assist support consultants in identifying psychosocial problems. METHODS Prospective observational study focusing on patients visiting support consultants at hospital-affiliated centres for information and support. The feasibility of using screening instruments was assessed based on the percentage of patients willing to participate. For these patients, possible psychosocial problems were objectified, and referral to formal care was assessed. RESULTS Out of 227 eligible patients at IntermeZZo, 48 participated (21.1%). At PATIO, over 141 consultations took place and 27 patients participated. Main reason for non-participation was that patients did not feel such a need. The majority showed elevated scores, indicating possible psychosocial problems and around half were referred. Respecting the individual needs of patients and offering them with what benefits them is crucial, including screening instruments does not match their needs nor did support consultants feel it was appropriate in certain cases. CONCLUSION Given the low percentage of questionnaires administered, it does not seem feasible to systematically administer them to patients visiting support consultants.
Collapse
Affiliation(s)
| | - Carin C D van der Rijt
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus MC, Rotterdam, The Netherlands
| | - Jan J V Busschbach
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC, Rotterdam, The Netherlands
| | - Erna J Elfrink
- Erasmus MC Cancer Institute, Erasmus MC, Rotterdam, The Netherlands
| | - Leonieke W Kranenburg
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC, Rotterdam, The Netherlands
| |
Collapse
|
5
|
Driessen HPA, Busschbach JJV, van der Rijt CCD, Elfrink EJ, Raijmakers NJH, van Roij J, Rietjens J, Kranenburg LW. Unmet care needs of patients with advanced cancer and their relatives: multicentre observational study. BMJ Support Palliat Care 2023:spcare-2023-004242. [PMID: 37491145 DOI: 10.1136/spcare-2023-004242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 07/05/2023] [Indexed: 07/27/2023]
Abstract
OBJECTIVES The care needs of patients with advanced cancer and their relatives change throughout the disease trajectory. This study focused on the care-related problems and needs of patients with advanced cancer and their relatives. This was done from the perspective of centres for information and support. METHODS This cross-sectional study used data from the eQuiPe study: an observational cohort study in which 40 Dutch hospitals participated. All adult patients with a diagnosis of a metastasised tumour and their relatives were eligible. Measures included information on the patients' and relatives' care problems and needs, assessed by the short version of the Problems and Needs in Palliative Care questionnaire. Socioeconomic demographics were also collected. RESULTS 1103 patients with advanced cancer and 831 relatives were included. Both patients (M=60.3, SD=29.0) and relatives (M=59.2, SD=26.6) experienced most problems in the domain of 'psychological issues'. Both patients (M=14.0, SD=24.2) and relatives (M=17.7, SD=25.7) most frequently reported unmet needs within this domain. The most often reported unmet need by patients was 'worrying about the future of my loved ones' (22.0%); for relatives this was 'fear for physical suffering of the patient' (32.8%). There was no clear relationship between socioeconomic demographics and the experienced unmet needs. CONCLUSIONS The most often mentioned unmet needs consisted of fears and worries, followed by a broad range of topics within multiple domains. Centres for information and support may play a role in reducing the unmet needs of (potential) visitors as these centres provide support on a broad range of topics.
Collapse
Affiliation(s)
- Helen P A Driessen
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Jan J V Busschbach
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus Medical Center, Rotterdam, The Netherlands
| | | | - Erna J Elfrink
- Erasmus MC Cancer Institute, Erasmus Medical Center, Rotterdam, The Netherlands
| | | | - Janneke van Roij
- The Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, The Netherlands
- CoRPS - Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Judith Rietjens
- Department of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Design, Organization, and Strategy, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, The Netherlands
| | - Leonieke W Kranenburg
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus Medical Center, Rotterdam, The Netherlands
| |
Collapse
|
6
|
Fitriana TS, Purba FD, Stolk E, Busschbach JJV. Indonesia youth population norms for EQ-5D-Y-3 L, EQ-5D-Y-5 L and the PedsQL generic core scale: lower health related quality of life relates to high economic status and stress. BMC Public Health 2023; 23:1124. [PMID: 37308934 DOI: 10.1186/s12889-023-16003-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 05/27/2023] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND The availability of population norms from generic health-related quality of life (HRQoL) instruments can support the interpretation of health outcomes. This study aimed to provide Indonesian youth population norms for the generic HRQoL measures: EQ-5D-Y-3 L, EQ-5D-Y-5 L, and the PedsQL Generic Core Scales. In addition the opportunity arising from the generation of a large representative sample was taken to explore the relationships between HRQoL, health, and socio-economic factors. METHODS A representative sample of 1103 Indonesian children (aged 8-16 years) completed EQ-5D-Y-3 L, EQ-5D-Y-5 L, the PedsQL Generic Core Scales, and questions related to demographic data and self-reported health status. A stratified quota sampling design was used to represent Indonesian children in terms of residence, age, gender, and geographical area. Family expenses per capita per month were retrieved from parents to determine a child's economic status. RESULTS The total sample was representative of the Indonesian youth general population. The proportions of participants who reported problems were 43.35% (EQ-5D-Y-3 L), 44.10% (EQ-5D-Y-5 L), and 94.93% (PedsQL Generic), with 31.7% of children reporting health complaints. Older children (13-16 years) reported more problems than younger children (8-12 years). Children living in urban areas reported more problems than children living in rural areas. The lowest value health state reported was '12332' (valued at 0.54), and the minimum EQ VAS score was 60.00. Moderate correlations were found between EQ-5D-Y-3 L values to EQ VAS scores and to PedsQL Total Score. Hierarchical regression analysis showed that females, older age, and having health complaints contributed to a lower level of HRQoL as measured by EQ-5D-Y-3 L values, EQ VAS, and PedsQL Total Score. Remarkably, children with high economic status had lower EQ VAS and PedsQL Total Scores. Among symptoms, 'having stress' had the largest influence with respect to lower EQ-5D-Y-3L values, EQ VAS, and PedsQL Total Score. CONCLUSIONS Population norms for children's HRQoL as measured by EQ-5D-Y-3 L, EQ-5D-Y-5 L, and the PedsQL Generic Scales are now available for Indonesia. Age, gender, economic status, and health complaints were related to children's HRQoL. These results provide a basis for health studies and health policy for the youth population of Indonesia.
Collapse
Affiliation(s)
- Titi Sahidah Fitriana
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC University Medical Center, Wytemaweg 80, Rotterdam, 3015 CN, The Netherlands.
- Faculty of Psychology, YARSI University, Jakarta, Indonesia.
| | - Fredrick Dermawan Purba
- Department of Developmental Psychology, Faculty of Psychology, Universitas Padjadjaran, Jatinangor, Indonesia
| | - Elly Stolk
- The EuroQol Research Foundation, New York, USA
| | - Jan J V Busschbach
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC University Medical Center, Wytemaweg 80, Rotterdam, 3015 CN, The Netherlands
| |
Collapse
|
7
|
Merweland RV, Busschbach JJV, van de Wetering J, Ismail S. Paving the way for solutions improving access to kidney transplantation: a qualitative study from a multistakeholder perspective. BMJ Open 2023; 13:e071483. [PMID: 37263692 DOI: 10.1136/bmjopen-2022-071483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
OBJECTIVES The aim of this study was to obtain an in-depth perspective from stakeholders involved in access to kidney transplantation to pave the way for solutions in improving access to kidney transplantation. This study qualitatively explored factors influencing optimal access to kidney transplantation from a broad stakeholder perspective. DESIGN A qualitative study was performed using semistructured interviews both in focus groups and with individual participants. All interviews were recorded, transcribed and coded according to the principles of grounded theory. SETTING Participants were healthcare providers (geographically spread), patients and (former living) kidney donors, policy-makers and insurers. PARTICIPANTS Stakeholders (N=87) were interviewed regarding their perceptions, opinions and attitudes regarding access to kidney transplantation. RESULTS The problems identified by stakeholders within the domains-policy, medical, psychological, social and economic-were acknowledged by all respondents. According to respondents, more efforts should be made to make healthcare providers and patients aware of the clinical guideline for kidney transplantation. The same opinion applied to differences in medical inclusion criteria used in the different transplantation centres. Stakeholders saw room for improvement based on psychological and social themes, especially regarding the provision of information. Many stakeholders described the need to rethink the current economic model to improve access to kidney transplantation. This discussion led to a definition of the most urgent problems for which, according to the respondents, a solution must be sought to optimise access to kidney transplantation. CONCLUSIONS Stakeholders indicated a high sense of urgency to solve barriers in patient access to kidney transplantation. Moreover, it appears that some barriers are quite straightforward to overcome; according to stakeholders, it is striking that this process has not yet been overcome. Stakeholders involved in kidney transplantation have provided directions for future solutions, and now it is possible to search for solutions with them.
Collapse
Affiliation(s)
- Ruben van Merweland
- Department of Psychiatry, Section of Medical Psychology and Psychotherapy, Erasmus MC, Rotterdam, The Netherlands
| | - Jan J V Busschbach
- Department of Psychiatry, Section of Medical Psychology and Psychotherapy, Erasmus MC, Rotterdam, The Netherlands
| | - Jacqueline van de Wetering
- Department of Internal Medicine, Nephrology, and Transplantation, Erasmus MC, Rotterdam, The Netherlands
| | - Sohal Ismail
- Department of Psychiatry, Section of Medical Psychology and Psychotherapy, Erasmus MC, Rotterdam, The Netherlands
| |
Collapse
|
8
|
Blankers M, Smits ML, Feenstra DJ, Horn EK, Kamphuis JH, Bales DL, Lucas Z, Remeeus MGA, Dekker JJM, Verheul R, Busschbach JJV, Luyten P. Economic evaluation of day hospital versus intensive outpatient mentalization-based treatment alongside a randomized controlled trial with 36-month follow-up. Personal Disord 2023; 14:207-215. [PMID: 35771495 DOI: 10.1037/per0000577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Mentalization-based treatment (MBT) has demonstrated robust effectiveness in the treatment of borderline personality disorder (BPD) in both day-hospital (MBT-DH) and intensive outpatient MBT (MBT-IOP) programs. Given the large differences in intensity and associated treatment costs, there is a need for studies comparing their cost-effectiveness. A health economic evaluation of MBT-DH versus MBT-IOP was performed alongside a multicenter randomized controlled trial with a 36-month follow-up. In three mental health-care institutions in the Netherlands, 114 patients were randomly allocated to MBT-DH (n = 70) or MBT-IOP (n = 44) and assessed every 6 months. Societal costs were compared with quality-adjusted life years (QALYs) gained and the number of months in remission over 36 months. The QALY gains over 36 months were 1.96 (SD = .58) for MBT-DH and 1.83 (SD = .56) for MBT-IOP; the respective number of months in remission were 16.0 (SD = 11.5) and 11.1 (SD = 10.7). Societal costs were €106,038 for MBT-DH and €91,368 for MBT-IOP. The incremental cost for one additional QALY with MBT-DH compared with MBT-IOP was €107,000. The incremental cost for 1 month in remission was almost €3000. Assuming a willingness-to-pay threshold of €50,000 for a QALY, there was a 33% likelihood that MBT-DH is more cost-effective than MBT-IOP in terms of costs per QALY. Although MBT-DH leads to slightly more QALYs and remission months, it is probably not cost-effective when compared with MBT-IOP for BPD patients, as the small additional health benefits in MBT-DH did not outweigh the substantially higher societal costs. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Collapse
Affiliation(s)
| | - Maaike L Smits
- De Viersprong, Viersprong Institute for Studies on Personality Disorders
| | - Dine J Feenstra
- De Viersprong, Viersprong Institute for Studies on Personality Disorders
| | | | - Jan Henk Kamphuis
- De Viersprong, Viersprong Institute for Studies on Personality Disorders
| | - Dawn L Bales
- De Viersprong, Viersprong Institute for Studies on Personality Disorders
| | | | | | | | | | - Jan J V Busschbach
- De Viersprong, Viersprong Institute for Studies on Personality Disorders
| | - Patrick Luyten
- De Viersprong, Viersprong Institute for Studies on Personality Disorders
| |
Collapse
|
9
|
Smits ML, Feenstra DJ, Bales DL, Blankers M, Dekker JJM, Lucas Z, Kamphuis JH, Busschbach JJV, Verheul R, Luyten P. Day hospital versus intensive outpatient mentalization-based treatment: 3-year follow-up of patients treated for borderline personality disorder in a multicentre randomized clinical trial - ERRATUM. Psychol Med 2023; 53:605-608. [PMID: 33280629 DOI: 10.1017/s0033291720004018] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Maaike L Smits
- Viersprong Institute for Studies on Personality Disorders, Halsteren, The Netherlands
| | - Dine J Feenstra
- Viersprong Institute for Studies on Personality Disorders, Halsteren, The Netherlands
| | - Dawn L Bales
- Expertcentre MBT-Nederland, Bergen op Zoom, The Netherlands
| | - Matthijs Blankers
- Department of Research, Arkin Mental Health Care, Amsterdam, The Netherlands
- Trimbos Institute, The Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
- Department of Psychiatry, University of Amsterdam, Amsterdam, The Netherlands
| | - Jack J M Dekker
- Department of Research, Arkin Mental Health Care, Amsterdam, The Netherlands
- Department of Clinical Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - Jan H Kamphuis
- Viersprong Institute for Studies on Personality Disorders, Halsteren, The Netherlands
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Jan J V Busschbach
- Viersprong Institute for Studies on Personality Disorders, Halsteren, The Netherlands
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC, Rotterdam, The Netherlands
| | | | - Patrick Luyten
- Viersprong Institute for Studies on Personality Disorders, Halsteren, The Netherlands
- Faculty of Psychology and Educational Sciences, University of Leuven, Leuven, Belgium
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| |
Collapse
|
10
|
Fitriana TS, Roudijk B, Purba FD, Busschbach JJV, Stolk E. Estimating an EQ-5D-Y-3L Value Set for Indonesia by Mapping the DCE onto TTO Values. Pharmacoeconomics 2022; 40:157-167. [PMID: 36348155 PMCID: PMC9758088 DOI: 10.1007/s40273-022-01210-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/11/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND AND OBJECTIVES Methods for estimating health values in adult populations are well developed, but lag behind in children. The EuroQol standard protocol to arrive at value sets for the youth version of the EQ-5D-Y-3L combines discrete choice experiments with ten composite time trade-off values. Whether ten composite time trade-off values are sufficient remains to be seen and this is one of the reasons the protocol allows for experimental expansion. In this study, 23 health states were administered for the composite time trade-off. This methodological research is embedded in a study aimed at generating a representative value set for EQ-5D-Y-3L in Indonesia. METHODS A representative sample of 1072 Indonesian adults each completed 15 discrete choice experiment choice pairs via face-to-face interviews. The discrete choice experiment responses were analysed using a mixed-logit model. To anchor the discrete choice experiment values onto the full health-dead quality-adjusted life-year scale, composite time trade-off values were separately obtained from 222 adults living in Java for 23 EQ-5D-Y-3L states. The derived latent discrete choice experiment values were mapped onto the mean observed composite time trade-off values to create a value set for the EQ-5D-Y-3L. Linear and non-linear mapping models were explored to estimate the most efficient and valid model for the value set. RESULTS Coefficients obtained from the choice model were consistent with the monotonic structure of the EQ-5D-Y-3L instrument. The composite time trade-off data showed non-linearity, as the values for the two worst states being evaluated were much lower than predicted by a standard linear model estimated over all composite time trade-off data. Thus, the non-linear mapping strategies with a power term outperformed the linear mapping in terms of mean absolute error. The final model gave a value range from 1.000 for full health (11111) to - 0.086 for the worst health state (33333). Values were most affected by pain/discomfort and least by self-care. CONCLUSIONS This article presents the first EQ-5D-Y-3L value set for Indonesia based on the stated preferences of adults asked to consider their views about a 10-year-old child. Mapping the mixed-logit discrete choice experiment model with the inclusion of a power term (without a constant) allowed us to generate a consistent value set for Indonesian youth. Our findings support the expansion of the composite time trade-off part of the EQ-5D-Y valuation study design and show that it would be wise to account for possible non-linearities in updates of the design.
Collapse
Affiliation(s)
- Titi Sahidah Fitriana
- Section Medical Psychology and Psychotherapy, Department of Psychiatry, Erasmus MC University Medical Center, Wytemaweg 80, 3015 CN, Rotterdam, The Netherlands.
- Faculty of Psychology, YARSI University, Jakarta, Indonesia.
| | - Bram Roudijk
- EuroQol Research Foundation, Rotterdam, The Netherlands
| | - Fredrick Dermawan Purba
- Department of Developmental Psychology, Faculty of Psychology, Universitas Padjadjaran, Jatinangor, Indonesia
| | - Jan J V Busschbach
- Section Medical Psychology and Psychotherapy, Department of Psychiatry, Erasmus MC University Medical Center, Wytemaweg 80, 3015 CN, Rotterdam, The Netherlands
| | - Elly Stolk
- EuroQol Research Foundation, Rotterdam, The Netherlands
| |
Collapse
|
11
|
Fitriana TS, Purba FD, Stolk E, Busschbach JJV. EQ-5D-Y-3L and EQ-5D-Y-5L proxy report: psychometric performance and agreement with self-report. Health Qual Life Outcomes 2022; 20:88. [PMID: 35659313 PMCID: PMC9164342 DOI: 10.1186/s12955-022-01996-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 05/11/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Self-report is the standard for measuring people's health-related quality of life (HRQoL), including children. However, in certain circumstances children cannot report their own health. For this reason, children's HRQoL measures often provide both a self-report and a proxy-report form. It is not clear whether the measurement properties will be the same for these two forms. We investigated whether it would be beneficial to extend the classification system of the EQ-5D-Y proxy questionnaire from 3 to 5 response levels. The agreement between self-report and proxy-report was assessed for both EQ-5D-Y measures. METHODS The study included 286 pediatric patients and their caregivers as proxies. At three consecutive measurements-baseline, test-retest and follow-up-the proxies assessed the child's HRQoL using the EQ-5D-Y-3L, EQ-5D-Y-5L, the PedsQL Generic, and matched disease-specific instruments. The proxy versions of EQ-5D-Y-3L and EQ-5D-Y-5L were compared in terms of feasibility, distribution properties, convergent validity, test-retest and responsiveness. Agreement between both EQ-5D-Y proxy versions to their respective self-report versions was assessed at baseline and follow-up. RESULTS The proportion of missing responses was 1% for the EQ-5D-Y-3L and 1.4% for the EQ-5D-Y-5L. The frequency of health state with no problems in all dimensions (11111) was slightly lower for the EQ-5D-Y-5L (21.3% vs 16.7%). Regarding the convergent validity with the PedsQL and disease-specific measures, the proxy versions of EQ-5D-Y-3L and EQ-5D-Y-5L had similar magnitudes of associations between similar dimensions. The means of test-retest coefficients between the two versions of the EQ-5D-Y proxy were comparable (0.83 vs. 0.84). Regarding reported improved conditions, responsiveness of the EQ-5D-Y-5L proxy (26.6-54.1%) was higher than that of the EQ-5D-Y-3L proxy (20.7-46.4%). Except for acutely ill patients, agreement between the EQ-5D-Y-5L proxy and self-reports was at least moderate. CONCLUSIONS Extending the number of levels of the proxy version of EQ-5D-Y can improve the classification accuracy and the ability to detect health changes over time. The level structure of EQ-5D-Y-5L was associated with a closer agreement between proxy and self-report. The study findings support extending the EQ-5D-Y descriptive system from 3 to 5 levels when administered by a proxy, which is often the case in the pediatric population.
Collapse
Affiliation(s)
- Titi Sahidah Fitriana
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC University Medical Center, Wytemaweg 80, 3015 CN, Rotterdam, The Netherlands. .,Faculty of Psychology, YARSI University, Jakarta, Indonesia.
| | - Fredrick Dermawan Purba
- Department of Developmental Psychology, Faculty of Psychology, Universitas Padjadjaran, Jatinangor, Indonesia
| | - Elly Stolk
- The EuroQol Research Foundation, Rotterdam, The Netherlands
| | - Jan J V Busschbach
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC University Medical Center, Wytemaweg 80, 3015 CN, Rotterdam, The Netherlands
| |
Collapse
|
12
|
Claessens AKM, Busschbach JJV, Ramaekers BLT, Erdkamp FLG, Bouma JM, van Leeuwen-Stok AE, Tjan-Heijnen VCG, Bos MEMM. Cost-effectiveness of continuous versus intermittent chemotherapy for patients with HER2-negative advanced breast cancer. Acta Oncol 2022; 61:619-624. [PMID: 35139727 DOI: 10.1080/0284186x.2022.2033832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Anouk K. M. Claessens
- Department of Medical Oncology, GROW – School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jan J. V. Busschbach
- Department of Psychiatry, Section of Medical Psychology and Psychotherapy, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Bram L. T. Ramaekers
- Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA), Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Frans L. G. Erdkamp
- Department of Medical Oncology, Zuyderland Medical Centre, Geleen, The Netherlands
| | - Jeanette M. Bouma
- Department of Trial Registration, Comprehensive Cancer Centre the Netherlands, Rotterdam, The Netherlands
| | | | - Vivianne C. G. Tjan-Heijnen
- Department of Medical Oncology, GROW – School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Monique E. M. M. Bos
- Department of Medical Oncology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | | |
Collapse
|
13
|
Smits ML, Feenstra DJ, Bales DL, Blankers M, Dekker JJM, Lucas Z, Kamphuis JH, Busschbach JJV, Verheul R, Luyten P. Day hospital versus intensive outpatient mentalization-based treatment: 3-year follow-up of patients treated for borderline personality disorder in a multicentre randomized clinical trial. Psychol Med 2022; 52:485-495. [PMID: 32602830 DOI: 10.1017/s0033291720002123] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Two types of mentalization-based treatment (MBT), day hospital MBT (MBT-DH) and intensive outpatient MBT (MBT-IOP), have been shown to be effective in treating patients with borderline personality disorder (BPD). This study evaluated trajectories of change in a multi-site trial of MBT-DH and MBT-IOP at 36 months after the start of treatment. METHODS All 114 patients (MBT-DH n = 70, MBT-IOP n = 44) from the original multicentre trial were assessed at 24, 30 and 36 months after the start of treatment. The primary outcome was symptom severity measured with the Brief Symptom Inventory. Secondary outcome measures included borderline symptomatology, personality and interpersonal functioning, quality of life and self-harm. Data were analysed using multilevel modelling and the intention-to-treat principle. RESULTS Patients in both MBT-DH and MBT-IOP maintained the substantial improvements made during the intensive treatment phase and showed further gains during follow-up. Across both conditions, 83% of patients improved in terms of symptom severity, and 97% improved on borderline symptomatology. No significant differences were found between MBT-DH and MBT-IOP at 36 months after the start of treatment. However, trajectories of change were different. Whereas patients in MBT-DH showed greater improvement during the intensive treatment phase, patients in MBT-IOP showed greater continuing improvement during follow-up. CONCLUSIONS Patients in both conditions showed similar large improvements over the course of 36 months, despite large differences in treatment intensity. MBT-DH and MBT-IOP were associated with different trajectories of change. Cost-effectiveness considerations and predictors of differential treatment outcome may further inform optimal treatment selection.
Collapse
Affiliation(s)
- Maaike L Smits
- Viersprong Institute for Studies on Personality Disorders, Halsteren, The Netherlands
| | - Dine J Feenstra
- Viersprong Institute for Studies on Personality Disorders, Halsteren, The Netherlands
| | - Dawn L Bales
- Expertcentre MBT-Nederland, Bergen op Zoom, The Netherlands
| | - Matthijs Blankers
- Department of Research, Arkin Mental Health Care, Amsterdam, The Netherlands
- Trimbos Institute, The Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
- Department of Psychiatry, University of Amsterdam, Amsterdam, The Netherlands
| | - Jack J M Dekker
- Department of Research, Arkin Mental Health Care, Amsterdam, The Netherlands
- Department of Clinical Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - Jan H Kamphuis
- Viersprong Institute for Studies on Personality Disorders, Halsteren, The Netherlands
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Jan J V Busschbach
- Viersprong Institute for Studies on Personality Disorders, Halsteren, The Netherlands
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC, Rotterdam, The Netherlands
| | | | - Patrick Luyten
- Viersprong Institute for Studies on Personality Disorders, Halsteren, The Netherlands
- Faculty of Psychology and Educational Sciences, University of Leuven, Leuven, Belgium
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| |
Collapse
|
14
|
Smits ML, Luyten P, Feenstra DJ, Bales DL, Kamphuis JH, Dekker JJM, Verheul R, Busschbach JJV. Trauma and Outcomes of Mentalization-Based Therapy for Individuals With Borderline Personality Disorder. Am J Psychother 2022; 75:12-20. [PMID: 35099263 DOI: 10.1176/appi.psychotherapy.20210027] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Recent meta-analyses suggest that many patients with borderline personality disorder have a history of complex trauma. Although trauma is central in mentalization-based approaches to the understanding of borderline personality disorder, surprisingly little is known about the effects of trauma on outcomes of mentalization-based treatment (MBT). This article investigates the prevalence and impact of childhood trauma among patients with borderline personality disorder participating in a randomized controlled trial (RCT) comparing day hospital MBT (MBT-DH) and intensive outpatient MBT (MBT-IOP). METHODS All 114 patients from the original multicenter RCT in the Netherlands were included in this study. Childhood trauma was assessed at baseline (with the Childhood Trauma Questionnaire), and its impact on symptom severity, interpersonal functioning, and borderline pathology was investigated through multilevel modeling for 36 months after the start of treatment. RESULTS Childhood trauma was common among patients with borderline personality disorder referred to MBT, with more than 85% meeting cutoff criteria for substantial childhood trauma. Childhood trauma had little impact on outcomes of either MBT-DH or MBT-IOP in terms of improved borderline personality disorder features or interpersonal functioning. However, patients with substantial childhood trauma seemed to improve more rapidly with MBT-DH, as compared with MBT-IOP, in terms of symptom severity. In addition, patients with a history of emotional neglect showed more rapid changes in symptoms of borderline personality disorder with MBT-DH compared with MBT-IOP. CONCLUSIONS Findings are discussed in the context of a social communicative approach to borderline personality disorder, with a focus on the need to address trauma in MBT.
Collapse
Affiliation(s)
- Maaike L Smits
- De Viersprong, Viersprong Institute for Studies on Personality Disorders, Halsteren, the Netherlands (Smits, Luyten, Feenstra, Bales); Faculty of Psychology and Educational Sciences, University of Leuven, Leuven, Belgium, and Research Department of Clinical, Educational and Health Psychology, University College London, London (Luyten); Department of Psychology, University of Amsterdam, Amsterdam (Kamphuis); Department of Research, Arkin Mental Health Care, and Department of Clinical Psychology, Vrije Universiteit Amsterdam, Amsterdam (Dekker); Lentis, Groningen, the Netherlands (Verheul); Department of Psychiatry, Section of Medical Psychology and Psychotherapy, Erasmus Medical Center, Rotterdam, the Netherlands (Busschbach)
| | - Patrick Luyten
- De Viersprong, Viersprong Institute for Studies on Personality Disorders, Halsteren, the Netherlands (Smits, Luyten, Feenstra, Bales); Faculty of Psychology and Educational Sciences, University of Leuven, Leuven, Belgium, and Research Department of Clinical, Educational and Health Psychology, University College London, London (Luyten); Department of Psychology, University of Amsterdam, Amsterdam (Kamphuis); Department of Research, Arkin Mental Health Care, and Department of Clinical Psychology, Vrije Universiteit Amsterdam, Amsterdam (Dekker); Lentis, Groningen, the Netherlands (Verheul); Department of Psychiatry, Section of Medical Psychology and Psychotherapy, Erasmus Medical Center, Rotterdam, the Netherlands (Busschbach)
| | - Dine J Feenstra
- De Viersprong, Viersprong Institute for Studies on Personality Disorders, Halsteren, the Netherlands (Smits, Luyten, Feenstra, Bales); Faculty of Psychology and Educational Sciences, University of Leuven, Leuven, Belgium, and Research Department of Clinical, Educational and Health Psychology, University College London, London (Luyten); Department of Psychology, University of Amsterdam, Amsterdam (Kamphuis); Department of Research, Arkin Mental Health Care, and Department of Clinical Psychology, Vrije Universiteit Amsterdam, Amsterdam (Dekker); Lentis, Groningen, the Netherlands (Verheul); Department of Psychiatry, Section of Medical Psychology and Psychotherapy, Erasmus Medical Center, Rotterdam, the Netherlands (Busschbach)
| | - Dawn L Bales
- De Viersprong, Viersprong Institute for Studies on Personality Disorders, Halsteren, the Netherlands (Smits, Luyten, Feenstra, Bales); Faculty of Psychology and Educational Sciences, University of Leuven, Leuven, Belgium, and Research Department of Clinical, Educational and Health Psychology, University College London, London (Luyten); Department of Psychology, University of Amsterdam, Amsterdam (Kamphuis); Department of Research, Arkin Mental Health Care, and Department of Clinical Psychology, Vrije Universiteit Amsterdam, Amsterdam (Dekker); Lentis, Groningen, the Netherlands (Verheul); Department of Psychiatry, Section of Medical Psychology and Psychotherapy, Erasmus Medical Center, Rotterdam, the Netherlands (Busschbach)
| | - Jan Henk Kamphuis
- De Viersprong, Viersprong Institute for Studies on Personality Disorders, Halsteren, the Netherlands (Smits, Luyten, Feenstra, Bales); Faculty of Psychology and Educational Sciences, University of Leuven, Leuven, Belgium, and Research Department of Clinical, Educational and Health Psychology, University College London, London (Luyten); Department of Psychology, University of Amsterdam, Amsterdam (Kamphuis); Department of Research, Arkin Mental Health Care, and Department of Clinical Psychology, Vrije Universiteit Amsterdam, Amsterdam (Dekker); Lentis, Groningen, the Netherlands (Verheul); Department of Psychiatry, Section of Medical Psychology and Psychotherapy, Erasmus Medical Center, Rotterdam, the Netherlands (Busschbach)
| | - Jack J M Dekker
- De Viersprong, Viersprong Institute for Studies on Personality Disorders, Halsteren, the Netherlands (Smits, Luyten, Feenstra, Bales); Faculty of Psychology and Educational Sciences, University of Leuven, Leuven, Belgium, and Research Department of Clinical, Educational and Health Psychology, University College London, London (Luyten); Department of Psychology, University of Amsterdam, Amsterdam (Kamphuis); Department of Research, Arkin Mental Health Care, and Department of Clinical Psychology, Vrije Universiteit Amsterdam, Amsterdam (Dekker); Lentis, Groningen, the Netherlands (Verheul); Department of Psychiatry, Section of Medical Psychology and Psychotherapy, Erasmus Medical Center, Rotterdam, the Netherlands (Busschbach)
| | - Roel Verheul
- De Viersprong, Viersprong Institute for Studies on Personality Disorders, Halsteren, the Netherlands (Smits, Luyten, Feenstra, Bales); Faculty of Psychology and Educational Sciences, University of Leuven, Leuven, Belgium, and Research Department of Clinical, Educational and Health Psychology, University College London, London (Luyten); Department of Psychology, University of Amsterdam, Amsterdam (Kamphuis); Department of Research, Arkin Mental Health Care, and Department of Clinical Psychology, Vrije Universiteit Amsterdam, Amsterdam (Dekker); Lentis, Groningen, the Netherlands (Verheul); Department of Psychiatry, Section of Medical Psychology and Psychotherapy, Erasmus Medical Center, Rotterdam, the Netherlands (Busschbach)
| | - Jan J V Busschbach
- De Viersprong, Viersprong Institute for Studies on Personality Disorders, Halsteren, the Netherlands (Smits, Luyten, Feenstra, Bales); Faculty of Psychology and Educational Sciences, University of Leuven, Leuven, Belgium, and Research Department of Clinical, Educational and Health Psychology, University College London, London (Luyten); Department of Psychology, University of Amsterdam, Amsterdam (Kamphuis); Department of Research, Arkin Mental Health Care, and Department of Clinical Psychology, Vrije Universiteit Amsterdam, Amsterdam (Dekker); Lentis, Groningen, the Netherlands (Verheul); Department of Psychiatry, Section of Medical Psychology and Psychotherapy, Erasmus Medical Center, Rotterdam, the Netherlands (Busschbach)
| |
Collapse
|
15
|
Fitriana TS, Purba FD, Rahmatika R, Muhaimin R, Sari NM, Bonsel G, Stolk E, Busschbach JJV. Comparing measurement properties of EQ-5D-Y-3L and EQ-5D-Y-5L in paediatric patients. Health Qual Life Outcomes 2021; 19:256. [PMID: 34781978 PMCID: PMC8591892 DOI: 10.1186/s12955-021-01889-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 10/27/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The adult versions EQ-5D-3L and EQ-5D-5L have been extensive compared. This is not the case for the EQ-5D youth versions. The study aim was to compare the measurement properties and responsiveness of EQ-5D-Y-3L and EQ-5D-Y-5L in paediatric patients. METHODS A sample of patients 8-16 years old with different diseases and a wide range of disease severity was asked to complete EQ-5D-Y-3L, EQ-5D-Y-5L, PedsQL Generic Core Scale, and selected, appropriate disease-specific instruments, three times. EQ-5D-Y-3L and EQ-5D-Y-5L were compared in terms of: feasibility, (re-)distribution properties, discriminatory power, convergent validity, test-retest reliability, and responsiveness. RESULTS 286 participating patients suffered from one of the following diseases: major beta-thalassemia, haemophilia, acute lymphoblastic leukaemia, acute illness. Missing responses were comparable between versions of the EQ-5D-Y, suggesting comparable feasibility. The number of patients in the best health state (level profile 11111) was equal in both EQ-5D-Y versions. The projection of EQ-5D-Y-3L scores onto EQ-5D-Y-5L for all dimensions showed that the two additional levels in EQ-5D-Y-5L slightly improved the accuracy of patients in reporting their problems, especially if severe. Convergent validity with PedsQL and disease-specific measures showed that the two EQ-5D-Y versions performed about equally. Test-retest reliability (EQ-5D-Y-3L 0.78 vs EQ-5D-Y-5L 0.84), and sensitivity for detecting health changes, were both better in EQ-5D-Y-5L. CONCLUSIONS Extending the number of levels did not give clear superiority to EQ-5D-Y-5L over EQ-5D-Y-3L based on the criteria assessed in this study. However, increasing the number of levels benefitted EQ-5D-Y performance in the measurement of moderate to severe problems and especially in longitudinal study designs.
Collapse
Affiliation(s)
- Titi Sahidah Fitriana
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC University Medical Center, Wytemaweg 80, 3015 CN, Rotterdam, The Netherlands.
- Faculty of Psychology, YARSI University, Jakarta, Indonesia.
| | - Fredrick Dermawan Purba
- Department of Developmental Psychology, Faculty of Psychology, Universitas Padjadjaran, Jatinangor, Indonesia
| | - Rina Rahmatika
- Faculty of Psychology, YARSI University, Jakarta, Indonesia
| | - Riski Muhaimin
- Department of Child Health, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Nur Melani Sari
- Department of Child Health, Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin Hospital, Bandung, Indonesia
| | - Gouke Bonsel
- The EuroQol Research Foundation, Rotterdam, The Netherlands
- Department of Public Health, Erasmus MC University Medical Center, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - Elly Stolk
- The EuroQol Research Foundation, Rotterdam, The Netherlands
| | - Jan J V Busschbach
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC University Medical Center, Wytemaweg 80, 3015 CN, Rotterdam, The Netherlands
| |
Collapse
|
16
|
Jansen LAW, Somanje-Bolweg RRJ, Wierdsma AI, Busschbach JJV, Lijmer JG. Evaluation of opening a type III/IV medical psychiatric unit. Int J Psychiatry Clin Pract 2021; 25:147-151. [PMID: 33586580 DOI: 10.1080/13651501.2021.1881973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The aim of this study is to examine the impact of opening a medical psychiatric unit (MPU) on a variety of outcomes. METHODS In this non-equivalent groups design, there were two groups: 'pre-MPU' and 'actual MPU'. Staff assessed whether patients in the pre-MPU group were eligible for admission to a planned MPU, resulting in virtual admissions and discharges. The actual MPU group consisted of patients admitted after opening of the MPU. RESULTS The length of stay (LOS) in the hospital was one day longer for patients in the MPU group (8.68 vs. 9.89, p = .004), but the LOS on the MPU was comparable in both groups (5.63 vs. 6.06, p = .231). The LOS on the intensive care unit (ICU) was longer in the MPU group (0.10 vs. 0.40, p < .001), even as the time patients were physically restraint (0.28 vs. 0.83, p < .001). In the pre-MPU group, the odds were not significantly different for involuntary commitment (OR = 0.92; p = .866) and death within six months after discharge (OR = 1.84; p = .196). CONCLUSIONS Both physical restraint and ICU admission have a link with patient complexity, it therefore seemed that opening of the MPU resulted in the treatment of more complex patients with a comparable LOS on the MPU.KEY POINTSThe LOS on the MPU was not significantly different between the groups before and after opening of the MPU.Opening of the MPU resulted in the admission of patients that were admitted more days to the ICU and to more days of physically restraint.It can be considered that opening of the MPU resulted in an increased ability to treat complex patients.
Collapse
Affiliation(s)
- Luc A W Jansen
- Department of Psychiatry, Erasmus MC, Rotterdam, The Netherlands.,DC Klinieken Almere, Almere, The Netherlands
| | | | - Andre I Wierdsma
- Department of Psychiatry, Erasmus MC, Rotterdam, The Netherlands
| | | | | |
Collapse
|
17
|
Dietz de Loos ALP, Jiskoot G, Timman R, Beerthuizen A, Busschbach JJV, Laven JSE. Improvements in PCOS characteristics and phenotype severity during a randomized controlled lifestyle intervention. Reprod Biomed Online 2021; 43:298-309. [PMID: 34238659 DOI: 10.1016/j.rbmo.2021.05.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 04/26/2021] [Accepted: 05/06/2021] [Indexed: 11/30/2022]
Abstract
RESEARCH QUESTION What is the effect of weight loss through different interventions (three-component lifestyle intervention with short message service [SMS+] versus three-component lifestyle intervention without SMS [SMS-] versus care as usual [CAU]) on polycystic ovary syndrome (PCOS) characteristics (ovulatory dysfunction, hyperandrogenism, polycystic ovarian morphology [PCOM]) and phenotype distribution? DESIGN Analysis of secondary outcome measures of a randomized controlled trial. Women diagnosed with PCOS (n = 183), who wished to become pregnant, with a body mass index above 25 kg/m², were assigned to a 1-year three-component (cognitive behavioural therapy, diet, exercise) lifestyle intervention group, with or without SMS, or to CAU (advice to lose weight). RESULTS The prevalence of biochemical hyperandrogenism was 30.9% less in the SMS- group compared with CAU after 1 year (P = 0.027). Within-group analyses revealed significant improvements in ovulatory dysfunction (SMS+: -39.8%, P = 0.001; SMS-: -30.5%, P = 0.001; CAU: -32.1%, P < 0.001), biochemical hyperandrogenism (SMS-: -27.8%, P = 0.007) and PCOM (SMS-: -14.0%, P = 0.034). Weight loss had a significantly favourable effect on the chance of having ovulatory dysfunction (estimate 0.157 SE 0.030, P < 0.001) and hyperandrogenism (estimate 0.097 SE 0.027, P < 0.001). CONCLUSIONS All groups demonstrated improvements in PCOS characteristics, although these were more profound within the lifestyle intervention groups. Weight loss per se led to an amelioration of diagnostic characteristics and in the phenotype of PCOS. A three-component lifestyle intervention aimed at a 5-10% weight loss should be recommended for all women with PCOS before they become pregnant.
Collapse
Affiliation(s)
- Alexandra L P Dietz de Loos
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynaecology, Erasmus MC, PO Box 2040, Rotterdam CA 3000, the Netherlands.
| | - Geranne Jiskoot
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynaecology, Erasmus MC, PO Box 2040, Rotterdam CA 3000, the Netherlands; Department of Psychiatry, Section Medical Psychology and Psychotherapy Erasmus MC, PO Box 2040, Rotterdam CA 3000, the Netherlands
| | - Reinier Timman
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynaecology, Erasmus MC, PO Box 2040, Rotterdam CA 3000, the Netherlands
| | - Annemerle Beerthuizen
- Department of Psychiatry, Section Medical Psychology and Psychotherapy Erasmus MC, PO Box 2040, Rotterdam CA 3000, the Netherlands
| | - Jan J V Busschbach
- Department of Psychiatry, Section Medical Psychology and Psychotherapy Erasmus MC, PO Box 2040, Rotterdam CA 3000, the Netherlands
| | - Joop S E Laven
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynaecology, Erasmus MC, PO Box 2040, Rotterdam CA 3000, the Netherlands
| |
Collapse
|
18
|
Visser MS, Amarakoon S, Missotten T, Timman R, Busschbach JJV. Six and eight weeks injection frequencies of bevacizumab are non-inferior to the current four weeks injection frequency for quality of life in neovascular age-related macular degeneration: a randomized controlled trial. Qual Life Res 2020; 29:3305-3313. [PMID: 32666333 PMCID: PMC7686180 DOI: 10.1007/s11136-020-02580-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2020] [Indexed: 01/22/2023]
Abstract
Purpose Patients with neovascular age-related macular degeneration (nARMD) will not deteriorate on visual acuity and retinal thickness when treated with bevacizumab injection frequencies of 6 or 8 weeks compared to 4 weeks. This study aimed to investigate this non-inferiority in quality of life (QoL). We hypothesized that less frequent bevacizumab injections are not inferior regarding patients reported QoL. Methods Patients were randomized to bevacizumab every 4 (n = 64), 6 (n = 63), and 8 weeks (n = 64). Patients were at least 65 years old, have a best-corrected visual acuity of 20/200 to 20/20, no previous ARMD treatment and active leakage. Vision-related QoL questionnaire NEI VFQ-39 was used to assess QoL at baseline and after 1 year. General QoL questionnaire SF-36 was included for secondary analysis. Multilevel analyses were performed, correcting for age, gender and baseline. Results The 6 (3.68; 95% CI − 0.63 to 8.00) and 8 (2.15; 95% CI − 2.26 to 6.56) weeks bevacizumab regimens resulted in non-inferior QoL differences compared to 4 weeks on the NEI VFQ-39. Also on the SF-36 the differences were well within the non-inferiority limits. Conclusion Non-inferiority of the 6 and 8 weeks frequencies was demonstrated compared to 4 weeks on vision-related and general QoL in patients with nARMD. These results are in line with previously published results of lower frequency injections regarding visual acuity and central retinal thickness. Lower injection frequency may reduce burden, side effects, and treatment costs. In consideration of these results, 8 weeks frequency injections of intravitreal bevacizumab could be considered in patients with nARMD. Electronic supplementary material The online version of this article (10.1007/s11136-020-02580-9) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Martijn S Visser
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands. .,Rotterdam Ophthalmic Institute, Rotterdam, The Netherlands.
| | | | - Tom Missotten
- Rotterdam Ophthalmic Institute, Rotterdam, The Netherlands
| | - Reinier Timman
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Jan J V Busschbach
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| |
Collapse
|
19
|
Jansen L, Hunnik F, Busschbach JJV, Lijmer JG. Measuring outcomes on a Medical Psychiatric Unit: HoNOS,, CANSAS and costs. Psychiatry Res 2019; 280:112526. [PMID: 31445422 DOI: 10.1016/j.psychres.2019.112526] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 08/16/2019] [Accepted: 08/17/2019] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To study the course of the functional status and healthcare needs of patients on a Medical Psychiatric Unit (MPU). METHODS In a single-centre observational prospective design the Health of the Nation Outcome Scales (HoNOS) and Camberwell Assessment of Needs Short Appraisal Schedule (CANSAS) instruments were administered at admission and discharge. Functional status and healthcare needs were assessed utilizing the HoNOS and CANSAS respectively. The total costs of healthcare claims related to the admission were calculated based on claims data. RESULTS In total 50 patients were included with a mean improvement of 4.6 on the HoNOS and an effect size of 0.6.The total number of unmet needs fell from 208 to 115. The median costs per decreased HoNOS point were €2.842 and €6.880 per unmet need. DISCUSSION Many patients improved, but due to a large standard deviation at baseline and a low Cronbach's alpha, only 4 patients showed a reliable improvement on functional status. That substantial remission was achieved was shown by the decrease in unmet needs of 93 (44.7%) for the whole group. These observations support the implementation of MPUs, although more research is warranted to ensure cost-effectiveness.
Collapse
Affiliation(s)
- L Jansen
- Erasmus MC - Deparment of Psychiatry, University Hospital located in Rotterdam, the Netherlands; DC Klinieken - Chain of Private Clinics, staff is situated in Almere, the Netherlands.
| | - F Hunnik
- OLVG - Large Teaching Hospital located in Amsterdam, the Netherlands
| | - J J V Busschbach
- Erasmus MC - Deparment of Psychiatry, University Hospital located in Rotterdam, the Netherlands
| | - J G Lijmer
- OLVG - Large Teaching Hospital located in Amsterdam, the Netherlands
| |
Collapse
|
20
|
Kloss K, Ismail S, Redeker S, van Hoogdalem L, Luchtenburg A, Busschbach JJV, van de Wetering J. Factors influencing access to kidney transplantation: a research protocol of a qualitative study on stakeholders' perspectives. BMJ Open 2019; 9:e032694. [PMID: 31558463 PMCID: PMC6773277 DOI: 10.1136/bmjopen-2019-032694] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Unequal access to kidney transplantation is suggested, but no systematic inventory exists about factors influencing access to kidney transplantation. There is an absence of any research that has combined stakeholder perspectives along the complete trajectory of transplantation. The present qualitative study explores the contributing factors from the perspectives of multiple stakeholders in this trajectory, including patients, health professionals and health insurance and financial representatives in the Netherlands. Moreover, stakeholders will be invited to suggesting strategies and solutions for handling the facilitating and hindering factors found. By means of interaction, stakeholder groups will arrive at a consensus for new policymaking in the field of a Dutch transplantation care. METHODS AND ANALYSIS The different stakeholders' perspectives and possible solutions will be explored by interviewing in three phases. In the first phase, stakeholders' group perspectives will be explored with individual interviews and focus group interviews without confrontation of views from other perspectives. In the second phase of focus group interviewing, perspectives will be confronted with the other stakeholders' perspectives assessed. Finally, in the third phase, stakeholders will be invited to focus group discussions for suggesting solutions to overcome barriers and promote facilitators for improving access to transplantation. Approximately, groups from six to twelve participants per focus group and four to maximal six focus groups will be held per stakeholder, depending on the level of saturation, as prescribed by grounded theory. The interviews will be audio-recorded and transcribed verbatim, and qualitative data will be analysed according to the principles of grounded theory supported by using NVivo software. ETHICS AND DISSEMINATION The Medical Ethical Committee of Erasmus MC, Rotterdam, The Netherlands, has approved this study. The results will be disseminated in peer-reviewed journals and major international conferences.
Collapse
Affiliation(s)
- Katja Kloss
- Medical Psychology and Psychotherapy, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Sohal Ismail
- Medical Psychology and Psychotherapy, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Steef Redeker
- Medical Psychology and Psychotherapy, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Lothar van Hoogdalem
- Medical Psychology and Psychotherapy, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Annemarie Luchtenburg
- Medical Psychology and Psychotherapy, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Jan J V Busschbach
- Medical Psychology and Psychotherapy, Erasmus Medical Center, Rotterdam, The Netherlands
| | | |
Collapse
|
21
|
Pickard AS, Law EH, Jiang R, Pullenayegum E, Shaw JW, Xie F, Oppe M, Boye KS, Chapman RH, Gong CL, Balch A, Busschbach JJV. United States Valuation of EQ-5D-5L Health States Using an International Protocol. Value Health 2019; 22:931-941. [PMID: 31426935 DOI: 10.1016/j.jval.2019.02.009] [Citation(s) in RCA: 180] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Revised: 02/12/2019] [Accepted: 02/27/2019] [Indexed: 05/05/2023]
Abstract
OBJECTIVE To derive a US-based value set for the EQ-5D-5L questionnaire using an international, standardized protocol developed by the EuroQol Group. METHODS Respondents from the US adult population were quota-sampled on the basis of age, sex, ethnicity, and race. Trained interviewers guided participants in completing composite time trade-off (cTTO) and discrete choice experiment (DCE) tasks using the EuroQol Valuation Technology software and routine quality control measures. Data were modeled using a Tobit model for cTTO data, a mixed logit model for DCE data, and a hybrid model that combined cTTO and DCE data. Model performance was compared on the basis of logical ordering of coefficients, statistical significance, parsimony, and theoretical considerations. RESULTS Of 1134 respondents, 1062, 1099, and 1102 respondents provided useable cTTO, DCE, and cTTO or DCE responses, respectively, on the basis of quality control criteria and interviewer judgment. Respondent demographic characteristics and health status were similar to the 2015 US Census. The Tobit model was selected as the preferred model to generate the value set. Values ranged from -0.573 (55 555) to 1 (11 111), with 20% of all predicted health states scores less than 0 (ie, worse than dead). CONCLUSIONS A societal value set for the EQ-5D-5L was developed that can be used for economic evaluations and decision making in US health systems. The internationally established, standardized protocol used to develop this US-based value set was recommended by the EuroQol Group and can facilitate cross-country comparisons.
Collapse
Affiliation(s)
- A Simon Pickard
- Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, Chicago, IL, USA.
| | - Ernest H Law
- Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, Chicago, IL, USA
| | - Ruixuan Jiang
- Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, Chicago, IL, USA
| | | | | | - Feng Xie
- McMaster University, Hamilton, ON, Canada
| | - Mark Oppe
- Axentiva Solutions, Santa Cruz de Tenerife, Spain
| | | | | | | | - Alan Balch
- Patient Advocate Foundation, Hampton, VA, USA
| | - Jan J V Busschbach
- Section of Medical Psychology, Department of Psychiatry, Erasmus MC, Rotterdam, the Netherlands
| |
Collapse
|
22
|
van Hoogdalem LE, Siemes C, Lugtenburg PJ, Busschbach JJV, Ismail SY. Patients' decision-making, experiences and preferences regarding pixantrone treatment in relapsed or refractory diffuse large B-cell lymphoma: study protocol for a longitudinal mixed methods study. BMJ Open 2019; 9:e026505. [PMID: 31122976 PMCID: PMC6538055 DOI: 10.1136/bmjopen-2018-026505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION There is a lot of speculation about why and how patients decide to use invasive treatment in an advanced stage of cancer, but the body of research is limited. The present longitudinal qualitative and quantitative study reflects real-life practice of pixantrone use and aims to collect data on patients' considerations for, expectations of and experiences with pixantrone and trajectories in their quality-of-life (QoL) values in a Dutch clinical setting. Hence, two questions emerge. Why do patients choose for this treatment, while the treatment success rate is limited and curation cannot be achieved? And second, once chosen, what conditions would patients like to satisfy and how do they experience the treatment? METHODS AND ANALYSIS This is a non-interventional longitudinal and multicentre study. Patients are eligible if they are >18 years, have never been treated with pixantrone before, have an Eastern Cooperative Oncology Group performance score ≤2, have a relapsed or refractory diffuse large B-cell lymphoma and have been treated with at least two prior regimens. The decision to treat patients with pixantrone has been taken by the treating physician before patients are asked to participate in the study. If patients refuse study participation after being informed by the investigator, reasons for refusal (if given) will be recorded. Participants will receive at least three interviews accompanied by three QOL questionnaires. Based on the required sample size, we aim to include 20 patients over a period of 2 years. ETHICS AND DISSEMINATION The Medical Ethical Committee of Erasmus MC, Rotterdam, The Netherlands, has approved this study. The results will be disseminated in peer-reviewed journals and major international conferences. The study is non-interventional and falls therefore not under Medical Research Involving Human Subjects Act (In Dutch: Wet medisch-wetenschappelijk onderzoek met mensen; WMO). Hence, this study is approved to be carried out in the Erasmus MC. Each other participating centre will receive this approval and will separately undergo the ethical approval to be able to participate. In addition to the ethical approval, the participating centres need to obtain written informed consent of their patients. Given the non-interventional nature of this study, a study registration was considered but deemed unnecessary. The study will be conducted in accordance with the Declaration of Helsinki (Tokyo, Venice, Hong Kong and Somerset West amendments). A sequential identification number will be automatically attributed to each patient that has given consent to participate in the study. This number will identify the patient and must be included on all documents. Only the main researcher can link the code to the patient's identity.
Collapse
Affiliation(s)
- Lothar E van Hoogdalem
- Department of Psychiatry, Section of Medical Psychology & Psychotherapy, Erasmus MC, Rotterdam, The Netherlands
| | - Claire Siemes
- Department of Hematology, Erasmus MC, Rotterdam, The Netherlands
| | | | - Jan J V Busschbach
- Department of Psychiatry, Section of Medical Psychology & Psychotherapy, Erasmus MC, Rotterdam, The Netherlands
| | - Sohal Y Ismail
- Department of Psychiatry, Section of Medical Psychology & Psychotherapy, Erasmus MC, Rotterdam, The Netherlands
| |
Collapse
|
23
|
Abstract
INTRODUCTION Living donor kidney transplantation (LDKT) is the optimal treatment for most patients with end-stage renal disease (ESRD). However, there are numerous patients who cannot find a living kidney donor. Randomised controlled trials have shown that home-based education for patients with ESRD and their family/friends leads to four times more LDKTs. This educational intervention is currently being implemented in eight hospitals in the Netherlands. Supervision and quality assessment are being employed to maintain the quality of the intervention. In this study, we aim to: (1) conduct a cost-effectiveness analysis of the educational programme and its quality assurance system; (2) investigate the relationship between the quality of the implementation of the intervention and the outcomes knowledge, communication and LDKT activities; and (3) investigate policy implications. METHODS AND DESIGN Patients with ESRD who do not have a living kidney donor are eligible to receive the home-based educational intervention. This is carried out by allied health transplantation professionals and psychologists across eight hospitals in the Netherlands. The cost-effectiveness analysis will be conducted with a Markov model. Cost data will be obtained from the literature. We will obtain the quality of life data from the patients who participate in the educational programme. Questionnaires on knowledge and communication will be used to measure the outcomes of the programme. Data on LDKT activities will be obtained from medical records up to 24 months after the education. A protocol adherence measure will be assessed by a third party by means of a telephone interview with the patients and the invitees. ETHICS AND DISSEMINATION Ethical approval was obtained through all participating hospitals. Results will be disseminated through peer-reviewed publications and scientific presentations. Results of the cost-effectiveness of the educational programme will also be disseminated to the Dutch National Health Care Institute. TRIAL REGISTRATION NUMBER NL6529.
Collapse
Affiliation(s)
- Steef Redeker
- Section Medical Psychology and Psychotherapy, Department of Psychiatry, Erasmus MC, Rotterdam, The Netherlands
| | - Mark Oppe
- EuroQol Research Foundation, Rotterdam, The Netherlands
| | - Martijn Visser
- Section Medical Psychology and Psychotherapy, Department of Psychiatry, Erasmus MC, Rotterdam, The Netherlands
| | - Jan J V Busschbach
- Section Medical Psychology and Psychotherapy, Department of Psychiatry, Erasmus MC, Rotterdam, The Netherlands
| | - Willem Weimar
- Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Emma Massey
- Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Sohal Ismail
- Section Medical Psychology and Psychotherapy, Department of Psychiatry, Erasmus MC, Rotterdam, The Netherlands
| |
Collapse
|
24
|
van Hoogdalem LE, Hoitsma A, Timman R, van der Zwart R, Körnmann J, van Rijssel T, Busschbach JJV, Ismail SY. Shared Decision-Making in Kidney Patients: Involvement in Decisions Regarding the Quality of Deceased Donor Kidneys. Transplant Proc 2018; 50:3152-3159. [PMID: 30577181 DOI: 10.1016/j.transproceed.2018.06.045] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 06/27/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVES This study examined whether kidney patients want to participate in decisions regarding the minimal acceptable quality of deceased donor kidneys. We also explored patients' opinions about the trade-off between a higher-quality organ with a longer waiting time vs a lower-quality organ with a shorter waiting time. METHODS A questionnaire was distributed among kidney patients. Additionally, a sub-sample of these patients participated in in-depth interviews, which were analyzed using the grounded theory approach. RESULTS Sixty-three percent of the patients wished to participate in decisions concerning the quality of a deceased donor kidney. The majority of the respondents indicated that they prefer a kidney of good quality and would therefore accept a longer waiting time. Responses to the qualitative interviews illustrated a more balanced choice regarding this trade-off. CONCLUSIONS Many patients wish to be involved in deciding on the quality of the kidney, but it may evoke the experience of decisional conflicts when they have to make rational trade-offs between the desire for the best kidney at the expense of a longer waiting time.
Collapse
Affiliation(s)
- L E van Hoogdalem
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
| | - A Hoitsma
- Department of Nephrology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - R Timman
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - R van der Zwart
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - J Körnmann
- Department of Nephrology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - T van Rijssel
- Department of Nephrology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - J J V Busschbach
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - S Y Ismail
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| |
Collapse
|
25
|
van Schijndel MA, Caarls PJ, van Wijngaarden JDH, Wierdsma AI, Lijmer JG, Boenink AD, Hoogendijk WJG, van Waarde JA, Busschbach JJV. Identifying value-based quality indicators for general hospital psychiatry. Gen Hosp Psychiatry 2018; 55:27-37. [PMID: 30296675 DOI: 10.1016/j.genhosppsych.2018.09.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 09/21/2018] [Accepted: 09/21/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To define generic quality indicators for general hospital psychiatry from the perspectives of patients, professionals (physicians, nurses, and managers), and payers (health insurance companies). METHODS Quality variables were identified by reviewing the relevant literature. A working. group consisting of patients', professionals' and payers' representatives was mandated by their respective umbrella organizations. The working group prioritized the quality variables that were identified. Core values were defined and subsequently linked to preliminary quality indicators. These were tested for feasibility in ten hospitals in a four-week period. Stakeholder consultation took place by means of two invitational conferences and two written commentary rounds. RESULTS Forty-one quality variables were identified from the literature. After prioritization, seven core values were defined and translated to 22 preliminary indicators. Overall, the feasibility study showed high relevance scores and good implementability of the preliminary quality indicators. A final set of twenty-two quality indicators (17 structure, 3 process and 2 outcome indicators) was then established using a consensus-based approach. CONCLUSION Consensus on a quality framework for general hospital psychiatry was built by incorporating the perspectives of relevant stakeholders. Results of the feasibility study suggest broad support and good implementability of the final quality indicators. Structural indicators were broadly defined, and process and outcome indicators are generic to facilitate quality measurement across settings. The quality indicator set can now be used to facilitate quality and outcome assessment, stimulate standardization of services, and help demonstrate (cost-) effectiveness.
Collapse
Affiliation(s)
- Maarten A van Schijndel
- Rijnstate hospital, Arnhem, the Netherlands; Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
| | - Petra J Caarls
- Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | | | - André I Wierdsma
- Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | | | | | | | | | | |
Collapse
|
26
|
Laurenssen EMP, Luyten P, Kikkert MJ, Westra D, Peen J, Soons MBJ, van Dam AM, van Broekhuyzen AJ, Blankers M, Busschbach JJV, Dekker JJM. Day hospital mentalization-based treatment v. specialist treatment as usual in patients with borderline personality disorder: randomized controlled trial. Psychol Med 2018; 48:2522-2529. [PMID: 29478425 DOI: 10.1017/s0033291718000132] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Day hospital mentalization-based treatment (MBT-DH) is a promising treatment for borderline personality disorder (BPD) but its evidence base is still limited. This multi-site randomized trial compared the efficacy of MBT-DH delivered by a newly set-up service v. specialist treatment as usual (S-TAU) tailored to the individual needs of patients, and offered by a well-established treatment service. METHODS Two mental healthcare institutes in The Netherlands participated in the study. Patients who met DSM-IV criteria for BPD and had a score of ⩾20 on the borderline personality disorder severity index (BPDSI) were randomly allocated to MBT-DH (N = 54) or S-TAU (N = 41). The primary outcome variable was the total score on the BPDSI. Secondary outcome variables included symptom severity, quality of life, and interpersonal functioning. Data were collected at baseline and every 6 months until 18-month follow-up, and were analyzed using multilevel analyses based on intention-to-treat principles. RESULTS Both treatments were associated with significant improvements in all outcome variables. MBT-DH was not superior to S-TAU on any outcome variable. MBT-DH was associated with higher acceptability in BPD patients compared v. S-TAU, reflected in significantly higher early drop-out rates in S-TAU (34%) v. MBT-DH (9%). CONCLUSIONS MBT-DH delivered by a newly set-up service is as effective as specialist TAU in The Netherlands in the treatment of BPD at 18-month follow-up. Further research is needed to investigate treatment outcomes in the longer term and the cost-effectiveness of these treatments.
Collapse
Affiliation(s)
| | - Patrick Luyten
- Faculty of Psychology and Educational Sciences,University of Leuven,Belgium;Research Department of Clinical, Educational and Health Psychology,University College London,UK
| | - Martijn J Kikkert
- Department of Research,Arkin Mental Health Care,Amsterdam,The Netherlands
| | | | - Jaap Peen
- Department of Research,Arkin Mental Health Care,Amsterdam,The Netherlands
| | - Mirjam B J Soons
- NPI Specialist in Personality Problems,Amsterdam,The Netherlands
| | | | | | - Matthijs Blankers
- Department of Research,Arkin Mental Health Care,Amsterdam,The Netherlands
| | - Jan J V Busschbach
- Department of Psychiatry,Section Medical Psychology and Psychotherapy,Erasmus MC, Rotterdam,The Netherlands
| | - Jack J M Dekker
- Department of Research,Arkin Mental Health Care,Amsterdam,The Netherlands
| |
Collapse
|
27
|
Purba FD, Hunfeld JAM, Timman R, Iskandarsyah A, Fitriana TS, Sadarjoen SS, Passchier J, Busschbach JJV. Test-Retest Reliability of EQ-5D-5L Valuation Techniques: The Composite Time Trade-Off and Discrete Choice Experiments. Value Health 2018; 21:1243-1249. [PMID: 30314626 DOI: 10.1016/j.jval.2018.02.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 01/18/2018] [Accepted: 02/15/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES To explore the test-retest reliability of the composite time trade-off (C-TTO) and discrete choice experiment (DCE) used in the Indonesian five-level EuroQol five-dimensional questionnaire (EQ-5D-5L) valuation study. METHODS A representative sample aged 17 years and older was recruited from the Indonesian general population by stratified quota sampling with respect to residence, sex, and age. Trained interviewers conducted computer-assisted face-to-face interviews using the EuroQol valuation technology. Each respondent valued 10 health states using C-TTO and 7 pairs of health states in a DCE exercise. The retest interview was conducted after 2 weeks by the same interviewer. The Wilcoxon matched-pairs signed-rank test, intraclass correlation coefficient, and multilevel regression were applied in comparing the C-TTO test and retest data. For DCE, the analysis of proportions was used. RESULTS A total of 226 respondents with characteristics similar to the Indonesian population completed the retest interview. For C-TTO, 82 (95.3%) of 86 health states had no significant mean value differences between test and retest. The mean value of the second test was statistically significantly higher than that of the first test by 0.042. For DCE, 72.5% of responses were identical. DCE retest showed a different pattern concerning the relative importance of the dimensions, whereas the C-TTO remained the same. CONCLUSIONS C-TTO is stable over time, whereas in DCE the relative values of the dimensions shift. The results support the use of the C-TTO, in particular the Indonesian EQ-5D-5L value set, and suggest a critical examination of the reliability of DCE results over time.
Collapse
Affiliation(s)
- Fredrick Dermawan Purba
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC University Medical Center, Rotterdam, The Netherlands; Department of Developmental Psychology, Faculty of Psychology, Universitas Padjadjaran, Jatinangor, Indonesia.
| | - Joke A M Hunfeld
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Reinier Timman
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Aulia Iskandarsyah
- Department of Clinical Psychology, Faculty of Psychology, Universitas Padjadjaran, Jatinangor, Indonesia
| | - Titi Sahidah Fitriana
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC University Medical Center, Rotterdam, The Netherlands; Faculty of Psychology, YARSI University, Jakarta, Indonesia
| | - Sawitri S Sadarjoen
- Department of Clinical Psychology, Faculty of Psychology, Universitas Padjadjaran, Jatinangor, Indonesia
| | - Jan Passchier
- Department of Clinical, Neuro and Developmental Psychology, VU University, Amsterdam, The Netherlands
| | - Jan J V Busschbach
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| |
Collapse
|
28
|
Purba FD, Hunfeld JAM, Fitriana TS, Iskandarsyah A, Sadarjoen SS, Busschbach JJV, Passchier J. Living in uncertainty due to floods and pollution: the health status and quality of life of people living on an unhealthy riverbank. BMC Public Health 2018; 18:782. [PMID: 29929524 PMCID: PMC6013864 DOI: 10.1186/s12889-018-5706-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 06/13/2018] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND People living on the banks of polluted rivers with yearly flooding lived in impoverished and physically unhealthy circumstances. However, they were reluctant to move or be relocated to other locations where better living conditions were available. This study aimed to investigate the health status, quality of life (QoL), happiness, and life satisfaction of the people who were living on the banks of one of the main rivers in Jakarta, Indonesia, the Ciliwung. METHODS Respondents were 17 years and older and recruited from the Bukit Duri community (n = 204). Three comparison samples comprised: i) a socio-demographically matched control group, not living on the river bank (n = 204); ii) inhabitants of Jakarta (n = 305), and iii) the Indonesian general population (n = 1041). Health status and QoL were measured utilizing EQ-5D-5L, WHOQOL-BREF, the Happiness Scale, and the Life Satisfaction Index. A visual analogue scale question concerning respondents' financial situations was added. MANOVA and multivariate regression analysis were used to analyze the differences between the Ciliwung respondents and the three comparison groups. RESULTS The Ciliwung respondents reported lower physical QoL on WHOQOL-BREF and less personal happiness than the matched controls but rated their health (EQ-5D-5L) and life satisfaction better than the matched controls. Similar results were obtained by comparison with the Jakarta inhabitants and the general population. Bukit Duri inhabitants also perceived themselves as being in a better financial situation than the three comparison groups even though their incomes were lower. CONCLUSIONS The recent relocation to a better environment with better housing might improve the former Ciliwung inhabitants' quality of life and happiness, but not necessarily their perceived health, satisfaction with life, and financial situations.
Collapse
Affiliation(s)
- Fredrick Dermawan Purba
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC University Medical Center, Wytemaweg 80 Room Na2018, 3015 CN, Rotterdam, The Netherlands. .,Department of Developmental Psychology, Faculty of Psychology, Padjadjaran University, Jatinangor, Indonesia.
| | - Joke A M Hunfeld
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC University Medical Center, Wytemaweg 80 Room Na2018, 3015 CN, Rotterdam, The Netherlands
| | - Titi Sahidah Fitriana
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC University Medical Center, Wytemaweg 80 Room Na2018, 3015 CN, Rotterdam, The Netherlands.,Faculty of Psychology, YARSI University, Jakarta, Indonesia
| | - Aulia Iskandarsyah
- Department of Clinical Psychology, Faculty of Psychology, Padjadjaran University, Jatinangor, Indonesia
| | - Sawitri S Sadarjoen
- Faculty of Psychology, YARSI University, Jakarta, Indonesia.,Department of Clinical Psychology, Faculty of Psychology, Padjadjaran University, Jatinangor, Indonesia
| | - Jan J V Busschbach
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC University Medical Center, Wytemaweg 80 Room Na2018, 3015 CN, Rotterdam, The Netherlands
| | - Jan Passchier
- Department of Clinical, Neuro & Developmental Psychology, VU University, Amsterdam, The Netherlands
| |
Collapse
|
29
|
Lange AMC, van der Rijken REA, Delsing MJMH, Busschbach JJV, Scholte RHJ. Development of Therapist Adherence in Relation to Treatment Outcomes of Adolescents with Behavioral Problems. J Clin Child Adolesc Psychol 2018; 48:S337-S346. [PMID: 29913088 DOI: 10.1080/15374416.2018.1477049] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Therapist adherence to the treatment manual is assumed to be crucial for adequate implementation and subsequent achievement of the intended, positive treatment outcomes. Although adherence has been mostly studied as a static factor, recent studies suggest that adherence might be dynamic and changes over time. We investigated how parent-perceived adherence to the multisystemic therapy (MST) model develops during treatment and how this development is related to treatment outcomes up to 18 months posttreatment, controlling for the effect of alliance. We used routinely collected data from 848 adolescents (66% male and 76% Western, M age = 15.25 years) and their caregivers participating in MST, a family- and community-based intervention for antisocial adolescents. Adherence and alliance were measured monthly through phone interviews with the caregivers using the Therapist Adherence Measure-Revised. Outcomes were assessed at the end of the treatment and at 18 months posttreatment using the scale Rule-Breaking Behavior of the Child Behavior Checklist and two MST Ultimate Outcomes (i.e., police contact and out-of-home placement). On average, adherence showed an increasing and then flattening slope. The initial level of adherence predicted treatment outcomes at the end of treatment but not at 18 months posttreatment. Change in adherence did not predict treatment outcomes after controlling for alliance. We advocate the need to consider the dynamic nature of adherence in research as well as clinical practice. Change in adherence during treatment, as well as its association with outcome, is likely to be dependent on the adherence measure being used.
Collapse
Affiliation(s)
- Aurelie M C Lange
- a Viersprong Institute for Studies on Personality Disorders.,b Department of Psychiatry, Section of Medical Psychology & Psychotherapy , Erasmus Medical Center
| | | | | | - Jan J V Busschbach
- a Viersprong Institute for Studies on Personality Disorders.,b Department of Psychiatry, Section of Medical Psychology & Psychotherapy , Erasmus Medical Center
| | - Ron H J Scholte
- a Viersprong Institute for Studies on Personality Disorders.,d Praktikon.,e Behavioural Science Institute, Radboud University Nijmegen
| |
Collapse
|
30
|
Eeren HV, Goossens LMA, Scholte RHJ, Busschbach JJV, van der Rijken REA. Multisystemic Therapy and Functional Family Therapy Compared on their Effectiveness Using the Propensity Score Method. J Abnorm Child Psychol 2018; 46:1037-1050. [PMID: 29313186 PMCID: PMC6010495 DOI: 10.1007/s10802-017-0392-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Multisystemic Therapy (MST) and Functional Family Therapy (FFT) have overlapping target populations and treatment goals. In this study, these interventions were compared on their effectiveness using a quasi-experimental design. Between October, 2009 and June, 2014, outcome data were collected from 697 adolescents (mean age 15.3 (SD 1.48), 61.9% male) assigned to either MST or FFT (422 MST; 275 FFT). Data were gathered during Routine Outcome Monitoring. The primary outcome was externalizing problem behavior (Child Behavior Checklist and Youth Self Report). Secondary outcomes were the proportion of adolescents living at home, engaged in school or work, and who lacked police contact during treatment. Because of the non-random assignment, a propensity score method was used to control for observed pre-treatment differences. Because the risk-need-responsivity (RNR) model guided treatment assignment, effectiveness was also estimated in youth with and without a court order as an indicator of their risk level. Looking at the whole sample, no difference in effect was found with regard to externalizing problems. For adolescents without a court order, effects on externalizing problems were larger after MST. Because many more adolescents with a court order were assigned to MST compared to FFT, the propensity score method could not balance the treatment groups in this subsample. In conclusion, few differences between MST and FFT were found. In line with the RNR model, higher risk adolescents were assigned to the more intensive treatment, namely MST. In the group with lower risk adolescents, this more intensive treatment was more effective in reducing externalizing problems.
Collapse
Affiliation(s)
- Hester V Eeren
- Viersprong Institute for Studies on Personality Disorders (VISPD), Halsteren, The Netherlands. .,Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus Medical Center, Rotterdam, The Netherlands.
| | - Lucas M A Goossens
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Ron H J Scholte
- Viersprong Institute for Studies on Personality Disorders (VISPD), Halsteren, The Netherlands.,Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Jan J V Busschbach
- Viersprong Institute for Studies on Personality Disorders (VISPD), Halsteren, The Netherlands.,Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus Medical Center, Rotterdam, The Netherlands
| | | |
Collapse
|
31
|
Staphorst MS, Timman R, Passchier J, Busschbach JJV, van Goudoever JB, Hunfeld JAM. The development of the DISCO-RC for measuring children's discomfort during research procedures. BMC Pediatr 2017; 17:199. [PMID: 29187148 PMCID: PMC5707811 DOI: 10.1186/s12887-017-0949-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 11/15/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is a need for data on children's self-reported discomfort in clinical research, helping ethics committees to make their evaluation of discomfort described in study protocols evidence-based. Since there is no appropriate instrument to measure children's discomfort during medical research procedures, we aimed to develop a generic, short and child-friendly instrument: the DISCO-RC questionnaire (DISCOmfort in Research with Children). METHODS This article describes the six steps of the development of the DISCO-RC. First, we updated a literature search on children's self-reported discomfort in clinical research to get insight in what words are used to measure discomfort (step 1). Subsequently, we interviewed 46 children (6-18 years) participating in research to get insight into important forms of discomfort for children (step 2), and asked them about their preferred response option for measuring discomfort (step 3). Next, we consulted nine paediatric research professionals from various backgrounds for input on the content and feasibility of the DISCO-RC (step 4). Based on the previous steps, we developed a draft version of the DISCO-RC, which we discussed with the professionals. The DISCO-RC was then pretested in 25 children to ensure face-validity from the child's perspective and feasibility (step 5). Finally, validity, reliability and internal consistency were tested (step 6). RESULTS The search-update revealed several words used for measuring discomfort in research (e.g. 'worries', 'unpleasantness'). The interviews gave insight into important forms of discomfort for children in research (e.g. 'pain', 'boredom'). Children preferred a 5-point Likert scale as response option for the DISCO-RC. The experts recommended a short, digital instrument involving different forms of discomfort, and measuring discomfort of individual research procedures. Pretesting of the DISCO-RC resulted in a few layout changes, and feedback from the children confirmed the feasibility of the DISCO-RC. Convergent validity and test-retest reliability were acceptable. Internal consistency based on item-rest correlations and Cronbach's alpha were low, as expected. CONCLUSIONS The DISCO-RC is a generic, practical and psychometrically sound instrument for measuring children's discomfort during research procedures. It contributes to make the evaluation of discomfort in paediatric research evidence-based. Therefore, we recommend including the DISCO-RC as standard component of paediatric research studies.
Collapse
Affiliation(s)
- Mira S. Staphorst
- Department of Psychiatry, section of Medical Psychology and Psychotherapy, Erasmus University Medical Center, Room: Na-2013, PO box 2040, 3000 CA Rotterdam, The Netherlands
| | - Reinier Timman
- Department of Psychiatry, section of Medical Psychology and Psychotherapy, Erasmus University Medical Center, Room: Na-2013, PO box 2040, 3000 CA Rotterdam, The Netherlands
| | - Jan Passchier
- Department of Clinical Psychology/EMGO+, VU University, Amsterdam, The Netherlands
| | - Jan J. V. Busschbach
- Department of Psychiatry, section of Medical Psychology and Psychotherapy, Erasmus University Medical Center, Room: Na-2013, PO box 2040, 3000 CA Rotterdam, The Netherlands
| | - Johannes B. van Goudoever
- Department of Pediatrics, VU University Medical Centre, Amsterdam, The Netherlands
- Department of Pediatrics, Emma Children’s Hospital, Academic Medical Centre, Amsterdam, The Netherlands
| | - Joke A. M. Hunfeld
- Department of Psychiatry, section of Medical Psychology and Psychotherapy, Erasmus University Medical Center, Room: Na-2013, PO box 2040, 3000 CA Rotterdam, The Netherlands
| |
Collapse
|
32
|
Purba FD, Hunfeld JAM, Iskandarsyah A, Fitriana TS, Sadarjoen SS, Ramos-Goñi JM, Passchier J, Busschbach JJV. The Indonesian EQ-5D-5L Value Set. Pharmacoeconomics 2017; 35:1153-1165. [PMID: 28695543 PMCID: PMC5656740 DOI: 10.1007/s40273-017-0538-9] [Citation(s) in RCA: 108] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
BACKGROUND The EQ-5D is one of the most used generic health-related quality-of-life (HRQOL) instruments worldwide. To make the EQ-5D suitable for use in economic evaluations, a societal-based value set is needed. Indonesia does not have such a value set. OBJECTIVE The aim of this study was to derive an EQ-5D-5L value set from the Indonesian general population. METHODS A representative sample aged 17 years and over was recruited from the Indonesian general population. A multi-stage stratified quota method with respect to residence, gender, age, level of education, religion and ethnicity was utilized. Two elicitation techniques, the composite time trade-off (C-TTO) and discrete choice experiments (DCE) were applied. Interviews were undertaken by trained interviewers using computer-assisted face-to-face interviews with the EuroQol Valuation Technology (EQ-VT) platform. To estimate the value set, a hybrid regression model combining C-TTO and DCE data was used. RESULTS A total of 1054 respondents who completed the interview formed the sample for the analysis. Their characteristics were similar to those of the Indonesian population. Most self-reported health problems were observed in the pain/discomfort dimension (39.66%) and least in the self-care dimension (1.89%). In the value set, the maximum value was 1.000 for full health (health state '11111') followed by the health state '11112' with value 0.921. The minimum value was -0.865 for the worst state ('55555'). Preference values were most affected by mobility and least by pain/discomfort. CONCLUSIONS We now have a representative EQ-5D-5L value set for Indonesia. We expect our results will promote and facilitate health economic evaluations and HRQOL research in Indonesia.
Collapse
Affiliation(s)
- Fredrick Dermawan Purba
- Section Medical Psychology and Psychotherapy, Department of Psychiatry, Erasmus MC University Medical Center, Wytemaweg 80, Room Na-2019, 3015 CN, Rotterdam, The Netherlands.
- Department of Developmental Psychology, Faculty of Psychology, Padjadjaran University, Jatinangor, Indonesia.
| | - Joke A M Hunfeld
- Section Medical Psychology and Psychotherapy, Department of Psychiatry, Erasmus MC University Medical Center, Wytemaweg 80, Room Na-2019, 3015 CN, Rotterdam, The Netherlands
| | - Aulia Iskandarsyah
- Department of Clinical Psychology, Faculty of Psychology, Padjadjaran University, Jatinangor, Indonesia
| | - Titi Sahidah Fitriana
- Center of Applied Psychometrics, Faculty of Psychology, YARSI University, Jakarta, Indonesia
| | - Sawitri Supardi Sadarjoen
- Department of Clinical Psychology, Faculty of Psychology, Padjadjaran University, Jatinangor, Indonesia
| | | | - Jan Passchier
- Department of Clinical, Neuro and Developmental Psychology, VU University, Amsterdam, The Netherlands
| | - Jan J V Busschbach
- Section Medical Psychology and Psychotherapy, Department of Psychiatry, Erasmus MC University Medical Center, Wytemaweg 80, Room Na-2019, 3015 CN, Rotterdam, The Netherlands
| |
Collapse
|
33
|
Lange AMC, van der Rijken REA, Delsing MJMH, Busschbach JJV, van Horn JE, Scholte RHJ. Alliance and adherence in a systemic therapy. Child Adolesc Ment Health 2017; 22:148-154. [PMID: 32680378 DOI: 10.1111/camh.12172] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/23/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND The client-therapist working alliance is a key contributor to effective adult psychotherapy. However, little is known about its role in family and systemic therapy. Moreover, few studies have assessed alliance longitudinally or have investigated how it interrelates with other process variables, such as therapist adherence (i.e. the extent to which the therapist adheres to the treatment protocol or manual). We hypothesised that alliance and adherence interrelate over the course of the therapy. METHOD This study investigated the bidirectional associations between alliance and therapist adherence using cross-lagged panel analyses for a sample of 1970 adolescents and their families participating in Multisystemic Therapy (MST). A number of client characteristics were included as moderators, namely demographic characteristics, type and severity of adolescent problem behaviour, and whether or not the MST treatment was court ordered. Alliance and adherence were scored by the primary caregiver through telephone interviews at monthly intervals during treatment. RESULTS Alliance in 1 month predicted therapist adherence in a subsequent month. Adherence only predicted subsequent alliance during the middle part of the treatment process. The results were not moderated by any of the client factors. CONCLUSIONS The results suggest that alliance and therapist adherence may reinforce one another during therapy. Although alliance may facilitate the development of therapist adherence, adherence may subsequently deepen and consolidate the client-therapist alliance. These results are independent of client characteristics.
Collapse
Affiliation(s)
- Aurelie M C Lange
- Viersprong Institute for Studies on Personality Disorders, P.O. Box 7, 4660 AA, Halsteren, The Netherlands.,Department of Psychiatry, Section of Medical Psychology & Psychotherapy, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Rachel E A van der Rijken
- Viersprong Institute for Studies on Personality Disorders, P.O. Box 7, 4660 AA, Halsteren, The Netherlands.,MST-Netherlands, Zevenbergen, The Netherlands
| | | | - Jan J V Busschbach
- Viersprong Institute for Studies on Personality Disorders, P.O. Box 7, 4660 AA, Halsteren, The Netherlands.,Department of Psychiatry, Section of Medical Psychology & Psychotherapy, Erasmus Medical Center, Rotterdam, The Netherlands
| | | | - Ron H J Scholte
- Viersprong Institute for Studies on Personality Disorders, P.O. Box 7, 4660 AA, Halsteren, The Netherlands.,Praktikon, Nijmegen, The Netherlands.,Developmental Psychopathology, Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| |
Collapse
|
34
|
Staphorst MS, Benninga MA, Bisschoff M, Bon I, Busschbach JJV, Diederen K, van Goudoever JB, Haarman EG, Hunfeld JAM, Jaddoe VVW, de Jong KJM, de Jongste JC, Kindermann A, Königs M, Oosterlaan J, Passchier J, Pijnenburg MW, Reneman L, de Ridder L, Tamminga HG, Tiemeier HW, Timman R, van de Vathorst S. The child's perspective on discomfort during medical research procedures: a descriptive study. BMJ Open 2017; 7:e016077. [PMID: 28765130 PMCID: PMC5642655 DOI: 10.1136/bmjopen-2017-016077] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE The evaluation of discomfort in paediatric research is scarcely evidence-based. In this study, we make a start in describing children's self-reported discomfort during common medical research procedures and compare this with discomfort during dental check-ups which can be considered as a reference level of a 'minimal discomfort' medical procedure. We exploratory study whether there are associations between age, anxiety-proneness, gender, medical condition, previous experiences and discomfort. We also describe children's suggestions for reducing discomfort. DESIGN Cross-sectional descriptive study. SETTING Paediatric research at three academic hospitals. PATIENTS 357 children with and without illnesses (8-18 years, mean=10.6 years) were enrolled: 307 from paediatric research studies and 50 from dental care. MAIN OUTCOME MEASURES We measured various generic forms of discomfort (nervousness, annoyance, pain, fright, boredom, tiredness) due to six common research procedures: buccal swabs, MRI scans, pulmonary function tests, skin prick tests, ultrasound imaging and venepunctures. RESULTS Most children reported limited discomfort during the research procedures (means: 1-2.6 on a scale from 1 to 5). Compared with dental check-ups, buccal swab tests, skin prick tests and ultrasound imaging were less discomforting, while MRI scans, venepunctures and pulmonary function tests caused a similar degree of discomfort. 60.3% of the children suggested providing distraction by showing movies to reduce discomfort. The exploratory analyses suggested a positive association between anxiety-proneness and discomfort. CONCLUSIONS The findings of this study support the acceptability of participation of children in the studied research procedures, which stimulates evidence-based research practice. Furthermore, the present study can be considered as a first step in providing benchmarks for discomfort of procedures in paediatric research.
Collapse
Affiliation(s)
- Mira S Staphorst
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus University Medical Centre, Rotterdam, The Netherlands
- Department of Paediatrics, Emma Children's Hospital, Academic Medical Center (AMC), Amsterdam, The Netherlands
| | - Marc A Benninga
- Department of Paediatrics, Emma Children's Hospital, Academic Medical Center (AMC), Amsterdam, The Netherlands
| | - Margriet Bisschoff
- Departments of Paediatrics and Child Psychiatry, Sophia Children's Hospital, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Irma Bon
- Department of Paediatrics, VU University Medical Center (VUmc), Amsterdam, The Netherlands
| | - Jan J V Busschbach
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Kay Diederen
- Department of Paediatrics, Emma Children's Hospital, Academic Medical Center (AMC), Amsterdam, The Netherlands
| | - Johannes B van Goudoever
- Department of Paediatrics, Emma Children's Hospital, Academic Medical Center (AMC), Amsterdam, The Netherlands
- Department of Paediatrics, VU University Medical Center (VUmc), Amsterdam, The Netherlands
| | - Eric G Haarman
- Department of Paediatrics, VU University Medical Center (VUmc), Amsterdam, The Netherlands
| | - Joke A M Hunfeld
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Vincent V W Jaddoe
- Departments of Paediatrics and Child Psychiatry, Sophia Children's Hospital, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Karin J M de Jong
- Department of Pedodontology, Academic Center Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Johan C de Jongste
- Departments of Paediatrics and Child Psychiatry, Sophia Children's Hospital, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Angelika Kindermann
- Department of Paediatrics, Emma Children's Hospital, Academic Medical Center (AMC), Amsterdam, The Netherlands
| | - Marsh Königs
- Section of Clinical Neuropsychology, VU University, Amsterdam, The Netherlands
| | - Jaap Oosterlaan
- Section of Clinical Neuropsychology, VU University, Amsterdam, The Netherlands
| | - Jan Passchier
- Department of Clinical Psychology/EMGO+, VU University, Amsterdam, The Netherlands
| | - Mariëlle W Pijnenburg
- Departments of Paediatrics and Child Psychiatry, Sophia Children's Hospital, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Liesbeth Reneman
- Department of Paediatrics, Emma Children's Hospital, Academic Medical Center (AMC), Amsterdam, The Netherlands
| | - Lissy de Ridder
- Departments of Paediatrics and Child Psychiatry, Sophia Children's Hospital, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Hyke G Tamminga
- Department of Paediatrics, Emma Children's Hospital, Academic Medical Center (AMC), Amsterdam, The Netherlands
| | - Henning W Tiemeier
- Departments of Paediatrics and Child Psychiatry, Sophia Children's Hospital, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Reinier Timman
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Suzanne van de Vathorst
- Department of Ethics and Philosophy, Erasmus University Medical Centre, Rotterdam, The Netherlands
| |
Collapse
|
35
|
Lange AMC, van der Rijken REA, Busschbach JJV, Delsing MJMH, Scholte RHJ. It's not just the Therapist: Therapist and Country-Wide Experience Predict Therapist Adherence and Adolescent Outcome. Child Youth Care Forum 2017; 46:455-471. [PMID: 28680257 PMCID: PMC5487707 DOI: 10.1007/s10566-016-9388-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Objective Therapist adherence is a quality indicator in routine clinical care when evaluating the success of the implementation of an intervention. The current study investigated whether therapist adherence mediates the association between therapist, team, and country-wide experience (i.e. number of years since implementation in the country) on the one hand, and treatment outcome on the other hand. We replicated and extended a study by Löfholm et al. (2014). Method Data over a 10-year period were obtained from 4290 adolescents (12–17 years) with antisocial or delinquent problem behavior, who were treated with Multisystemic Therapy (MST) by 222 therapists, working in 27 different teams in the Netherlands. Multilevel structural equation modeling was used to assess the associations between experience, therapist adherence, and post-treatment outcomes. Results Treatment outcomes were directly predicted by therapist experience, countrywide experience, and therapist adherence, but not by team experience. Moreover, therapist adherence mediated the association between therapist and country-wide experience, and treatment outcomes. The association between therapist experience and therapist adherence was not affected by the number of years of team experience or country-wide experience. Conclusion The effect of country-wide experience on outcome may reflect increasing experience of training and supporting the therapists. It suggests that nation-wide quality control may relate to better therapist adherence and treatment outcome for adolescents treated with systemic therapy.
Collapse
Affiliation(s)
- Aurelie M C Lange
- Viersprong Institute for Studies on Personality Disorders, Kooikersweg 203 C, 5223 KE 's Hertogenbosch, The Netherlands.,Department of Psychiatry, Section of Medical Psychology & Psychotherapy, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Rachel E A van der Rijken
- Viersprong Institute for Studies on Personality Disorders, Kooikersweg 203 C, 5223 KE 's Hertogenbosch, The Netherlands.,MST-Netherlands, Zevenbergen, The Netherlands
| | - Jan J V Busschbach
- Viersprong Institute for Studies on Personality Disorders, Kooikersweg 203 C, 5223 KE 's Hertogenbosch, The Netherlands.,Department of Psychiatry, Section of Medical Psychology & Psychotherapy, Erasmus Medical Center, Rotterdam, The Netherlands
| | | | - Ron H J Scholte
- Viersprong Institute for Studies on Personality Disorders, Kooikersweg 203 C, 5223 KE 's Hertogenbosch, The Netherlands.,Developmental Psychopathology, Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands.,Praktikon, Nijmegen, The Netherlands
| |
Collapse
|
36
|
Visser MS, Dieleman M, Klijn S, Timman R, Lundström M, Busschbach JJV, Reus NJ. Validation, test-retest reliability and norm scores for the Dutch Catquest-9SF. Acta Ophthalmol 2017; 95:312-319. [PMID: 27775237 DOI: 10.1111/aos.13287] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Accepted: 09/13/2016] [Indexed: 11/26/2022]
Abstract
PURPOSE The Catquest-9SF questionnaire is a unidimensional, reliable, valid and short patient-reported outcome measure for quantifying benefits in visual functioning from cataract surgery. Our aim was to develop a formal Dutch translation, calculate norm scores, assess its validity and test-retest reliability and provide an easy way for use in clinical practice. METHODS Translation of the questionnaire was performed according to guidelines of the International Society for Pharmacoeconomics and Outcomes Research. Catquest-9SF was obtained in 657 patients pre- and postcataract surgery. We applied Rasch and classical analyses to determine the questionnaire performance with characteristics such as unidimensionality, reliability, separation and differential item functioning. Test-retest reliability was assessed in another group of 145 patients. A cut-off value to discriminate between people with and without cataract, norm scores and a reliable change index (RCI) were calculated using data from a sample of 916 'healthy' persons from the normal population. RESULTS The Dutch Catquest-9SF was unidimensional, and both person and item reliability were high; 0.87 and 0.99, respectively. Cronbach's alpha was 0.94, test-retest reliability was 0.85 and the intraclass correlation coefficient was 0.93. Catquest-9SF showed to be responsive to the effect of cataract surgery (effect size = 1.27; p < 0.001). The cut-off value was -1.90, and RCI was 2.27. A quick-access table with norm scores and percentiles was established to facilitate clinical interpretation. CONCLUSION This investigation provides validity and reliability of the Dutch Catquest-9SF as well as norm scores and a new tool to facilitate the clinical interpretation of patient scores. This makes Catquest-9SF suitable for routine use in clinical practice.
Collapse
Affiliation(s)
- Martijn S. Visser
- Department of Psychiatry; Section of Medical Psychology and Psychotherapy; Erasmus Medical Center; Rotterdam The Netherlands
- Rotterdam Ophthalmic Institute; Rotterdam The Netherlands
| | | | - Stijn Klijn
- Rotterdam Ophthalmic Institute; Rotterdam The Netherlands
| | - Reinier Timman
- Department of Psychiatry; Section of Medical Psychology and Psychotherapy; Erasmus Medical Center; Rotterdam The Netherlands
| | - Mats Lundström
- Department of Clinical Sciences, Ophthalmology; Faculty of Medicine; Lund University; Lund Sweden
| | - Jan J. V. Busschbach
- Department of Psychiatry; Section of Medical Psychology and Psychotherapy; Erasmus Medical Center; Rotterdam The Netherlands
| | - Nicolaas J. Reus
- The Rotterdam Eye Hospital; Rotterdam The Netherlands
- Department of Ophthalmology; Amphia Hospital; Breda The Netherlands
| |
Collapse
|
37
|
Ramos-Goñi JM, Oppe M, Slaap B, Busschbach JJV, Stolk E. Quality Control Process for EQ-5D-5L Valuation Studies. Value Health 2017; 20:466-473. [PMID: 28292492 DOI: 10.1016/j.jval.2016.10.012] [Citation(s) in RCA: 112] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 10/07/2016] [Accepted: 10/16/2016] [Indexed: 05/21/2023]
Abstract
BACKGROUND The values of the five-level EuroQol five-dimensional questionnaire (EQ-5D-5L) are elicited using composite time trade-off and discrete choice experiments. Unfortunately, data quality issues and interviewer effects were observed in the first few EQ-5D-5L valuation studies. To prevent these issues from occurring in later studies, the EuroQol Group established a cyclic quality control (QC) process. OBJECTIVES To describe this QC process and show its impact on data quality. METHODS A newly developed QC tool provided information about protocol compliance, interviewer effects, and mean values by health state severity. In a cyclic process, this information is initially used to evaluate whether new interviewers meet minimal quality requirements and later to provide feedback about how their performance may be improved. To investigate the impact of this cyclic process, we compared the quality of the data in Dutch and Spanish valuation studies that did not have this QC process with that in the follow-up studies in the same countries that used the QC process. Data quality was measured using protocol violations, variability between interviewers, the proportion of inconsistent responders, and clustering of composite time trade-off values. RESULTS In Spain, protocol violations were reduced from 87% in the valuation study to 5% in the follow-up study and in the Netherlands from 20% to 8%. In both countries, interviewers performed more homogeneously in the follow-up studies. The number of inconsistent respondents was reduced by 23.2% in Spain and 23.6% in the Netherlands. Values were less clustered in the follow-up studies. CONCLUSIONS The implementation of a strict QC process in EQ-5D-5L valuation studies increases interviewer protocol compliance and promotes data quality.
Collapse
Affiliation(s)
- Juan M Ramos-Goñi
- Executive Office, EuroQol Research Foundation, Rotterdam, The Netherlands.
| | - Mark Oppe
- Executive Office, EuroQol Research Foundation, Rotterdam, The Netherlands
| | - Bernhard Slaap
- Executive Office, EuroQol Research Foundation, Rotterdam, The Netherlands
| | - Jan J V Busschbach
- Section of Medical Psychology, Department of Psychiatry, Erasmus MC, Rotterdam, The Netherlands
| | - Elly Stolk
- Executive Office, EuroQol Research Foundation, Rotterdam, The Netherlands; Institute for Health Policy and Management, Erasmus University, Rotterdam, The Netherlands
| |
Collapse
|
38
|
Bijlard E, Kouwenberg CAE, Timman R, Hovius SER, Busschbach JJV, Mureau MAM. Burden of Keloid Disease: A Cross-sectional Health-related Quality of Life Assessment. Acta Derm Venereol 2017; 97:225-229. [PMID: 27378582 DOI: 10.2340/00015555-2498] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Keloid scars may be painful, itch severely and be cosmetically disturbing. The burden of keloid disease, however, has not yet been determined. This study evaluated the association of keloid disease with health-related quality of life (HRQL) and identified indicators of burden using a cross-sectional survey study, with one disease-specific HRQL measure (Skindex-29) and 2 generic HRQL measures (SF-36 and EQ-5D-5L). A total of 106 keloid patients with no other skin diseases participated in the study. Having keloid disease was associated with a considerable impairment of emotional wellbeing, with most impairment on the emotional and mental HRQL. Pain and itch were the strongest indicators of HRQL impairment in keloid patients. Having painful or itchy keloids was related to low mental and emotional HRQL, implying that patients with keloids require access to effective treatment aimed at alleviating physical symptoms.
Collapse
Affiliation(s)
- Eveline Bijlard
- Department of Plastic and Reconstructive Surgery, Erasmus MC, University Medical Center Rotterdam, 3015CN Rotterdam, The Netherlands.
| | | | | | | | | | | |
Collapse
|
39
|
de Vries ACQ, Thio HB, de Kort WJA, Opmeer BC, van der Stok HM, de Jong EMGJ, Horvath B, Busschbach JJV, Nijsten TEC, Spuls PI. A prospective randomized controlled trial comparing infliximab and etanercept in patients with moderate-to-severe chronic plaque-type psoriasis: the Psoriasis Infliximab vs. Etanercept Comparison Evaluation (PIECE) study. Br J Dermatol 2017; 176:624-633. [PMID: 27416891 DOI: 10.1111/bjd.14867] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2016] [Indexed: 12/14/2022]
Abstract
BACKGROUND There are currently no independent data available comparing infliximab and etanercept for the treatment of psoriasis. OBJECTIVES To compare these biologics without funding from pharmaceutical companies. METHODS Overall, 50 patients were randomized to etanercept (n = 23) 50 mg subcutaneously twice weekly or infliximab (n = 25) 5 mg kg-1 intravenously at week 0, 2, 6, 14 and 22. After 24 weeks, 19 patients stopped and 22 continued treatment and were followed up to week 48. The primary outcome was ≥ 75% improvement of Psoriasis Area and Severity Index (PASI 75) at week 24. The secondary outcomes included PASI 75 at week 6 (onset of action) and week 12, Investigator's Global Assessment (IGA), Patient Global Assessment, impact on quality of life (Skindex-17 and SF-36), Treatment Satisfaction Questionnaire of Medication, duration of remission, maintenance treatment and safety. RESULTS At week 24, PASI 75 was achieved in 72% (infliximab) vs. 35% (etanercept) (P = 0·01). The onset of action was achieved in 52% (infliximab) and 4% (etanercept). At week 12, 76% (infliximab) and 22% (etanercept) achieved PASI 75 (P < 0·001). At week 24, IGA 'clear or almost clear' was observed in 76% (infliximab) and 30% (etanercept) (P = 0·01). Skindex-17 symptom score was significantly better for infliximab. Maintenance treatment achieved PASI 75 for 67% (n = 6) infliximab vs. 50% (n = 5) etanercept, at week 48 (P = 0·65). Mild adverse events were reported in 76% (infliximab) vs. 66% (etanercept). CONCLUSIONS Infliximab showed a rapid and significant higher level of efficacy until week 24 compared with etanercept. Long-term data showed no significant differences between both groups at week 48. Safety parameters were comparable.
Collapse
Affiliation(s)
- A C Q de Vries
- Department of Dermatology, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands
| | - H B Thio
- Department of Dermatology, Erasmus Medical Center, 3015 CA, Rotterdam, the Netherlands
| | - W J A de Kort
- Department of Dermatology, Amphia Hospital, Molengracht 21, 4818 CK, Breda, the Netherlands
| | - B C Opmeer
- Clinical Research Unit, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands
| | - H M van der Stok
- Department of Dermatology, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands
| | - E M G J de Jong
- Department of Dermatology, UMC St Radboud, René Descartesdreef 1, 6525 GL, Nijmegen, the Netherlands
| | - B Horvath
- Department of Dermatology, UMC Groningen, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands
| | - J J V Busschbach
- Medical Psychology and Psychotherapy Section, Erasmus Medical Center, 3015 CA, Rotterdam, the Netherlands
| | - T E C Nijsten
- Department of Dermatology, Erasmus Medical Center, 3015 CA, Rotterdam, the Netherlands
| | - Ph I Spuls
- Department of Dermatology, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands
| |
Collapse
|
40
|
Pasma A, Hazes JMW, Busschbach JJV, van der Laan WH, Appels C, de Man YA, Nieboer D, Timman R, van 't Spijker A. Psychosocial predictors of DMARD adherence in the first three months of treatment for early arthritis. Patient Educ Couns 2017; 100:126-132. [PMID: 27516438 DOI: 10.1016/j.pec.2016.07.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 06/20/2016] [Accepted: 07/13/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVES To induce disease remission, early arthritis patients should adhere to their disease-modifying antirheumatic drugs (DMARD) in the first months after diagnosis. It remains unknown why some patients are non-adherent. We aimed to identify patients at risk for non-adherence in the first 3 months of treatment. METHODS Adult DMARD-naive early arthritis patients starting synthetic DMARDs filled out items on potential adherence predictors at baseline. Adherence was measured continuously. Non-adherence was defined as not opening the electronically monitored pill bottle when it should have been. Items were reduced and clustered using principal component analysis. The most discriminating items were identified with latent trait models. We used a multivariable logistic regression model to find non-adherence predictors. RESULTS 301 patients agreed to participate. Adherence was high and declined over time. Principal component analysis led to 7 dimensions, while subsequent latent trait models analyses led to 15 dimensions. Two dimensions were associated with adherence, one dimension was associated with non-adherence. CONCLUSIONS Information seeking behavior and positive expectations about the course of the disease are associated with adherence. Patients who become passive because of pain are at risk for non-adherence. PRACTICE IMPLICATIONS Rheumatologists have cues to identify non-adherence, and may intervene on non-adherence through implementing shared decision making techniques.
Collapse
Affiliation(s)
- Annelieke Pasma
- Department of Rheumatology, Erasmus MC, University Medical Center Rotterdam, the Netherlands; Department of Psychiatry, section Medical Psychology and Psychotherapy, Erasmus MC, University Medical Center Rotterdam, the Netherlands.
| | - Johanna M W Hazes
- Department of Rheumatology, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Jan J V Busschbach
- Department of Psychiatry, section Medical Psychology and Psychotherapy, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | | | | | - Yaël A de Man
- Department of Rheumatology, Sint Antonius hospital, Nieuwegein, the Netherlands
| | - Daan Nieboer
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Reinier Timman
- Department of Psychiatry, section Medical Psychology and Psychotherapy, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Adriaan van 't Spijker
- Department of Psychiatry, section Medical Psychology and Psychotherapy, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| |
Collapse
|
41
|
Purba FD, Hunfeld JAM, Iskandarsyah A, Fitriana TS, Sadarjoen SS, Passchier J, Busschbach JJV. Employing quality control and feedback to the EQ-5D-5L valuation protocol to improve the quality of data collection. Qual Life Res 2016; 26:1197-1208. [PMID: 27796774 PMCID: PMC5376385 DOI: 10.1007/s11136-016-1445-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2016] [Indexed: 11/30/2022]
Abstract
Objectives In valuing health states using generic questionnaires such as EQ-5D, there are unrevealed issues with the quality of the data collection. The aims were to describe the problems encountered during valuation and to evaluate a quality control report and subsequent retraining of interviewers in improving this valuation. Methods Data from the first 266 respondents in an EQ-5D-5L valuation study were used. Interviewers were trained and answered questions regarding problems during these initial interviews. Thematic analysis was used, and individual feedback was provided. After completion of 98 interviews, a first quantitative quality control (QC) report was generated, followed by a 1-day retraining program. Subsequently individual feedback was also given on the basis of follow-up QCs. The Wilcoxon signed-rank test was used to assess improvements based on 7 indicators of quality as identified in the first QC and the QC conducted after a further 168 interviews. Results Interviewers encountered problems in recruiting respondents. Solutions provided were: optimization of the time of interview, the use of broader networks and the use of different scripts to explain the project’s goals to respondents. For problems in interviewing process, solutions applied were: developing the technical and personal skills of the interviewers and stimulating the respondents’ thought processes. There were also technical problems related to hardware, software and internet connections. There was an improvement in all 7 indicators of quality after the second QC. Conclusion Training before and during a study, and individual feedback on the basis of a quantitative QC, can increase the validity of values obtained from generic questionnaires.
Collapse
Affiliation(s)
- Fredrick Dermawan Purba
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC University Medical Center Rotterdam, s-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands. .,Department of Developmental Psychology, Faculty of Psychology, Padjadjaran University, Jatinangor, Indonesia.
| | - Joke A M Hunfeld
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC University Medical Center Rotterdam, s-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands
| | - Aulia Iskandarsyah
- Department of Clinical Psychology, Faculty of Psychology, Padjadjaran University, Jatinangor, Indonesia
| | - Titi Sahidah Fitriana
- Center of Applied Psychometrics, Faculty of Psychology, YARSI University, Jakarta, Indonesia
| | - Sawitri S Sadarjoen
- Department of Clinical Psychology, Faculty of Psychology, Padjadjaran University, Jatinangor, Indonesia
| | - Jan Passchier
- Department of Clinical Psychology, VU University, Amsterdam, The Netherlands
| | - Jan J V Busschbach
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC University Medical Center Rotterdam, s-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands
| |
Collapse
|
42
|
Laurenssen EMP, Eeren HV, Kikkert MJ, Peen J, Westra D, Dekker JJM, Busschbach JJV. The burden of disease in patients eligible for mentalization-based treatment (MBT): quality of life and costs. Health Qual Life Outcomes 2016; 14:145. [PMID: 27733207 PMCID: PMC5062911 DOI: 10.1186/s12955-016-0538-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 09/09/2016] [Indexed: 11/28/2022] Open
Abstract
Background Mentalization-Based Treatment (MBT) is a promising, though expensive treatment for severely ill patients with Borderline Personality Disorder (BPD). A high burden of disease in terms of quality of life (QoL) and life years lost can be a reason to prioritize mental health interventions, and specifically for BPD patients. Moreover, when the societal costs of the illness are high, spending resources on high treatment costs would be more easily legitimized. Therefore, the purpose of this study was to calculate the burden of disease of BPD patients eligible for MBT. Methods The 403 patients included in this study were recruited from two mental health care institutes in the Netherlands. All patients were eligible for MBT. Burden of disease consisted of QoL, measured with the EuroQol EQ-5D-3L, and costs, calculated using the Trimbos and Institute for Medical Technology Assessment Questionnaire for Costs Associated with Psychiatric Illness. Results The mean QoL index score was .48. The mean total costs in the year prior to treatment were €16,879 per patient, of which 21 % consisted of productivity costs. Conclusions The burden of disease in BPD patients eligible for MBT is high, which makes it more likely that society is willing to invest in treatment for these patients. However, this finding should not be interpreted as a license to unlimitedly use resources to reimburse treatment for severe BPD patients, as these findings do not provide any information on the effectiveness of MBT or other available treatment programs for BPD. The effectiveness of available treatments should be evident by studies on the effectiveness of the treatment itself and by comparing the effectiveness of these treatments to treatment as usual and to other treatment options for BPD patients. Trial registration The data on this paper came from two trials: NTR2175 and NTR2292.
Collapse
Affiliation(s)
- Elisabeth M P Laurenssen
- Viersprong Institute for Studies on Personality Disorders (VISPD), Halsteren, The Netherlands. .,Arkin, Amsterdam, The Netherlands.
| | - Hester V Eeren
- Viersprong Institute for Studies on Personality Disorders (VISPD), Halsteren, The Netherlands
| | | | | | | | - Jack J M Dekker
- Arkin, Amsterdam, The Netherlands.,Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands
| | - Jan J V Busschbach
- Viersprong Institute for Studies on Personality Disorders (VISPD), Halsteren, The Netherlands.,Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC, Rotterdam, The Netherlands
| |
Collapse
|
43
|
Lange AMC, Scholte RHJ, van Geffen W, Timman R, Busschbach JJV, van der Rijken REA. The Lack of Cross-National Equivalence of a Therapist Adherence Measure (TAM-R) in Multisystemic Therapy (MST). European Journal of Psychological Assessment 2016. [DOI: 10.1027/1015-5759/a000262] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. This two-study report investigates the equivalence of the Dutch Therapist Adherence Measure Revised (TAM-R) to the US original. The TAM-R is a questionnaire measuring therapist adherence to the treatment model of Multisystemic Therapy (MST). Monitoring of therapist adherence is essential for evidence-based interventions to ensure the quality of the delivered treatment. International implementation of the TAM-R assumes cross-national equivalence, even though this assumption has never been investigated. In study 1 Rasch analysis was applied to 1,875 Dutch TAM-R reports and the response category frequency distributions of the items of 1,875 US TAM-R reports. Response frequencies were more heavily skewed in the US compared to the Netherlands and several items showed Differential Item Functioning (DIF). Study 2 investigated whether adaptations to the translation of the items and response categories could improve equivalence. For this purpose, 237 families were randomly allocated to 1 of 3 versions (original TAM-R, adapted items only, adapted items and response categories) and the analyses from study 1 were replicated. Results indicated that equivalence was not improved by the adapted translations. The article concludes with a discussion of several potential other sources of bias, such as differences in sample characteristics, implementation of MST, and response styles.
Collapse
Affiliation(s)
- Aurelie M. C. Lange
- Viersprong Institute for Studies on Personality Disorders, Halsteren, The Netherlands
- Department of Psychiatry, Section of Medical Psychology & Psychotherapy, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Ron H. J. Scholte
- Viersprong Institute for Studies on Personality Disorders, Halsteren, The Netherlands
- Developmental Psychopathology, Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands
| | | | - Reinier Timman
- Viersprong Institute for Studies on Personality Disorders, Halsteren, The Netherlands
- Department of Psychiatry, Section of Medical Psychology & Psychotherapy, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Jan J. V. Busschbach
- Viersprong Institute for Studies on Personality Disorders, Halsteren, The Netherlands
- Department of Psychiatry, Section of Medical Psychology & Psychotherapy, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Rachel E. A. van der Rijken
- Viersprong Institute for Studies on Personality Disorders, Halsteren, The Netherlands
- MST-Netherlands, Zevenbergen, The Netherlands
| |
Collapse
|
44
|
Klitsie PJ, ten Brinke B, Timman R, Busschbach JJV, Theeuwes HP, Lange JF, Kleinrensink GJ. Training for endoscopic surgical procedures should be performed in the dissection room: a randomized study. Surg Endosc 2016; 31:1754-1759. [DOI: 10.1007/s00464-016-5168-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 07/30/2016] [Indexed: 10/21/2022]
|
45
|
Eijk ESV, Busschbach JJV, Timman R, Monteban HC, Vissers JMH, van Meurs JC. What made you wait so long? Delays in presentation of retinal detachment: knowledge is related to an attached macula. Acta Ophthalmol 2016; 94:434-40. [PMID: 27008986 DOI: 10.1111/aos.13016] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 01/14/2016] [Indexed: 11/27/2022]
Abstract
PURPOSE In rhegmatogenous retinal detachment, the time between first symptoms and reattachment surgery is critical to prevent macular detachment. We explored which determinants discriminate between 'macula-ON' and 'macula-OFF' retinal detachments to improve timely treatment. METHODS Eight-hundred patients with rhegmatogenous retinal detachment admitted for surgery at the Rotterdam Eye Hospital in the Netherlands were eligible to complete a questionnaire to explore the following determinants: (i) patient's delay and doctor's delay; (ii) patient-reported causes for delay; (iii) symptoms as early warning signals; (iv) patient's prior knowledge about retinal detachment; and (v) trait anxiety. RESULTS Five hundred and twenty-one questionnaires (65%) were analysed. Median interval between first symptoms and surgery was 14 days. Macula-ON/OFF ratio was 46/54. Patient's delay in macula-ON patients (median 3 days) was shorter than in macula-OFF (5 days, p = 0.026). No difference was found in doctor's delay except for 'waiting time for surgery': macula-ON patients were operated on faster (median 1 day) than macula-OFF (median 5 days, p < 0.001). Macula-ON patients more often attributed symptoms to retinal problems. Except floaters, no symptoms were determined as early warning signals for macula-ON. Macula-ON patients more often reported knowing that prognosis would be worse when treated later, even when controlled for previous experience with retinal detachment. CONCLUSION Macula-ON patients seem to self-refer faster to a healthcare provider, seem more sensitive to floaters and seem more informed. This suggests that increasing awareness, especially about floaters, might increase the proportion of patients with macula still on at the moment of referral to the ophthalmologist.
Collapse
Affiliation(s)
- Eva S. V. Eijk
- Rotterdam Ophthalmic Institute; Rotterdam The Netherlands
- Department of Psychiatry; Section of Medical Psychology & Psychotherapy; Erasmus MC; Rotterdam The Netherlands
| | - Jan J. V. Busschbach
- Department of Psychiatry; Section of Medical Psychology & Psychotherapy; Erasmus MC; Rotterdam The Netherlands
| | - Reinier Timman
- Department of Psychiatry; Section of Medical Psychology & Psychotherapy; Erasmus MC; Rotterdam The Netherlands
| | | | - Jan M. H. Vissers
- Institute of Health Policy & Management; Erasmus University Rotterdam; Rotterdam The Netherlands
| | - Jan C. van Meurs
- Rotterdam Eye Hospital; Rotterdam The Netherlands
- Department of Ophthalmology; Erasmus MC; Rotterdam The Netherlands
| |
Collapse
|
46
|
Horn EK, Verheul R, Thunnissen M, Delimon J, Goorden M, Hakkaart-van Roijen L, Soons M, Meerman AMMA, Ziegler UM, Rossum BV, Stijnen T, Emmelkamp PMG, Busschbach JJV. Cost-Effectiveness of Short-Term Inpatient Psychotherapy Based on Transactional Analysis in Patients With Personality Disorder. J Pers Disord 2016; 30:483-501. [PMID: 26305396 DOI: 10.1521/pedi_2015_29_210] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Short-term inpatient psychotherapy based on transactional analysis (STIP-TA) in patients with personality disorders (PD) has shown to be more effective than comparable other specialized psychotherapies (OP). The aim of this study was to assess whether the higher effectiveness of STIP-TA also results in a better cost-effectiveness. Patients treated with STIP-TA were matched with patients treated with OP by the propensity score. Healthcare costs and lost productivity costs were measured over 3 years and from the societal perspective. Cost-effectiveness was represented by costs per quality adjusted life years (QALYs). Uncertainty was assessed using bootstrapping. Mean 3-year costs were €59,834 for STIP-TA and €69,337 for OP, a difference of -€9,503, 95% CI [-32,561, 15,726]. QALYs were 2.29 for STIP-TA and 2.05 for OP, a difference of .24, 95% CI [.05, .44]. STIP-TA is a dominant treatment compared to OP: less costly and more effective. We conclude that STIP-TA is a cost-effective treatment in PD patients.
Collapse
Affiliation(s)
- Eva K Horn
- Viersprong Institute for Studies on Personality Disorders (VISPD), Bergen op Zoom, The Netherlands.,Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC, Rotterdam, The Netherlands
| | - Roel Verheul
- Viersprong Institute for Studies on Personality Disorders (VISPD), Bergen op Zoom, The Netherlands.,Department of Clinical Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Moniek Thunnissen
- GGZ WNB, Bergen op Zoom, The Netherlands.,Private Practice, Bergen op Zoom, The Netherlands
| | - Jos Delimon
- Viersprong Institute for Studies on Personality Disorders (VISPD), Bergen op Zoom, The Netherlands
| | - Maartje Goorden
- Institute for Medical Technology Assessment (iMTA), Erasmus University, Rotterdam, The Netherlands
| | | | | | | | | | | | - Theo Stijnen
- Department of Medical Statistics and Bioinformatics, Leiden University Medical Centre, Leiden, The Netherlands
| | - Paul M G Emmelkamp
- Department of Clinical Psychology, University of Amsterdam, Amsterdam, The Netherlands.,The Center for Social and Humanities Research, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Jan J V Busschbach
- Viersprong Institute for Studies on Personality Disorders (VISPD), Bergen op Zoom, The Netherlands.,Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC, Rotterdam, The Netherlands
| |
Collapse
|
47
|
Pasma A, den Boer E, van 't Spijker A, Timman R, van den Bemt B, Busschbach JJV, Hazes JMW. Nonadherence to disease modifying antirheumatic drugs in the first year after diagnosis: comparing three adherence measures in early arthritis patients. Rheumatology (Oxford) 2016; 55:1812-9. [PMID: 27354686 DOI: 10.1093/rheumatology/kew247] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES The aim of this study was to compare three measurement methods for non-adherence to DMARDs in early arthritis patients: the Compliance Questionnaire Rheumatology (CQR), the intracellular uptake of MTX in the form of MTX-polyglutamates (MTX-PGs) and electronic measurement with Medication Event Monitoring Systems (MEMS). METHODS DMARD naïve early arthritis patients were included in an ongoing cohort study. MEMS were used to measure adherence continuously, while every 3 months MTX-PGs were collected together with the CQR. The associations between the measures were estimated with Spearman rank correlations. Sensitivity and specificity of the CQR against a MEMS cut-off was compared at 3, 6, 9 and 12 months. The same applied to MTX-PGs against a MEMS cut-off and MTX-PGs against a CQR cut-off. For the association between MEMS, the CQR and MTX-PGs, a multilevel linear regression model was performed with age, gender, weeks of treatment and MTX dosage as covariates. RESULTS We included 206 patients. Non-adherence measured with MEMS varied over time and between DMARDs. The CQR score was not associated with MEMS non-adherence at 3, 9 and 12 months. At 9 months, MTX-PGs was associated with MEMS non-adherence, as well as with the CQR. All correlations were below 0.30. CONCLUSION Associations between the three measures are weak. Explanations are individual differences in the uptake of MTX, and little variance in adherence between patients. Moreover, the measurement domains differ: perceptions (CQR), behaviour (MEMS) and pharmacokinetics (MTX).
Collapse
Affiliation(s)
| | | | - Adriaan van 't Spijker
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus Medical Center, University Medical Center Rotterdam
| | - Reininer Timman
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus Medical Center, University Medical Center Rotterdam
| | - Bart van den Bemt
- Department of Pharmacy, Sint Maartenskliniek, Nijmegen, the Netherlands
| | - Jan J V Busschbach
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus Medical Center, University Medical Center Rotterdam
| | | |
Collapse
|
48
|
Timmerman L, Timman R, Laging M, Zuidema WC, Beck DK, IJzermans JNM, Busschbach JJV, Weimar W, Massey EK. Predicting mental health after living kidney donation: The importance of psychological factors. Br J Health Psychol 2016; 21:533-54. [DOI: 10.1111/bjhp.12184] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Revised: 12/22/2015] [Indexed: 01/06/2023]
Affiliation(s)
- Lotte Timmerman
- Department of Internal Medicine; Section Nephrology & Transplantation; Erasmus Medical Center; Rotterdam The Netherlands
| | - Reinier Timman
- Department of Psychiatry; Section Medical Psychology and Psychotherapy; Erasmus Medical Center; Rotterdam The Netherlands
| | - Mirjam Laging
- Department of Internal Medicine; Section Nephrology & Transplantation; Erasmus Medical Center; Rotterdam The Netherlands
| | - Willij C. Zuidema
- Department of Internal Medicine; Section Nephrology & Transplantation; Erasmus Medical Center; Rotterdam The Netherlands
| | - Denise K. Beck
- Department of Internal Medicine; Section Nephrology & Transplantation; Erasmus Medical Center; Rotterdam The Netherlands
| | - Jan N. M. IJzermans
- Department of General Surgery; Erasmus Medical Center; Rotterdam The Netherlands
| | - Jan J. V. Busschbach
- Department of Psychiatry; Section Medical Psychology and Psychotherapy; Erasmus Medical Center; Rotterdam The Netherlands
| | - Willem Weimar
- Department of Internal Medicine; Section Nephrology & Transplantation; Erasmus Medical Center; Rotterdam The Netherlands
| | - Emma K. Massey
- Department of Internal Medicine; Section Nephrology & Transplantation; Erasmus Medical Center; Rotterdam The Netherlands
| |
Collapse
|
49
|
Timman R, Bouwmans C, Busschbach JJV, Hakkaart-van Roijen L. Development of the Treatment Inventory of Costs in Psychiatric Patients: TIC-P Mini and Midi. Value Health 2015; 18:994-999. [PMID: 26686783 DOI: 10.1016/j.jval.2015.07.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Revised: 07/13/2015] [Accepted: 07/25/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND Medical costs of (psychiatric) illness can be validly measured with patient report questionnaires. These questionnaires comprise many detailed items resulting in lengthy administrations. OBJECTIVES We set out to find the minimal number of items needed to retrieve 80% and 90% of the costs as measured by the Treatment Inventory of Costs in Patients with psychiatric disorders (TIC-P). METHODS The TIC-P is a validated patient-reported outcome measure concerning the utilization of medical care and productivity losses. The present study focused on direct medical costs. We applied data of 7756 TIC-P administrations from three studies in patients with mental health care issues. Items that contribute least to the total cost were eliminated, providing that 80% and 90% of the total cost was retained. RESULTS Average medical costs per patient were €658 over the last 4 weeks. The distribution of cost was highly skewed, and 5 of the 14 items of the TIC-P accounted for less than 10% of the total costs. The 80% Mini version of the TIC-P required five items: ambulatory services, private practice, day care, general hospital, and psychiatric clinic. The TIC-P Midi 90% inventory required eight items. Both had variance between the three samples in the optimal choice of the items. CONCLUSIONS The number of items of the TIC-P can be reduced considerably while maintaining 80% and 90% of the medical costs estimated by the complete TIC-P. The reduced length makes the questionnaire more suitable for routine outcome monitoring.
Collapse
Affiliation(s)
- Reinier Timman
- Department of Psychiatry, Section of Medial Psychology and Psychotherapy, Erasmus University Medical Centre, Rotterdam, The Netherlands; Viersprong Institute for Study on Personality Disorders, Halsteren, The Netherlands.
| | - Clazien Bouwmans
- Institute for Medical Technology Assessment, Erasmus University, Rotterdam, The Netherlands
| | - Jan J V Busschbach
- Department of Psychiatry, Section of Medial Psychology and Psychotherapy, Erasmus University Medical Centre, Rotterdam, The Netherlands; Viersprong Institute for Study on Personality Disorders, Halsteren, The Netherlands
| | | |
Collapse
|
50
|
Pasma A, Schenk CV, Timman R, Busschbach JJV, van den Bemt BJF, Molenaar E, van der Laan WH, Schrauwen S, Van't Spijker A, Hazes JMW. Non-adherence to disease-modifying antirheumatic drugs is associated with higher disease activity in early arthritis patients in the first year of the disease. Arthritis Res Ther 2015; 17:281. [PMID: 26449852 PMCID: PMC4599322 DOI: 10.1186/s13075-015-0801-4] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Accepted: 09/25/2015] [Indexed: 11/30/2022] Open
Abstract
Introduction Non-adherence to disease-modifying antirheumatic drugs (DMARDs) hampers the targets of rheumatoid arthritis (RA) treatment, obtaining low disease activity and decreasing radiological progression. This study investigates if, and to what extent, non-adherence to treatment would lead to a higher 28-joint count disease activity score (DAS28) in the first year after diagnosis. Methods Adult patients from an ongoing cohort study on treatment adherence were selected if they fulfilled the EULAR/ACR2010 criteria for RA, and were to start with their first DMARDs. Clinical variables were assessed at baseline and every 3 months. Non-adherence was continuously electronically measured and was defined as the proportion of days with a negative difference between expected and observed openings of the medication container out of the 3-month period before DAS28 measurement. Generalized linear mixed models were used to investigate whether the DAS28 related to non-adherence. Covariates included were age, sex, baseline DAS28, rheumatoid factor positivity, anti-cyclic citrullinated peptide antibodies (ACPA) positivity, anxiety, depression, weeks of treatment, number of DMARDs used, education level, use of subcutaneous methotrexate and biological use. Results One hundred and twenty patients met the inclusion criteria for RA. During the study period 17 patients became lost to follow-up. There was a decline in adherence over time for all DMARDs except for prednisone. Non-adherence is a predictor of disease activity in the first 6 months of therapy, adjusted for weeks of treatment, baseline DAS28, and baseline anxiety. Conclusions Non-adherence relates to disease activity. Therefore, interventions towards enhancing adherence can improve disease outcome.
Collapse
Affiliation(s)
- Annelieke Pasma
- Department of Rheumatology, Erasmus MC, University Medical Center Rotterdam, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands. .,Department of Psychiatry, section Medical Psychology and Psychotherapy, Erasmus MC, University Medical Center Rotterdam, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.
| | - Charlotte V Schenk
- Department of Rheumatology, Erasmus MC, University Medical Center Rotterdam, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.
| | - Reinier Timman
- Department of Psychiatry, section Medical Psychology and Psychotherapy, Erasmus MC, University Medical Center Rotterdam, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.
| | - Jan J V Busschbach
- Department of Psychiatry, section Medical Psychology and Psychotherapy, Erasmus MC, University Medical Center Rotterdam, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.
| | - Bart J F van den Bemt
- Department of Pharmacy, Sint Maartenskliniek, Hengstdal 3, 6574, NA, Nijmegen, The Netherlands.
| | - Esmeralda Molenaar
- Department of Rheumatology, Groene Hart Hospital, Bleulandweg 10, 2803 HH, Gouda, The Netherlands.
| | - Willemijn H van der Laan
- Department of Rheumatology, Sint Maartenskliniek, Hengstdal 3, 6574 NA, Nijmegen, The Netherlands.
| | - Saskia Schrauwen
- Department of Rheumatology, Sint Franciscus Gasthuis, Kleiweg 500, 3045, PM, Rotterdam, The Netherlands.
| | - Adriaan Van't Spijker
- Department of Psychiatry, section Medical Psychology and Psychotherapy, Erasmus MC, University Medical Center Rotterdam, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.
| | - Johanna M W Hazes
- Department of Rheumatology, Erasmus MC, University Medical Center Rotterdam, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.
| |
Collapse
|