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  1. Article ; Online: An online tool for the calculation and graphical presentation of the NNTnet.

    Coenen, Samuel / Colliers, Annelies

    Journal of clinical epidemiology

    2021  Volume 133, Page(s) 168–169

    Language English
    Publishing date 2021-01-20
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 639306-8
    ISSN 1878-5921 ; 0895-4356
    ISSN (online) 1878-5921
    ISSN 0895-4356
    DOI 10.1016/j.jclinepi.2021.01.005
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    Uh III Zs.206: Show issues Location:
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    ab Jg. 2022: Lesesaal (EG)

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  2. Article ; Online: Impact of the COVID-19 pandemic on community antibiotic consumption in the EU/European Economic Area: a changepoint analysis.

    Vermeulen, Helene / Hens, Niel / Catteau, Lucy / Catry, Boudewijn / Coenen, Samuel

    The Journal of antimicrobial chemotherapy

    2023  Volume 78, Issue 10, Page(s) 2572–2580

    Abstract: Objectives: A decrease in community antibiotic consumption in Europe has been observed during the COVID-19 pandemic. The magnitude of this decrease, how fast after the outbreak it occurred, whether it was sustained during the pandemic and whether the ... ...

    Abstract Objectives: A decrease in community antibiotic consumption in Europe has been observed during the COVID-19 pandemic. The magnitude of this decrease, how fast after the outbreak it occurred, whether it was sustained during the pandemic and whether the seasonal variation in antibiotic consumption was affected, have not yet been evaluated in detail.
    Methods: Data on community antibiotic consumption were available from the European Surveillance of Antimicrobial Consumption Network for 28 EU/European Economic Area (EEA) countries between 2010 and 2021. Antibiotic consumption was expressed as DDDs per 1000 inhabitants per day (DID). The impact of the pandemic on antibiotic consumption was investigated using descriptive statistics and non-linear mixed changepoint models for quarterly and yearly data.
    Results: The decrease in overall antibiotic consumption between 2019 and 2020 (-3.4 DID; -18.6%) was mainly due to a decrease in the consumption of penicillins [Anatomical Therapeutic Chemical (ATC) code J01C] (-1.9 DID; -23.0%), other β-lactam antibacterials (J01D) (-0.6 DID; -25.8%) and macrolides, lincosamides and streptogramins (J01F) (-0.5 DID; -17.4%) and was sustained during 2021. The changepoint analysis of yearly data (28 countries) estimated a decrease of 3.3 DID in overall antibiotic consumption (J01) between 2019 and 2020. The analysis of quarterly data (16 countries) estimated a decrease in overall antibiotic consumption (J01) of 4.0 DID and a decrease in seasonal variation of 1.2 DID between the first and second quarters of 2020.
    Conclusions: The changepoint analysis indicated a significant, sudden and steep decrease in community antibiotic consumption in the EU/EEA immediately after the start of the COVID-19 outbreak in Europe, as well as a decrease in its seasonal variation.
    MeSH term(s) Humans ; Anti-Bacterial Agents/therapeutic use ; Pandemics ; Drug Utilization ; COVID-19/epidemiology ; Streptogramins ; Europe/epidemiology
    Chemical Substances Anti-Bacterial Agents ; Streptogramins
    Language English
    Publishing date 2023-10-03
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 191709-2
    ISSN 1460-2091 ; 0305-7453
    ISSN (online) 1460-2091
    ISSN 0305-7453
    DOI 10.1093/jac/dkad273
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    Zs.A 1197: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)
    Zs.MO 124: Show issues

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  3. Article: Asthma occurrence in children and early life systemic antibiotic use: an incidence density study.

    Bentouhami, Hayat / Bungwa, Milcah Kahkelam / Casas, Lidia / Coenen, Samuel / Weyler, Joost

    Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology

    2023  Volume 19, Issue 1, Page(s) 18

    Abstract: Background: Results of studies evaluating the relationship between asthma occurrence and early life antibiotic use have been conflicting. The aim of this study was to investigate the relationship between occurrence of asthma in children and systemic ... ...

    Abstract Background: Results of studies evaluating the relationship between asthma occurrence and early life antibiotic use have been conflicting. The aim of this study was to investigate the relationship between occurrence of asthma in children and systemic antibiotic use in the first year of life based on an incidence density study with careful consideration of the temporal aspects of the determinant-outcome relationship.
    Methods: We conducted an incidence density study nested in a data collection project with information on 1128 mother-child pairs. Systemic antibiotic use in the first year of life was defined as excessive (≥ 4 courses) vs. non-excessive (< 4 courses) use based on information from weekly diaries. Events (cases) were defined as the first parent-reported occurrence of asthma in a child between 1 and 10 years of age. Population time 'at risk' was probed by sampling population moments (controls). Missing data were imputed. Multiple logistic regression was used to assess the association between current first asthma occurrence (incidence density) and systemic antibiotic use in the first year of life, to evaluate effect modification and adjust for confounding.
    Results: Forty-seven first asthma events and 147 population moments were included. Excessive systemic antibiotic use in the first year of life showed more than twice the incidence density of asthma compared to non-excessive use (adjusted IDR [95% CI]: 2.18 [0.98, 4.87], p = 0.06). The association was more pronounced in children who have had lower respiratory tract infections (LRTIs) in the first year of life compared to children who had no LRTIs in the first year of life (adjusted IDR [95% CI]: 5.17 [1.19, 22.52] versus 1.49 [0.54, 4.14]).
    Conclusions: Excessive use of systemic antibiotics in the first year of life may play a role in the genesis of asthma in children. This effect is modified by the occurrence of LRTIs in the first year of life, with a stronger association observed in children experiencing LRTIs in the first year of life.
    Language English
    Publishing date 2023-03-06
    Publishing country England
    Document type Journal Article
    ZDB-ID 2434973-2
    ISSN 1710-1492 ; 1710-1484
    ISSN (online) 1710-1492
    ISSN 1710-1484
    DOI 10.1186/s13223-023-00773-8
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    Zs.A 6713: Show issues Location:
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    ab Jg. 2022: Lesesaal (EG)

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  4. Article ; Online: Impact of changing reimbursement criteria on the use of fluoroquinolones in Belgium.

    Vermeulen, Helene / Coenen, Samuel / Hens, Niel / Bruyndonckx, Robin

    The Journal of antimicrobial chemotherapy

    2021  Volume 76, Issue 10, Page(s) 2725–2732

    Abstract: Objectives: The criteria for the reimbursement of fluoroquinolones changed in Belgium on 1 May 2018. This study aims to quantify the difference in fluoroquinolone use after this change, and to assess the timing and persistence of this effect, both in ... ...

    Abstract Objectives: The criteria for the reimbursement of fluoroquinolones changed in Belgium on 1 May 2018. This study aims to quantify the difference in fluoroquinolone use after this change, and to assess the timing and persistence of this effect, both in terms of total reimbursed fluoroquinolone use and its relative proportion.
    Methods: Longitudinal reimbursement data on fluoroquinolone use in the Belgian community from January 2017 to November 2018 were analysed to identify a change in reimbursed fluoroquinolone use expressed in DDD per 1000 inhabitants per day (DID), using a set of non-linear mixed models including change-points. In addition, longitudinal data on the relative proportion of prescribed fluoroquinolones from January 2017 to December 2018 were analysed to identify a change in the relative proportion of prescribed fluoroquinolones using generalized estimation equations including change-points.
    Results: Fluoroquinolone use dropped significantly immediately after the change in reimbursement criteria, from 2.21 DID (95% CI: 2.03-2.38) to 0.52 DID (95% CI: 0.48-0.56) and from 9.14% (95% CI: 8.75%-9.56%) to 6.52% (95% CI: 6.04%-7.04%). The observed decrease in fluoroquinolone use persisted over time.
    Conclusions: While fluoroquinolone use was still above the target of 5% after the change in reimbursement criteria, its implementation helped to lower fluoroquinolone use in Belgium.
    MeSH term(s) Anti-Bacterial Agents/therapeutic use ; Belgium ; Fluoroquinolones/therapeutic use
    Chemical Substances Anti-Bacterial Agents ; Fluoroquinolones
    Language English
    Publishing date 2021-08-10
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 191709-2
    ISSN 1460-2091 ; 0305-7453
    ISSN (online) 1460-2091
    ISSN 0305-7453
    DOI 10.1093/jac/dkab255
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    Zs.A 1197: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)
    Zs.MO 124: Show issues

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  5. Article ; Online: Infectious diseases in primary care; managing the interface between the person and the community.

    Coenen, Samuel

    The European journal of general practice

    2012  Volume 18, Issue 2, Page(s) 117–121

    Abstract: Respiratory infections are still among the most common new diagnoses in primary care. The most frequent reason for encounter is acute cough. General practitioners have to make antibiotic prescribing decisions in a context of diagnostic uncertainty, ... ...

    Abstract Respiratory infections are still among the most common new diagnoses in primary care. The most frequent reason for encounter is acute cough. General practitioners have to make antibiotic prescribing decisions in a context of diagnostic uncertainty, patient preferences and antimicrobial resistance. There is a causal link between antimicrobial resistance and antibiotic prescribing in primary care. GRACE observational studies (www.grace-lrti.org), show that variation in clinical presentation does not explain the considerable variation in antibiotic prescribing in Europe for adults presenting in primary care with acute cough and that recovery is similar between those treated with any antibiotic, a particular antibiotic class, or no antibiotic. A GRACE randomized controlled trial (RCT) of the effect of antibiotics for acute cough has recruited more patients than all RCTs combined in the current Cochrane Review and will have the power to identify subgroups of patients who will (not) benefit from amoxicillin. Another multi-country GRACE RCT assessing the effect on antibiotic prescribing of largely web-based versions of successful interventions including a C-reactive protein point-of-care test, a communication skill training and an interactive patient booklet is awaited. Given potential long-term cost-effectiveness, the GRACE suite of observational and interventional studies are enhancing the evidence base for reducing diagnostic uncertainty and managing patient expectations in a patient-centred way to achieve greater evidence-based antibiotic prescribing that is likely to help containing antimicrobial resistance.
    MeSH term(s) Acute Disease ; Adult ; Anti-Bacterial Agents/therapeutic use ; Bacterial Infections/diagnosis ; Bacterial Infections/drug therapy ; Bacterial Infections/microbiology ; Communication ; Cough/diagnosis ; Cough/drug therapy ; Cough/etiology ; Drug Resistance, Bacterial ; Europe ; Evidence-Based Medicine ; General Practice/standards ; Humans ; Practice Patterns, Physicians'/standards ; Primary Health Care/standards ; Quality Indicators, Health Care ; Randomized Controlled Trials as Topic ; Respiratory Tract Infections/drug therapy ; Respiratory Tract Infections/microbiology
    Chemical Substances Anti-Bacterial Agents
    Language English
    Publishing date 2012-06
    Publishing country England
    Document type Journal Article
    ZDB-ID 1281338-2
    ISSN 1751-1402 ; 1381-4788
    ISSN (online) 1751-1402
    ISSN 1381-4788
    DOI 10.3109/13814788.2012.680061
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    Zs.A 4343: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  6. Article ; Online: Safety netting advice for respiratory tract infections in out-of-hours primary care: A qualitative analysis of consultation videos.

    Colliers, Annelies / Philips, Hilde / Bombeke, Katrien / Remmen, Roy / Coenen, Samuel / Anthierens, Sibyl

    The European journal of general practice

    2022  Volume 28, Issue 1, Page(s) 87–94

    Abstract: Background: General practitioners (GPs) use safety netting advice to communicate with patients when and how to seek further help when their condition fails to improve or deteriorate. Although many respiratory tract infections (RTI) during out-of-hours ( ... ...

    Abstract Background: General practitioners (GPs) use safety netting advice to communicate with patients when and how to seek further help when their condition fails to improve or deteriorate. Although many respiratory tract infections (RTI) during out-of-hours (OOH) care are self-limiting, often antibiotics are prescribed. Providing safety netting advice could enable GPs to safely withhold an antibiotic prescription by dealing both with their uncertainty and the patients' concerns.
    Objectives: To explore how GPs use safety netting advice during consultations on RTIs in OOH primary care and how this advice is documented in the electronic health record.
    Methods: We analysed video observations of 77 consultations on RTIs from 19 GPs during OOH care using qualitative framework analysis and reviewed the medical records. Videos were collected from August until November 2018 at the Antwerp city GP cooperative, Belgium.
    Results: Safety netting advice on alarm symptoms, expected duration of illness and/or how and when to seek help is often lacking or vague. Communication of safety netting elements is scattered throughout the end phase of the consultation. The advice is seldom recorded in the medical health record. GPs give more safety netting advice when prescribing an antibiotic than when they do not prescribe an antibiotic.
    Conclusion: We provided a better understanding of how safety netting is currently carried out in OOH primary care for RTIs. Safety netting advice during OOH primary care is limited, unspecific and not documented in the medical record.
    MeSH term(s) After-Hours Care ; Anti-Bacterial Agents/therapeutic use ; Electronic Health Records ; Humans ; Practice Patterns, Physicians' ; Primary Health Care ; Referral and Consultation ; Respiratory Tract Infections/drug therapy
    Chemical Substances Anti-Bacterial Agents
    Language English
    Publishing date 2022-05-10
    Publishing country England
    Document type Journal Article
    ZDB-ID 1281338-2
    ISSN 1751-1402 ; 1381-4788
    ISSN (online) 1751-1402
    ISSN 1381-4788
    DOI 10.1080/13814788.2022.2064448
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    Zs.A 4343: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  7. Article ; Online: Improving antibiotic prescribing quality in out-of-hours primary care: a mixed-methods study using participatory action research.

    Colliers, Annelies / Coenen, Samuel / Teughels, Stefan / Boogaerts, Yentry / Vandeput, Olivia / Tans, Anouk / Vermeulen, Helene / Remmen, Roy / Philips, Hilde / Anthierens, Sibyl

    JAC-antimicrobial resistance

    2023  Volume 5, Issue 6, Page(s) dlad131

    Abstract: Background: During out-of-hours (OOH) primary care, GPs overprescribe antibiotics for respiratory tract infections (RTIs). Many interventions have been shown to improve antibiotic prescribing quality, but their implementation in practice remains ... ...

    Abstract Background: During out-of-hours (OOH) primary care, GPs overprescribe antibiotics for respiratory tract infections (RTIs). Many interventions have been shown to improve antibiotic prescribing quality, but their implementation in practice remains difficult. Participatory action research (PAR) aims to explore, implement and evaluate change in practice with an active involvement of local stakeholders, while generating knowledge through experience.
    Objectives: To evaluate whether PAR improves antibiotic prescribing quality for RTIs during OOH primary care and simultaneously identify the pivotal lessons learned.
    Methods: A mixed-methods study with a PAR approach in three OOH GP cooperatives (GPCs). Each GPC co-created a multifaceted intervention focusing on improving antibiotic use for RTIs through plan-do-study-act cycles. We quantified antibiotic prescribing quality indicators and formulated the lessons learned from a qualitative process analysis.
    Results: Interventions were chosen with the GPs and adapted to be context-relevant. The willingness to work on quality and engagement of local stakeholders led to ownership of the project, but was time-consuming. In one GPC, antibiotic prescribing significantly decreased for tonsillitis, bronchitis, otitis media and acute upper RTI. In all three GPCs, use of guideline-recommended antibiotics for otitis media significantly increased.
    Conclusions: Implementing multifaceted interventions through PAR can lower total and increase guideline-recommended antibiotic prescribing for RTIs in OOH primary care. Co-creating interventions with GPs to suit local needs is feasible, but reaching all GPs targeted is challenging.
    Language English
    Publishing date 2023-12-11
    Publishing country England
    Document type Journal Article
    ISSN 2632-1823
    ISSN (online) 2632-1823
    DOI 10.1093/jacamr/dlad131
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  8. Article: Antibiotic Prescribing and Doctor-Patient Communication During Consultations for Respiratory Tract Infections: A Video Observation Study in Out-of-Hours Primary Care.

    Colliers, Annelies / Bombeke, Katrien / Philips, Hilde / Remmen, Roy / Coenen, Samuel / Anthierens, Sibyl

    Frontiers in medicine

    2021  Volume 8, Page(s) 735276

    Abstract: Objective: ...

    Abstract Objective:
    Language English
    Publishing date 2021-12-01
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2775999-4
    ISSN 2296-858X
    ISSN 2296-858X
    DOI 10.3389/fmed.2021.735276
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  9. Article ; Online: The DAWN antivirals trial: process evaluation of a COVID-19 trial in general practice.

    Tare, Dajana / Coenen, Samuel / De Sutter, An / Heytens, Stefan / Devroey, Dirk / Buret, Laetitia / Schoenmakers, Birgitte / Delvaux, Nicolas / Verbakel, Jan Y / Bogaerts, Kris / van den Bruel, Ann

    BJGP open

    2024  

    Abstract: Background: The DAWN antivirals trial was a multicentric, randomised placebo-controlled trial evaluating antiviral medication for COVID-19 in general practice. The trial was prematurely terminated because of insufficient recruitment.: Aim: To explore ...

    Abstract Background: The DAWN antivirals trial was a multicentric, randomised placebo-controlled trial evaluating antiviral medication for COVID-19 in general practice. The trial was prematurely terminated because of insufficient recruitment.
    Aim: To explore which factors contributed to the premature termination.
    Design & setting: General practice in Belgium.
    Method: Patients were randomised to camostat or placebo (patients and physicians blinded) between June 2021 and July 2022; a third arm evaluating molnupiravir (open label) was opened in March 2022. The outcome assessor was blinded for all comparisons except for the patient reported outcomes in case of molnupiravir. The authors analysed available trial data and evaluated trial context, implementation, and mechanisms of impact based on semi-structured interviews with trial stakeholders.
    Results: The trial recruited 44 participants; 19 were allocated to camostat (median age 55 years), 8 to molnupiravir (median age 60 years), and 17 to placebo (median age 56 years). There were no serious adverse events in either group. Most difficulties were related to the pandemic context: disruption to routine clinical services; multiple changes to the service model for COVID-19 patients; overwhelmed clinical staff; delays of trial medication; and staff shortages in the sponsor and clinical team. In addition, regulatory approval processes were lengthy and led to additional study procedures. It was felt that the trial started too late, when vaccinations had already begun.
    Conclusion: The DAWN antivirals trial was stopped prematurely. Although many barriers were related to the pandemic itself, hurdles such as a small and inexperienced sponsor and clinical teams, delays in regulatory processes, and research capacity in routine settings could be overcome by established research infrastructure and standardisation of processes.
    Language English
    Publishing date 2024-04-17
    Publishing country England
    Document type Journal Article
    ISSN 2398-3795
    ISSN (online) 2398-3795
    DOI 10.3399/BJGPO.2023.0109
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  10. Article ; Online: Development and validation of a simplified risk prediction model for preterm birth: a prospective cohort study in rural Ethiopia.

    Kassahun, Eskeziaw Abebe / Gebreyesus, Seifu Hagos / Tesfamariam, Kokeb / Endris, Bilal Shikur / Roro, Meselech Assegid / Getnet, Yalemwork / Hassen, Hamid Yimam / Brusselaers, Nele / Coenen, Samuel

    Scientific reports

    2024  Volume 14, Issue 1, Page(s) 4845

    Abstract: Preterm birth is one of the most common obstetric complications in low- and middle-income countries, where access to advanced diagnostic tests and imaging is limited. Therefore, we developed and validated a simplified risk prediction tool to predict ... ...

    Abstract Preterm birth is one of the most common obstetric complications in low- and middle-income countries, where access to advanced diagnostic tests and imaging is limited. Therefore, we developed and validated a simplified risk prediction tool to predict preterm birth based on easily applicable and routinely collected characteristics of pregnant women in the primary care setting. We used a logistic regression model to develop a model based on the data collected from 481 pregnant women. Model accuracy was evaluated through discrimination (measured by the area under the Receiver Operating Characteristic curve; AUC) and calibration (via calibration graphs and the Hosmer-Lemeshow goodness of fit test). Internal validation was performed using a bootstrapping technique. A simplified risk score was developed, and the cut-off point was determined using the "Youden index" to classify pregnant women into high or low risk for preterm birth. The incidence of preterm birth was 19.5% (95% CI:16.2, 23.3) of pregnancies. The final prediction model incorporated mid-upper arm circumference, gravidity, history of abortion, antenatal care, comorbidity, intimate partner violence, and anemia as predictors of preeclampsia. The AUC of the model was 0.687 (95% CI: 0.62, 0.75). The calibration plot demonstrated a good calibration with a p-value of 0.713 for the Hosmer-Lemeshow goodness of fit test. The model can identify pregnant women at high risk of preterm birth. It is applicable in daily clinical practice and could contribute to the improvement of the health of women and newborns in primary care settings with limited resources. Healthcare providers in rural areas could use this prediction model to improve clinical decision-making and reduce obstetrics complications.
    MeSH term(s) Humans ; Pregnancy ; Female ; Infant, Newborn ; Premature Birth/epidemiology ; Premature Birth/diagnosis ; Prospective Studies ; Ethiopia/epidemiology ; Risk Factors ; Pre-Eclampsia/epidemiology
    Language English
    Publishing date 2024-02-28
    Publishing country England
    Document type Journal Article
    ZDB-ID 2615211-3
    ISSN 2045-2322 ; 2045-2322
    ISSN (online) 2045-2322
    ISSN 2045-2322
    DOI 10.1038/s41598-024-55627-z
    Database MEDical Literature Analysis and Retrieval System OnLINE

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