The perception of patients' rights among Belgian population.

The aim of this study was to explore the knowledge and perception of specific patients' rights and the problems experienced with their fulfilment among the Belgian population. Participants were recruited through patient association groups and health insurance companies. They completed an Internet-based questionnaire with 20 questions concerning patients' rights. In total, 309 persons completed all questions. The mean age of participants was 46 years (SD = 15), 58% of them were women. Participants judged patients' rights concerning the end of life (88%), affordable health care (87%) and information about health status (85%) as the most important issues. Participants particularly showed concern about their legal rights for care offered in the patients' own language (21%), euthanasia (15%) and affordable health care (14%). The most important problems experienced so far were related to care offered in the patients' own language (12%), affordable health care (11%) and access to their medical file (7%).

Influence of methylphenidate treatment assumptions on cognitive function in healthy young adults in a double-blind, placebo-controlled trial.

BACKGROUND: Increasing numbers of students use stimulants such as methylphenidate (MPH) to improve their study capacity, making them prone to subsequent prolonged drug abuse. This study explored the cognitive effects of MPH in students who either assumed they received MPH or assumed they received a placebo. METHODS: In a double-blind, randomized, placebo-controlled trial with a between-subjects design, 21 students were subjected to partial sleep deprivation, receiving no more than 4 hours sleep the night before they were tested. In the morning, they were given either a placebo or 20 mg of MPH. They then performed free recall verbal tests and Go/No-Go tasks repeatedly, their moods were evaluated using Profile of Mood States and their tiredness was assessed using a visual analog scale, with evaluation of vigilance. RESULTS: No significant differences were found between those subjects who received MPH and those who received a placebo. However, significant differences were found between subjects who assumed they had received MPH or had no opinion, and those who assumed they had received a placebo. At three minutes, one hour, and one day after memorizing ten lists of 20 words, those who assumed they had received MPH recalled 54%, 58%, and 54% of the words, respectively, whereas those who assumed they had received placebo only recalled 35%, 37%, and 34%. CONCLUSION: Healthy, partially sleep-deprived young students who assume they have received 20 mg of MPH experience a substantial placebo effect that improves consolidation of information into long-term memory. This is independent of any pharmacologic effects of MPH, which had no significant effects on verbal memory in this study. This information may be used to dissuade students from taking stimulants such as MPH during examination periods, thus avoiding subsequent abuse and addiction.

Lack of confidence in administering emergency care among Dutch-speaking family physicians in Belgium.

BACKGROUND: Practical knowledge of emergency medical care among physicians seems to be insufficient worldwide. Research specifically aimed at family physicians is rather scarce. Additionally, in Belgium there are no data on this subject. PURPOSES: Our aim was to ascertain how confident Belgian family physicians feel about their ability to give adequate emergency care and to examine their assessment of their knowledge of relevant medical conditions. METHODS: We used a web-based questionnaire for which a convenience sample of 974 Dutch-speaking family practitioners was invited through email. The survey assessed how these physicians perceived their own emergency skills and their knowledge of relevant medical conditions. RESULTS: The survey had a recruitment rate of 22% (n = 210), with a 75% completion rate. The minimum criteria formulated pertaining to skills and knowledge were met by 64% and 55% of the participants, respectively. The mean cumulative scores on skills and knowledge were 2.5 and 3.2, respectively (on a scale from 0 to 4). Physicians with additional training in emergency care (3.07 versus 2.72), or with a spirometry certificate (2.94 versus 2.72) scored better than those without. Practitioners from rural areas felt more confident than those from urbanized regions (3.25 versus 3.15). Physicians felt more competent in aspects of emergency care where they had experience. CONCLUSION: Almost half of the Dutch-speaking family physicians in Belgium felt insufficiently competent to offer emergency medical care.

Patient health information materials in waiting rooms of family physicians: do patients care?

BACKGROUND: Patient health information materials (PHIMs), such as leaflets and posters are widely used by family physicians to reinforce or illustrate information, and to remind people of information received previously. This facilitates improved health-related knowledge and self-management by patients. OBJECTIVE: This study assesses the use of PHIMs by patient. It also addresses their perception of the quality and the impact of PHIMs on the interaction with their physician, along with changes in health-related knowledge and self-management. METHODS: QUESTIONNAIRE SURVEY AMONG PATIENTS OF FAMILY PRACTICES OF ONE TOWN IN BELGIUM, ASSESSING: (1) the extent to which patients read PHIMs in waiting rooms (leaflets and posters) and take them home, (2) the patients' perception of the impact of PHIMs on interaction with their physician, their change in health-related knowledge and self-management, and (3) the patients judgment of the quality of PHIMs. RESULTS: We included 903 questionnaires taken from ten practices. Ninety-four percent of respondents stated they read PHIMs (leaflets), 45% took the leaflets home, and 78% indicated they understood the content of the leaflets. Nineteen percent of respondents reportedly discussed the content of the leaflets with their physician and 26% indicated that leaflets allowed them to ask fewer questions of their physician. Thirty-four percent indicated that leaflets had previously helped them to improve their health-related knowledge and self-management. Forty-two percent reportedly discussed the content of the leaflets with others. Patient characteristics are of significant influence on the perceived impact of PHIMS in physician interaction, health-related knowledge, and self-management. CONCLUSION: This study suggests that patients value health information materials in the waiting rooms of family physicians and that they perceive such materials as being helpful in improving patient-physician interaction, health-related knowledge, and self-management.

The Gay Men Sex Studies: prevalence of sexual dysfunctions in Belgian HIV(+) gay men.

The aim of this Internet-based survey was to investigate the prevalence and associated predictors of sexual dysfunctions in Belgian self-reported HIV-positive men who have sex with other men. Of the 72 participants, 56% had a mild-to-severe erectile dysfunction, and 15% reported a hypoactive sexual desire disorder. The prevalence of premature ejaculation and anodyspareunia was 18% for both. Independent predictors for erectile dysfunction were frequency of masturbation, frequency of sex with partner, use of erectile enhancement drugs, having a passive sex role, and not having a steady relationship. Independent predictors for hypoactive sexual desire disorder were frequency of masturbation and having a lower lifetime number of sexual partners. Independent predictors for premature ejaculation were not having a steady relationship, having a lower lifetime number of sexual partners, and a lower level of education. The only independent predictor for anodyspareunia was having an active sex role.

Effectiveness of a quality improvement intervention targeting cardiovascular risk factors: are patients responsive to information and encouragement by mail or post?

INTRODUCTION: There is important evidence on the beneficial effects of treatment of cardiovascular risk factors in terms of morbidity and mortality, but important challenges remain in motivating patients to adhere to their treatment regimen. This study aimed to describe the effectiveness of a quality improvement intervention that included information and regular encouragement by email or letter on cardiovascular risk factors for patients at high risk for cardiovascular disease. METHODS: This randomized single-blind study included patients of both sexes aged between 45 and 80 years old who had increased cardiovascular risk. Patients were randomly allocated to either a usual care group (UCG) or advanced care group (ACG). Patients in the UCG received regular care while patients in the ACG received usual care plus regular information and encouragement on cardiovascular risk factors by email or letter. Visits for both groups were planned at 0, 3, and 6 months. The outcome measures were blood pressure, weight, body mass index (BMI), waist circumference (WC), and smoking status. RESULTS: Out of 178 eligible patients from one single primary care practice, 55 participated in the study, three of whom dropped out. After 6 months, there was a significant decrease in mean systolic and diastolic blood pressure in the UCG and ACG (P < 0.05). The decreases were already significant after 3 months, except for systolic blood pressure in the UCG. There was also a significant increase in the proportion of patients who met the target values for blood pressure in the UCG and ACG. There was a nonsignificant decrease of the average weight in the ACG, but significantly more patients lost weight in the UCG (P = 0.02). BMI, WC, and smoking status did not change in either group. CONCLUSION: This study found that there was a significant decrease of systolic and diastolic blood pressure in both study groups. Weight, BMI, WC, and smoking did not improve in either group. Information on cardiovascular risk factors and encouragement by means of letters or email did not provide additional benefits. Thus, effective patient empowerment probably requires more behaviorally sophisticated support to increase self-management, self-efficacy, and self-esteem in patients.

Comparison of knowledge and attitudes about vaccination between Belgian and immigrant adolescents.

Immigrant adolescents have different beliefs and attitudes about health and disease compared to Belgian adolescents. The aim of this study was to compare the knowledge of Belgian and immigrant adolescents concerning vaccination. In March 2009, adolescents between the ages of 14 and 17 years from three schools with a mixed Belgian and immigrant population in Antwerp completed a written questionnaire concerning vaccination. In total, 186 adolescents (88 immigrants and 98 Belgians) completed the questionnaire. Knowledge about vaccinations was slightly lower among immigrant adolescents (P<0.001). In both groups, the family physician and the school were the most important information sources for vaccination. Parents played a less important role among immigrant adolescents (50%) compared to Belgian adolescents (80%) (P=0.002). The physician, the school and the parents played key roles in the vaccination of both immigrants and Belgian adolescents.

Online monitoring of flu in Belgium.

BACKGROUND: The diagnosis and treatment of patients with the A(H1N1) pandemic flu caused some serious burden for general practitioners (GPs) in the summer and autumn of 2009. OBJECTIVE: The aim of this study was to track the incidence of influenza and influenza-like illness (ILI) in Belgium and to describe the characteristics of the affected patients. METHODS: In July 2009, the Belgian online influenza surveillance system (BOISS) was set up to monitor the spread of influenza and ILI. Registrations were made by 93 GPs from all 10 Belgian provinces who participated at least 1 week during the first 12 months of the registration. Only patients who met the WHO criteria for flu were recorded. RESULTS: In total, 1254 patients (53% men) with influenza or ILI were included. Mainly younger persons were affected: 43% was under the age of 20 years. A risk factor for influenza-related complications was determined in 19% of cases, mainly patients with chronic respiratory problems. A treatment with oseltamivir or zanamivir was prescribed in 13%, and 3% of the patients was admitted to a hospital. The time of the peak incidence (44th week) and the magnitude (623 cases per week per 100,000 inhabitants) corresponded with the figures of the existing paper-based registration network. The small sample size and possible reporting biases may have influenced the findings of the study. CONCLUSIONS: The BOISS provides a good alternative to conduct surveillance activities for influenza and ILI in Belgium. It provides complementary information regarding ILI compared to the existing data capturing.

Follow-up of a cardiovascular prevention campaign.

The aim of this study was to evaluate the cardiovascular risk (CVR) factors and morbidity in a sample of the population that received a brief intervention on cardiovascular prevention seven years ago. All family physicians who participated in the Cardiovascular Prevention Campaign in five Belgian towns in 2002-2003 received a follow-up questionnaire for each participating patient. The questionnaire included questions about new cardiovascular diagnoses, parameters of the latest physical examination and blood tests. Analyses were based on the 318 questionnaires that included essential information such as the date of the latest contact and the new diagnosis or mortality. The proportion of patients with a low CVR decreased from 75% in 2002-2003 to 40% in 2010. Participants showed a significant increase of the abdominal circumference, triglycerides and fasting glycaemia. Only LDL-cholesterol levels decreased significantly (p = 0.002). Four percent of the patients died, more male (7 ) than female (2%) (p = 0.03). One in ten patients presented with a cardiovascular event. Most of the changes are probably attributable to age. It is clear that the long-term effect of a brief intervention only followed by usual care is not sufficient to attain optimal level of cardiovascular prevention.