Research Johan Wens

Abstract

Heart failure is a common condition that mainly affects elderly patients. It has a significant impact on quality of life and is associated with repeated hospital admissions and a greatly increased risk of death. Guidelines recommend multidisciplinary care for patients with heart failure. However, this is not yet the reality in Belgium. Healthcare providers in the field also felt this way. In various Flemish regions, multidisciplinary heart failure projects were established with the aim of improving care for patients with heart failure. The Heart Failure Learning Network was launched in 2019 with the support of the Dr. Daniël De Coninck Fund, managed by the King Baudouin Foundation. As a democratic and participatory network, the Learning Network aimed to bring together projects so that they could learn from each other by exchanging experiences and best practices. We have found that the Learning Network is a successful model for supporting or accelerating the implementation of complex projects. All 8 heart failure projects that are part of the network worked transmurally, interdisciplinarily, and placed the patient and their environment at the center. We, as the network, focused on the development of training programs, materials, and protocols that promote the initiation and implementation of a transmural, interdisciplinary project. As a result, we developed a brand-new training program for heart failure educators in primary care and a visual atlas to support patient education. Stakeholder experiences were mapped out. We contributed to the development of a medical-pharmaceutical consultation for heart failure, a multidisciplinary heart failure care pathway, and the update of the heart failure guideline for primary care. Finally, we will describe and evaluate the participating projects. The developed materials and protocols will be launched in the course of 2023. Gradually, the ambition of the network grew. In the next step, we want to scale up integrated heart failure care in new Flemish/Belgian regions. We want to support these regions as a network in implementing integrated heart failure care. Furthermore, one of the major gaps in the current chronic care organization is the lack of patient education and empowerment in primary care. Patient education is only reimbursed for patients with diabetes/chronic kidney insufficiency. All other chronic patients are left out in this regard. We have already taken some steps to address this gap concerning heart failure, but our work in this area is not complete: further development with a focus on health and e-health literacy skills is needed. In several projects of the Learning Network, technology played an important role in the form of telemonitoring. Further research is needed to determine how we can optimally integrate telemonitoring into a multidisciplinary care pathway. Specifically, we want to examine which parameters are truly important for telemonitoring in the home setting and which patients would benefit the most from this telemonitoring. In addition, it is important not only to support healthcare providers in improving heart failure care, but also to provide students in basic education with the necessary tools, with a focus on interdisciplinary collaboration, accessible education, self-management support, and the smart integration of healthcare technology. So far, we have focused on improving and supporting patients with heart failure who live at home. In residential care centers, the prevalence of heart failure is high, and there is still a lot of room for improvement in heart failure care, including the recognition and timely identification of decompensation alarm symptoms by nursing and care staff. The first steps have been taken for the implementation of a heart failure protocol in residential care centers. This is a research line that we want to further expand in the coming years.

Researcher(s)

• Promoter: Wens Johan

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

The current state-of-the art advocates for a biopsychosocial rehabilitation approach for persistent pain after breast cancer treatment. Within this approach pain science education is combined with promotion of an active lifestyle based on self-regulation techniques. We argue for testing an innovative eHealth self-management support program for this purpose. The assumption is that this delivery mode reduces barriers to pain self-management support, through bringing timely support near to people, creating a safe environment as opposed to hospital settings, providing a multidimensional support model taking into account the biopsychosocial needs of patients, and lowering costs. This program can provide patients with the knowledge, proactive, cognitive and self-management skills to master their situation and journey towards less pain and pain-related disability and participation in normal life again. Therefore, the general aim of the proposed project is to investigate the effectiveness of an eHealth self-management support program for pain-related disability (I) in breast cancer survivors with persistent pain (P). The program makes use of an innovative chatbot format for delivering pain science education and motivating and monitoring physical activity. The eHealth program is automated and personalized using comprehensive decision-tree-based algorithms in order to promote pain self-management support. The primary scientific objective of the study is to determine the effectiveness of this eHealth self-management support program for persistent pain after breast cancer treatment compared to 1) usual care (i.e. superiority of the eHealth self-management support program) (C1) and 2) a comprehensive pain rehabilitation program delivered face-to-face in a physical therapy setting (i.e. non-inferiority of the eHealth self-management support program) (C2) on pain-related disability (O).

Researcher(s)

• Promoter: De Groef An
• Co-promoter: Meeus Mira
• Co-promoter: van Olmen Josefien
• Co-promoter: Wens Johan
• Co-promoter: Willem Lander

Research team(s)

• Movement Antwerp (MOVANT)

Project type(s)

• Research Project

Abstract

The aim is to develop a multidisciplinary good clinical practice guideline on oncological post-acute care in primary care, according to the international standards for the development of an evidence-based guideline and the criteria used by the Belgian Centre for Evidence-Based Medicine (CEBAM) for the validation of guidelines.

Researcher(s)

• Promoter: van Olmen Josefien
• Co-promoter: De Groef An
• Co-promoter: Van Royen Paul
• Co-promoter: Wens Johan

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

)The existing T2DM guideline should be updated. the work is split and divided between different working groups. 1. tracing and tackling people at high risk (pre-diabetes, including follow-up of gestational diabetes; 2. non-drug treatment of T2DM 3. drug treatment of T2DM

Researcher(s)

• Promoter: Wens Johan

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

The aim of the project is to create an international platform for the participating universities to exchange case-driven experiences and proven solutions at two levels: 1. train FM/PHC professionals in the competencies of interprofessional team working in the participating countries by exchanging working experiences via an interactive web-based platform and 2. increase knowledge, skills and expertise about early recognition and self-management of type 2 diabetes mellitus (T2DM) through interprofessional learning at community health centres (CHCs) and private clinics (PCs) in urban and rural areas. Though the focus of the case-based experiences will be on T2DM early detection and self-management, the main purpose of this project will be on exchanging needs and experiences for working interprofessionally by the participating academic centres via a web-based platform. There will be a yearly live meeting and regular (bimonthly) webinars or digital meetings (zoom, skype, …) of the leading teams in the different countries, and monthly meetings of the national network of (urban, rural, remote,…) participating CHCs and private clinics within each country.

Researcher(s)

• Promoter: Wens Johan
• Co-promoter: Tsakitzidis Giannoula

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project website

Project type(s)

• Research Project

Abstract

The ultimate goal of this project is to optimize the provision of care for migrant cancer patients and thier families who need to rely on interpreters. We will do so by creating the conditions that enable both patients and their next of kin to better understand the information provided to them in orde for them to be able to be involved in the process of shared decision making. This means that we aim to improve: - the interaction beween patients, their next of kin, interpreters and doctors during interpreter mediated consultations - the interaction between doctors and interpreters during collaboration by offering to all of them evidence-based recommendations on how to interact with each other during the interpreter mediated consultation. It should be clarified at this stage that in this study, we perceive patients and family members attending the consultation as a single recipient of the doctor's communication. Therefore, in this study, we also include family members whose behaviour during the consultation and understanding after the consultation will be investigated next to the patients' own behaviour and understanding.

Researcher(s)

• Promoter: Wens Johan

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

This small project aims to examine if disabled people die a "good death". This objective only is possible on condition that a professional framework on care for these vulnerable people exists. However, it seems that care professionals need a lot of support and guidance in the palliative care provision to this specific desired population. Besides assessment of the dying quality, specific needs will be inquired by qualitative research methodology where after specific tools will be suggested and evaluated aiming to achieve the proposed goals.

Researcher(s)

• Promoter: Wens Johan

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project website

Project type(s)

• Research Project

Abstract

The aim of this study is to investigate opinions of Belgian patients, relatives, spiritual counsellors and health care professionals on what they consider '(in)appropriate care' at the end of life and how futile/inappropriate care can be avoided.

Researcher(s)

• Promoter: Wens Johan

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project website

Project type(s)

• Research Project

Abstract

This project represents a formal research agreement between UA and on the other RIZIV. UA provides RIZIV research results mentioned in the title of the project under the conditions as stipulated in this contract.

Researcher(s)

• Promoter: Wens Johan
• Co-promoter: Van Den Eynden Bart

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

The project aims to prevent costly complications and frailty in elderly with type 2 diabetes, enabling them to live independent, healthy and active lives as long as possible. This will be achieved by driving innovation and change in the current treatment approach, shifting from diabetes management to chronic care management. A roadmap for implementation of the model will be developed, providing, also guidelines for development of chronic care model in a broader context.

Researcher(s)

• Promoter: Wens Johan

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

This project represents a formal research agreement between UA and on the other RIZIV. UA provides RIZIV research results mentioned in the title of the project under the conditions as stipulated in this contract.

Researcher(s)

• Promoter: Van Den Eynden Bart
• Co-promoter: Wens Johan

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

TRANSFoRm will develop rigorous, generic methods for the integration of Primary Care clinical and research activities, to support patient safety and clinical research via: - rich capture of clinical data, including symptoms and signs rather than just a clinical diagnosis. A generic, dynamic interface, with potential to operate with any electronic health record (eHR), will facilitatie both diagnostic decision support and identification of patients eligible for research, thus enhancing patient safety - distributed interoperability of eHR data and other data sources that maintains provenance, confidentiality and security. This will enable large-scale phenoptype-genotype association studies and follow-up of trials. - software tools and services to enable use of controlled vocabulary and standardised data elements in clinical research. This will enable integration and reuse of clinical data. The scientific aims of this project are to radically advance our understanding of ICT system interoperability relevant to healthcare and clinical research and to develop an EU-wide system capable of integrating Primary Care electronic health record systems and research systems.

Researcher(s)

• Promoter: Van Royen Paul
• Co-promoter: Vermeire Etienne
• Co-promoter: Wens Johan

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project website

Project type(s)

• Research Project