bluuebunny/crossref_metadata_2025_split huggingface dataset:
Management of Patients with Hypertension at Family Medicine Practices at the Community Health Centre Ljubljana (Slovenia): A Protocol of a Cross-Sectional Study
Authors: Zavrnik Črt , Mihevc Matic , Virtič Tina , Lukančič Majda Mori , Ketiš Zalika Klemenc , Susič Antonija Poplas 
Published: January 2024

Introduction: Hypertension is a major public health problem worldwide due to rapid urbanization, an aging population, and the global spread of unhealthy lifestyles. In 2011, model primary care practices were established in Slovenia to improve hypertension care at the primary level. Patients with hypertension undergo a standardized examination by a nurse practitioner every year. However, a proportion of patients with hypertension still do not meet the criteria for controlled disease. Therefore, there is an urgent need to identify the bottlenecks of current hypertension care in family medicine practices in Slovenia in order to improve it for the future.
Aim: The aim of this study is to develop a research protocol to evaluate the current management (both process and outcome) of patients with hypertension in family medicine practices in Community Health Centre Ljubljana (CHCL).
Methods: A cross-sectional study will be conducted. First, the list of patients with hypertension aged 30 years or older who were treated in primary care practices at CHCL in 2019 will be collected from the health information system. Individual clinical and demographic data will then be collected from clinical protocols of the same patient population. Descriptive statistics, logistic regression analysis, and linear regression analysis will then be performed to assess various aspects (parameters) of hypertension care.
Results: Data from a total of 15,186 patient visits will be analyzed. (1) The process of care will be assessed by the ratio of performed hypertension-specific visits, blood pressure measurement, screening for hypertension complications (nephropathy, peripheral arterial disease, and ECG signs of heart failure), and screening for hypertension comorbidities (hypercholesterolemia, type 2 diabetes, metabolic syndrome, and depression). (2) Treatment outcomes will be assessed by the ratio of blood pressure values, fasting glucose, LDL, and depression values in the target ranges. (3) The above variables will also be stratified by patient lifestyle factors (BMI, smoking status, physical activity, eating habits, and alcohol consumption), sociodemographic factors (age, gender, education, employment, and subjective assessment of financial status), treatment adherence assessment (regularity and correctness of medication intake, and dietary errors), and treatment motivation and empowerment assessment.
Conclusions: The proposed research protocol will provide evidence of bottlenecks in current hypertension care in family medicine practices in CHCL and identify potential opportunities for future expansion. It will also isolate the key (patient-related) determinants that lead to suboptimal management of the disease.
Network Table
Authors: Storms Roel 
Published: January 2024

Network tables: Integrated care for people with severe psychiatric disorders.
Since 2010 there is the Psy107 initiative in Mental Health Care in Belgium. Aim is to downsize the number of people in Psychiatric Hospitals and to make a shift towards care in the community by organizing Networks of Mental Care and Circuits of Care.
The result of this shift is that people with severe psychiatric disorders are less hospitalized and for a shorter time. They stay longer in their natural environment. This means that first line professionals and mobile psychiatric teams are confronted with more complex situations and crises. Some show health care avoidance behaviour and are hard to reach.
This is where the “Network-tables” come in: on a monthly basis a ‘Network table’ is convened. A group of professionals from the general first line, the specialized second line and residential third line – all with affinity with mental disorders - come together for a multidisciplinary consultation.
A first line professional - who is confronted with a complex case or with health care avoidance behavior – can present his case to this ‘Network Table’. The partners round the table all have different specializations and the transdisciplinary approach, the look at the case from different perspectives helps to find solutions that wouldn’t have been found without this collaboration.
The aim of these Network Tables is to put the patient/client in the center and formulate some realistic goals. The ambition is to come to specific actions and make clear arrangements about who will be responsible for short term actions and for the continuity of care. It is also possible that the mobile healthcare professional visits the patient/client, for a few times, for making contact and exploring the problems.
The Network Tables started a year ago. The cases that are presented, come from different first line actors: social housing organization, social workers, jobcoaches… So far the Network tables managed to find solutions for all the cases.
All the participants were a bit surprised that working together can make such a big difference in finding solutions. Needless to say that these positive results are a powerful incentive to continue this new initiative.
Missed opportunities for integrated testing: An Evaluation of the implementation of TB and HIV EID Testing on the GeneXpert platform in Lesotho
Authors: Gwaza Gamuchirai , Leqheka Monkoe , Dittrich Sabine , Mots'oane Tsietso , Kao Kekeletso 
Published: January 2024

Introduction: Integrated testing of TB and HIV can improve health outcomes and save costs. The GeneXpert (GX) instrument, a multi-disease testing platform, can allow for simultaneous HIV and TB testing. However, utilization of the platform for integrated testing remains suboptimal, and there are operational barriers to implementing integrated TB and HIV testing.
Methods: We evaluated the implementation of TB and HIV testing on the GX instrument for early infant detection (EID) of HIV and tuberculosis (TB) testing in thirteen health facilities in Lesotho. The data collection process used a survey questionnaire, semi-structured interviews, and a review of records at each health facility. Data was collected for the period 2017 and 2019.
Results: All thirteen health facilities had at least one GX instrument for TB or EID testing. In 2017, the average utilization rate for the GX instrument for TB and EID testing was 63% and 24%, while in 2019, the average utilization rate was 61% for TB testing and 27% for EID. However, none of the health facilities included testing for TB and HIV on the same GX instrument simultaneously. In general, utilization rates were sufficiently low that all the HIV and TB tests undertaken in 2017 and 2019 could have been performed using only the instruments currently dedicated to TB testing. All except for three sites (Scott, Motebang and Maluti) where the testing rates were high.
Conclusion and Policy Implications: Much progress has been made in integrating TB and HIV activities in Africa. However, there is a missed opportunity for the integration of testing for TB and HIV on the GX instrument, which could save costs.
This evaluation highlights areas that need more focus and more detailed diagnostic network optimization exercises to improve service delivery and allocate stocks, staff, equipment, and training. Better coordination of donor support or increased flexibility in reporting of use will be important to maximize the use of resources, where integration may be more effective than purchasing new equipment. Monitoring and evaluation should be a routine part of the implementation and should be budgeted and demanded by policymakers and donors. Health facilities may require additional resources and technical support to improve data collection, analysis, and dissemination.
In conclusion, areas highlighted in this evaluation merit further exploration, such as the need to understand integrated testing models, including what works, why, and for which target groups. This will allow for effective targeted interventions to improve testing coverage across several diseases especially taking advantage of the multi-disease testing platforms.
30 by 2030 campaign
Authors: Farje Fiorella , De Sá e Silva Bianca 
Published: January 2024

Primary Health Care (PHC) is a cornerstone of universal health coverage (UHC). To prevent diseases and holistically treat people, community-based primary healthcare systems need to be strengthened. PHC is an approach that aims to address physical, mental, and social health and well-being, and to provide comprehensive care for a person's health needs throughout life rather than focus on treating a specific set of diseases. To achieve this approach, we must strengthen horizontal PHC systems and encourage vertical programmes, including disease-specific programmes, to be developed, integrated, and implemented in the context of integrated Primary Health Care.
In early 2020 the WHO Collaborating Centre on Family Medicine and Primary Health Care launched the 30by2030 campaign (https://www.30by2030.net), whereby signatories are asking donors of vertical disease-oriented projects to invest at least 30% of their budgets for vertical programs in strengthening coordinated and integrated primary health care. The initiative is a pull of efforts of different organizations such as Wonca: World Organisation of Family Doctors, The Network: Towards Unity for Health (TUFH), African Forum for Primary Health Care, European Forum for Primary Care, PRIMAFAMED network, among others.
The 30 by 2030 has two aims: the first one is to inform and raise awareness of the impact of vertical programs on health systems. Most of the private and external funds, which represent one-third of the total spending of PHC, are channelled through programmes that focus on the health problems of specific population subgroups (e.g., HIV, tuberculosis, malaria) which also leads to inequity by disease. The second aim is to call for international donors to assign 30% of their vertical top-down, disease-oriented budgets to strengthen primary healthcare services through coordination, increased human resources and improved infrastructure.
Health related-quality of life and patient experiences regarding transitional care in hospitalized older adults: a survey study.
Authors: Leithaus Merel , Flamaing Johan , Goderis Geert , Verbeek Hilde , Deschodt Mieke 
Published: January 2024

Introduction: Frail older patients with various care needs often undergo hospitalization and thus experience frequent transitions across different settings. Poorly performed care transitions can increase the risk of adverse outcomes. Implementing integrated care services can improve the quality of care transitions. The aim of this survey study was 1) to assess health related quality of life (hr-qol) and experiences with transitional care in older patients and 2) to compare these outcomes between patients who were living within an integrated care project (ICP) region vs. outside an ICP region in Belgium.
Methods: This study is part of the European TRANS-SENIOR project. We used a survey using the EQ-5D-5L instrument to measure the hr-qol and the ‘Experiences with hospital care, admission and discharge’ instrument to measure patient experience. The survey questionnaire was given to frail patients aged 65 years and older and who were discharged home from one of six different wards of the University Hospital Leuven. Patients were asked to fill out the survey at home and send it back to the researchers. Descriptive analysis and inferential statistical analysis were conducted to summarize survey results, identify trends and validate hypothesis.
Results: 119 questionnaires were filled in and sent back. Patients had a mean age of 81 years and 54.2% were female. Problems with mobility, pain/discomfort, daily activities and self-care were reported in more than 70% of the participants. The average EQ-5D-5L visual analogue scale score was 56.97 out of 100 (SD 19.05). We observed high scores for the patient experience dimensions hospital accessibility, hospital safety and care received by doctors and nurses. However, in comparison to other experience dimensions, no clear positive trend was observed for treatment communication, admission conversation and hospital discharge.
Moreover, when comparing the outcomes between patients living in ICP and non-ICP regions, we saw no statistically significant differences in terms of hr-qol and patient experience.
Conclusion: The survey allowed to identify potential areas for improvement by assessing patient reported outcomes and experiences with transitional care. Similar challenges in patient experiences during information exchange concerning treatment, admission and discharge were identified in the whole patient population and within the ICP regions.
The Role and Experiences of Frontline Social Care Staff within Integrated Care
Authors: Hussain Mohammed 
Published: January 2024

Background: This study explores the role of those frontline individuals working in care and support roles in ensuring that people receive Integrated Care and how they interact, collaborate and work in partnership with external professionals. Such staff are often central to the people’s experience of person-centred, co-ordinated care due to their frequent contact with people, their families and a multitude of professionals. Despite the centrality of their role, there is a lack of research on these individuals with most research around Integrated Care focused on formal professions such as Nurses and Social Workers.
Who is it for? This research study has been conducted for frontline social care staff within Integrated Care services and for all stakeholders involved in a person’s care ranging from Social Workers, CPNs, Housing support, health and local authorities. This will also be of interest to those responsible for managing future integrated services and to those implementing new Integrated Care programmes.
Who did you involve and engage with? This research study was led by a PhD Research student around an Integrated Mental Health Recovery Service for Adults in the Midlands region of England which had been implementing integrated care over the past five years. The service supports people to leave /avoid hospital or prison etc to develop new skills, manage their risks and to support the Mental Health Recovery journey for individuals. The emerging insights from this study will be shared with a lived experience panel in order to gain their perspectives.
What did you do? A scoping literature review was conducted which highlighted the limited number of research studies involving frontline social care and support staff. With the premise that all involved in Integrated Care are equal partners, a lack of literature on these individuals highlighted a gap in data. Qualitative semi-structured interviews are being conducted with social care staff and various professionals involved in the case study site, based on themes which emerged in the literature review.
What results did you get? This research study is part of a PhD Thesis due for completion in September 2023 and data gathering will be complete and initial analysis will be presented at the conference.
What is the learning for the international audience? The areas of learning will be around the key themes which emerge from the findings of the qualitative interviews on barriers and facilitators of Integrated Care based on the role and experiences of frontline social care staff, a group which has been under researched both within the UK and internationally.
What are the next steps? The insights from this research study will help to inform the Integrated service and the local areas to improve the support to people in services, to help advance practice within Integrated Care and for the future development of Integrated Care services and programmes.
The introduction and impact of a National Frailty Education Programme
Authors: Lang Deirdre , Carmel Hoey , Whitty Helen , Oshea Diarmuid 
Published: January 2024

Background: Frailty is a dynamic functional state. Its onset and progression can be reduced and even reversed, if early intervention and correct management strategies are set in place. A number of reports suggest that healthcare professionals in general, have a poor understanding and view frailty as an inevitable part of ageing. In response the NCPOP developed The National Frailty Education Programme
Aim: The programme aim is to provide healthcare professionals with an enhanced understanding of frailty and frailty assessments; thereby ensuring earlier recognition of frailty, improved healthcare management, and better outcomes for older adults living with frailty.
Methods: A Test of Concept, using quality improvement (QI) methodology was employed. This allowed for small tests of change, which informed the development of the programme content and the programme delivery.
Results: From 21st September 2017 to December 2019 n=3045 healthcare professionals completed the programme. A further 87 staff attended the programme during 2020.
97% of respondents rated the programme highly in relation to their level of enhanced understanding following participation in the study day.
In early 2020, due to the outbreak of the COVID-19 the pandemic face to face education had to cease. The impact of COVID-19 on older adults and the increased prevalence of frailty on this cohort meant the development of and access to an eLearning programme became a priority and an eLearning programme was developed. A blended programme is due to be launched in 2023.
Impact: In 2018, the NFEP was awarded the Zenith Global Healthcare Award in recognition of its pioneer educational approach to the delivery of integrated interprofessional education. The programme has also been included in the European Union’s Joint Action on Frailty Prevention (Rodríguez-Laso et al., 2019), as a case study of good practice under Domain 7: Education and Training. Many other projects, publications and developments have arisen out of this programme including: the evolving Frailty Networks nationally, the inaugural meeting of the Irish Frailty Network of the Irish Gerontological Society in September 2019 , the first All-Ireland Frailty Network meeting in October 2021 , advisory inputs to the Northern Ireland Frailty Network in November 2021 towards developing a Frailty Education Programme for Northern Ireland, and many other initiatives and contributions to improve patient care. The programme has been cited internationally as an exemplar of an interprofessional approach to learning (Walsh, & Currid 2018, Adja, et al. 2020, Munro & Murphy, 2022, Romero-Ortuno, et al. 2022); in recognition, since 2022, Trinity College Dublin offers up to 5 annual scholarships to NFEP Facilitators for the online, standalone module in Assessment and Management of Frailty in Ageing Adults .
The development of the Dutch national model integrated care for childhood overweight and obesity
Authors: Halberstadt Jutka , Koetsier Leandra 
Published: January 2024

Background: Childhood obesity is a chronic disease with negative physical and psychosocial health consequences. To manage childhood overweight and obesity, integrated care as part of an integrated approach is needed. In order to realise implementation of this integrated care, practical guidance for policy and practice is needed. The aim of this study is to describe the development of a Dutch national model of integrated care for childhood overweight and obesity and accompanying materials for policy and practice.
Methods: The development of the national model was led by a university based team in collaboration with eight selected Dutch municipalities who were responsible for the actual local realisation of the integrated care and with frequent input from other stakeholders. Learning communities were organised to exchange knowledge, experiences and tools between the participating municipalities.
Results: The developed national model describes the vision, process, partners and finance of the integrated care. It sets out a structure that provides a basis for local integrated care that should facilitate improvement of support and care for children with overweight or obesity and their families. The accompanying materials are divided into materials for policymakers to support local realisation of the integrated care and materials for healthcare professionals to support them in delivering the needed support and care.
Conclusions: The developed national model and accompanying materials can contribute to improvement of support and care for children with overweight or obesity and their families, and thereby help improve the health, quality of life and societal participation of these children. Further implementation of the evidence- and practice-based integrated care while evaluating on the way is needed.
Educational game “GUIDE in Health and Healthcare” to improve health literacy.
Authors: Goossens Joline , Lamote Sofie , Byl2 Stephanie , Vyncke Veerle 
Published: January 2024

Research suggests that 33% of the Belgian population aged 15 years and over has a low level of health literacy (Charafeddine et al. 2018). Low health literacy is associated with greater use of health care services, and higher morbidity and mortality (Dewalt et al 2004). In the last decade, the emphasis is on a system approach to improve health literacy rather than focusing on individual behavioral change alone (Brach 2017). Although professionals in social and health organizations try to improve health literacy in their clients, few tools are available to guide such efforts. Therefore, an educational game “GUIDE in Health and Healthcare” (in Dutch: WEGWIJS in Zorg en Gezondheid) was developed to improve health literacy among clients. By playing the game, people gain more insight into the Belgian healthcare system.
The game was created by the workgroup “Health literacy” of 11 community health centers in Ghent in cooperation with educational game developer “De Aanstokerij” and several health and social organizations. The game was evaluated in six different settings through a questionnaire, observation, and focus group interviews with the participants and their supervisor.
The game is a board game with a digital component, and consists of 15 characters with different health and social needs. By guiding the characters to the most appropriate primary care organization, people collect points. The group with the most points wins.
An instructional video was developed for professionals and can be displayed during the conference.