References of "Berrewaerts, Marie-Astrid"
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See detailL’infection par le VIH : une maladie chronique redéfinissant la collaboration entre généralistes et spécialistes. Obstacles et opportunités
Belche, Jean-Luc ULg; Kang, Thida; Ketterer, Frédéric ULg et al

in Santé Publique : Revue Multidisciplinaire pour la Recherche et l'Action (2015), 27(3/2015), 373-381

Purpose : With the development of antiretroviral therapy, Human Immunodeficiency Virus (HIV) infection has become a chronic disease. In order to develop an efficient response to this new challenge, there ... [more ▼]

Purpose : With the development of antiretroviral therapy, Human Immunodeficiency Virus (HIV) infection has become a chronic disease. In order to develop an efficient response to this new challenge, there is a need for closer collaboration between specialized units and general practitioners. This article identifies the opportunities for and the barriers to this collaboration. Methods : Semi-structured interviews were conducted with patients living with HIV, general practitioners working in multidisciplinary group practice using the capitation system and infectiologists from one Belgian urban area. Interviews focused on experiences and expectations in relation to diagnosis, follow-up and collaboration between general practitioners and infectiologists. Results : Overall, infectiologists and general practitioners aspire to improved communication and collaboration. There are overlaps between general practitioner’s and infectiologist’s field of action. The general practitioner’s intervention is sometimes restricted to common uncomplicated or psychosocial problems, in the context of unplanned and short contacts. Infectiologists prefer to focus on HIV problems, leaving general practitioners to take care of these patients’ other health problems. The patient may be an obstacle to greater involvement of general practitioners due to fear of stigmatization from his family and social circle or lack of confidence in the general practitioner’s skills. Conclusion : This research underlines the difficulties and gaps in the care of HIV patients and provides preliminary explanations for the lack of active cooperation between general practitioners and infectiologists. Overlaps between the areas of professional skills can result in uncovered aspects of care, which can have a negative impact on patients, but also on general practitioners and infectiologists. Collaboration between general practitioners and infectiologists should be based on a concerted decision, with clear allocation of tasks, taking into account the patient’s expectations. [less ▲]

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See detailCréation d'un stage obligatoire de médecine générale, pour tous les étudiants de 6e année en médecine
Dumont, Virginie ULg; Burette, Philippe ULg; MASSART, Valérie ULg et al

Poster (2014, November 27)

Introduction : Depuis 2013, un stage obligatoire d'un mois de Médecine générale (MG) a été accepté par la faculté, pour tous les étudiants de 6ème année. Il vient compléter un court stage de découverte de ... [more ▼]

Introduction : Depuis 2013, un stage obligatoire d'un mois de Médecine générale (MG) a été accepté par la faculté, pour tous les étudiants de 6ème année. Il vient compléter un court stage de découverte de la MG, programmé depuis 10 ans en 4ème année. Les objectifs sont de permettre à tous étudiants, quelle que soit leur future spécialité, de comprendre le rôle du généraliste auprès des patients et dans le système de santé, d'acquérir des habilités professionnelles utiles à tous et de susciter de l'intérêt pour la MG. Objectif : Sur base de ces objectifs, les généralistes enseignants ont élaboré des activités programmées en stage et à l'université. Ensuite, ce dispositif a été soumis à des étudiants sortant de 6ème année: leurs besoins de formation ressentis ont donc été pris en compte dans la structure finale. Les maitres de stage (MDS) ont été formés spécifiquement à ce nouveau dispositif. Méthode et moyens : Le stage est organisé mensuellement pour un groupe de 15 étudiants. Un carnet de stage commun aux stagiaires et MDS, décrit les activités obligatoires et facultatives à réaliser. Les étudiants participent activement à la vie professionnelle de leur MDS en première ligne, et reviennent pour 3 demi-journées à l'université. Des ateliers y sont programmés : recueil des représentations de la MG et besoins des étudiants, examen clinique, apprentissage à l'entrevue médicale font partie des modalités proposées lors de ces demi-journées. Les étudiants sont également invités à échanger sur leur vécu et apprentissage lors de ce stage. Résultats attendus : Le département a investi des moyens humains importants dans un suivi rapproché des étudiants et des MDS. Il en attend une amélioration des aptitudes cliniques de base et une meilleure visibilité de la MG en formation initiale. [less ▲]

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See detailRetrospective analysis of a suburban out-ofhours clinic in Belgium
Belche, Jean-Luc ULg; Berrewaerts, Marie-Astrid ULg; Burette, Philippe ULg et al

in Acta Clinica Belgica (2014), 69(5), 341-347

Introduction: In many countries, out-of-hours medical care is under scrutiny. The aim of this article is to study the activities recorded by the first out-of-hours clinic that has been opened, as a pilot ... [more ▼]

Introduction: In many countries, out-of-hours medical care is under scrutiny. The aim of this article is to study the activities recorded by the first out-of-hours clinic that has been opened, as a pilot study, in two Walloon communes. Material and method: A retrospective analysis of anonymized data was conducted for 2009. Coding of diagnoses was conducted using the International Classification of Primary Care (ICPC-2). Results: A total of 3949 contacts were recorded in 2009 with the out-of-hours clinic, 3294 related to inhabitants of the two communes covered, which was equivalent to 13% of the total population in question. Compared to 7.2% of contacts between midnight and 8 a.m., 82.9% of contacts took place between 8 a.m. and 9 p.m., and 91.6% of contacts were handled locally, with only 8.4% resulting in hospitalization. In addition, 52% of contacts were with patients aged between 25 and 65; 29.9% of contacts were with paediatric patients (,15 years). Patients over the age of 65 made up 18% of contacts. The most common pathologies were respiratory (R). Analysis of flu diagnoses identified two epidemic peaks. Discussion: The suburban out-of-hours clinic studied fulfilled an important role in managing the demand for health care. The large majority of health problems were resolved locally, and the inhabitants did not need to go to hospital. Appointments between midnight and 8 a.m. were in the minority, which points towards adjusting the organization of the out-of-hours service during the night. The geriatric population is not highly over-represented contrary to what might be expected considering its largest number of pathologies. The on-call doctor’s skills profile should take account of the populations and morbidities encountered. Out-ofhours clinics could possibly play a sentinel role in terms of flu epidemics. Conclusion: This study describes a pilot suburban out-of-hours clinic which met three of recommendations set by the KCE in its report on out-of-hours care in general medicine: the organization of an out-of-hours clinic with logistical support, the use of a single telephone number and merging out-of-hours areas. While debate exists on the management of out-of-hours care, this study provides evidence on the role of the physician during these hours. [less ▲]

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See detailLa place et le rôle des médecins généralistes dans le suivi de chirurgie bariatrique en province de Liège
Gaspard, Stéphanie; Ketterer, Frédéric ULg; Belche, Jean-Luc ULg et al

in Revue Médicale de Liège (2014), 69

This paper is concerned with the place and role of general practitioners in the follow-up of patients submitted to bariatric surgery in the province of Liège. The results of the analysis were compared ... [more ▼]

This paper is concerned with the place and role of general practitioners in the follow-up of patients submitted to bariatric surgery in the province of Liège. The results of the analysis were compared with clinical practice guidelines published by the French Haute Autorité de Santé (HAS). Fifteen interviews were conducted with GPs who follow up operated patients. The results highlight the GPs’ wish to fully participate in the follow-up of those patients. Their medical supervision is centered on the HAS clinical practice guidelines, taking into account the intake deficiencies as well as the patient’s psychological experience. However, some aspects are disregarded, mainly because of a lack of theoretical knowledge (some biological parameters, pregnancy and contraception). The short consultation time along with the poor communication with the hospital multidisciplinary team were mentioned as obstacles to a good quality follow-up. Progress is still needed to reach the clinical practice guidelines. However, there is a wish to better collaborate. Organising coordination meetings between professionals along with an early implication of the GP – even before surgery – represent possible solutions. [less ▲]

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See detailSuggestions for improving continuity of medication between hospital and home in a local context of Wallonia
Belche, Jean-Luc ULg; Berrewaerts, Marie-Astrid ULg; Duchesnes, Christiane ULg et al

Conference (2012, October 20)

Background: Unjustified modifications of the patient’s usual medication during his hospitalisation induce various problems for the patient (confusion, additional costs) and for healthcare professionals ... [more ▼]

Background: Unjustified modifications of the patient’s usual medication during his hospitalisation induce various problems for the patient (confusion, additional costs) and for healthcare professionals (work overload, additional cost). The principle of favouring dialogue between local actors to reach commonly accepted solutions (KCE, 2010) was used in the current study. Research question: Which local strategies could be implemented to improve continuity of drug therapy when the patient moves to hospital or back home? Method: The study took place in Liège (Wallonia). Participants were recruited within four professional groups: general practitioners, hospital specialists, pharmacists and hospital stakeholders. First, a nominal group was carried out for each professional group. Prioritized suggestions were obtained. In a second phase, Delphi method was used. Suggestions from the nominal group were submitted to representatives of each profession (a total of 40) to evaluate relevance, acceptability and feasibility of each one. Results: A total of 101 suggestions were evoked in the first phase. They were related to two main themes: implication of well-defined actors and development of specific means. Five consensual suggestions emerged from the Delphi process: provision by the general practitioner of a complete list of medication on hospital admission; provision by the hospital specialist of a list of drugs at discharge; development of formal hospital processes to keep the patient’s usual medication; centralisation of medication data; development and use of a unique medical record. Conclusion: A link medium handled by the patient when he moves to the hospital and back home is the major idea mentioned and accepted by local actors. [less ▲]

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