References of "Remmen, Roy"
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See detailKnowledge transfer from Belgian government to medical doctors
MORTELMANS, Katrien; REMMEN, Roy; BERKEIN, Philip et al

Conference (2014, October 02)

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See detailWhat factors determine Belgian general practitioners' approaches to detecting and managing substance abuse? A qualitative study based on the I-Change Model.
Ketterer, Frédéric ULg; Symons, Linda; Lambrechts, Marie-Claire et al

in BMC Family Practice (2014), 15(1), 119

BACKGROUND: General practitioners (GPs) are considered to play a major role in detecting and managing substance abuse. However, little is known about how or why they decide to manage it. This study ... [more ▼]

BACKGROUND: General practitioners (GPs) are considered to play a major role in detecting and managing substance abuse. However, little is known about how or why they decide to manage it. This study investigated the factors that influence GP behaviours with regard to the abuse of alcohol, illegal drugs, hypnotics, and tranquilisers among working Belgians. METHODS: Twenty Belgian GPs were interviewed. De Vries' Integrated Change Model was used to guide the interviews and qualitative data analyses. RESULTS: GPs perceived higher levels of substance abuse in urban locations and among lower socioeconomic groups. Guidelines, if they existed, were primarily used in Flanders. Specific training was unevenly applied but considered useful. GPs who accepted abuse management cited strong interpersonal skills and available multidisciplinary networks as facilitators.GPs relied on their clinical common sense to detect abuse or initiate management. Specific patients' situations and their social, psychological, or professional dysfunctions were cited as cues to action.GPs were strongly influenced by their personal representations of abuse, which included the balance between their professional responsibilities toward their patients and the patients' responsibilities in managing their own health as well the GPs' abilities to cope with unsatisfying patient outcomes without reaching professional exhaustion. GPs perceived substance abuse along a continuum ranging from a chronic disease (whose management was part of their responsibility) to a moral failing of untrustworthy people. Alcohol and cannabis were more socially acceptable than other drugs. Personal experiences of emotional burdens (including those regarding substance abuse) increased feelings of empathy or rejection toward patients.Multidisciplinary practices and professional experiences were cited as important factors with regard to engaging GPs in substance abuse management. Time constraints and personal investments were cited as important barriers.Satisfaction with treatment was rare. CONCLUSIONS: Motivational factors, including subjective beliefs not supported by the literature, were central in deciding whether to manage cases of substance abuse. A lack of theoretical knowledge and training were secondary to personal attitudes and motivation. Personal development, emotional health, self-awareness, and self-care should be taught to and fostered among GPs to help them maintain a patient-centred focus. Health authorities should support collaborative care. [less ▲]

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See detailLes facteurs qui favorisent l’implication des médecins généralistes belges dans la gestion des abus de substances. Une étude qualitative basée sur le I-Change Model
Ketterer, Frédéric ULg; Symons, Linda; Lambrechts, Marie-Claire et al

in Revue Médicale de Bruxelles (2014), 35(3),

Objectifs Les médecins généralistes (MG) jouent un rôle majeur dans la détection et la gestion des abus de substances. L’étude présentée ici investiguait les facteurs qui influencent leur implication ... [more ▼]

Objectifs Les médecins généralistes (MG) jouent un rôle majeur dans la détection et la gestion des abus de substances. L’étude présentée ici investiguait les facteurs qui influencent leur implication concernant la gestion des abus d’alcool, des drogues illégales, des hypnotiques et des anxiolytiques dans la population belge des 18-65 ans. Méthodes 20 MG ont été interrogés par entretiens semi-directifs dans les régions de Liège et d’Anvers. Le I-Change Model de de Vries a été utilisé pour construire le guide d’entretien et analyser les données récoltées. Résultats Parmi les principaux résultats de l’étude, il ressortait que les MG étaient fortement influencés dans leur approche par leurs propres représentations de l’abus, qui oscillait leurs responsabilités professionnelles envers ces patients et la responsabilité de ces derniers quant à la gestion de leur santé, avec l’idée de faute morale en substrat. En ce sens, l’abus de substance était perçu sur un continuum entre l’abus comme forme de maladie chronique d’une part, et la faute morale d’autre part. L’alcool et le cannabis étaient néanmoins mieux acceptés socialement que les autres substances. Les propres expériences personnelles des MG concernant les abus avaient aussi une incidence sur leur volonté de s’investir avec ces patients. Pour autant, les pratiques multidisciplinaires (notamment au forfait) et l’expérience étaient évoqués comme des facteurs importants quant à l’engagement dans la gestion. Les contraintes temporelles et l’investissement demandé étaient, en revanche, considérés comme des barrières. Conclusion Les facteurs motivationnels apparaissaient centraux dans la décision de s’investir dans la gestion des abus de substances, bien davantage que les connaissances théoriques et les formations qui semblaient plus secondaires. La peur du burn-out s’exprimait donc en substrat. La formation des MG devrait tenir compte de ce souhait de se protéger, afin de favoriser simultanément une approche centrée sur le patient. [less ▲]

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See detailDissemination and implementation of clinical practice guidelines in Belgium
Desomer, Anja; Dilles, Tinne; Steckel, Sarah et al

Report (2013)

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See detailEffectiveness of case management for maintaining frail older persons at home - intermediate results
Van Durme; Schmitz, Olivier; Cès, Sophie et al

Poster (2013, October)

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See detailGP’s engagement in detecting and managing abuse of alcohol, illegal drugs, hypnotics and tranquilizers in the Belgian adult population
Ketterer, Frédéric ULg; Lambrechts, Marie-Claire; Symons, Linda et al

in European Journal of General Practice (2013, September), 19(3), 162-184

Background General practitioners (GPs) Occupational physicians (OPs) can play an important role in detecting and managing substance abuse in the working population. The UP TO DATE project aims at ... [more ▼]

Background General practitioners (GPs) Occupational physicians (OPs) can play an important role in detecting and managing substance abuse in the working population. The UP TO DATE project aims at identifying the difficulties these professionals encounter in this area, and to explore ways of collaboration in providing appropriate care. Research question What are the experiences, attitudes and decision making of GPs and OPs regarding to alcohol, illegal drugs, hypnotics and tranquilizers abuse from a physician’s perspective? Method In this qualitative study, with a phenomenological perspective, 20 GPs and 16 OPs, experienced with substance abuse in daily practice, got a face to face in-depth interview. (October until December 2012). Along with the data collection process the analysis started with a constant comparison between the data and the chosen integrated model of change (De Vries), using coding techniques of grounded theory. Results GPs meet important barriers to detect misuse of all substances. To address this issue and the patient’s motivation for change, the doctor-patient relationship is crucial. The risk to disturb the relationship, and loose the patient’s trust, is a major concern. An attitude of patient-centeredness, collaboration and empowerment of the patient is needed to make any progress, to get results and to overcome as a GP the burden of those demanding encounters. Self-care is an important concern. Collaboration with specialised health providers confronted GPs with various problems: not enough services, long waiting lists, unclear methods and criteria. GPs lack an insight in the OP’s role, and experience problems to contact them. Whether the OP is a trustful health advocate for their patient is a major concern. Some OPs are perceived too linked to the employer, raising legitimate concerns about professional confidentiality. Conclusion These are preliminary results. At the conference, a comprehensive overview on the qualitative analysis will be given. [less ▲]

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See detailInformal caregiver involvement in innovative home care projects in Belgium
Lopez Hartmann; Van Durme, Thérèse; Maggi, Patrick ULg et al

Poster (2013, April)

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See detailCase management projects enabling frail older people to stay in their own home a nested analysis within the framework of the evaluation of Protocol 3 projects
Van Durme, Thérèse; Macq, Jean; Lopez Hartmann, Maja et al

Poster (2013, February 22)

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See detailA review of guidelines for collaboration in substance misuse management
Van Royen, Kathleen; Remmen, Roy; Vanmeerbeek, Marc ULg et al

in Occupational Medicine (2013), 63(6), 445-447

Background: Substance abuse among the working population results in increasing economic costs. General practitioners (GP) and occupational physicians (OP) can play a central role in detecting and managing ... [more ▼]

Background: Substance abuse among the working population results in increasing economic costs. General practitioners (GP) and occupational physicians (OP) can play a central role in detecting and managing substance abuse in the working population. Their collaboration could be critical in coordinating care, in facilitating rehabilitation and in reducing sick leave. Aims: To search in guidelines for evidence on collaboration between GPs and OPs in substance abuse detection and management in the working population. Methods: International guidelines regarding collaborative care for alcohol abuse, illicit drug use and hypnotics and tranquilizers were identified by a systematic search in the Guidelines International Network (GIN) and US National Guidelines Clearinghouse (NGC) databases. Results: In total 20 guidelines were considered of sufficient methodological quality, based on criteria of the Appraisal of Guidelines for Research and Education (AGREE) II instrument. Only two guidelines reported on the OP’s role in screening and intervention for alcohol abuse. Conclusion: There is a lack of evidence on the OP’s role and on collaboration between GPs and OPs. We recommend studying their respective roles in substance abuse management, the effectiveness of workplace interventions, pros and cons of collaboration as well as the best way to achieve this if recommended. [less ▲]

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See detailCollaborative care in the addiction management of alcohol, illicit drugs and hypnotics and tranquilizers in the Belgian working population
Van Royen, Kathleen; Remmen, Roy; Vanmeerbeek, Marc ULg et al

Poster (2012, October)

Background: General practitioners (GPs) and occupational physicians (OPs) play an important role in detecting and managing substance abuse in the working population. Their collaboration is critical in ... [more ▼]

Background: General practitioners (GPs) and occupational physicians (OPs) play an important role in detecting and managing substance abuse in the working population. Their collaboration is critical in coordinating care, facilitate a quicker rehabilitation and shorten sickleave. A systematic literature search was performed according to the ADAPTE-framework to explore if guidelines exist for collaboration between GPs and OPs in substance abuse management. Method: International guidelines regarding collaborative care for alcohol abuse, illicit drug use and hypnotics and tranquilizers were identified by a detailed systematic search in the Guidelines International Network (GIN) and US National Guidelines Clearinghouse (NGC) databases. Results: In total 20 guidelines were considered of sufficient methodological quality, based on criteria of the Appraisal of Guidelines for Research and Education (AGREE) II instrument. Two out of 20 eligible guidelines reported on the role of OPs. There is a lack of adequate evidence on the role of the OP in substance abuse management. No practical avenues for collaboration between GPs and OPs in the management of substance abuse were suggested. Conclusions: In order to ensure adequate substance abuse management, collaborative models for general practice and occupational health should be developed. We recommend to study pros and cons for collaboration as well as the best way to achieve it. [less ▲]

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See detailAdvantages, disadvantages and feasibility of Pay-for-Quality programs in Belgium
Van Herck, Pieter; Sermeus, Walter; Annemans, Lieven et al

in BMC Health Services Research (2010, October), 10

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See detailAvantages, désavantages et faisabilité de l’introduction de programmes “P4Q” en Belgique
Annemans, Lieven; Boeckxstaens, Pauline; Borgermans, Liesbeth et al

Report (2009)

This study is a logical follow up of previous KCE reports about quality of care, namely report 41 about clinical quality indicators in hospitals and report 76 about quality promotion in general practice ... [more ▼]

This study is a logical follow up of previous KCE reports about quality of care, namely report 41 about clinical quality indicators in hospitals and report 76 about quality promotion in general practice. Pay for Performance (P4P) or Pay for Quality initiatives (P4Q), who concentrate exclusively on the quality constituent of performance, establishes a direct correlation between the payment and the outcomes, assessed by structure, process and\or outcome indicators). P4Q initiative arouses an increasing interest, abroad as in our own country. However, the future Belgian initiatives will be able to reach their objective if they are based on what can be learned from experiences led abroad and on a theoretical frame fitting to the Belgian context. Accordingly, the present report will answer the following research questions: 1. What can be learned from the international P4Q models about: • Assessment: what are the benefits and the unintended consequences of the P4Q programs? • The concept and the implementation: which theoretical framework can be applied to the Belgian health care system; how should be conceived the financial incentives; what are the determining success factors? 2. What are the essential conditions required to apply the international P4Q models or add a P4Q constituent to the Belgian quality experiences? • What are the current initiatives in Belgium? Are there proofs of their impact on quality of care? • To what extent are financial planning, databases and other current tools (recommendations of good practice, quality indicators) adequate to implement a P4Q program in the Belgian context of health care? What are the determining factors for success or failure in the implementation of these programs? [less ▲]

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