Papers by Onno Van Schayck
npj Primary Care Respiratory Medicine
Although tobacco smoking is the world’s most important preventable cause of many chronic diseases... more Although tobacco smoking is the world’s most important preventable cause of many chronic diseases (including COPD and asthma) and premature death, many physicians do not routinely apply smoking cessation in the daily health care of their patients. Two widely felt important concerns of physicians are that smoking cessation as part of a treatment is time-consuming and may jeopardize their relationship with patients. Very Brief Advice (VBA) is a non-confrontational method, which could assist general practitioners (GPs) as a simple, quick first step in getting patients to stop smoking. In this study, we investigated the opinions and experiences of GPs with VBA in their routine care in two rounds of telephone interviews with 19 GPs. The interviews were recorded and transcribed and subsequently analysed with NVivo12. We observed that the GPs had a very positive experience with using VBA. They found the method to be efficient as to the time involved, patient-friendly and easy to implement.
BACKGROUND The impact of the Corona Virus Disease (COVID-19) is being felt across the world, and ... more BACKGROUND The impact of the Corona Virus Disease (COVID-19) is being felt across the world, and yet we still know little about its full impact. One of the most serious gaps in our current knowledge concerns infection’s long-term mental and physical impact of the infection on affected individuals. The COVID-19 pandemic hit the Netherlands in the end of February 2020, resulting in almost 50,000 people testing positive for the virus, 11,850 hospitalizations, and over 6,000 deaths by the end of June1. Although many patients recover from the acute phase of the disease, experience with other viruses raises serious concerns regarding possible late sequelae of the infection. OBJECTIVE A group of experts (members of a patient-oriented pressure group, pulmonologists, scientists, IT-experts) recognized the need for a reliable tool to assess the long-term impact of COVID-19 infection on individual patients. METHODS Here, we describe the process of the development, assessment, programming, impl...
International Journal of Environmental Research and Public Health
Randomized studies have shown that financial incentives can significantly increase the effect of ... more Randomized studies have shown that financial incentives can significantly increase the effect of smoking cessation treatment in company settings. Evidence of effectiveness alone is, however, not enough to ensure that companies will offer this intervention. Knowledge about the barriers and facilitators for implementation in the workplace is needed, in order to develop an implementation strategy. We performed a qualitative needs assessment among 18 employers working in companies with relatively many employees with a low educational level, and our study revealed priority actions that aim to improve the implementation process in these types of workplaces. First, employers need training and support in how to reach their employees and convince them to take part in the group training. Second, employers need to be convinced that their non-smoking employees will not consider the incentives unfair, or they should be enabled to offer alternative incentives that are considered less unfair. Thir...
Nutrients
Schools can help to improve children’s health. The ‘Healthy Primary School of the Future’ (HPSF) ... more Schools can help to improve children’s health. The ‘Healthy Primary School of the Future’ (HPSF) aims to sustainably integrate health and well-being into the school system. This study examined the effects of HPSF on children’s dietary and physical activity (PA) behaviours after 1 and 2 years’ follow-up. The study (n = 1676 children) has a quasi-experimental design with four intervention schools, i.e., two full HPSF (focus: nutrition and PA) and two partial HPSF (focus: PA), and four control schools. Accelerometers and child- and parent-reported questionnaires were used at baseline, after 1 (T1) and 2 (T2) years. Mixed-model analyses showed significant favourable effects for the full HPSF versus control schools for, among others, school water consumption (effect size (ES) = 1.03 (T1), 1.14 (T2)), lunch intake of vegetables (odds ratio (OR) = 3.17 (T1), 4.39 (T2)) and dairy products (OR = 4.43 (T1), 4.52 (T2)), sedentary time (ES = −0.23 (T2)) and light PA (ES = 0.22 (T2)). Almost no ...
Thorax, 2018
Improved biomass cookstoves may help reduce the substantial global burden of morbidity and mortal... more Improved biomass cookstoves may help reduce the substantial global burden of morbidity and mortality due to household air pollution (HAP) that disproportionately affects women and children in low and middle income countries (LMICs). Systematic review and meta-analysis of (quasi-)experimental studies identified from 13 electronic databases (last update: 6 April 2018), reference and citation searches and via expert consultation. LMICs PARTICIPANTS: Women and children INTERVENTIONS: Improved biomass cookstoves MAIN OUTCOME MEASURES: Low birth weight (LBW), preterm birth, perinatal mortality, paediatric acute respiratory infections (ARIs) and COPD among women. We identified 53 eligible studies, including 24 that met prespecified design criteria. Improved cookstoves had no demonstrable impact on paediatric lower ARIs (three studies; 11 560 children; incidence rate ratio (IRR)=1.02 (95% CI 0.84 to 1.24)), severe pneumonia (two studies; 11 061 children; IRR=0.88 (95% CI 0.39 to 2.01)), LBW...
Global health action, 2018
While any type of field-based research is challenging, building action-oriented, participatory re... more While any type of field-based research is challenging, building action-oriented, participatory research in resource-constrained settings can be even more so. In this article, we aim to examine and provide insights into some of the practical challenges that were faced during the course of a participatory project based in two non-notified slums in Bangalore, India, aiming to build solutions to indoor air pollution from cooking on traditional cook stoves. The article draws upon experiences of the authors as field researchers engaged in a community-based project that adopted an exploratory, iterative design to its planning and implementation, which involved community visits, semi-structured interviews, prioritization workshops, community forums, photo voice activities, chulha-building sessions and cooking trials. The main obstacles to field work were linked to fostering open, continued dialogue with the community, aimed at bridging the gap between the 'scientific' and the 'l...
Lancet (London, England), Feb 17, 2017
Translational Behavioral Medicine
iOS and Android smartphone users may differ in ways that affect their use and likelihood of succe... more iOS and Android smartphone users may differ in ways that affect their use and likelihood of success when using a smoking cessation application (app). If so, it may be necessary to take the device type (iOS and Android) into account when designing smoking cessation apps and in studies evaluating app effectiveness. How do sociodemographic and smoking characteristics, potentially relevant to engagement and cessation outcomes, of the SF28 app users differ between those using the iOS version and those using the Android version? Data were collected between October 2013 and April 2015. The variables measured were age, gender, social grade, time since the most recent quit attempt, choice of medication use (nicotine replacement therapy or varenicline), weekly expenditure on cigarettes, cigarettes smoked per day, reason for using the app and quit date set. The alpha was set to p < 0.006 to adjust for multiple comparisons. A total of 1368 users were included in the analysis. iOS and Android device users were similar in terms of age, social grade, weekly expenditure on cigarettes and cigarettes smoked per day. Compared with Android users, iOS users were more likely to have downloaded the app for a serious quit attempt (74.3 versus 69.6%, p = 0.001), made a quit attempt within the last 12 months (59.6 versus 45.9%, p < 0.001) and set their quit date on the day of registration (61 versus 46.2%, p < 0.001). They were less likely to have used stop-smoking medication to support their quit attempt (31.5 versus 48.6%, p < 0.001). Differences between smokers using the iOS version of smoking cessation apps and those using the Android version may influence quit success.
Addiction
Aims To study the effectiveness of intensive counselling by a practice nurse (PN) versus brief ad... more Aims To study the effectiveness of intensive counselling by a practice nurse (PN) versus brief advice by a general practitioner (GP), each combined with pharmacotherapy, for 6 months' tobacco abstinence (primary outcome). Secondary outcomes included 12-month abstinence, medication adherence and incremental costs per life-year gained. Design A multi-site (n = 10), two-group, parallel, pragmatic randomized controlled trial. Setting A network of primary healthcare centres in the Netherlands. Participants A total of 295 adult daily smokers (mean age = 48 years; mean cigarettes/day = 19). Intervention and comparator Patients were randomized to receive individual counselling by a practice nurse (PN) (n = 149) or brief advice by a general practitioner (GP) (146). All patients received 12 weeks of open-label varenicline. Measurements The primary outcome was prolonged biochemically validated abstinence from weeks 9 to 26 after treatment initiation. Secondary outcomes included abstinence from weeks 9 to 52, good dosing adherence (> 80% days taken) and incremental costs per life-year gained. Findings Abstinence rates in the PN versus GP groups were 32.2% (n = 48) versus 39.0% [n = 57; odds ratio (OR) = 0.71; 95% confidence interval (CI) = 0.44-1.16] from weeks 9 to 26 and 25.5% (n = 38) versus 28.8% (n = 42; OR = 0.84, 95% CI = 0.50-1.43) from weeks 9 to 52, respectively. Values of the Bayes factor indicated that the PN and GP were equally effective. Good dosing adherence was significantly lower in the PN (45.5%, n = 56/123) than in the GP group (62.0%, n = 75/121; OR = 0.45, 95% CI = 0.26-0.77), and the incremental costs per life-year gained were -€416.10. Conclusions Among people seeking help to stop smoking from their general practice, one-off brief advice from a general practitioner appears to be as effective as several sessions of behavioural support from a practice nurse when smoking cessation medication is provided.
European Respiratory Journal
In Western countries, cigarette smoking is the most important risk factor for the development of ... more In Western countries, cigarette smoking is the most important risk factor for the development of chronic obstructive pulmonary disease (COPD) . Besides, patients with COPD who continue to smoke have a higher prevalence of respiratory symptoms, more accelerated decline in lung function and higher mortality rate than nonsmokers . Therefore, smoking cessation is the single most effective way to prevent COPD and reduce its progression . The Cochrane Review on smoking cessation interventions for people with COPD shows that evidence-based smoking cessation interventions exist, but the chances of successful quitting are still relatively low in this group of smokers [2]. The effectiveness of such interventions can depend on the characteristics of the patient [3]. Knowing which patient characteristics are associated with successful quitting might facilitate the design of more effective smoking cessation interventions for patients with COPD.
International Journal of Integrated Care
In the last years a large number of telecare and eHealth technologies have been developed which c... more In the last years a large number of telecare and eHealth technologies have been developed which can be used in primary care to support patients with a chronic condition with selfmanagement. However, these technologies are not yet frequently implemented and routinely used in the healthcare process. One of the reasons is that there is a mismatch between patients' needs and technological solutions. Before care technologies can be implemented on a large scale, patients' needs and preferences regarding the use of these services should be investigated.
Psychopharmacology
Objective In the current study, we use functional magnetic resonance imaging (fMRI) and multi-vox... more Objective In the current study, we use functional magnetic resonance imaging (fMRI) and multi-voxel pattern analysis (MVPA) to investigate whether tobacco addiction biases basic visual processing in favour of smoking-related images. We hypothesize that the neural representation of smoking-related stimuli in the lateral occipital complex (LOC) is elevated after a period of nicotine deprivation compared to a satiated state, but that this is not the case for object categories unrelated to smoking. Methods Current smokers (≥10 cigarettes a day) underwent two fMRI scanning sessions: one after 10 h of nicotine abstinence and the other one after smoking ad libitum. Regional blood oxygenated level-dependent (BOLD) response was measured while participants were presented with 24 blocks of 8 colour-matched pictures of cigarettes, pencils or chairs. The functional data of 10 participants were analysed through a pattern classification approach.
The European respiratory journal, 2017
We thank for their comments on the Assessment of Burden of COPD (ABC) tool. They raised questions... more We thank for their comments on the Assessment of Burden of COPD (ABC) tool. They raised questions about the purpose of the ABC tool. The aims of ABC were clarified before its development, in the study protocol . The ABC tool is multifaceted and was developed to measure burden of disease, facilitating shared decision making and formulation of a personal treatment plan . All of these purposes relate to increasing self-management and stimulating behavioural change, which are, most often, important components of individual treatment plans. The goal of most treatment plans is to increase health status. Health status was therefore the primary outcome of our study .
1.6 General Practice and Primary Care
PharmacoEconomics - Open
Introduction A multi-strategy community intervention known as the National Rural Health Mission (... more Introduction A multi-strategy community intervention known as the National Rural Health Mission (NRHM) was implemented in India from 2005 to 2012 in an attempt to reduce maternal and child mortality. Objective This study examined the extent to which the NRHM's maternal and child health (MCH) sector plans were implemented. We observed trends in how intergovernmental (use of central government funds by state governments) budgets were allocated and used to implement MCH plans in Haryana, India. Methods We conducted a retrospective assessment of programme implementation plans, MCH budget allocation and expenditure and financial monitoring reports during the NRHM implementation period. The yearly budget utilization rate was calculated for each MCH strategy implemented. On the basis of this budget utilization rate, we classed the extent of MCH strategy implementation as fully, partially or not implemented. The status of MCH indicators before, during and after the NRHM period was obtained from national demographic surveys. The budget utilization rate was correlated with MCH outcomes. Results The overall budget allocated for MCH plans increased from $US6.6 million during the 2005-2006 period to $US66.7 million in the 2012-2013 period. The rate of budget utilization increased from 20.6% in 2007-2008 to 89% in 2012-2013. Expenditure exceeded the initially allocated budget for patient referral services (111.5%), human resources (110.1%), drugs and logistics (170%), accredited social health activists (133.3%) and immunization (106.4%). Additional budget was obtained from the state health budget. Plans for referral services, human resources, drug provision, accredited social health activists and immunization were fully implemented, few schemes (\1%) were not implemented, and all other schemes were only partially implemented. MCH indicators improved significantly (p \ 0.05). The rate of institutional childbirth was highly and positively correlated with rates of budget utilization for implementing accredited social health activists (r = 0.96) and financial incentives for hospital delivery schemes (r = 0.5).
BMC Public Health
Background: A multi pronged community based strategy, known as National Rural Health Mission (NRH... more Background: A multi pronged community based strategy, known as National Rural Health Mission (NRHM), was implemented from 2005-06 to 2012-13 in India to curtail maternal and child health (MCH) disparities between poor and rich, rural and urban areas, and boys and girls,. This study aimed to determine the degree to which MCH plans of NRHM implemented, and resulted in improving the MCH outcomes and reducing the inequalities. Methods: An explanatory sequential mixed methods study was conducted, first to assess the degree of implementation of MCH plans by estimating the budget utilization rates of each MCH plan, and the effectiveness of these plans by comparing demographic health surveys data conducted post (2012-13), during (2007-08) and pre-(2002-04) NRHM implementation period, in the quantitative study. Then, perceptions and beliefs of stakeholders regarding extent and effectiveness of NRHM in Haryana were explored in the qualitative study during 2013. A logistic regression analysis was done for quantitative data, and inductive applied thematic analysis for qualitative data. The findings of the quantitative and qualitative parts of study were mixed at the interpretation level. Results: The MCH plans, like free ambulance service, availability of free drugs and logistics, accredited social health activists were fully implemented according to the budget spent on implementing these activities in Haryana. This was also validated by qualitative study. Availability of free medicines and treatment in the public health facilities had benefitted the poor patients the most. Accredited Social Health Activists scheme was also the most appreciated scheme that had increased the institutional delivery rates. There was acute shortage of human resources in-spite of full utilization of funds allocated for this plan. The results of the qualitative study validated the findings of quantitative study of significant (p < 0.05) improvement in MCH indicators and reduction in MCH disparities between higher and lower socioeconomic groups, and rural and urban areas. Conclusions: MCH plans of NRHM might have succeeded in improving the MCH outcomes and reducing the geographical and socioeconomic MCH inequalities by successfully implementing the schemes like accredited social health activists, free ambulance services, free treatment and medicines in hospitals for the poor and in rural areas.
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Papers by Onno Van Schayck