Harm Van Marwijk

Harm Van Marwijk
Brighton and Sussex Medical School | BSMS · Department of Primary Care and Public Health Medicine

MD, PhD

About

489
Publications
86,768
Reads
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16,043
Citations
Citations since 2017
122 Research Items
8655 Citations
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Introduction
Harm van Marwijk is Head of the Department of Primary Care and Public Health at Brighton and Sussex Medical School and Primary and Community Care lead for the Kent Surrey and Sussex Applied Research Collaboration. His interests are driven by his key value, connectedness. He wants to support accessible primary care. He currently works on community engagement, symptoms management, real-world data, stress, pain, and frailty. He uses mixed methods for implementation science.
Additional affiliations
December 2017 - present
Brighton and Sussex Medical School
Position
  • Professor
February 2015 - December 2017
The University of Manchester
Position
  • Chair
March 2007 - March 2015
Amsterdam University Medical Center
Position
  • Professor (Associate)

Publications

Publications (489)
Article
Full-text available
Objective Identifying and managing the needs of frail people in the community is an increasing priority for policy makers. We sought to identify factors that enable or constrain the implementation of interventions for frail older persons in primary care. Design A rapid realist review. Data sources Cochrane Library, SCOPUS and EMBASE, and grey lit...
Article
Background: Current evidence supports the use of wearable trackers in by people with cardiometabolic conditions. However, as the health benefits are small and conflicted confounded by heterogeneity, there remains uncertainty of as to which patient groups are most helped by wearable trackers are most helpful. Objective: This study examined the eff...
Article
Full-text available
Background: Mobile health (mHealth) has the potential to bring preventive healthcare within reach of populations with limited access to preventive services, by delivering personalized support at low cost. Although numerous mHealth interventions are available, very few have been developed following an evidence-based rationale or have been tested for...
Article
Background: In some countries, such as the Netherlands and Norway, point-of-care testing (POCT) is more widely implemented in general practice compared to countries such as England and Australia. To comprehend what is necessary to realize the benefits of POCT, regarding its integration in primary care, it would be beneficial to have an overview of...
Article
Full-text available
Background Patients with diabetes mellitus type 2 (DM2) and/or coronary heart disease (CHD) are at high risk to develop major depression. Preventing incident major depression may be an important tool in reducing the personal and societal burden of depression. The aim of the current study was to assess the cost-effectiveness of a stepped care progra...
Article
De Vierdimensionale Klachtenlijst (4DKL) wordt in de huisartsenpraktijk veel gebruikt om psychische klachten in kaart te brengen. Huisartsen vragen zich wel eens af of de 4DKL wel hetzelfde meet bij mensen met een migratieachtergrond als bij mensen met een Nederlandse achtergrond. En mogen we de scores op dezelfde manier interpreteren? Om deze vrag...
Article
Full-text available
Objectives The aim of this study was to explore the extent of implementation of the General Medical Services 2018/2019 ‘frailty identification and management’ contract in general practitioner (GP) practices in England, and link implementation outcomes to a range of practice and Clinical Commissioning Group (CCG) factors. Design A cross-sectional s...
Article
Full-text available
Importance Wearable physical activity (PA) trackers, such as accelerometers, fitness trackers, and pedometers, are accessible technologies that may encourage increased PA levels in line with current recommendations. However, whether their use is associated with improvements in PA levels in participants who experience 1 or more cardiometabolic condi...
Article
Full-text available
Background Well-established electronic data capture in UK general practice means that algorithms, developed on patient data, can be used for automated clinical decision support systems (CDSSs). These can predict patient risk, help with prescribing safety, improve diagnosis and prompt clinicians to record extra data. However, there is persistent evi...
Article
Full-text available
Introduction Profiles of high risk for future dementia are well understood and are likely to concern mostly those in low-income and middle-income countries and people at greater disadvantage in high-income countries. Approximately 30%–40% of dementia cases have been estimated to be attributed to modifiable risk factors, including hypertension, smok...
Article
Full-text available
Purpose: All UK medical schools are required to include frailty in their curriculum. The term is open to interpretation and associated with negative perceptions. Understanding and recognising frailty is a prerequisite for consideration of frailty in the treatment decision-making process across clinical specialities. The aim of this survey was to d...
Article
Purpose: To assess the impact of EQ-5D country-specific value sets on cost-utility outcomes. Methods: Data from 2 randomized controlled trials on low back pain (LBP) and depression were used. 3L value sets were identified from the EuroQol Web site. A nonparametric crosswalk was employed for each tariff to obtain the likely 5L values. Differences...
Article
Full-text available
Cardiovascular disorders (CVD) are the single greatest cause of mortality worldwide. In the UK, the National Health Service (NHS) has launched an initiative of health checks over and above current care to tackle CVD. However, the uptake of Health Checks is poor in disadvantaged communities. This protocol paper sets out a UK-based study (Sussex and...
Article
The rising prevalence of dementia will largely occur in low‐ and middle‐income countries. Up to 30% of all dementia cases may be attributable to potentially modifiable risk factors. Therefore, lifestyle interventions targeting these risk factors can potentially prevent or delay the onset of dementia. Mobile Health (mHealth) may be a suitable way to...
Article
Objective: To assess the cost-effectiveness of a brief cognitive behavioural intervention for patients with medically unexplained physical symptoms (MUPS) provided by a mental health nurse practitioner (MHNP) in primary care in comparison with usual care. Methods: We performed an economic evaluation from a societal perspective alongside a cluster r...
Article
Full-text available
Objective To explore dementia management from a primary care physician perspective. Design One-page seven-item multiple choice questionnaire; free text space for every item; final narrative question of a dementia case story. Inductive explorative grounded theory analysis. Derived results in cluster analyses. Appropriateness of dementia drugs asses...
Presentation
Background: Older people (65+) with multimorbidity are more likely to experience patient safety incidents. In primary care, threats to patient safety often arise as a result of breakdowns in communication between patients and staff. Thus, interventions to improve communication could help reduce risks to patient safety. Research and policy regardi...
Article
Full-text available
Background: Sub-Saharan Africa (SSA) is experiencing an increasing burden of Cardiovascular Diseases (CVDs). Modifiable risk factors including hypertension, diabetes, obesity, central obesity, sedentary behaviours, smoking, poor diet (characterised by inadequate vegetable and fruit consumption), and psychosocial stress are attributable to the grow...
Article
Full-text available
Background: Timely diagnosis of dementia is a policy priority in the United Kingdom (UK). Primary care physicians receive incentives to diagnose dementia; however, 33% of patients are still not receiving a diagnosis. We explored automating early detection of dementia using data from patients’ electronic health records (EHRs). We investigated: a) ho...
Article
Background Policymakers are directing attention to addressing the needs of an ageing population. Since 2017, general practices in England have been contractually required to identify and code ‘frailty’ as a new clinical concept and, in doing so, support targeted management for this population with the aim of improving outcomes. However, embedding f...
Article
Full-text available
Objective Clinically applicable diabetes severity measures are lacking, with no previous studies comparing their predictive value with glycated hemoglobin (HbA 1c ). We developed and validated a type 2 diabetes severity score (the DIabetes Severity SCOre, DISSCO) and evaluated its association with risks of hospitalization and mortality, assessing i...
Article
Full-text available
Background Policymakers are directing attention to addressing the needs of an ageing population. Since 2017, general practices in England have been contractually required to identify and code ‘frailty’ as a new clinical concept and, in doing so, support targeted management for this population with the aim of improving outcomes. However, embedding f...
Article
Huisartsen zien veel patiënten met somatisch onvoldoende verklaarde lichamelijke klachten (SOLK). We onderzochten de effectiviteit van cognitieve gedragstherapie uitgevoerd door de praktijkondersteuner ggz bij patiënten met SOLK die minstens een half jaar klachten hadden met een clustergerandomiseerde gecontroleerde trial in 85 huisartsenpraktijken...
Article
Full-text available
Background: The presence of additional chronic conditions has a significant impact on the treatment and management of type 2 diabetes (T2DM). Little is known about the patterns of comorbidities in this population. The aims of this study are to quantify comorbidity patterns in people with T2DM, to estimate the prevalence of six chronic conditions i...
Preprint
Full-text available
Introduction Sub-Saharan Africa (SSA) is experiencing an increasing burden of Cardiovascular Diseases (CVDs). Modifiable risk factors including hypertension, diabetes, obesity, central obesity, sedentary behaviours, smoking, poor diet (characterised by inadequate vegetable and fruit consumption), and psychosocial stress are attributable to the grow...
Article
Full-text available
Naltrexone is used as an off-label treatment in low doses for several chronic immune-modulated disorders in many countries. Although only small-scale clinical trials have been performed, these suggest efficacy in several diseases including Crohn's disease, fibromyalgia and Gulf War Illness. Despite numerous internet reports of response to low-dose...
Article
Full-text available
Aim: To develop a questionnaire to measure quantitatively barriers and facilitators to women's disclosure of perinatal mental health problems in UK primary care. To pilot and evaluate the questionnaire for content validity and internal consistency. Background: Around 15% of women develop a mental illness in the perinatal period, such as depressi...
Article
Full-text available
Background: Identifying dementia early in time, using real world data, is a public health challenge. As only two-thirds of people with dementia now ultimately receive a formal diagnosis in United Kingdom health systems and many receive it late in the disease process, there is ample room for improvement. The policy of the UK government and National...
Article
Objective: To examine if chest pain increases the risk of depression and anxiety, or, on the other hand, depression and anxiety increase the risk of chest pain onset in patients with coronary heart disease (CHD). Design: Prospective clinical study. Setting: 16 general practices in the Greater London Primary Care Research Network. Participants...
Article
Full-text available
Importance Accelerometers and pedometers are accessible technologies that could have a role in encouraging physical activity (PA) in line with current recommendations. However, there is no solid evidence of their association with PA in participants with 1 or more cardiometabolic conditions such as diabetes, prediabetes, obesity, and cardiovascular...
Preprint
Introduction Sub-Saharan Africa (SSA) is experiencing an increasing burden of Cardiovascular Diseases (CVDs). Modifiable risk factors including hypertension, diabetes, obesity, central obesity, sedentary behaviours, smoking, poor diet (characterised by inadequate vegetable and fruit consumption), and psychosocial stress are attributable to the grow...
Preprint
Full-text available
Introduction Sub-Saharan Africa (SSA) is experiencing an increasing burden of Cardiovascular Diseases (CVDs). Modifiable risk factors including hypertension, diabetes, obesity, central obesity, sedentary behaviours, smoking, poor diet (characterised by inadequate vegetable and fruit consumption), and psychosocial stress are attributable to the grow...
Conference Paper
Full-text available
Background and aims: Type 2 diabetes (T2DM) prevalence is increasing worldwide. But, a validated and clinically applicable T2DM severity measure derived from medical data is lacking. We aimed to: 1) develop and validate a disease severity score (DISSCO) in T2DM patients using electronic health data, 2) evaluate the score's association with risks of...
Article
Full-text available
Background The presence of additional chronic conditions has a significant impact on the treatment and management of type 2 diabetes (T2DM). Little is known about the patterns of comorbidities in this population. The aims of this study are to quantify comorbidity patterns in people with T2DM, to estimate the prevalence of six chronic conditions in...
Article
Full-text available
Background: Depressive symptoms and impaired physical functioning are prevalent among older adults. Supplementation with vitamin D might improve both conditions, particularly in persons with low vitamin D status. Objective: The D-Vitaal study primarily aimed to investigate the effect of vitamin D supplementation on depressive symptoms, functiona...
Presentation
The problem: Older people with multimorbidity are likely to experience more patient safety incidents. In primary care, threats to patient safety often arise as a result of breakdowns in communication between patients and staff. Thus, interventions to improve communication could help reduce risks to patient safety. Such interventions are commonly ai...
Article
Full-text available
Background: This study aimed to identify subgroups for whom supported self-help preventive cognitive therapy (S-PCT) is more (cost)effective than treatment as usual (TAU) in preventing relapse and recurrence of major depression. Methods: We conducted a randomized controlled trial in which 248 remitted, recurrently depressed participants were ran...
Article
Full-text available
Background Comorbid depression is common among patients with diabetes and has severe health consequences, but often remains unrecognized. Several questionnaires are used to screen for depression. A systematic review and meta-analysis regarding the diagnostic accuracy of depression questionnaires in adults with diabetes is unavailable. Our aim was t...
Article
Objective: To examine the effectiveness of a cognitive behavioural intervention delivered by mental health nurse practitioners (MHNPs) to patients with undifferentiated somatoform disorder (USD), compared to usual care. Methods: We conducted a cluster randomized trial among primary care patients with USD comparing the intervention to usual care....
Article
Full-text available
Background: Uganda is experiencing a shift in major causes of death with cases of stroke, heart attack, and heart failure reportedly on the rise. In a study in Mukono and Buikwe in Uganda, more than one in four adults were reportedly hypertensive. Moreover, very few (36.5%) reported to have ever had a blood pressure measurement. The rising burden...
Article
Full-text available
Background The Hopkins Symptom Checklist in 25 items (HSCL-25) helps to assess anxiety and depression in Primary Care. Anxiety and depression show considerable overlap in primary care. This self-administrated questionnaire is valid, reliable and ergonomic in the original US version. We have translated it into French. The aim of this study was to es...
Data
HSCL-25 Original version / HSCL-25 French version. (DOCX)
Data
Calculation of the F-HSCL-25 predictive values. (DOCX)
Conference Paper
Full-text available
Background/Aims: The assessment of disease severity in people with diabetes enables identification of patients in need for intensive and targeted therapies, and could help optimise the allocation of healthcare resources. We aimed to identify and appraise measures that have used clinical data to establish systems for grading Type 2 diabetes severity...
Article
Aims To identify and critically appraise measures that use clinical data to grade the severity of Type 2 diabetes. Methods We searched MEDLINE, Embase and PubMed between inception and June 2018. Studies reporting on clinical data‐based diabetes‐specific severity measures in adults with Type 2 diabetes were included. We excluded studies conducted s...
Article
Full-text available
Background Naltrexone is an opioid antagonist used in many different conditions, both licensed and unlicensed. It is used at widely varying doses from 3 to 250 mg. The aim of this review was to extensively evaluate the safety of oral naltrexone by examining the risk of serious adverse events and adverse events in randomised controlled trials of nal...
Article
Full-text available
Mindfulness has transdiagnostic applicability, but little is known about how people first begin to practice mindfulness and what sustains practice in the long term. The aim of the present research was to explore the experiences of a large sample of people practicing mindfulness, including difficulties with practice and associations between formal a...
Article
Full-text available
Background Comorbid depression is common in patients with type 2 diabetes (DM2) and/or coronary heart disease (CHD) and is associated with poor quality of life and adverse health outcomes. However, little is known about patients’ and practice nurses’ (PNs) perceptions of depression. Tailoring care to these perceptions may affect depression detectio...
Article
Full-text available
Background Major depression is a prevalent mental disorder with a high risk of relapse or recurrence. Only few studies have focused on the cost-effectiveness of interventions aimed at the prevention of relapse or recurrence of depression in primary care. Aim To evaluate the cost-effectiveness of a supported Self-help Preventive Cognitive Therapy (...
Article
Full-text available
Objective From a systematic literature review (SLR), it became clear that a consensually validated tool was needed by European General Practitioner (GP) researchers in order to allow multi-centred collaborative research, in daily practice, throughout Europe. Which diagnostic tool for depression, validated against psychiatric examination according t...
Article
Pain might be an important risk factor for common mental disorders. Insight into the longitudinal association between pain and common mental disorders in the general adult population could help improve prevention and treatment strategies. Data were used from the first 2 waves of the Netherlands Mental Health Survey and Incidence Study-2, a psychiat...
Article
Full-text available
Objective: To explore the persistency of Medically Unexplained Symptoms (MUS) and its prognostic factors in the general adult population. Knowledge of prognostic factors of MUS may indicate possible avenues for intervention development. Methods: Data were derived from the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2), a nationa...
Article
Objective: To examine the longitudinal association between pain and suicidal ideation in the general adult population. Method: Data were used from two waves (baseline and three-year follow-up) of the Netherlands Mental Health Survey and Incidence Study-2. Persons without prior 12-month suicidal ideation at baseline were included in this study (N...
Article
Doel Preventieve cognitieve therapie (PCT) is een zelfhulptherapie voor de eerste lijn, ontwikkeld om terugval in een depressie te voorkomen. Methode Gerandomiseerd gecontroleerd onderzoek waarin gebruikelijke zorg (onder andere antidepressiva) werd vergeleken met gebruikelijke zorg plus PCT. Deelnemers waren 18 jaar of ouder, hadden minimaal twee...