
Henk J SchersRadboud University Medical Centre (Radboudumc) · Department of Primary and Community care
Henk J Schers
Professor in General Practice
About
337
Publications
29,464
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Introduction
Henk J Schers is an academic general practitioner, researcher, Principal Clinician and Director of the Practice Based Research Network at the Department of Primary and Community care, Radboud University Medical Centre. His research interest is primarily on innovation: in general practice, transmural care (oncology, palliative care, elderly care), and registration and classification.
Publications
Publications (337)
Background
Personal continuity is an important dimension of continuity of care in general practice and is associated with many benefits including a higher quality of GP care and lower mortality rate. Over time, changes in society and health care have challenged the provision of personal continuity. Older patients in particular experience more negat...
Introduction
Despite recommendations, non-surgical treatment modalities in knee and/or hip osteoarthritis (KHOA) are underused. An information campaign was developed targeting patients with early stage KHOA and healthcare professionals (HCPs) to optimise timing of referral to secondary care. This protocol describes the development and design of thi...
Background
Implementing shared decision-making in oncology practice is often limited, particularly integrating the patient’s context into decision-making. To improve this, we conducted a quality improvement project, CONtext. CONtext attempts to accomplish this by: (1) Integrating the patient’s context into shared decision-making during consultation...
b>Background Personal continuity is an important dimension of continuity of care in general practice and is associated with many benefits including a higher quality of GP care and lower mortality rate. Over time, changes in society and healthcare have challenged the provision of personal continuity. Especially older patients experience more negativ...
Background:
Increases in opioid prescriptions have been described; however, recent trends and prescribing patterns of analgesics in Dutch general practice are largely unknown.
Objective:
To investigate recent changes in the number of analgesic prescriptions, and the indications for prescribing strong opioids. Furthermore, we aim to identify risk...
BACKGROUND
Artificial intelligence (AI) based diagnostic prediction models could aid primary care (PC) in decision making for faster and more accurate diagnoses. AI has the potential to transform electronic health records (EHR) data into valuable diagnostic prediction models. Different prediction models based on EHR have been developed. However, th...
Levothyroxine is one of the most prescribed drugs in the western world. Dosing is challenging due to high‐interindividual differences in effective dosage and the narrow therapeutic window. Model‐informed precision dosing (MIPD) using machine learning could assist general practitioners (GPs), but no such models exist for primary care. Furthermore, i...
Aim
To evaluate the effectiveness, feasibility and acceptability of a multicomponent intervention for improving personal continuity for older patients in general practice.
Design
A cluster randomised three-wedged, pragmatic trial during 18 months.
Setting
32 general practices in the Netherlands.
Participants
221 general practitioners (GPs), prac...
Background
Due to a heterogeneity of symptoms, a lack of an adequate diagnostic test and a lack of awareness, diagnostic delay in endometriosis in primary care on average amounts to 35 months.
Aim
To determine which interventions are most feasible to reduce time to diagnosis in primary care, focusing on GPs’ preferences, the intervention’s content...
Background
Several studies showed that during the pandemic patients have refrained from visiting their general practitioner (GP). This resulted in medical care being delayed, postponed or completely forgone. The provision of low-value care, i.e. care which offers no net benefit for the patient, also could have been affected. We therefore assessed t...
Objectives
Specialist-provided end-of-life scenarios (SP-EOLS) may improve advance care planning (ACP) implementation in primary care by helping overcome barriers such as uncertain prognosis and poor interprofessional collaboration. We aimed to explore the current use and potential impact of SP-EOLS on ACP in Dutch primary care.
Methods
We perform...
Background
Recent findings show that intentions to adhere to conservative treatment of OA are negatively influenced by certain beliefs and rely strongly on testimonies of others. Message framing, i.e., focusing on either gains or losses, and the use of a patient testimonial in educational material are commonly used techniques to influence beliefs,...
Introduction:
The burden of symptoms is a subjective experience of distress. Little is known on the burden of feeling unwell in patients with persistent symptom diagnoses. The aim of this study was to assess the burden in primary care patients with persistent symptom diagnoses compared to other primary care patients.
Methods:
A cross-sectional s...
Objectives
For older people who worry about their memory, their general practitioner (GP) is often the first healthcare professional they turn to. This study aims to increase knowledge of GPs' daily practice on diagnostic strategies for patients who present themselves with memory complaints and/or worries about dementia for the first time in genera...
Background
Because of the increasing incidence of actinic keratosis (AK), optimal use of limited healthcare resources is essential. Although most patients can be managed in primary care, dermatology referrals are common. More profound knowledge of general practitioners’ (GPs) considerations might assist in enhancing AK care.
Methods
The aim of the...
Objective
During the COVID-19 pandemic new collaborative-care initiatives were developed for treating and monitoring COVID-19 patients with oxygen at home. Aim was to provide a structured overview focused on differences and similarities of initiatives of acute home-based management in the Netherlands.
Methods
Initiatives were eligible for evaluati...
Background:
knee complaints are one of the most common reasons to consult the general practitioners in the Netherlands and contribute to the increasing burden on general practitioners. A proportion of patients that are referred to orthopedic outpatient clinics are potentially referred unnecessarily. We believe osteoarthritis is not always consider...
Purpose:
Personal continuity between patient and physician is a core value of primary care. Although previous studies suggest that personal continuity is associated with fewer potentially inappropriate prescriptions, evidence on continuity and prescribing in primary care is scarce. We aimed to determine the association between personal continuity...
This study aimed to quantify the confirmation of gallstones on ultrasound (US) in patients with suspicion of gallstone disease. To aid general practitioners (GPs) in diagnostic workup, a model to predict gallstones was developed. A prospective cohort study was conducted in two Dutch general hospitals. Patients (≥18 years) were eligible for inclusio...
Introduction:
Symptom diagnoses are diagnoses used in primary care when the relevant diagnostic criteria of a disease are not fulfilled. Although symptom diagnoses often get resolved spontaneously without a clearly defined illness nor treatment, up to 38% of these symptoms persist more than 1 year. It is largely unknown how often symptom diagnoses...
Objective
To describe beliefs about urate lowering therapy (ULT) of physicians and patients in primary and secondary care, to examine differences in physicians’ medication beliefs, and to examine the association of physicians’ medication beliefs with prescribed dosage of ULT, gout outcomes, and patients’ medication beliefs.
Methods
Cross-sectional...
Background
Despite recommendations, non-surgical treatment modalities in knee and/or hip osteoarthritis (KHOA) are underused. This article describes the development and content of an information campaign and the design of a randomized controlled trial (RCT) on the effectiveness of such a information campaign, targeting both KHOA patients and health...
Background
Message framing, i.e., focusing on either gains or losses, is a commonly used technique in health communication to influence beliefs, and ultimately, health behaviors. The use of a patient testimonial in educational material might also strengthen effects.
Objectives
To study the effects of 1) message framing and 2) patient testimonials...
Background
Prescription opioid use has increased steadily in many Western countries over the past two decades, most notably in the US, Canada, and most European countries, including the Netherlands. Especially the increasing use of prescription opioids for chronic non-cancer pain has raised concerns. Most opioids in the Netherlands are prescribed i...
Background
Personal continuity – having a GP who knows his or her patients and keeps track of them -is an important dimension of continuity of care andis associated with lower mortality rates, higher quality of life and reduced healthcare costs. In the last decades, it has become more challenging for general practitioners (GPs) to provide personal...
Context Knowledge of incidence, prevalence and trends in morbidity support the diagnostic process of general practitioners (GPs). GPs use estimated probabilities of probable diagnoses to guide their policy on testing and referral. However, GPs estimations often are implicit and imprecise. The International Classification of Primary Care (ICPC) has...
Objectives To identify highly-ranked features related to clinicians’ diagnosis of clinically relevant knee osteoarthritis (OA).
Methods General practitioners (GPs) and secondary care physicians (SPs) were recruited to evaluate 5–10 years follow-up clinical and radiographic data of knees from the CHECK cohort for the presence of clinically relevant...
Background
Timely initiation of advance care planning (ACP) in general practice is challenging, especially in patients with non-malignant conditions. Our aim was to investigate how perceived optimal timing of ACP initiation and its triggers relate to recorded actual timing in patients with cancer, organ failure, or multimorbidity.
Methods
In this...
Background
Persistent fatigue after COVID-19 is common; however, the exact incidence and prognostic factors differ between studies. Evidence suggests that age, female sex, high body mass index, and comorbidities are risk factors for long COVID.
Aim
To investigate the prevalence of persistent fatigue after COVID-19 in patients with a mild infection...
Introduction
Optimal collaboration between general practice and hospital care is crucial to maintain affordable and sustainable access to healthcare for the entire population. General practitioners (GPs) are the gatekeepers to specialist care and patients will visit hospitals mostly only after referral. However, a substantial part of these referral...
Background
knee complaints are one of the most common reasons to consult the general practitioners in the Netherlands and contribute to the increasing burden on general practitioners. A proportion of patients that are referred to orthopedic outpatient clinics are potentially referred unnecessarily. We believe osteoarthritis is not always considered...
Bij veel klachten in de huisartsenpraktijk speelt sociale problematiek een rol. Huisartsen en praktijkondersteuners kunnen via een ‘sociaal recept’ verwijzen naar een niet-medische instantie voor het aanpakken van risicofactoren, financiële problemen, eenzaamheid of chronische psychiatrische klachten. Meestal gaat het dan om gezamenlijke activiteit...
Background
Personal continuity of care is a core value of general practice. It is increasingly threatened by societal and healthcare changes.
Aim
To investigate the association between personal continuity and both practice and patient characteristics; and to incorporate GPs’ views to enrich and validate the quantitative findings.
Design and setti...
The World Organization of Family Doctors (WONCA) developed the third edition of the International Classification of Primary Care (ICPC-3) to support the shift from a medical perspective to a person-centered perspective in primary health care. The previous editions (ICPC-1 and ICPC-2) allowed description of 3 important elements of health care encoun...
Medicatieovergebruikshoofdpijn (MOH) is een veelvoorkomend probleem waar artsen te weinig alert op zijn. Het beste is abrupt stoppen met de pijnmedicatie, maar voor veel patiënten is dat erg lastig. Ondersteunende medicatie is niet bewezen effectief om een terugval te voorkomen. Wat wel helpt, is vertrouwen, begrip en intensieve begeleiding – zo no...
Basal cell carcinoma (BCC) is the most common cancer type in the Netherlands and frequently diagnosed in older adults. Unlike other common forms of skin cancer (squamous cell carcinoma and melanoma), BCC generally grows slowly and the risk of metastasis and/or death is extremely small. In the first years after presentation, BCC often causes no or o...
Background
In primary care, a shift from a disease‐oriented approach for patients with multimorbidity towards a more person‐centred approach is needed.
Aim
To transform a self‐report questionnaire for patients with chronic conditions in primary care, the Primary Care Functioning Scale (PCFS), into an understandable, visually attractive and feasibl...
Background
Quality indicators (QIs) are used to monitor quality of care and adherence to osteoarthritis (OA) standards of care. Patient reported QIs can identify the most important gaps in quality of care and the most vulnerable patient groups. The aim of this study was to capture the perspective of people with knee OA (KOA) in the Netherlands on t...
The past 20 years, the USA is facing a serious opioid crisis initiated by an increase in prescription opioid use. Europe has also seen an increase in prescription opioid use, but the extent of related harm is still largely unknown. Given the impact of the US opioid epidemic, it is important to closely monitor signs of emerging opioid-related proble...
The management of gallstones in primary care is challenging. After diagnosis, the GP has to decide which symptomatic patients will profit from referral for surgery. This is complicated, as many patients will continue to have symptoms also after surgery. A prediction model can support the GP in giving a more personalized advice. The prediction model...
Objective:
The shared decision-making (SDM) process for the treatment of pancreatic and oesophageal cancer primarily takes place with healthcare professionals (HCPs) in the hospital setting. This study aims to explore the perspectives of general practitioners (GPs) on their possible roles during this SDM process, their added value and their requir...
Background
Advance Care Planning (ACP) enables physicians to align healthcare with patients’ wishes, reduces burdensome life-prolonging medical interventions, and potentially improves the quality of life of patients in the last phase of life. However, little objective information is available about the extent to which structured ACP conversations a...
Background
Appropriate timing to initiate advance care planning is difficult, especially for individuals with non-malignant disease in community settings.
Aim
To identify the optimal moment for, and reasons to initiate advance care planning in different illness trajectories.
Design and methods
A health records survey study; health records were pr...
In 2015 is met de Wet langdurige zorg (WLZ) de ouderenzorg hervormd. In dit onderzoek zijn 4 huisartsen geïnterviewd over de effecten daarvan. Zij waren gematigd positief, maar versnippering van de thuiszorg en gebrek aan financiering voor multidisciplinaire samenwerking zijn bedreigingen voor geïntegreerde zorg aan kwetsbare thuiswonende ouderen.
Background
Early diagnosis of knee osteoarthritis (OA) is important in managing this disease, but such an early diagnostic tool is still lacking in clinical practice. The purpose of this study was to develop diagnostic models for early stage knee OA based on the first 2-year clinical course after the patient’s initial presentation in primary care a...
Objectives:
To examine general practitioners' (GP) management of cholecystolithiasis and to evaluate persisting abdominal complaints in the years after the diagnosis.
Design:
Retrospective analysis of registry data and a subset of individual medical records.
Setting:
Seventeen primary care practices affiliated with the Radboudumc Practice Base...
Background
Continuity of care, in particular personal continuity, is a core principle of general practice and is associated with many benefits such as a better patient-provider relationship and lower mortality. However, personal continuity is under pressure due to changes in society and healthcare. This affects older patients more than younger pati...
Background
From the beginning of the COVID-19 pandemic, worries have been exposed about collateral damage to patients’ health through postponed appointments, and delayed diagnostic testing and referrals in general practice.AimTo study delays in presentation and management of health problems in general practice during the first 9 months of the COVID...
Background: Quality indicators (QIs) are used to monitor quality of care and adherence to osteoarthritis (OA) standards of care. Patient reported QIs can identify the most important gaps in quality of care and the most vulnerable patient groups. The aim of this study was to capture the perspective of people with knee OA (KOA) in the Netherlands on...
Introduction:
Structuring patient and practice data into episodes formed the foundation of the earliest evidence base of family medicine. We aim to make patients' narratives part of the evidence base for family medicine by incorporating coded and structured information on the patient's reason to visit the family physician (FP) and adding the patie...
Background
Advance Care Planning (ACP) enables physicians to align healthcare with patients wishes, reduces burdensome life-prolonging medical interventions, and potentially improves the quality of life of patients in the last phase of life. However, little objective information is available about the extent to which structured ACP conversations ar...
Background
Uric acid lowering therapy (ULT) can be effective in gout if taken correctly (1), but non-adherence is a known problem (2). Although patients’ adherence barriers regarding ULT, such as lack of knowledge on disease and therapy, and beliefs, have been widely studied (3), less is known physicians’ beliefs.
Objectives
To investigate the phy...
Over the past decades, health care services for pancreatic surgery were reorganized. Volume norms were applied with the result that only a limited number of expert centers perform pancreatic surgery. As a result of this centralization of pancreatic surgery, the patient journey of patients with pancreatic tumors has become multi-institutional. To il...
This study explores the long-term care (LTC) reform in the Netherlands and its relation to the day-to-day integrated care for frail elderly people, from the perspective of general practitioners (GPs). We assessed GP perspectives regarding which elements of the LTC reform have promoted and hindered the provision of person-centred, integrated care fo...
Wanneer huisartsen meer aandacht besteden aan de familiaire belasting voor premature hartzieken kunnen nog niet ontdekte risicofactoren aan het licht komen, zoals een hoog cholesterol of een hoge bloeddruk. Dat kan leiden tot een betere primaire preventie. Moeten huisartsen niet vaker de familieanamnese uitvragen, zodat ze hoogrisicopatiënten tijdi...
Background
The Surprise Question (“ Would I be surprised if this patient were to die within the next 12 months?”) is widely used to identify palliative patients, though with low predictive value. To improve timely identification of palliative care needs, we propose an additional Surprise Question (“ Would I be surprised if this patient is still ali...
We studied the changes in presented health problems and demand for primary care since the outbreak of coronavirus disease 2019 (COVID-19) in the Netherlands. We analyzed prominent symptom features of COVID-19, and COVID-19 itself as the reason for encounter. Also, we analyzed the number and type of encounters for common important health problems. R...
Background:
Respiratory tract infections (RTIs) are common in children with febrile illness visiting the general practitioner (GP) or emergency department. We studied the management of children with fever and RTI at 3 different levels of healthcare in The Netherlands, focusing on antibiotic prescription.
Methods:
This prospective observational s...
Background
Long-term health sequelae of COVID-19 may be multiple but have thus far not been systematically studied.
Methods
All patients discharged after COVID-19 from the Radboud university medical centre, Nijmegen, The Netherlands, were consecutively invited to a multidisciplinary outpatient facility. Also, non-admitted patients with mild diseas...
Background:
General practitioners (GPs) are advised to offer advance care planning (ACP) to people with dementia (PWD). In a randomized controlled trial, an educational intervention for GPs aimed at initiating and optimizing ACP proved to be effective. During the intervention most GPs were accompanied by their practice nurse (PN). To provide insig...
Background:
To evaluate the effect of a stand-alone mobile and web-based educational intervention (eHealth tool) compared to usual preparation of a first orthopedic consultation of patients with hip or knee osteoarthritis (OA) on patients' satisfaction.
Methods:
A two-armed randomized controlled trial involving 286 patients with (suspicion of) h...
Objective
We evaluated the psychometric properties of a newly developed self-report questionnaire that aims for a more person-centered approach in primary care for patients with chronic conditions; the Primary Care Functioning Scale (PCFS).
Study Design and Setting
In order to test the measurement properties of the PCFS we asked patients with diab...