Jaap C A Trappenburg

University Medical Center Utrecht | UMC Utrecht · The Healthcare Innovation Center (THINC.)

Background: -Self-management interventions are widely implemented in care for patients with heart failure (HF). Trials however show inconsistent results and whether specific patient groups respond differently is unknown. This individual patient data meta-analysis assessed the effectiveness of self-management interventions in HF patients and whethe...

Objective: To quantify diversity in components of self-management interventions and explore which components are associated with improvement in health-related quality of life (HRQoL) in patients with chronic heart failure (CHF), chronic obstructive pulmonary disease (COPD), or type 2 diabetes mellitus (T2DM). Methods: Systematic literature searc...

A substantial proportion of chronic disease patients do not respond to self-management interventions, which suggests that one size interventions do not fit all, demanding more tailored interventions. To compose more individualized strategies, we aim to increase our understanding of characteristics associated with patient activation for self-managem...

An individualised action plan (AP) is a potentially effective method of helping patients with chronic obstructive pulmonary disease (COPD) to recognise and anticipate early exacerbation symptoms. This multicentre randomised controlled trial evaluates the hypothesis that individualised APs reduce exacerbation recovery time. Two hundred and thirty-th...

Objective No dedicated studies have been performed on the optimal management of patients with an acute stroke related to carotid intervention nor is there a solid recommendation given in the European Society for Vascular Surgery guideline. By implementation of an international expert Delphi panel, this study aimed to obtain expert consensus on the...

Objective To evaluate the fidelity of delivery of a nurse-led intervention to enhance physical activity in patients at risk for cardiovascular diseases, the Activate intervention, by assessing: (1) self-reported fidelity of delivery; (2) observed fidelity of delivery; (3) quality of delivery of the Activate intervention and (4) nurses’ beliefs abou...

Objective To explore how to build and maintain the resilience of frontline healthcare professionals exposed to COVID-19 outbreak working conditions. Design Scoping review supplemented with expert interviews to validate the findings. Setting Hospitals. Methods We searched PubMed, Embase, PsycINFO, CINAHL, bioRxiv and medRxiv systematically and gr...

Background: Theories can provide a foundation to explain behavior, investigate relationships, and to predict the effect of interventions. The aim of the study was to clarify the use of theories in studies testing interventions to promote self-care. Method: A scoping review. PubMed, EMBASE, PsychINFO, and CINAHL were searched from January 2008 th...

Background: There is an emergence of mobile health (mHealth) interventions to support self-management in patients with chronic obstructive pulmonary disease (COPD). Recently, an evidence-driven mHealth intervention has been developed to support patients with COPD in exacerbation-related self-management: the Copilot app. Health care providers (HCPs)...

Introduction: Self-care requires behavior change in patients and healthcare providers play a pivotal role in supporting those changes. Examination of the behavior change techniques used by providers in self-care interventions can provide insights into how self-care behavior is enhanced in patients with a chronic condition. Objective: To quantify th...

Background The effectiveness of a nurse-led intervention to enhance physical activity, the Activate intervention, was evaluated in primary care patients at risk for cardiovascular diseases in a cluster-randomised controlled trial (n = 195 patients, 31 general practices). To contribute to an accurate interpretation of the trial results, understandin...

Background Self-care is a fundamental element of treatment for patients with a chronic condition and a major focus of many interventions. A large body of research exists describing different types of self-care interventions, but these studies have never been compared across conditions. Examination of heterogeneous interventions could provide insigh...

Objective In women at risk of developing preeclampsia, we evaluated the use of a digital health platform for telemonitoring blood pressure and symptoms combined with a minimal antenatal visit schedule. Study design A case-control study for women with chronic hypertension, history of preeclampsia, or maternal cardiac or kidney disease. A care path...

BACKGROUND There is an emergence of mobile health (mHealth) interventions to support self-management in patients with chronic obstructive pulmonary disease (COPD). Recently, an evidence-driven mHealth intervention has been developed to support patients with COPD in exacerbation-related self-management: the Copilot app. Health care providers (HCPs)...

Background To understand better the success of self-management interventions and to enable tailoring of such interventions at specific subgroups of patients, the nurse-led Activate intervention is developed targeting one component of self-management (physical activity) in a heterogeneous subgroup (patients at risk of cardiovascular disease) in Dutc...

Background: Adequate self-management skills are of great importance for patients with chronic obstructive pulmonary disease (COPD) to reduce the impact of COPD exacerbations. Using mobile health (mHealth) to support exacerbation-related self-management could be promising in engaging patients in their own health and changing health behaviors. Howev...

BACKGROUND Adequate self-management skills are of great importance for patients with chronic obstructive pulmonary disease (COPD) to reduce the impact of COPD exacerbations. Using mobile health (mHealth) to support exacerbation-related self-management could be promising in engaging patients in their own health and changing health behaviors. However...

Objective To explore the experiences of patients at risk for cardiovascular disease in primary care with the Activate intervention in relation to their success in increasing their physical activity. Methods A convergent mixed methods study was conducted, parallel to a cluster-randomised controlled trial in primary care, using a questionnaire and s...

Overview of the potential themes, subthemes and key themes that emerged from the analysis. (DOCX)

Checklist of criteria for good thematic analysis: 15-point checklist. (DOCX)

Consolidated criteria for reporting qualitative studies (COREQ): 32-item checklist. (DOCX)

Background Self-management support is widely accepted for the management of chronic conditions. Self-management often requires behaviour change in patients, in which primary care nurses play a pivotal role. To support patients in changing their behaviour, the structured behaviour change Activate intervention was developed. This intervention aims to...

This study aims to examine the effect of preoperative inspiratory muscle training (IMT) on pre- and postoperative functional exercise performance in patients undergoing esophagectomy. A subcohort of patients recruited to the PREPARE randomized control trial were studied. Following evaluation of respiratory muscle function (spirometry, maximum inspi...

Background: Self-management of exacerbations in COPD patients is important to reduce exacerbation impact. There is a need for more comprehensive and individualized interventions to improve exacerbation-related self-management behavior. The use of mobile health (mHealth) could help to achieve a wide variety of behavioral goals. Understanding of pat...

Background: In recent years there has been much emphasis on 'research waste' caused by poor question selection, insufficient attention to previous research results, and avoidable weakness in research design, conduct and analysis. Little attention has been paid to the effect of inadequate development of interventions before proceeding to a full cli...

Objectives: To examine how and to what extent self-management support, including behaviour change support, is provided by primary care nurses in routine consultations with chronically ill patients. Design: Observational study design. Methods: Routine consultations of primary care nurses in the Netherlands with chronically ill patients were aud...

Background: Little is known about which self-management behaviors have the highest potential to influence exacerbation impact in COPD patients. We aimed to reach expert consensus on the most relevant set of self-management behaviors that can be targeted and influenced to maximize reduction of exacerbation impact. Materials and methods: A 2-round De...

Background: Self-management interventions are considered effective in patients with chronic disease, but trials have shown inconsistent results, and it is unknown which patients benefit most. Adequate self-management requires behaviour change in both patients and health care providers. Therefore, the Activate intervention was developed with a focu...

Background and aim Self-management support is an integral part of current chronic care guidelines. The success of self-management interventions varies between individual patients, suggesting a need for tailored self-management support. Understanding the role of patient factors in the current decision making of health professionals can support futur...

An example of a questionnaire in English and in Dutch. (DOCX)

Graphical test for proportional odds assumption. The lines in the graph represent the different dichotomized models (solid line represents the model unlikely to very likely to provide SMS vs. very unlikely to provide SMS, and the dashed line represents the model somewhat likely to very likely to provide SMS vs unlikely and very unlikely to provide...

Relative importance of factors. SM = Self-management, CI = confidence interval, GP = general practitioner, PN = practice nurse, DM-II = Diabetes mellitus type II, COPD = Chronic obstructive pulmonary disease. (DOCX)

In de zorg is vrijwel geen setting te bedenken waarin het woord zelfmanagement nooit valt. De verwachtingen zijn doorgaans hooggespannen. Maar eigenlijk is er nog geen consensus over wat zelfmanagement-interventies zouden moeten inhouden. Tijd voor een conceptuele duiding. Jaap Trappenburg ontrafelt het begrip, legt uit dat zelfmanagement geen haar...

Objectives: Meta-analyses using individual patient data (IPD) rather than aggregated data are increasingly applied to analyse sources of heterogeneity between trials and have only recently been applied to unravel multicomponent, complex interventions. This paper reflects on methodological challenges encountered in two IPD meta-analyses on self-man...

Background Self-management interventions are considered effective in chronic disease patients, but trials have shown inconsistent results and it is unknown which patients benefit most. Adequate self-management often requires behaviour change. To unravel effectiveness of self-management, a nurse-led intervention was comprehensively developed using...

Background In patients with COPD, self-management skills are important to reduce the impact of exacerbations. However, both detection and adequate response to exacerbations appear to be difficult for some patients. Little is known about the underlying process of exacerbation-related self-management. Therefore, the objective of this study was to ide...

Background: Research waste is often related to inadequate reporting, design or poor intervention description. However, less attention has been given to a poorly developed intervention, and how to optimize the development process of a complex intervention before pro- ceeding to a full clinical trial. Although the Medical Research Council (MRC) Frame...

Background: Patients with Chronic Obstructive Pulmonary Disease (COPD) experience exacerbations that negatively affect lung function, quality of life and mortality. Self-management skills are important to detect exacerbations early and to take prompt actions to reduce the impact. However, patients have difficulties with performing adequate exacerbat...

Background COPD self-management is a complex behavior influenced by many factors. Despite scientific evidence that better disease outcomes can be achieved by enhancing self-management, many COPD patients do not respond to self-management interventions. To move toward more effective self-management interventions, knowledge of characteristics associa...

Objectives: Systematic reviews on complex interventions like self-management interventions often do not explicitly state an operational definition of the intervention studied, which may impact the review's conclusions. This study aimed to propose an operational definition of self-management interventions and determine its discriminative performanc...

Background Self-management interventions are considered effective in patients with COPD, but trials have shown inconsistent results and it is unknown which patients benefit most. This study aimed to summarize the evidence on effectiveness of self-management interventions and identify subgroups of COPD patients who benefit most. Methods Randomized...

Background: To identify those characteristics of self-management interventions in patients with heart failure (HF) that are effective in influencing health-related quality of life, mortality, and hospitalizations. Methods and results: Randomized trials on self-management interventions conducted between January 1985 and June 2013 were identified...

Background/aims: This study examines the feasibility of a preoperative exercise program to improve the physical fitness of a patient before gastrointestinal surgery. Methods: An outpatient exercise program was developed to increase preoperative aerobic capacity, peripheral muscle endurance and respiratory muscle function in patients with pancrea...

It is unknown whether heterogeneity in effects of self-management interventions in patients with chronic obstructive pulmonary disease (COPD) can be explained by differences in programme characteristics. This study aimed to identify which characteristics of COPD self-management interventions are most effective. Systematic search in electronic datab...

There is an urgent need for consensus on what defines a chronic obstructive pulmonary disease (COPD) self-management intervention. We aimed to obtain consensus regarding the conceptual definition of a COPD self-management intervention by engaging an international panel of COPD self-management experts using Delphi technique features and an additiona...

Objectives: Pre-operative inspiratory muscle training has been shown to decrease the incidence of postoperative pneumonia and length of hospital stay in patients undergoing coronary artery bypass graft surgery (CABG). This study investigated if this decrease acted as a mediator on the time course of quality of life. Design: Complementary analyse...

Background: Self-management interventions are considered effective in COPD patients, but trials have shown inconsistent results and it is unknown which patients benefit most. Aims: To summarise the evidence on effectiveness of self-management interventions and identify subgroups of COPD patients who benefit most. Methods: Randomised trials on sel...

In this paper, we aim to emphasise the need for a more comprehensive and tailored approach to manage the broad nature of non-adherence, to personalise current asthma management. Although currently several methods are available to measure the extent of asthma patients’ adherence, the vast majority do not incorporate confirmation of the actual inhala...

Although self-management interventions are, to some extent, individualized in clinical practice, the decision-making process is not fully understood. Exploring nurses' clinical reasoning about how and to what extent they currently tailor self-management support can provide new insights, enhancing process and outcome of chronic care. The aim of this...