Johan Wens

University of Antwerp | UA · Primary and interdisciplinary care

The varicella-zoster virus (VZV) infects >95% of the population. VZV reactivation causes herpes zoster (HZ), known as shingles, primarily affecting the elderly and individuals who are immunocompromised. However, HZ can occur in otherwise healthy individuals. We analyzed the immune signature and risk profile in patients with HZ using a genome-wide a...

The varicella-zoster virus (VZV) infects over 95% of the population and establishes latency afterwards. Reactivation of VZV causes herpes zoster (HZ), commonly known as shingles, which presents as a painful rash in mostly the elderly and people with a weakened immune system. However, HZ might occur in otherwise healthy individuals too. In this stud...

Background The COVID-19 pandemic has profoundly affected assessment practices in medical education necessitating distancing from the traditional classroom. However, safeguarding academic integrity is of particular importance for high-stakes medical exams. We utilised remote proctoring to administer safely and reliably a proficiency-test for admissi...

Background: The COVID-19 pandemic has profoundly affected assessment practice in higher education including a complex planning of supervision. To organise safely and reliably a remote proficiency-test for admission to the Advanced Master of General Practice (AMGP), we developed a supervisor app tracking and tracing candidates’ behaviour. Methods: A...

The Covid-19 pandemic could facilitate an end-of-life conversation The new “severe acute respiratory syndrome” coronavirus (SARS-CoV-2) is testing our health care system in several ways. The need for clear end-of-life conversation is, more than ever, emphasized. The potential overcrowding in health facilities creates an important ethical dilemma ab...

The current study aimed to examine the health-related quality of life (HRQoL) and to identify its related factors amongst adult patients with type 2 diabetes mellitus (T2DM). This cross-sectional study recruited randomly 519 patients diagnosed with T2DM for at least 6 months in the Family medicine center (FMC) of Agricultural General Hospital in Ha...

BACKGROUND The COVID19 pandemic affected education and assessment and led to a complex planning. Therefore, we organised the proficiency test for admission to Family Medicine as a proctored exam. To prevent from fraud we developed a virtual supervisor app tracking and tracing candidates’ behaviour. OBJECTIVE To assess efficiency and accuracy of th...

Background The COVID-19 pandemic has affected education and assessment programs and has resulted in complex planning. Therefore, we organized the proficiency test for admission to the Family Medicine program as a proctored exam. To prevent fraud, we developed a web-based supervisor app for tracking and tracing candidates’ behaviors. Objective We a...

Background: Most current care models are disease- or symptom-focused and mostly do not account for the individual needs of patients with chronic diseases. The aim of this study was to develop an innovative, evidence-based and expert-based practice model for the management of patients with type 2 diabetes mellitus. Method: An iterative approach w...

Aim The aim of this position paper is to assist primary health care (PHC) providers, policymakers, and researchers by discussing the current context in which palliative health care functions within PHC in Europe. The position paper gives examples for improvements to palliative care models from studies and international discussions at European Forum...

Diabetes in later life is associated with a range of factors increasing the complexity of glycaemic management. This position statement, developed from an extensive literature review of the subject area, represents a consensus opinion of primary care clinicians and diabetes specialists. It highlights many challenges facing older people living with...

Summary of pro-Spinoza project outline and results.

Around 30% of individuals will develop herpes zoster (HZ), caused by the varicella zoster virus (VZV), during their life. While several risk factors for HZ, such as immunosuppressive therapy, are well known, the genetic and molecular components that determine the risk of otherwise healthy individuals to develop HZ are still poorly understood. We cr...

Background: Chronic disease management (CDM) is an approach to health care that keeps people as healthy as possible through the prevention, early detection and management of chronic diseases. The aim of this study was to develop interventions to improve management of chronic diseases in the form of an integrated, evidence-based chronic disease man...

Theory: In Belgium, there are no family medicine admission requirements. A three-phase admission program is developed and implemented by the collaboration of four involved universities. Hypotheses: A pilot testing of phase 2, comprising actual proficiency test, is designed as answer to two research questions: What is the validity and reliability...

Wat wordt in ons land beschouwd als passende zorg in de laatste levensfase? Hoe komt het dat sommige mensen deze zorg niet krijgen, en hoe kan dit worden voorkomen? Het Federaal Kenniscentrum voor de Gezondheidszorg (KCE) doorzocht de Belgische publicaties en organiseerde samen met het onderzoeksteam van UAntwerpen en de UCL een grootschalig onderz...

Background Modern health systems are increasingly faced with the challenge to provide effective, affordable and accessible health care for people with chronic conditions. As evidence on the specific unmet needs and their impact on health outcomes is limited, practical research is needed to tailor chronic care to individual needs of patients with di...

The number of people in their last years of life with advanced chronic conditions, palliative care needs and limited life prognosis due to different causes including multi-morbidity, organ failure, frailty, dementia, and cancer is rising. Such people represent more than 1% of the population. They are present in all care settings, cause around 75% o...

Objectives We evaluated the effectiveness of European chronic care programmes for type 2 diabetes mellitus (characterised by integrative care and a multicomponent framework for enhancing healthcare delivery), compared with usual diabetes care. Design Systematic review and meta-analysis. Data sources MEDLINE, Embase, CENTRAL and CINAHL from Januar...

Aims: 1) To explore the effect of household composition on the psychological health of adults with diabetes by comparing those living with other adult(s) including a partner with those living with neither partner nor other adult(s); 2) to examine potential mediation of social support in the association between household composition and psychologic...

The Belgian care trajectory (CT) for diabetes mellitus type 2 (T2DM), implemented in September 2009, aims at providing integrated, evidence-based, multidisciplinary patient- centred care, based on the chronic care model. The research project ACHIL (Ambulatory Care Health Information Laboratory) studied the adherence of CT patients, in the early pha...

The aim of this study was to describe the perspectives of diabetes care professionals regarding the roles and responsibilities of people with diabetes (PWD), health care professionals (HCPs), and the larger society to improve the provision of person-centered diabetes care. The survey contained open-ended items about challenges of, successes of, and...

In 2009 werden de resultaten gepubliceerd van een studie waarin 1791 gepensioneerde militairen met diabetes type 2 al dan niet aan een strikte glucoseregeling werden onderworpen.1 Het doel van deze studie bestond erin om de cardiovasculaire uitkomsten te bestuderen bij een intensieve aanpak van diabetes versus die bij normale zorg. Tijdens de duur...

Background Chronic disease management (CDM) is an approach to health care that keep people as healthy as possible through the prevention, early detection and management of chronic diseases. The aim of this study was to develop an integrated evidence-based model for the management of chronic non communicable diseases (NCDs) in a rural community of D...

We assessed the impact of a nation-wide ambulatory care complex intervention (the "care trajectory program") on quality of care in Belgium. We used the three-step public health triangulation method described in this paper and data from four different data sources: a national reimbursement database, an electronic patient record-based general practit...

Women with a history of gestational diabetes (GDM) have an increased risk for developing type 2 diabetes in the years after the index pregnancy. Some women with GDM already develop glucose intolerance in early postpartum. The best screening strategy for glucose intolerance in early postpartum among women with a history of GDM is still debated. We r...

De meeste palliatieve patienten wensen thuis verzorgd te worden tot het overlijden. Om deze complexe taak tot een goed einde te brengen kunnen huisartsen een beroep doen op expert-verpleegkundigen van regionale palliatieve thuiszorgequipes.

Naar jaarlijkse gewoonte organiseerde Domus Medica ook in 2013 een inwooncursus met dat jaar als thema ‘In vuur en vlam’. We vroegen de deelnemers om tijdens het congres vier open vragen te beantwoorden die peilden naar het enthousiasme voor hun beroep. Hiervoor creëerden we een specifieke setting, ‘the passion room’, waar deelnemers zich rustig en...

Meer en meer mensen lijden aan meer dan één chronische aandoening. Drie factoren komen vaak samen voor bij deze combinatie van aandoeningen: een cardiovasculaire factor, een mentale gezondheidsfactor (meestal depressie, angst) en een pijnfactor.

Background Prescribing that is not concordant with guidelines is increasingly referred to as clinical inertia (CI). However, CI may be only apparent, and the absence of decision may actually reflect appropriate inaction as a result of good clinical reasoning. Our study aimed to: (i) elucidate GPs¿ beliefs regarding CI and the risk of CI in their ow...

Objective: To identify the psychosocial experiences of diabetes, including negative accounts of diabetes and adaptive ways of coping from the perspective of the person with diabetes. Research design and methods: Participants were 8,596 adults (1,368 with type 1 diabetes and 7,228 with type 2 diabetes) in the second Diabetes Attitudes, Wishes and...

Failure to initiate or intensify therapy according to evidence-based guidelines is increasingly being acknowledged as a phenomenon that contributes to inadequate management of chronic conditions, and is referred to as clinical inertia. However, the number and complexity of factors associated with the clinical reasoning that underlies the decision-m...

Objectives: To investigate if the psychometric qualities of an OSCE consisting of more complex simulated patient encounters remain valid and reliable in the assessment of postgraduate trainees in general practice. Methods: In this intervention study without control group, the traditional OSCE was formally replaced by the new, complex version. The...

Background In order to improve quality of care for chronic conditions, in 2009 the National Institute for Health and Disability Insurance in Belgium created care trajectories (CTs) for diabetes mellitus type 2 (T2DM) and chronic kidney disease (CKD). A CT, formalised by a contract between patient, GP and specialist, aims to ensure integrated, evi...

Background In 2009, the Care Trajectory (CT) project - a nation-wide quality improving program enabling the reimbursement of self monitoring of Blood Glucose, patient education and structured shared care between generalist and specialist care - was set up in Belgium. Patients with Diabetes Mellitus Type 2 (T2DM), HbA1c > 7% (53 mmol/l) and in nee...

AimsThe second Diabetes Attitudes, Wishes and Needs (DAWN2) study aimed to assess psychosocial outcomes in people with diabetes across countries for benchmarking. Methods Surveys included new and adapted questions from validated questionnaires that assess health-related quality of life, self-management, attitudes/beliefs, social support and priorit...

Aims: The second Diabetes Attitudes, Wishes and Needs (DAWN2) study sought cross-national comparisons of perceptions on healthcare provision for benchmarking and sharing of clinical practices to improve diabetes care. Methods: In total, 4785 healthcare professionals caring for people with diabetes across 17 countries participated in an online su...

Aims: The second Diabetes Attitudes, Wishes and Needs (DAWN2) study examined the experiences of family members of people with diabetes for benchmarking and identifying unmet needs or areas for improvement to assist family members and those with diabetes to effectively self-manage. Methods: In total, 2057 family members of people with diabetes pa...

Unlabelled: To test the hypothesis that care typology-being complex and highly unpredictable versus being clear-cut and highly predictable-guides healthcare payment preferences of physicians, policy makers, healthcare executives, and researchers. We collected survey data from 942 stakeholders across Canada, Europe, Oceania, and the United States....

BACKGROUND: Research suggests adherence to treatment recommendations is low. In type 2 diabetes, which is a chronic condition slowly leading to serious vascular, nephrologic, neurologic and ophthalmological complications, it can be assumed that enhancing adherence to treatment recommendations may lead to a reduction of complications. Treatment regi...

Background. One of the methods to test knowledge of Family Medicine trainees is a written exam composed of multiple choice questions. Creating high-quality multiple choice questions requires a lot of experience, knowledge, and time. This study explores the opportunity to run the Dutch knowledge assessment in Flanders as well, the use of this test f...

Aims: The Diabetes Attitudes Wishes and Needs 2 (DAWN2) study aims to provide a holistic assessment of diabetes care and management among people with diabetes (PWD), family members (FM), and healthcare professionals (HCPs) and explores potential drivers leading to active management. Methods: DAWN2 survey over 16,000 individuals (∼9000 PWD, ∼2000...

As non-communicable or chronic diseases are a growing threat to human health and economic growth, political stakeholders are aiming to identify options for improved response to the challenges of prevention and management of non-communicable diseases. This paper is intended to contribute ideas on personalized chronic disease management which are bas...

Old age is a well-known risk factor for both depression and hypovitaminosis D, and an association between both conditions has been postulated. We document the prevalence of vitamin D deficiency in nursing home residents, and we examine the link with self-reported depressive symptoms and pharmacotherapy for depression. Cross- sectional. nursing home...

Inleiding. Periodieke evaluatie en herwaardering (accreditering) voor artsen is wereldwijd aanvaard. De voorwaarden voor herwaardering vertonen echter grote variaties en kunnen navorming (bijscholing), peer review en een evaluatie van het praktijkfunctioneren omvatten, al dan niet aangevuld met een examen. Een controle hierop kan uitgeoefend worden...

Introduction. The idea of periodic recertification has become generally accepted in the medical profession. Still, the requirements for recertification vary widely and may comprise participation in continuing medical education (CME), peer review and practice performance assessment. An official examination may complete the requirements. Regulating b...

John en Jonathan, grootvader en kleinzoon, hebben veel met elkaar gemeen. Dezelfde hobby (schelpen), dezelfde interesses (natuurbeheer) en dezelfde ziekte (diabetes). Het voorbije jaar was speciaal: John, net 60, beëindigde zijn loopbaan en is nu met pensioen; Jonathan, net 12, beëindigde de basisschool.

Nurses now provide the majority of education and support for people with diabetes both in community and hospital settings. However, there are very few studies on nurse-led interventions to improve adherence to medication, a crucial element of the self-management of diabetes.The four studies reviewed formed a subgroup of a Cochrane review on interve...

Background and objective: Pharmacists are now adopting a crucial role in the management of chronic illness in primary care, providing diabetes care and advice. This review aims to show whether a range of diabetes care interventions delivered by pharmacists is successful in improving adherence to medication. Methods: The studies reviewed formed a...

Nurses now provide the majority of education and support for people with diabetes both in community and hospital settings. However, there are very few studies on nurse-led interventions to improve adherence to medication, a crucial element of the self-management of diabetes.The four studies reviewed formed a subgroup of a Cochrane review on interve...