Lotte Ramerman

• Researcher at Nivel – Research for better care

Background Explantation of breast implants is increasingly performed in response to concerns about Breast Implant Illness (BII), an array of various health symptoms. However, the benefits of explantation remain unclear due to methodological limitations in prior studies. Objectives To examine the occurrence of health symptoms before and after expla...

Explantation is the proposed treatment for breast implant illness (BII). Little is known about which medical specialists are visited and what diagnoses are made before explantation is provided as the treatment. This study investigated medical specialist care utilization in women with cosmetic breast implants who underwent explantation compared to w...

Background Many countries observed a sharp decline in the use of general practice services after the outbreak of the COVID-19 pandemic. However, research has not yet considered how changes in healthcare consumption varied among regions with the same restrictive measures but different COVID-19 prevalence. Aim To investigate how the COVID-19 pandemi...

Background General practitioners (GPs) often assess patients with acute infections. It is challenging for GPs to recognize patients needing immediate hospital referral for sepsis while avoiding unnecessary referrals. This study aimed to predict adverse sepsis-related outcomes from telephone triage information of patients presenting to out-of-hours...

Background Experiences with organizational changes in daytime general practices and out-of-hours (OOH) services during the COVID-19 pandemic may help to address the challenges in general practice care that were already a concern before the crisis. This study aimed to describe these experiences and the potential usefulness of the organizational chan...

The impact of the COVID-19 pandemic on general practitioners' (GP) care for patients with asthma and/or COPD is largely unknown. To describe the impact of the pandemic on asthma or COPD-related GP care, we analysed routinely recorded electronic health records data from Dutch general practices and out-of-hours (OOH) services. During the COVID-19 pan...

Background Changes in primary care provision during the COVID-19 pandemic could have affected patient experience of primary care both positive and negative. Aim To assess the experiences of patients of primary care during the COVID-19 pandemic. Design & setting A qualitative study of patients from regions with high and low COVID-19 prevalence in...

Importance It is unknown how often breast implant illness (BII) is the indication for revision in women with silicone breast implants. Objective To examine how often women with silicone breast implants have their implants explanted or replaced because of BII compared with local postoperative complications. Design, Setting, and Participants A lega...

Objectives To explore available data sources, secondary uses and key considerations for optimising the actionability of primary care prescribing data to improve quality of care in the Dutch context. Design An exploratory qualitative study was undertaken based on semi-structured interviews. We anchored our investigation around three tracer prescrip...

Objective : Part of the funding of Dutch General Practitioners (GPs) care is based on pay-for-performance, including an incentive for appropriate prescribing according to guidelines in national formularies. Aim of this paper is to describe the development of an indicator and an infrastructure based on prescription data from GP Electronic Health Rec...

Background In the Netherlands, General Practitioners (GP) are usually the first point of contact with a health professional for most health problems. Out-of-hours (OOH) primary care is provided by regional OOH services. Changes in consultation rates at OOH services may be regarded as a warning system for failures elsewhere in the healthcare system....

Objectives. To explore available data sources, secondary uses, and key considerations for optimizing the actionability of primary care prescribing data to improve quality of care in the Dutch context. Design. An exploratory qualitative study was undertaken based on semi-structured interviews. We anchored our investigation around three tracer pres...

COVID-19 restrictions have resulted in major changes in healthcare, including the prescribing of antibiotics. We aimed to monitor antibiotic prescribing trends during the COVID-19 pandemic in Dutch general practice, both during daytime and out-of-hours (OOH). Routine care data were used from 379 daytime general practices (DGP) and 28 OOH-services o...

Background: The prevalence of antipsychotic drug use in people with intellectual disability (id) is high and largely off-label for challenging behaviour (cb), while evidence for their efficacy lacks. Side-effects frequently occur. Guidelines recommend appropriate psychotropic drug use by monitoring of effects and side-effects and discontinuing off...

Background Many people with intellectual disabilities use risperidone long term for the management of challenging behaviours, despite its limited proof of effectiveness and its clear association with adverse events. Therefore, this study aimed to investigate the effectiveness of ongoing treatment with risperidone in reducing challenging behaviours...

Health‐related quality of life in people with intellectual disabilities can be affected by challenging behaviors and side effects of antipsychotics. The aim of this study was to evaluate the effect of discontinuation antipsychotic drugs on health‐related quality of life, including data from 2 discontinuation trials: an open‐label trial of various a...

Background It is unknown why professionals’ adherence to guideline recommendations on antipsychotic drug prescription in the intellectual disabilities care is insufficient. This study aimed to explore barriers and facilitators in the implementation and use of these recommendations. Methods In‐depth interviews with four intellectual disability phys...

Background: Many people with intellectual disabilities use long-term antipsychotics for challenging behaviour and experience side-effects from these drugs, which may affect Health-related Quality of Life (HQoL). Aims: This study aimed to investigate HQoL in people with intellectual disabilities who use long-term antipsychotics and to investigate...

Purpose Antipsychotic drugs are frequently prescribed to people with intellectual disabilities (ID) to ameliorate psychotic symptoms and behavioural symptoms with and without mental condition. Guidelines recommend systematic evaluation of treatment effects and adverse effects, and limiting the treatment duration. Studies have shown that adherence t...

Kinderen en jeugdigen met een verstandelijke beperking en gedragsproblemen slikken vaak langdurig risperidon. Maar is dat wel effectief? En wat gebeurt er als zij deze medicijnen afbouwen?

This study systematically reviews the literature on self-management interventions provided by health care teams, community partners, patients and families and discusses the potential relevance of these interventions for people living with HIV in sub-Saharan Africa. We searched major databases for literature published between 1995 and 2012. 52 studi...