
Mattijs E NumansLeiden University Medical Centre | LUMC · Department of Public Health and Primary care
Mattijs E Numans
MD PhD
About
302
Publications
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Introduction
Mattijs E Numans currently works at the Department of Public Health and Primary care, Leiden University Medical Centre. And he is director of the LUMC Campus The Hague, developing the theme "Population Health Management". Mattijs does research in Epidemiology, Gastroenterology and Primary Care, mainly based on routine primary healthcare data. Current projects are various, one of them is 'Evaluating Cessation of STatins and Antihypertensive Treatment In primary Care - the ECSTATIC trial.'
Skills and Expertise
Additional affiliations
October 2013 - January 2016
January 2011 - December 2015
VU University Medical Center
Position
- Part-time Professor of Innovation and Quality of Academic Primary Care
May 1986 - September 2013
Publications
Publications (302)
Background
Routine body mass index (BMI) recording in electronic health records (EHR) could support general practitioners (GPs) in managing patients with obesity. This study aimed to evaluate recording practices of BMI, overweight, and obesity in adults including subgroup analysis of age, sex, and comorbidities in primary care in the Netherlands....
Background
This study aimed to explore the impact of the COVID-19 pandemic and resulting changes to diabetes care, especially concerning disease control, the use of (tele)consultation and lessons worth implementing to improve diabetes care, with a specific focus on ethnic minority groups.
Methods
A mixed-methods prospective cohort study among peop...
Objectives
Educational initiatives in residency may lack alignment with residents’ learning objectives. Furthermore, they may overlook residents’ struggle to find fulfilment in their work. Professional identity formation (PIF) is a conceptual lens through which to explore the alignment of educational initiatives with residents’ learning objectives....
Background
The COVID-19 lockdown had profound effects on society and healthcare. Cardiology departments reported declines in chest pain evaluations and acute coronary syndrome (ACS) diagnoses. However, the pattern of chest pain in primary care is not clear yet. This study aims to assess the impact of the COVID-19 lockdown on the number of patients...
Introduction:
Advance care planning (ACP) aims at empowering patients with chronic progressive disease to express and communicate their preferences for future care, but is not yet consistently applied in general practice. We explored GP residents' experiences with practicing ACP conversations through virtual simulation and its educational value....
Background
Healthy eating behaviour is an essential determinant of overall health. This behaviour is generally poor among people at risk of experiencing food insecurity, which may be caused by many factors including perceived higher costs of healthy foods, financial stress, inadequate nutritional knowledge, and inadequate skills required for health...
Aim
Although South Asians have an increased risk to develop diabetes, data on the difference in development and progression of diabetic nephropathy between ethnic groups are not consistent. The aim of this study was to evaluate possible differences in the development and progression of albuminuria in South Asians and Western Europeans (WE) with typ...
Bundled payments are increasingly used globally to move health care delivery in a value-based direction. However, evidence remains scant in key clinical areas. We evaluated bundled payments for maternity care in the Netherlands during the period 2016-18. We used a quasi-experimental difference-in-differences design to measure the association betwee...
Objectives
This study aims to describe the incidence, symptom clusters and determinants of post-acute COVID symptoms using data from the COVID RADAR app in the Netherlands.
Design
Prospective cohort.
Setting
General population in the Netherlands from April 2020 to February 2022.
Participants
A total of 1478 COVID RADAR app users, with data spann...
Purpose
The purpose of this paper is to present the learnings of a broker organization that started a new Population Health Management initiative in two regions in the Netherlands. The research focusses on the role of the broker organization itself in supporting stakeholders in the region to adopt a new implementation strategy designed by the broke...
Introduction
Older adults with acute functional decline may visit emergency departments (EDs) for medical support despite a lack of strict medical urgency. The introduction of transitional care teams (TCT) at the ED has shown promise in reducing avoidable admittances. However, the optimal composition and implementation of TCTs are still poorly defi...
Key Features
The Extramural Leiden University Medical Center Academic Network (ELAN) dynamic data infrastructure, based on routine healthcare data of general practitioners, hospitals and mental healthcare, linked to municipal and national data sources from Statistics Netherlands, was established with the aim to facilitate broad research topics to...
Background
In Europe, opioid use has surged, largely due to prescriptions for chronic non‐malignant pain (CNMP). General practitioners (GPs) and community pharmacists (CPs) play a major role in opioid prescribing for non‐malignant pain. Exploring their personal beliefs and practices might reveal underlying mechanisms to identify measures that could...
Background
Empanelment – identification and systematic categorization of patients sharing the same risk for cardiovascular disease (CVD) in primary care – provides the opportunity to tailor preventive treatment strategies to the care needs of individual patients in a proactive manner. It might provide opportunities to allocate resources to alleviat...
Background
Proton Pump Inhibitors (PPI) are frequently prescribed. Long-term use is associated with side-effects and patients often lack a valid indication. Inappropriate PPI prescribing thus needs to be addressed. This review aims to scope 1) what determinants are studied as reasons for PPI prescribing, 2) what strategies are used for changing PPI...
Aim
The 2021 European Society of Cardiology prevention guidelines recommend the use of (lifetime) risk prediction models to aid decisions regarding initiation of prevention. We aimed to update and systematically recalibrate the LIFEtime-perspective CardioVascular Disease (LIFE-CVD) model to four European risk regions for the estimation of lifetime...
Objectives
To evaluate the efficacy of topical miconazole or amorolfine compared to placebo for mild to moderately severe onychomycosis.
Design
Randomised, double-blind, placebo-controlled trial, with computer-generated treatment allocation at a 1:1:1 ratio.
Setting
Primary care, recruitment from February 2020 to August 2022.
Participants
193 pa...
Background
Lifestyle changes, especially regarding diet quality and physical activity, are important in the management of type 2 diabetes (T2D). This mixed-methods study explores self-initiated lifestyle changes in patients with T2D who followed a periodic fasting-mimicking diet (FMD).
Methods
Quantitative data were obtained from the Fasting In di...
Background
In the Netherlands, population-based cancer screening programmes (CSPs) are organized aiming at cervical, breast and colorectal cancer. For a CSP to be effective, high participation rates are essential; however, there is an alarming downward trend, including wide regional variation in screening uptake. General practitioner (GP) involveme...
Introduction
Diabetic foot ulcers are feared complications of diabetes mellitus (DM), requiring extensive treatment and hospital admissions, ultimately leading to amputation and increased mortality. Different factors contribute to the development of foot ulcers and related complications. Onychomycosis, being more prevalent in patients with diabetes...
Restriction of dietary carbohydrates, fat, and/or protein is often used to reduce body weight and/or treat (metabolic) diseases. Since diet is a key modulator of the human gut microbiome, which plays an important role in health and disease, this review aims to provide an overview of current knowledge of the effects of macronutrient-restricted diets...
Community-acquired Pneumonia (CAP) guidelines generally recommend to admit patients with moderate-to-severe CAP and start treatment with intravenous antibiotics. This study aims to explore the clinical outcomes of oral antibiotics in patients with moderate-to-severe CAP. We performed a nested cohort study of an observational study including all adu...
Aims/hypothesis
The aim of this study was to evaluate the impact on metabolic control of periodic use of a 5-day fasting-mimicking diet (FMD) programme as an adjunct to usual care in people with type 2 diabetes under regular primary care surveillance.
Methods
In this randomised, controlled, assessor-blinded trial, people with type 2 diabetes using...
Background
Due to increasing antibiotic resistance, the worldwide efficacy of Helicobacter pylori ( Hp ) eradication treatment has decreased.
Aim
To determine antimicrobial resistance of Hp in primary care.
Design & setting
Retrospective cohort study using real-world routine health care data from 80 general practices in the Netherlands.
Method
P...
Onychomycosis is the most prevalent nail disease and is frequently encountered in clinical practice. Despite having multiple therapeutic options, of which systemic antifungals are the most effective, treatment is not always mandatory in all patients. Especially when considering systemic treatment, the risk of adverse reactions may outweigh the pote...
Purpose:
Professional Identity Formation (PIF) is crucial for high-quality patient care and physician well-being. Few empirical studies examined PIF in residency from the perspective of supervisors. In GP residency, residents are supervised with an 'end in mind' that remains unexplored. To encourage supervisors to reflect on their teaching behavio...
Introduction
Observational data are increasingly seen as a valuable source for integrated care research. Especially since the growing availability of routinely collected data and quasi-experimental methods. The aim of this paper is to describe the potentials and challenges when using observational data for integrated maternity care research, based...
Background
Molluscum contagiosum (MC) can cause significant burden in children. So far, pharmacological treatment has not been proven beneficial. More rigorous interventions have not been well studied. Current guidelines advise a “wait and see” policy. However, children and their parents frequently visit their GP requesting intervention. Therefore,...
Background and objective
Even though children with complex problems frequently need psychosocial care, two thirds does not receive treatment. Various barriers, particularly expectations of barriers, can hinder effective access of care. Our aim was to assess the practical barriers expected by parents, and the child, family and need factors associate...
The rise in health care costs, caused by older and more complex patient populations, requires Population Health Management approaches including risk stratification. With risk stratification, patients are assigned individual risk scores based on medical records. These patient stratifications focus on future high costs and expensive care utilization...
Aims/hypothesis
The aim of this study was to evaluate the impact on metabolic control of the periodic use of a 5-day fasting-mimicking diet (FMD) program as an adjunct to usual care in people with type 2 diabetes under regular primary care surveillance.
Methods
In this randomised, controlled, assessor-blinded trial, people with type 2 diabetes usin...
Background:
Early diagnosis and treatment of obesity in primary care may help to tackle the obesity pandemic. Nonetheless general practitioners (GPs) frequently fail to address obesity and demonstrate limited adherence to guidelines.
Aim:
To explore Dutch GPs' perspectives on addressing obesity regarding three target behaviors: discussing weight...
Introduction:
Older adults with an acute moderate-to-severe lower respiratory tract infection (LRTI) or pneumonia are generally treated in hospitals causing risk of iatrogenic harm such as functional decline and delirium. These hospitalisations are often a consequence of poor collaboration between regional care partners, the lack of (acute) diagno...
Opioid use has risen again in the past year, partly due to overtaken operations. Some of the patients undergoing surgery already chronically use opioids. A fentanyl dependent patient enters the pharmacy with a oxycodone prescription from the orthopedist. The pharmacist doubts whether the orthopedist has the intention to continue the fentanyl use. T...
Aim
To analyse the reach, adoption and implementation of the HH-programme.
Design & setting
A mixed-methods study conducted in a general practice setting in the Netherlands.
Method
Quantitative data were collected from the Healthy Heart Study (HH-study), a non-randomised cluster stepped-wedge trial to assess the effect of the HH-programme on pati...
Objectives
Throughout Europe, many countries offer population-based cancer screening programmes (CSPs). In the Netherlands, two implemented CSPs are targeting people of 50 years and older, aiming at breast cancer (BC) and colorectal cancer (CRC). In order for a CSP to be (cost-)effective, high participation rates and outreach to the populations at...
Introduction:
Acute respiratory infections are common in frail, community-dwelling older people and are accompanied by considerable diagnostic and prognostic uncertainties. Inadequately coordinated care is associated with unnecessary hospital referral and admission with potential iatrogenic harm. Therefore, we aimed to co-create a regional integra...
Introduction
Chest pain is a common reason for consultation in primary care. To rule out acute coronary syndrome (ACS), general practitioners (GP) refer 40%–70% of patients with chest pain to the emergency department (ED). Only 10%–20% of those referred, are diagnosed with ACS. A clinical decision rule, including a high-sensitive cardiac troponin-I...
Background:
Over the past decades, opioid prescriptions have increased in the Netherlands. The Dutch general practitioners' guideline on pain was recently updated and now aims to reduce opioid prescriptions and high-risk opioid use for non-cancer pain. The guideline, however, lacks practical measures for implementation.
Objective:
This study aim...
Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): Leiden University Medical Centre University Leiden.
Background/introduction
There is much evidence on cardiovascular health disparities in different ethnic and socioeconomic subgroups in (European) populations. Whether ethnicity and socioeconomic statu...
Objectives
This study aimed to identify determinants of inappropriate antibiotic prescription in primary care in developed countries and to construct a framework with the determinants to help understand which actions can best be targeted to counteract development of antimicrobial resistance (AMR).
Design
A systematic review of peer-reviewed studie...
Nocebo effects are adverse treatment outcomes that are not ascribed to active treatment components. Potentially, their magnitude might be higher in patients with chronic pain compared to healthy controls since patients likely experience treatment failure more frequently. The current study investigated group differences in the induction and extincti...
Objective
The present study aimed to early identify patients with persistent somatic symptoms (PSS) in primary care by exploring routine care data-based approaches.
Design/setting
A cohort study based on routine primary care data from 76 general practices in the Netherlands was executed for predictive modelling.
Participants
Inclusion of 94 440 a...
Background:
It is unclear to what extent mental health and negative life events (NLEs) contribute to weight change in patients with overweight. This study aimed to evaluate the association of anxiety, depression, NLEs and quality of life (QoL) with weight change over ten years in middle-aged individuals with overweight.
Methods:
Population-based...
Background
Onychomycosis,the most common cause of nail dystrophy is generally diagnosed by clinical examination. Current guidelines for Dutch general practice advise confirmatory testing onlyin case of doubt or insufficient response to treatment. However, making a correct diagnosis can be challenging given the wide variety of clinical features and...
Objectives:
We studied trends in antibiotic prescribing by primary care and assessed the associations between generated antibiotic selection pressure (ASP) and the prevalence of sentinel drug-resistant microorganisms (SDRMs).
Methods:
The volume of antibiotic prescribing in primary and hospital care expressed in DDD/1000 inhabitants per day and...
Background
Prediction models for risk of cardiovascular events generally do not include young adults, and cardiovascular risk factors differ between women and men. Therefore, this study aimed to develop prediction models for first‐ever cardiovascular event risk in men and women aged 30 to 49 years.
Methods and Results
We included patients aged 30...
Objective
As in many other countries, the Netherlands is facing challenges in the provision of healthcare to its population. To ensure the population remains in good health in coming decades, an integrative approach to the many factors that influence health and health outcomes is needed. Population health management is gaining interest as a strateg...
Objective:
To evaluate the effectiveness and cost-effectiveness of offering the combined lifestyle programme "Healthy Heart", addressing overweight, diet, physical activity, smoking and alcohol, to improve lifestyle behaviour and reduce cardiovascular risk.
Design:
A practice-based non-randomised stepped-wedge cluster trial with two-year follow-...
Context:
The effectiveness of intermittent energy restriction (IER) and periodic fasting (PF) in the management of type 2 diabetes (T2D) remains a subject of discussion.
Objective:
The aim of this systematic review is to summarize current knowledge of the effects of IER and PF in patients with T2D on markers of metabolic control and the need for...
Summary
Background
Socioeconomic status and ethnicity are not explicitly incorporated as risk factors in the four SCORE2 cardiovascular disease (CVD) risk models developed for country-wide implementation across Europe (low, moderate, high and very-high model). The aim of this study was to evaluate the performance of the four SCORE2 CVD risk predi...
Improving population health and reducing inequalities through better integrated health and social care services is high up on the agenda of policymakers internationally. In recent years, regional cross-domain partnerships have emerged in several countries, which aim to achieve better population health, quality of care and a reduction in the per cap...
Background
Pre-existing lower urinary tract symptoms (LUTS), cognitive impairment and the high prevalence of asymptomatic bacteriuria (ASB) complicate the diagnosis of urinary tract infection (UTI) in older women. The presence of pyuria remains the cornerstone of UTI diagnosis. However, over 90% of ASB patients have pyuria, prompting unnecessary tr...
Aims:
Covid-19 caused changes on the delivery of diabetes care. This study aimed to explore perceptions of healthcare providers across Europe concerning 1) the impact of covid-19 on delivery of diabetes care; 2) impact of changes in diabetes care on experienced workload; 3) experiences with video consultation in diabetes care.
Methods:
Cross-sec...
Aims:
To quantify the impact of social determinants of health (SDOH) on top of medical determinants on the development of diabetes-related complications in young adults with type 2 diabetes.
Methods:
In this observational population-based study, SDOH (income and origin) were linked to routine primary care data. Young adults (18-45 years) with in...
Seksualiteit is belangrijk, ook voor mensen met een chronische ziekte. Chronische ziekten zorgen echter vaak voor seksuele problemen. Doordat de prevalentie van chronische ziekten toeneemt, wordt het thema seksualiteit in de spreekkamer steeds belangrijker. Ook als de patiënt er niet over begint, zou de huisarts het onderwerp moeten aankaarten. Vaa...
Background
The prevalence of coronary artery disease is increasing due to the aging population and increasing prevalence of cardiovascular risk factors. Non-acute chest pain often is the first symptom of stable coronary artery disease. To optimise care for patients with non-acute chest pain and make efficient use of available resources, we need to...