FaMe-Net: twee oude registratienetwerken in een nieuw jasje

Uijen, Annemarie; Bor, Hans; Boven, Kees van

doi:10.1007/s12508-015-0113-8

Cited by 6 publications

(4 citation statements)

References 3 publications

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“…This retrospective cohort study used electronic data from the Practice Based Research Network (PBRN) Family Medicine Network (FaMe-Net), a Dutch primary care research network from the Radboud University Medical Centre in Nijmegen ( 12 ). Since 1971, all encounters between patients and GPs are registered in this network, which consists of seven family practices (24 GPs and approximately 32 000 registered patients).…”

Section: Methodsmentioning

confidence: 99%

Sex differences in incidence of respiratory symptoms and management by general practitioners

et al. 2020

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Background Differences between women and men play an important role in lung physiology and epidemiology of respiratory diseases, but also in the health care processes. Objective To analyse sex differences in patients encountering their general practitioner (GP) with respiratory symptoms with regard to incidence, GP’s management and final diagnoses. Methods Retrospective cohort study, using data of the Dutch Practice Based Research Network. All patients who encountered their GP from 01-07-2013 until 30-06-2018 with a new episode of care starting with a reason for encounter in the respiratory category (R) of the ICPC-2 classification were included (n = 16 773). Multi-level logistic regression was used to analyse influence of patients’ sex on management of GPs with adjustment for possible confounders. Results We found a significant higher incidence of respiratory symptoms in women than in men: 230/1000 patient years [95% confidence interval (CI) 227–232] and 186/1000 patient years (95% CI 183–189), respectively. When presenting with cough, GPs are more likely to perform physical examination [odds ratio (OR) 1.22; 95% CI 1.11–1.35] and diagnostic radiology (OR 1.25; 95% CI 1.08–1.44), but less likely to prescribe medication (OR 0.88; 95% CI 0.82–0.95) in men. When visiting the GP with dyspnoea, men more often undergo diagnostic imaging (OR 1.32; 95% CI 1.05–1.66) and are more often referred to a specialist (OR 1.35; 95% CI 1.13–1.62). Conclusions Women encounter their GP more frequently with respiratory symptoms than men and GPs perform more diagnostic investigations in men. We suggest more research in general practice focussing on sex differences and possible confounders.

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Section: Methodsmentioning

confidence: 99%

Sex differences in incidence of respiratory symptoms and management by general practitioners

et al. 2020

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“…Episodebased epidemiology was the foundation for the earliest evidence base of family medicine, 3,4 and may be considered a foundational method for family physicians worldwide. Its richness can be expanded by incorporating biographical, contextual, and clinical data, [4][5][6][7] thus making patients' narratives part of the evidence base for family practice.…”

Section: Introductionmentioning

confidence: 99%

“…The Dutch Practice-Based Research Network (PBRN) 'Family Medicine Network (FaMe-Net),' the world's oldest PBRN, has a long history of systematically recording all morbidity presented to a family physician (FP), categorized in episodes. [4][5][6][7] FaMe-Net is the continuation of decades of primary care research. In this article, we will describe the network's methods of data collection and introduce its efforts to capture core values of family medicine in its expansion of the collection of data: patients' characteristics, contextual information, and the reason for encounter, which is the patient's verbalized reason why to contact the FP in the opening of every consultation.…”

Section: Introductionmentioning

confidence: 99%

Purposeful Incorporation of Patient Narratives in the Medical Record in the Netherlands

Luijks¹,

Boven²,

Hartman³

et al. 2021

J Am Board Fam Med

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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 patient's personal and contextual characteristics to routine registration data. This documentation allows studies of relations between morbidity and elements of the patient story, providing more insight into the range of problems presented to primary care and in the patient-centeredness applied by FPs.Methods: The Dutch Practice-Based Research Network (PBRN), named FaMe-Net, is the world's oldest PBRN. Seven Dutch family practices provide regular primary care and participate in the PBRN. It contains all morbidity data of the approximately 40,000 listed patients (308,000 patient-years and 2.2 million encounters from 2005 until 2019). All information belonging to 1 health problem is ordered in 1 episode. Morbidity (diagnoses), reasons for encounter (RFE), and interventions are coded according to the International Classification of Primary Care (ICPC-2). Registration occurs within the electronic health record (EHR), specially designed to facilitate the extensive registration for the PBRN. Since 2016, the network expanded routine registration with the duration of symptoms and coded personal and contextual characteristics (eg, country of birth, level of education, family history, traumatic events) obtained through the self-reported 'context survey' of listed patients. These data are added to the EHR. Registered data are extracted from the EHR and processed for scientific research.We present data on the differences in RFEs of the most prominent symptoms of COVID-19 between 2019 and 2020; the relation between the diagnosis of pneumonia and presentation of the symptom 'cough,' and how personal determinants influence the chances of final diagnoses. Lastly, we show the relation of selfreported abuse with patient's contact frequency and psychosocial problems.Results: Prompt introduction of registration rules brought insight into COVID-19-related symptoms early in the pandemic. In March 2020, symptoms related to COVID-19 were presented more often than in March 2019. Chronic conditions and prevention showed a collapsing contact frequency. Telephone, email, and video consultations increased from 31% to 53%.Episodes of pneumonia most frequently started with the RFE 'cough.' A combination of 'cough' and 'fever' as RFE increases the likelihood of pneumonia, as does cough in the presence of comorbid COPD among older men. The prevalence of pneumonia is higher among patients with low socioeconomic status.Discussion: The Dutch PBRN FaMe-Net has started to add elements of patients' narratives and context to decades of morbidity registration, creating options for a scientific approach to primary care's core values. Assumptions of 'pre/post chances' of the final diagnosis, already existing implicitl...

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“…8 Van cirrose alleen is de exacte prevalentie niet bekend; gegevens uit het registratienetwerk FaMe-net wijzen op een prevalentie van 0,3 per 1000 patiëntjaren tussen 2014 en 2016. 9 Een huisarts heeft gemiddeld naar schatting minder dan vijf patiënten met cirrose in zijn praktijk. Naar aanleiding van de nieuwe contra-indicatie 'levercirrose' en de bijbehorende adviezen bespreken wij in deze nascholing ■ ■ Patiënten met aspecifieke leverfunctiestoornissen vallen voortaan buiten de signalering.…”

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