Frans Dekker

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BACKGROUND Preventive treatment of migraine contributes to reducing the impact of migraine but its extent of use in routine care is unknown. OBJECTIVE The objective of this article is to assess current use, previous use, duration and course of preventive treatment of migraine in Dutch general practice. METHODS We conducted a retrospective cohort study,(More)
BACKGROUND Many patients with asthma or chronic obstructive pulmonary disease use their medication inhalers incorrectly. General practitioners, pharmacists and other health care providers do not always have the opportunity to instruct patients in correct inhaler technique. OBJECTIVE To find out whether the inhaler technique and respiratory symptoms of(More)
Inhaled steroid therapy is the most important treatment in the management of chronic asthma and currently twice-daily administration is recommended in mild to moderate asthma. Compliance is often a problem in asymptomatic patients and may lead to reduced disease control. Our aim was to investigate whether budesonide 0.2 mg once daily administered via the(More)
Most patients with two or more migraine attacks per month do not use prophylactic medication. The aim of this study is to investigate how many patients use prophylaxis or would like to use them, and which aspects of migraine contribute to the choice to use prophylactic treatment. In a cross-sectional survey in three general practices, patients were selected(More)
INTRODUCTION A population-based observational study was used to assess the prevalence, demographics, risk factors, and costs of triptan overuse, defined as more than 30 (International Headache Society criteria) or 54 (stringent criteria) defined daily doses per 3 months. METHODS Analysis of the Dutch Health Care Insurance Board Database for 2005, which(More)
BACKGROUND Prophylactic treatment is an important but under-utilised option for the management of migraine. Patients and physicians appear to have reservations about initiating this treatment option. This paper explores the opinions, motives and expectations of patients regarding prophylactic migraine therapy. METHODS A qualitative focus group study in(More)
Migraine patients who experience an average of 2 or more attacks per month are eligible for preventive treatment as well as treatment for acute attacks. The decision to offer preventative treatment is also made on the basis of the average attack duration, severity of the attacks, and response to attack treatment. Prior to initiating preventive treatment,(More)
BACKGROUND Migraine is a common, disabling headache disorder that leads to lost quality of life and productivity. We investigated whether a proactive approach to patients with migraine, including an educational intervention for general practitioners, led to a decrease in headache and associated costs. METHODS We conducted a pragmatic randomized controlled(More)
BACKGROUND Despite the considerable impact of migraine, the use of preventive medication in primary care is limited. Only about 5% of migraine patients who qualify for prophylaxis actually receive it, and adherence is far from optimal. AIM To explore the opinions of GPs regarding preventive medication for migraine. DESIGN AND SETTING A qualitative(More)
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