Marjan van den Akker

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Increasing numbers of people are found to have two or more diseases at the same time, which is termed multimorbidity. We studied the prevalence, incidence, and determinants of multimorbidity and the statistical clustering of chronic and recurrent diseases in a general practice setting. Prevalence of multimorbidity increased with all age groups from 10% in(More)
OBJECTIVES The aim of this review was to identify studies on patterns of associative multimorbidity, defined as the nonrandom association between diseases, focusing on the main methodological features of the studies and the similarities among the detected patterns. STUDY DESIGN AND SETTING Studies were identified through MEDLINE and EMBASE electronic(More)
We introduce a primary care practice model for caring for patients with multimorbidity. Primary care for these patients requires flexibility and ongoing coordination, and it often must be tailored to individual circumstances. Such complex and flexible care could be accomplished within communities of practice, whose participants are willing to learn from(More)
UNLABELLED AIMD: To assess the long-term effectiveness of an integrated disease management (IDM) program (consisting of optimal medication, reactivation, education, and exacerbation management) in primary care patients with chronic obstructive pulmonary disease (COPD). METHOD Controlled trial comparing the effects of IDM on quality of life--assessed by(More)
OBJECTIVE This study aimed to identify differences and similarities in health behavior clusters for respondents with different educational backgrounds. METHODS A total of 9449 respondents from the 2002 wave of the Dutch SMILE cohort study participated. Latent class analyses were used to identify clusters of people based on their adherence to Dutch(More)
BACKGROUND Information on the incidence and prevalence of diseases is a core indicator for public health. There are several ways to estimate morbidity in a population (e.g., surveys, healthcare registers). In this paper, we focus on one particular source: general practice based registers. Dutch general practice is a potentially valid source because nearly(More)
OBJECTIVES To assess the validity and reliability of the Turkish version of the Hill-Bone compliance to high blood pressure therapy scale for use in primary care in Turkey. METHODS To develop a Turkish version of the scale, it was translated into Turkish then back-translated into English. The final version was used in a survey in two urban primary health(More)
The object of this article was to validate the predictive value of Charlson's comorbidity index for the prediction of short-term mortality or morbidity in elderly people. The design was a cohort study comparing survival and hospitalization in institutionalized elderly people with different levels of comorbidity at baseline. The setting was 16 Flemish(More)
OBJECTIVE To compare the risk of developing diabetes mellitus (DM) in the general population between subjects who had a depression and subjects who never had a depression. METHOD Retrospective cohort design. People with depression were diagnosed with a depression between 1975 and 1990; controls never had a depression. Both groups were followed for a(More)