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Appropriate care at the end of life / Kris Van den Broeck / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2017)  

Appropriate care at the end of life [printed text] / Kris Van den Broeck, Author ; Olivier Schmitz, Author ; Isabelle Aujoulat, Author ; Patriek Mistiaen , Author ; Marie Friedel, Author ; Magali Genet, Author ; Céline Ricour, Author ; Laurence Kohn , Author ; Johan Wens, Author . - Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre, 2017 . - 203 p. : ill., ; A4. - (KCE Reports. Health Services Research (HSR); 296C) . ISSN : D/2017/10.273/90 : € 0,00 Languages : English (eng) Descriptors: Indexation 2015-14 ; Advance Care Planning ; Advance Directive Adherence ; Advance Directives ; Hospice and Palliative Care Nursing ; Hospice Care ; Life Support Care ; Medical Futility ; Palliative Care ; Palliative Medicine ; R296 ; Refusal to Treat ; Terminal Care ; Terminally Ill ; Treatment Refusal ; Withholding Treatment Classification WB 310 Hospice care. Palliative care. Terminal care Contents note: SCIENTIFIC REPORT .9 -- 1 INTRODUCTION 9 -- 1.1 GENERAL RESEARCH AIM 9 -- 1.2 POLICY RELEVANCE AND TARGET POPULATION .10 -- 1.3 RESEARCH QUESTIONS .10 -- 2 METHODOLOGY 11 -- 2.1 BUILDING UPON PREVIOUS WORK .11 -- 2.2 BELGIAN LITERATURE REVIEW .11 -- 2.2.1 Orientation of the study .11 -- 2.2.2 Search sources .11 -- 2.2.3 Search strategy .12 -- 2.2.4 In- and exclusion criteria and process 13 -- 2.2.5 Methodological assessment 13 -- 2.2.6 Data extraction 13 -- 2.2.7 Data synthesis 13 -- 2.3 ONLINE QUESTIONNAIRE 14 -- 2.3.1 Orientation of the study .14 -- 2.3.2 The questionnaire 14 -- 2.3.4 Data analysis 16 -- 2.4 QUALITATIVE FOLLOW-UP STUDY 17 -- 2.4.1 Orientation of the study .17 -- 2.4.2 Procedure .17 -- 2.4.3 Data analysis 18 -- 2.5 VALIDATION PROCEDURES 18 -- 2.6 ETHICAL APPROVAL 19 -- 2.7 OUTLINE OF THE REPORT .19 -- 3 BELGIAN LITERATURE SEARCH 19 -- 3.1 RESULTS 19 -- 3.1.1 Search results 19 -- 3.1.2 Terminology & definitions .20 -- 3.1.3 Prevalence 28 -- 3.1.4 Determinants and contributing factors 30 -- 3.1.5 Consequences 34 -- 3.1.6 Interventions 34 -- 3.2 CONCLUSIONS FROM THE LITERATURE REVIEW 36 -- 4.1 PRECEDING NOTES 38 -- 4.2 DESCRIPTION OF THE RESPONDENTS 41 -- 4.2.1 Description of the total eligible sample .41 -- 4.2.2 Sample descriptives by the perspective respondents adopted.42 -- 4.2.3 More information about respondents with a background in care .44 -- 4.3 CIRCUMSTANCES OF END OF LIFE CARE 44 -- 4.4 OPINIONS ABOUT AND ATTITUDES TOWARDS END OF LIFE CARE .46 -- 4.4.1 Who is responsible for inappropriate care? 46 -- 4.4.2 Opinions about and attitudes towards end of life care 49 -- 4.4.3 Balanced involvement in end of life care? 51 -- 4.4.4 Advance care planning regarding end of life care 53 -- 4.4.5 Preferences in decision making about end of life care .57 -- 5 QUALITATIVE ANALYSES 57 -- 5.1 CHAPTER OUTLINE AND AVAILABLE DATA 57 -- 5.1.1 Chapter outline: Three research questions .57 -- 5.1.2 Data and respondents 57 -- 5.2 RESEARCH QUESTION 1: DEFINITION OF ‘(IN)APPROPRIATE CARE AT THE END OF LIFE’ 60 -- 5.2.1 Procedure .60 -- 5.2.2 Qualitative analysis of the online questionnaire 60 -- 5.2.3 Supplementary analyses of the qualitative follow-up study 66 -- 5.2.4 Conclusion: one general definition, different accents 81 -- 5.3 RESEARCH QUESTION 2: CAUSES AND MECHANISMS UNDERLYING (IN)APPROPRIATE CARE AT THE END OF LIFE 83 -- 5.3.1 Procedure .83 -- 5.3.2 Qualitative analysis of the online questionnaire 84 -- 5.3.3 Supplementary analyses of the qualitative follow-up study 96 -- 5.3.4 Conclusion: causes and mechanisms underlying (in)appropriate end of life care 117 -- 5.4 RESEARCH QUESTION 3: SOLUTIONS FOR AND PREVENTION OF INAPPROPRIATE END OF LIFE CARE . 118 -- 5.4.1 Talking, talking, talking, and listening, listening, listening 118 -- 5.4.2 Training for health care practitioners . 119 -- 5.4.3 Organisation of care 120 -- 5.4.4 Guidance regarding ethical issues 121 -- 6 GENERAL DISCUSSION 122 -- 6.1 SUMMARY OF FINDINGS . 122 -- 6.1.1 Definition of (in)appropriate end of life care 122 -- 6.1.2 Causes and mechanisms underlying (in)appropriate end of life care 123 -- 6.1.3 Solutions for and measures to prevent inappropriate care . 124 -- 6.1.4 The weight of our findings 124 -- 6.2 LIMITATIONS 127 -- 6.3 DIRECTIVES FOR FURTHER RESEARCH . 129 -- EFERENCES . 131 -- APPENDICES 148 -- APPENDIX 1. THE QUESTIONNAIRE 148 -- APPENDIX 1.1. DUTCH QUESTIONNAIRE 148 -- APPENDIX 1.2. FRENCH QUESTIONNAIRE . 163 -- APPENDIX 2. TEMPLATE USED TO ANALYSE THE QUALITATIVE DATA COLLECTED WITH -- THE QUESTIONNAIRE 178 -- APPENDIX 3. TOPICS INVESTIGATED DURING THE QUALITATIVE FOLLOW-UP STUDY 179 -- APPENDIX 4. ADDITIONAL QUANTITATIVE DATA AND ANALYSES . 185 -- APPENDIX 5. CHARACTERISTICS OF RESPONDENTS INVOLVED IN THE QUALITATIVE FOLLOW-UP STUDY 200 Link for e-copy: https://doi.org/10.57598/R296C Format of e-copy: PDF (1,75 Mb) Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=4344

Economic Evaluation in renal transplantation. Outcome assesment & cost-utility of non-compliance / Irina Cleemput / Leuven [Belgium] : Katholieke Universiteit Leuven (KUL) (2003)

Economic Evaluation in renal transplantation. Outcome assesment & cost-utility of non-compliance [printed text] / Irina Cleemput , Author ; Katrien Kesteloot, Scientific advisor ; Yves Vanrenterghem, Scientific advisor ; S. De Geest, Scientific advisor . - Leuven [Belgium] : Katholieke Universiteit Leuven (KUL), 2003 . - I, 138p. + annexes. - (Faculteit der Geneeskunde = Faculty of Medicine) . ISSN : 352 Public Health Languages : English (eng) Descriptors: Classification W 74 Medical economics. Health care costs (General) Indexation Costs and Cost Analysis ; Kidney Transplantation ; Outcome Assessment (Health Care) ; Treatment Refusal Abstract: Non-Compliance Renal Transplantation Economic evaluations Cost utility analysis Markov modelling EuroQol Health Related Quality of life Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=348

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Barcode	Call number	Media type	Location	Section	Status
10273-00352	W74/CLE	Thesis	KCE	Library (10.124)	Available

Economic implications of non-compliance in health care / Irina Cleemput in Lancet (The), 359(2002)9324 ([06/01/2002])  

[article] Economic implications of non-compliance in health care [printed text] / Irina Cleemput , Author ; Katrien Kesteloot, Author . - 2002 . - 2129-30. Languages : English (eng) in Lancet (The) > 359(2002)9324 [06/01/2002] . - 2129-30 Descriptors: Classification W 1 Serials. Periodicals Indexation Costs and Cost Analysis ; Delivery of Health Care ; Great Britain ; Humans ; Journal Article ; Peer Review ; Practice Guideline [Publication type] ; Quality-Adjusted Life Years ; Treatment Refusal Link for e-copy: http://tiny.cc/gixys Format of e-copy: SCIENCE DIRECT (IP recognition): 2003-present Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=2120 [article]

Passende zorg in de laatste levensfase / Kris Van den Broeck / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2017)  

Passende zorg in de laatste levensfase : Synthese [printed text] / Kris Van den Broeck, Author ; Olivier Schmitz, Author ; Isabelle Aujoulat, Author ; Patriek Mistiaen , Author ; Marie Friedel, Author ; Magali Genet, Author ; Céline Ricour, Author ; Laurence Kohn , Author ; Johan Wens, Author . - Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre, 2017 . - 21 p. : ill., ; A4. - (KCE Reports A. Health Services Research (HSR); 296AS) . ISSN : D/2017/10.273/88 : € 0,00 Languages : Dutch (nla) Descriptors: Indexation 2015-14 ; Advance Care Planning ; Advance Directive Adherence ; Advance Directives ; Hospice and Palliative Care Nursing ; Hospice Care ; Life Support Care ; Medical Futility ; Palliative Care ; Palliative Medicine ; R296 ; Refusal to Treat ; Terminal Care ; Terminally Ill ; Treatment Refusal ; Withholding Treatment Classification WB 310 Hospice care. Palliative care. Terminal care Abstract: Wat wordt in ons land beschouwd als passende zorg in de laatste levensfase? Hoe komt het dat sommige mensen deze zorg niet krijgen, en hoe kan dit worden voorkomen? Het Federaal Kenniscentrum voor de Gezondheidszorg (KCE) doorzocht de Belgische publicaties en organiseerde samen met het onderzoeksteam van UAntwerpen en de UCL een grootschalig onderzoek (waaronder een enquête) bij zorgverleners, patiënten, familieleden en vrijwilligers. Passende zorg blijkt zorg te zijn die tegemoet komt aan wat een patiënt belangrijk vindt. Het tijdig vastleggen van wensen en voorkeuren in een voorafgaande zorgplanning is een zeer goede manier om niet passende zorg bij het levenseinde te voorkomen. Daarnaast moeten zorgverleners vooral tijd krijgen en maken voor gesprekken met hun patiënt. Wat verwacht deze nog van het leven? Waar liggen de prioriteiten? En de maatschappij moet opnieuw leren om te gaan met het levenseinde, zodat dit gemakkelijker bespreekbaar wordt tussen de patiënt en zijn naasten en zorgverleners. Contents note: 1. INLEIDING 4 -- 1.1. ACHTERGROND 4 -- 2. SCOPE VAN DE STUDIE EN METHODE .. 4 -- 2.1. WAT HEBBEN WE ONDERZOCHT? 4 -- 2.2. HOE GINGEN WE TE WERK? 4 -- 2.2.1. Onderzoek van de literatuur 4 -- 2.2.2. Onderzoek met online enquête, interviews en focusgroepen 5 -- 2.2.3. Stakeholderoverleg en validatie 5 -- 3. WAT IS (NIET) PASSENDE ZORG BIJ HET LEVENSEINDE? 6 -- 3.1. VELE TERMEN EN BETEKENISSEN VOOR NIET PASSENDE ZORG 6 -- 3.2. PREVALENTIE VAN NIET PASSENDE ZORG 7 -- 4. WAT WERKT (NIET) PASSENDE ZORG IN DE HAND? 7 -- 4.1. MAATSCHAPPIJ 7 -- 4.2. ZORGORGANISATIE. 8 -- 4.3. ZORGVERLENERS 9 -- 4.4. FAMILIELEDEN 10 -- 4.5. PATIËNT 10 -- 4.5.1. Onrealistische verwachtingen en onwetendheid over palliatieve zorg 10 -- 4.5.2. Terughoudendheid 10 -- 4.5.3. Soort van aandoening 11 -- 4.5.4. Andere factoren 11 -- 5. HOE PASSENDE ZORG BEVORDEREN? 11 -- 5.1. MAATSCHAPPIJ (EN PATIËNTEN) 11 -- 5.2. ZORGORGANISATIE 12 -- 5.3. ZORGVERLENERS 13 -- 6. CONCLUSIE. 15 Link for e-copy: https://doi.org/10.57598/R296AS Format of e-copy: PDF (429 Kb) Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=4347

Prevalence, consequences, and determinants of nonadherence in adult renal transplant patients / K. Denhaerynck in Transplant international, 18(2005)10 ([09/01/2005])  

[article] Prevalence, consequences, and determinants of nonadherence in adult renal transplant patients : a literature review [printed text] / K. Denhaerynck, Author ; F. Dobbels, Author ; Irina Cleemput , Author ; A. Desmyttere, Author ; P. Schäfer-Keller, Author ; S. Schaub, Author ; S. De Geest, Author . - 2005 . - 1121-33. Languages : English (eng) in Transplant international > 18(2005)10 [09/01/2005] . - 1121-33 Descriptors: Classification W 1 Serials. Periodicals Indexation Adult ; Economics ; Female ; Graft Rejection ; Great Britain ; Humans ; Immunosuppressive Agents ; Journal Article ; Kidney Transplantation ; Male ; Middle Aged ; Peer Review ; Prevalence ; Treatment outcome ; Treatment Refusal Abstract: This literature review summarizes the evidence on the prevalence, determinants, clinical and economic consequences of nonadherence with immunosuppressive drugs in renal transplant patients. A literature search yielded 38 articles measuring nonadherence by self-report, collateral report, assay, refill prescriptions or electronic monitoring. The weighted mean prevalence of self-reported nonadherence was 28%. Nonadherence is associated with poor clinical outcomes, contributing to 20% of late acute rejection episodes and 16% of the graft losses (weighted means). In addition, nonadherence results in lower lifetime costs because of shorter survival, yet also in a lower number of quality adjusted life years. Consistent determinants of nonadherence were younger age, social isolation, and cognitions (e.g. low self-efficacy, certain health beliefs). Determinants concerning the health care system/team seem to be under-investigated. Because the evidence summarized in this review is based on older immunosuppressive regimens, further research should focus on prevalence, determinants and consequences of nonadherence with newer immunosuppressive regimens. Link for e-copy: http://vdic.idm.oclc.org/login?url=http://onlinelibrary.wiley.com/doi/10.1111/j. [...] Format of e-copy: VDIC IP recognition Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=2131 [article]

A review of the literature on the economics of noncompliance / Irina Cleemput in Health Policy, 59(2002)1 ([01/01/2002])  

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Soins appropriés en fin de vie / Kris Van den Broeck / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2017)  

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The economic implications of non-adherence after renal transplantation / Irina Cleemput in Pharmacoeconomics, 22(2004)18 ([12/01/2004])  

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The foundations of bioethics / Hugh Tristram Engelhardt / Oxford ; Melbourne ; New York : Oxford University Press - OUP (1996)

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