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News in the research field of general practice medicine

Tryntsje Fokkema wins award at the Dutch Sports Medicine Congress 2017

On 23rd and 24rd November 2017 the annual Dutch Sports Medicine Congress 2017 took place in Ermelo. At this congress, PhD-student Tryntsje Fokkema won the award for the best oral presentation. She won this award for her presentation entitled ‘Prognosis and prognostic factors of running-related injuries in novice runners: a prospective study’. In her presentation, Tryntsje showed data of the duration of injuries in novice runners and which runners are prone to an injury with a poor prognosis.

Prijs Trynstje

Osteoarthritis guidebook for patients 

August 2017,
In the ongoing project JIGSAW-E the translation and cultural adaptation of the osteoarthritis guidebook for patients is finished. The guidebook will now be used in the pilot study to improve the care for patients with osteoarthritis in Primary Care. JIGSAW-E (Joint Implementation of Guidelines for oSteoArthritis in Western –Europe) is an implementation study to improve the care and support the self-management of patients with osteoarthritis.

The English osteoarthritis guidebook is developed by patients and general practitioners for osteoarthritis patients. The Dutch osteoarthritis guidebook is translated and adapted by patients, general practitioners, physiotherapists and other stakeholders.


NHG Science Day 2017

2nd of June,
Our department was widely represented at the NHG science day, the annual science day of the Dutch society of general practitioners.  Eleven researchers of our department gave an oral presentation on their research, and Marijke Kool was nominated for the Jan van Es award for her PhD thesis on febrile children.

It was held in on the beautiful location of the Julius center in Zeist, with important discussions on the importance of evidence based medicine in clinical practice.
Once again, it was an informative day and we are looking forward to next year’s iteration.

NHG 2017

Corticosteroid injection for knee osteoarthritis

End March 2017, the Netherlands Organisation for Health Research and Development (ZonMw) assigned funding (€250,000) for our study “Effectiveness in knee osteoarthritis of an intra-articular corticosteroid injection versus an intra-muscular gluteal corticosteroid injection versus analgesics (paracetamol/NSAID conform guideline) in general practice: a multicenter randomized, 24 weeks comparative parallel-group trial”. This trial will be executed (2017-2022) by a general practitioner trainee who will combine a PhD traject (AIOTHO) and will be supervised by Sita Bierma-Zeinstra and co-supervised by Pim Luijsterburg.


The Eczema study

Recently, a new research project has started at the Department of General Practice. The project is a new clinical study on children with eczema in general practice, the eczema study. Eczema or atopic dermatits (AD) is a chronic, highly itchy inflammatory skin disease, and is the most common chronic skin disorder in children. Eczema is in the top 10 of highest prevalence disorders in general practice in children up to 18 years. There is no cure for eczema, so treatment aims to control the disease. The majority of patients control their symptoms by daily application of emollients accompanied by symptomatic anti-inflammatory therapy consisting of topical corticosteroids (CS).

In this study, we want to determine whether a potent topical CS is more effective than a mild topical CS in the treatment of children with a moderate flare-up of AD in primary care.
The first goal of the project team will be to obtain approval of the Medical Ethical Committee to start with inclusion.


First PhD defences in 2017

On Wednesday January 25th, Desirée Dorleijn defended her thesis titled "Hip osteoarthritis; symptomatic presentation and non-operative treatment" at Erasmus University Medical Center Rotterdam. In her thesis, Dorleijn describes an additional therapy to reduce pain in patients with hip osteoarthritis. This intramuscular corticoid injection was compared to a placebo intramuscular injection in a fourfold-blinded randomized controlled trial. It shows that intramuscular corticoid injection was effective in hip pain reduction for 12 weeks.

This thesis also offers insight in the course of pain and comorbidities influencing hip complaints in patients with hip osteoarthritis. In a systematic review, the diagnostic value of intra-articular injections in patients with hip pain atypical for osteoarthritis was studied. Biomarkers could possibly be used to estimate progression of osteoarthritis symptoms. The association between cartilage biomarkers excreted in urine and hip pain was studied with 2-years follow-up. Patients with hip osteoarthritis often suggest that weather conditions change their symptoms. This thesis shows a small association between certain weather variables and osteoarthritis symptoms, but was this association too small to notice? Additionally, the prevalence of greater trochanter pain syndrome in patients with hip osteoarthritis was studied. It appeared that patients with this syndrome had more hip pain.

A full-text copy of this thesis can be found online here.

On Tuesday February 7th, Bastiaan de Vos will defend his thesis "Battling obesity; efforts in preventing knee osteoarthritis" at Erasmus University Medical Center Rotterdam.

The thesis of de Vos describes both the 2.5-years and 6.5-years follow-up of a preventive randomized controlled study on knee osteoarthritis development among middle-aged overweight and obese women (PROOF study). This study evaluated the preventive effects of a lifestyle intervention aimed to reduce body weight and of oral glucosamine sulphate in a 2x2 factorial design. In his thesis, de Vos describes and debates the effectiveness of the tailor-made lifestyle intervention in achieving a clinically significant amount of weight loss and the subsequent effect of this weight loss on the incidence of knee osteoarthritis. Also, advanced statistical techniques for handling longitudinal data collection to study different trajectories over time between subgroups of patients are applied to study factors associated to sustainable weight loss and physical exercise and their association to knee osteoarthritis development.

A full-text copy of this thesis can be found here.

Proefschriften Vos en Dorleijn

100 patients for the STAP-study

Last week (January 12th) we celebrated the inclusion of the 100th patient in the STAP-study. The STAP-study (Soles as Treatment Against Pain in feet) aims to investigate the (cost)effectiveness of insoles custom made by Dutch podiatrists in the treatment of plantar fasciopathy.
For this study our department collaborates with the Dutch Association of Podiatrist (NVVP) and the Netherlands Organisation for Health Research and Development (ZonMW). A total of 148 general practitioners, six sport physicians and 49 podiatrists are participating in the study. Inclusion has started in September 2015 and will continue until the end of 2017. On the 30th of December a milestone was reached when the 100th patient was included, just before the new year.


Social media as a tool for the recruitment of patients!

In 2014 the trAPP-study started: a trial to examine the cost-effectiveness of an unsupervised neuromuscular training program in combination with usual care In general practice, compared to usual care alone in patients with acute lateral ankle sprains.
A total of 169 patients have to be included for the trial by general practitioners; up to now a total of 94 patients are included. To increase the inclusion rate of the study, we have started recruitment by social media. A study website for interested patients was designed with information about the study and a registration form. In addition, Facebook and Twitter are fully used to advertise the study and to reach eligible patients for the study. This is the first study at the department that uses social media for recruitment. Hopefully in the future, social media will be more integrated in the field of research on our department: there's still much to learn!


PhD thesis defences.

On the 11th of October at 11:30, Rianne van der Heijden will defend her PhD thesis titled "Patellofemoral Pain: where does the pain come from?" Her thesis describes the results of the TripleP study, a case-control study including 64 patients with patellofemoral pain and 70 control subjects. She applied several novel imaging techniques to unravel the cause of pain in this prevalent knee condition among physically active individuals.

John van Ochten will defend his PhD thesis titled "Ankle sprains in general practice: Diagnosis and treatment of persistent complaints" on the 25th of October at 15:30. John has investigated the effectiveness of different treatment strategies of both acute and chronic ankles sprains in primary care. Additionally he performed a cohort study to investigate the impact of persistent complaints by making use of questionnaires and radiology.


Three new Masters in Health Sciences at the department of General Practice.

On Friday the 26th of August the graduation of Master and Doctor of Science of the NIHES (Netherlands Institute for Health Sciences) took place. Marieke Landsmeer, Janneke van Leeuwen and Carolien Teirlinck, all PhD-students and General Practitioner in training celebrated their graduation of Master of Science in Health Sciences, specialisation Clinical Epidemiology.
During their vocational training and research projects they followed core courses and electives. They completed their Master by writing a research paper about a part of their research. Marieke Landsmeer developed a predictive model of knee pain and symptomatic knee osteoarthritis among overweight and obese middle-aged women in general practice. Janneke van Leeuwen conducted a systematic review and meta-analysis about the association between bone mineral density and overweight and obesity in childhood. Carolien Teirlinck conducted a systematic review about prognostic factors of osteoarthritis of the hip.

Nihes Graduation

First Patient included in DUO-trial
15th of june

Recently, a new trial started at the department of General Practice. The DUO-trial is a pragmatic open-labeled cluster randomized controlled trial conducted by the department of General Practice. It is designed to investigate whether duloxetine is (cost-)effective as third choice pain medication for treating chronic pain in osteoarthritis patients.

Currently 77 general practitioners are participating in the study (34 clusters). At this moment the first patient is included in the trial.

duo logo2

International back and neck pain forum, Buxton, UK
31st of May - 3rd of June

7 researchers from the Erasmus MC department of General Practice attended the International Back and Neck Pain Forum in Buxton, UK that was themed 'Research without walls'. Several of our researchers presented their results to an international scientific audience at this conference and the International Collaboration of Early Career Researchers (ICECReam) organized a special pre-conference workshop on creativity in research, as well as social events for networking with international researchers. At the meeting, Professor Bart Koes was elected as a member of the executive team of the International Back and Neck Pain Forum, and he will thus be co-organizing the 15th edition that will be held in Oslo, Norway. We look forward to the next Forum, where we hope to share even more of the department's work with the international back pain research community!


International Back Pain Forum

NHG science day
27th of May

During the annual science day of the Dutch society of general practitioners, held the 27th of May, scientists from all Dutch academic centers gathered to share news in the field of research in primary practice. Clinical decision tools and decision making in primary practice were central features of the conference. Scientists from Rotterdam were strongly represented and the presentations were well received.

We are looking forward to this Dutch conference next year and hope many scientists will share their work again.

NHG wetenschapsdag

NHG science day
10th of May

At the NHG science day, on the 27th of May, six researchers of our department will give an oral presentation covering an up-to-date overview of (one of the) research project they are involved in. Both department's research themes 'Musculoskeletal Disorders' and 'Children in general practice' will be represented. Marienke van Middelkoop, Jos Runhaar, Bastiaan de Vos, Jacoline van den Driest, Adinda Mailuhu, Marieke Landsmeer and Annemieke Verwoerd will present their work.


Prof dr. Heleen Evenhuis receives a Royal Award
29th of April

As of April 29, the Department of General Practice and the chair of Intellectual Disability Medicine are proud to announce to be in company of a member of the Order of the Netherlands Lion.
Prof dr. Heleen Evenhuis received a ribbon and was named Knight in the Order of the Netherlands Lion for her extensive work as a medical doctor and professor in the field of intellectual disability medicine.
The Dutch Association of Intellectual Disability Physicians (NVAVG) initiated the nomination in corporation with the Department of General Practice and the chair of Intellectual Disability Medicine. The mayor of Rotterdam, Ahmed Aboutaleb, had the honor to award prof. Evenhuis with the ribbon and royal title.

The department would like to congratulate prof. Evenhuis with receiving this Royal Award.

Lintjesregen 2016

STAP-study patient inclusion exceeds expectations

22nd of April

The STAP-study is a trial conducted by the department of General Practice to study the (cost)effectiveness of podiatric treatment in patients with plantar fasciopathy in primary care. This study has started in September 2015 and is running successfully.

There have been 56 inclusions so far, which has exceeded expectations. Currently the first patients has finished their follow-up time and have filled out the last questionnaires. These patients shall receive a thank you message shortly.


Alex Bastick received the Young Investigator Award at OARSI
31st of March

The award was handed to him because of his study on defining hip pain trajectories. Bastick et al. were the first to define 4 distinct pain trajectories in individuals with early symptomatic hip OA (constant mild - moderate regression - moderate progression - constant severe).

Individuals whom are less educated, have higher activity limitation scores, use the pain coping strategy pain transformation frequently and/or have painful internal hip rotation have an increased risk for being in a trajectory with more severe pain. Baseline radiographic severity was not associated with the pain trajectories.


gepubliceerd: 8 december 2017

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