Aan de slag in de praktijk

Gebruik nascholing

Om de nascholing te volgen dient u in te loggen met uw naam en geboortedatum. Uw BIG-nummer wordt dan automatisch opgehaald. Indien dit niet lukt, vul dan het nummer handmatig in. U kunt deze nascholing op verschillende manieren gebruiken in uw praktijkvoering:

Het NHG zal in het najaar van 2011 een Programma voor Individuele Nascholing (PIN) aanbieden. De PIN geeft aanvullend op deze online nascholing een verdieping op de inhoud van de gehele NHG-standaard, inclusief acuut hoestende kinderen. De PIN gaat ook in op specifieke infecties, zoals kinkhoest, Q-koorts, RSV en pseudokroep.

CRP sneltestapparatuur

Deze nascholing is onafhankelijk tot stand gekomen met subsidie van ZonMW. We geven in de module geen aanbevelingen over specifieke apparatuur. Onderstaand vindt u wel een overzicht van de in Nederland beschikbare CRP sneltestapparaten. Deze apparaten zijn bewezen robuust, valide en betrouwbaar bij gebruik in de huisartsenpraktijk, zij het in verschillende mate. Van andere CRP sneltestapparatuur en losse CRP sneltesten kan validiteit en betrouwbaarheid niet gegarandeerd worden. De uitvoering en prijzen variëren sterk per apparaat. Naast de CRP sneltest kunnen op alle apparaten tevens andere bepalingen gedaan worden. Via de links kunt u meer informatie vinden.

NycoCard II Reader CRP sneltest
Afinion CRP sneltest

Fabrikant: Axis-Shield, Noorwegen
Importeur: Alere (http://www.alere.com/nl/nl/product-details/afinion-crp.html)

QuikRead CRP sneltest
QuikRead Go CRP sneltest

Fabrikant: Orion Diagnostica, Finland
Importeur: Mediphos (http://www.mediphos.com/quikread/index.php/crp)

Eurolyser Smart CRP sneltest
Fabrikant: Eurolyser, Oostenrijk
Importeur: Zkope Healthcare (http://www.zkopehealthcare.nl)

Bovenstaande apparaten zijn onder andere getest in deze valideringsstudies:
Minnaard et al. Analytical performance, agreement and user-friendliness of five C-reactive protein point-of-care tests. Scandinavian Journal of Clinical & Laboratory Investigation 2013;73(8):627-34 (http://www.ncbi.nlm.nih.gov/pubmed/24125120)
Brouwer et al. Validation and evaluation of eight commercially available point of care CRP methods. Clinica Chimica Acta 2015(439);195-201 (http://www.sciencedirect.com/science/article/pii/S0009898114004598)

Handouts

Klik hier voor een printbaar PDF kaartje met de CRP waardes en bijbehorende interpretatie. U kunt deze als bureaureminder gebruiken.

Meer handout materiaal volgt.

Literatuur

Akkerman AE, Kuyvenhoven MM, van der Wouden JC, Verheij TJ. Prescribing antibiotics for respiratory tract infections by GPs: management and prescriber characteristics. Br J Gen Pract 2005;55(511):114-8.
Download

Almirall J, Bolibar I, Toran P, Pera G, Boquet X, Balanzo X, et al. Contribution of C-Reactive Protein to the Diagnosis and Assessment of Severity of Community-Acquired Pneumonia. Chest 2004;125(4):1335-1342.
Download

Altiner A, Brockmann S, Sielk M, Wilm S, Wegscheider K, Abholz HH. Reducing antibiotic prescriptions for acute cough by motivating GPs to change their attitudes to communication and empowering patients: a cluster-randomized intervention study. J Antimicrob Chemother 2007;60(3):638-44.
Download

Andre M, Schwan A, Odenholt I. The use of CRP tests in patients with respiratory tract infections in primary care in Sweden can be questioned. Scand J Infect Dis 2004;36(3):192-7.
Download

Arnold SR, Straus SE. Interventions to improve antibiotic prescribing practices in ambulatory care. Cochrane Database Syst Rev 2005(4):CD003539.
Download

Arroll B. Antibiotics for upper respiratory tract infections: an overview of Cochrane reviews. Respir Med 2005;99(3):255-61.
Download

Avorn J, Solomon DH. Cultural and Economic Factors That (Mis)Shape Antibiotic Use: The Nonpharmacologic Basis of Therapeutics. Ann Intern Med 2000;133(2):128-135.
Download

Bjerrum L, Gahrn Hansen B, Munck AP. C-reactive protein measurement in general practice may lead to lower antibiotic prescribing for sinusitis. Br J Gen Pract 2004;54(506):659-62.
Download

Bont J, Hak E, Hoes AW, Macfarlane JT, Verheij TJ. Predicting death in elderly patients with community-acquired pneumonia: a prospective validation study reevaluating the CRB-65 severity assessment tool. Arch Intern Med 2008;168(13):1465-8.
Download

Bont J, Hak E, Hoes AW, Schipper M, Schellevis FG, Verheij TJ. A prediction rule for elderly primary-care patients with lower respiratory tract infections. Eur Respir J 2007;29(5):969-75.
Download

Bradley JS, Guidos R, Baragona S, Bartlett JG, Rubinstein E, Zhanel GG, et al. Anti-infective research and development--problems, challenges, and solutions. Lancet Infect Dis 2007;7(1):68-78.
Download

Briel M, Langewitz W, Tschudi P, Young J, Hugenschmidt C, Bucher HC. Communication training and antibiotic use in acute respiratory tract infections. A cluster randomised controlled trial in general practice. Swiss Med Wkly 2006;136(15-16):241-7.
Download

Briel M, Schuetz P, Mueller B, Young J, Schild U, Nusbaumer C, et al. Procalcitonin-guided antibiotic use vs a standard approach for acute respiratory tract infections in primary care. Arch Intern Med 2008;168(18):2000-7; discussion 2007-8.
Download

Butler CC, Kinnersley P, Prout H, Rollnick S, Edwards A, Elwyn G. Antibiotics and shared decision-making in primary care. J Antimicrob Chemother 2001;48(3):435-40.
Download

Butler CC, Rollnick S, Kinnersley P, Jones A, Stott N. Reducing antibiotics for respiratory tract symptoms in primary care: consolidating 'why' and considering 'how'. Br J Gen Pract 1998;48(437):1865-70.
Download

Butler CC, Rollnick S, Pill R, Maggs Rapport F, Stott N. Understanding the culture of prescribing: qualitative study of general practitioners' and patients' perceptions of antibiotics for sore throats. BMJ 1998;317(7159):637-42.
Download

Cals JW, Butler CC, Hopstaken RM, Hood K, Dinant GJ. Effect of point of care testing for C reactive protein and training in communication skills on antibiotic use in lower respiratory tract infections: cluster randomised trial. Bmj 2009;338:b1374.
Download

Cals JW, Chappin FH, Hopstaken RM, van Leeuwen ME, Hood K, Butler CC, et al. C-reactive protein point-of-care testing for lower respiratory tract infections: a qualitative evaluation of experiences by GPs. Fam Pract 2010;27(2):212-8.
Download

Cals JW, Francis NA. Acute cough in adults. Bmj 2010;340:c574.
Download
Download

Cals JW, Scheppers NA, Hopstaken RM, Hood K, Dinant GJ, Goettsch H, et al. Evidence based management of acute bronchitis; sustained competence of enhanced communication skills acquisition in general practice. Patient Educ Couns 2007;68(3):270-8.
Download

Cals JW, Schot MJ, de Jong SA, Dinant GJ, Hopstaken RM. Point-of-care C-reactive protein testing and antibiotic prescribing for respiratory tract infections: a randomized controlled trial. Ann Fam Med 2010;8(2):124-33.
Download

Cals JWL, Boumans D, Lardinois RJM, Gonzales R, Hopstaken RM, Butler CC, et al. Public beliefs on antibiotics and respiratory tract infections: an internet-based questionnaire study. Br J Gen Pract 2007;57:942-947.
Download
Download

Coenen S, Michiels B, Renard D, Denekens J, Van Royen P. Antibiotic prescribing for acute cough: the effect of perceived patient demand. Br J Gen Pract 2006;56(524):183-90.
Download

Davey P, Pagliari C, Hayes A. The patient's role in the spread and control of bacterial resistance to antibiotics. Clin Microbiol Infect 2002;8(Suppl 2):43-68.
Download

Falk G, Fahey T. C-reactive protein and community-acquired pneumonia in ambulatory care: systematic review of diagnostic accuracy studies. Fam Pract 2009;26(1):10-21.
Download

Gonzales R, Sande M. What will it take to stop physicians from prescribing antibiotics in acute bronchitis? Lancet 1995;345(8951):665-6.
Download

Goossens H, Ferech M, Vander Stichele R, Elseviers M. Outpatient antibiotic use in Europe and association with resistance: a cross-national database study. Lancet 2005;365(9459):579-87.
Download

Graffelman AW, Knuistingh Neven A, le Cessie S, Kroes ACM, Springer MP, van den Broek PJ. A diagnostic rule for the aetiology of lower respiratory tract infections as guidance for antimicrobial treatment. Br J Gen Pract 2004;54(Jan):20-4.
Download

Hamm RM, Hicks RJ, Bemben DA. Antibiotics and respiratory infections: are patients more satisfied when expectations are met? J Fam Pract 1996;43(1):56-62.
Download

Hopstaken RM, Butler CC, Muris JW, Knottnerus JA, Kester AD, Rinkens PE, et al. Do clinical findings in lower respiratory tract infection help general practitioners prescribe antibiotics appropriately? An observational cohort study in general practice. Fam Pract 2006;23(2):180-7.
Download

Hopstaken RM, Coenen S, Butler CC. Treating patients not diagnoses: challenging assumptions underlying the investigation and management of LRTI in general practice. J Antimicrob Chemother 2005;56(5):941-943.
Download

Hopstaken RM, Muris JWM, Knottnerus JA, Kester ADM, Rinkens PELM, Dinant GJ. Contributions of symptoms, signs, erythrocyte sedimentation rate and C-reactive protein to a diagnosis of pneumonia in acute lower respiratory tract infection. Br J Gen Pract 2003;53:358-64.
Download

Hopstaken RM, Stobberingh EE, Knottnerus JA, Muris JWM, Nelemans P, Rinkens PELM, et al. Clinical items not helpful in differentiating viral from bacterial lower respiratory tract infections in general practice. Journal of Clinical Epidemiology 2005;58(2):175-183.
Download

Kuyvenhoven M, van Essen G, Schellevis F, Verheij T. Management of upper respiratory tract infections in Dutch general practice; antibiotic prescribing rates and incidences in 1987 and 2001. Fam Pract 2006;23(2):175-9.
Download

Little P, Rumsby K, Kelly J, Watson L, Moore M, Warner G, et al. Information Leaflet and Antibiotic Prescribing Strategies for Acute Lower Respiratory Tract Infection: A Randomized Controlled Trial. JAMA 2005;293(24):3029-3035.
Download

Lundkvist J, Akerlind I, Borgquist L, Molstad S. The more time spent on listening, the less time spent on prescribing antibiotics in general practice. Fam Pract 2002;19(6):638-40.
Download

Melbye H, Straume B, Aasebo U, Brox J. The diagnosis of adult pneumonia in general practice. The diagnostic value of history, physical examination and some blood tests. Scand J Prim Health Care 1988;6(2):111-7.
Download

Menendez R, Martinez R, Reyes S, Mensa J, Filella X, Marcos MA, et al. Biomarkers improve mortality prediction by prognostic scales in community-acquired pneumonia. Thorax 2009.
Download

Okkes IM, Oskam SK, Lamberts H. Van klacht naar diagnose: episodegegevens uit de huisartspraktijk. [From complaint to diagnosis: Disease episodes in general practice]. Bussum: Couthino, 1998.

Poon EG, Gandhi TK, Sequist TD, Murff HJ, Karson AS, Bates DW. "I wish I had seen this test result earlier!": Dissatisfaction with test result management systems in primary care. Arch Intern Med 2004;164(20):2223-8.
Download

Rollnick S, Kinnersley P, Butler C. Context-bound communication skills training: development of a new method. Med Educ 2002;36(4):377-83.
Download

Rollnick S, Mason P, Butler C. Health Behavior Change; a guide for practitioners: Churchill Livingston, 1999.

Rollnick S, Seale C, Kinnersley P, Rees M, Butler C, Hood K. Developing a new line of patter: can doctors change their consultations for sore throat? Med Educ 2002;36(7):678-681.
Download

Smith SM, Schroeder K, Fahey T. Over-the-counter medications for acute cough in children and adults in ambulatory settings. Cochrane Database Syst Rev 2008(1):CD001831.
Download

Smucny J, Fahey T, Becker L, Glazier R. Antibiotics for acute bronchitis. Cochrane Database Syst Rev 2004(4).
Download

van de Nadort C, Smeets HM, Bont J, Zuithoff NP, Hak E, Verheij TJ. Prognosis of primary care patients aged 80 years and older with lower respiratory tract infection. Br J Gen Pract 2009;59(561):e110-5.
Download

van der Meer V, Neven AK, Broek PJvd, Assendelft WJJ. Diagnostic value of C reactive protein in infections of the lower respiratory tract: systematic review. BMJ 2005;331:26-9.
Download

van Duijn H, Kuyvenhoven M, Jones RT, Butler C, Coenen S, Van Royen P. Patients' views on respiratory tract symptoms and antibiotics. Br J Gen Pract 2003;53(491):491-2.
Download

Woodhead M, Blasi F, Ewig S, Huchon G, Leven M, Ortqvist A, et al. Guidelines for the management of adult lower respiratory tract infections. Eur Respir J 2005;26(6):1138-1180.
Download