Development of patient centered management of asthma and COPD in primary care Metting, Esther

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University of Groningen Development of patient centered management of asthma and COPD in primary care Metting, Esther IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite from it. Please check the document version below. Document Version Publisher's PDF, also known as Version of record Publication date: 2018 Link to publication in University of Groningen/UMCG research database Citation for published version (APA): Metting, E. I. (2018). Development of patient centered management of asthma and COPD in primary care [Groningen]: Rijksuniversiteit Groningen Copyright Other than for strictly personal use, it is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), unless the work is under an open content license (like Creative Commons). Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim. Downloaded from the University of Groningen/UMCG research database (Pure): http://www.rug.nl/research/portal. For technical reasons the number of authors shown on this cover page is limited to 10 maximum. Download date: 17-01-2019

Development of patient centered management of asthma and COPD in primary care Esther Immanuela Metting Cover photo: GPs and pulmonologists in the North of the Netherlands collaborated and implemented the Asthma/COPD-service in 2007 as support service for GPs.

Development of patient centered management of asthma and COPD in primary care Thesis, University of Groningen, the Netherlands ISBN ISBN 978-94-034-0658-9 (printed version) 978-94-034-0657-2 (digital version) Author Cover photo Chapter photo s Layout Printed by E.I. Metting Mark Baan Mark Baan Douwe Oppewal Netzodruk Groningen Copyright E.I.Metting, Groningen 2018 All rights reserved. No part of this thesis may be reproduced or transmitted in any form by any means, without permission of the copyright owner. The studies presented in this thesis were funded by the University Medical Center of Groningen and partly funded by the Stichting Asthma Bestrijding The author gratefully acklowledges the financial support from: SHARE UMCG CERTE

DEVELOPMENT OF PATIENT CENTERED MANAGEMENT OF ASTHMA AND COPD IN PRIMARY CARE PhD thesis to obtain the degree of PhD at the University of Groningen on the authority of the Rector Magnificus Prof. E. Sterken and in accordance with the decision by the College of Deans. This thesis will be defended in public on Monday 4 June 2018 at 14.30 hours by Esther Immanuela Metting born on 19 May 1977 in Joao Pessoa, Brazil

Supervisors Prof. T. van der Molen Prof. R. Sanderman Co-supervisor Dr. J.W.H. Kocks Assessment Committee Prof. H.M. Boezen Prof. M. Miravitlles Prof. N.H. Chavannes 4

CONTENTS Introduction 7 PART 1: HOW TO PROVIDE PATIENT CENTERED DISEASE 23 MANAGEMENT IN PRIMARY CARE RESPIRATORY PATIENTS? Chapter 2 25 Feasibility and effectiveness of an Asthma/COPD-service for primary care: a cross-sectional baseline description and longitudinal results Supplement chapter 2 45 Een Astma/COPD-dienst voor de huisartsenpraktijk: onderzoek naar haalbaarheid en effectiviteit Chapter 3 59 Development of a diagnostic decision tree for obstructive pulmonary diseases based on real-life data Supplement to chapter 3 77 Predicting diagnosis in primary care patients suspected of obstructive respiratory disease: IPCRG Desktop helper Chapter 4 81 Associations between chronic comorbidity and exacerbation risk in primary care patients with COPD PART 2: HOW TO INVOLVE PATIENTS? 107 Chapter 5 109 Needs and perspectives of patients with Asthma and Chronic Obstructive Pulmonary Disease on patient web portals: a focus group study Chapter 6 131 The forgotten social implications of asthma and Chronic Obstructive Pulmonary Disease: a focus group study Chapter 7 General discussion 145 Lay summary 157 Nederlandse samenvatting 159 Leken samenvatting 167 Dankwoord 169 About the author 172 Research Institute SHARE 174 5

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