Ijsselstein

Researchers are evaluating the effectiveness of the RISE blended behavioral intervention in people who have had a first stroke. The study aims to prevent major adverse cardiovascular events such as recurrent stroke, transient ischemic attack TIA, acute coronary events, and cardiovascular death over a one-year follow-up, compared to standard care. The study also examines the cost-effectiveness of the intervention and its impact on reducing sedentary behavior in community-dwelling stroke survivors with sedentary movement patterns. Participants are randomly assigned to either the experimental group receiving the 15-week RISE intervention alongside usual care or the control group receiving usual care only. The RISE intervention involves coaching by a primary care physiotherapist using behavior change techniques and the RISE eCoaching system, which includes an activity monitor, smartphone app with real-time feedback and e-learning modules, and a monitoring dashboard for the physiotherapist. Participants also receive support from someone in their social network. Usual care follows hospital-specific guidelines. Participants will be involved in baseline, post-treatment four months, and follow-up assessments at six, nine, and twelve months after randomization. These include wearing an activity monitor, completing questionnaires, and performing physical tests. Researchers measure major adverse cardiovascular events, 24-hour activity patterns including sedentary behavior, physical activity, and sleep, as well as cost-effectiveness, quality of life, healthcare utilization, and productivity losses. The study is designed to minimize burden with home or online sessions and non-invasive assessments, lasting approximately 3.5 hours per measurement period.

This research aims to evaluate how training healthcare professionals in medication assessment affects the medication use of nursing home residents aged 65 and older who have a limited life expectancy of less than 1.5 to 2 years. The study focuses on tailoring medication to the palliative treatment goals of these residents and is designed as a cluster randomized controlled trial involving six nursing home organizations and approximately 450 patients. The research is led by Amsterdam UMC and spans one year and three months starting in September 2024. The intervention involves a training program for healthcare professionals, including medical practitioners, pharmacists, and care workers, to align prescriptions with treatment goals established through advance care planning conversations. This training has two parts medication assessment using specialized criteria and advance care planning. Professionals in the intervention group receive this training along with supporting tools and educational materials, while the control group continues with usual care. Data collection occurs at baseline, 6 months, and 12 months. Participants will be assessed through medication reviews and questionnaires measuring involvement in decision-making, quality of life, and other health outcomes such as falls and hospital admissions. The main outcome is identifying potential under- or overprescribing of medications. The study also monitors experienced involvement in medication decisions, pain levels, and death rates. Participants stay in the study for at least one year, with evaluations at multiple time points to track changes.