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"The future of primary care research"

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Petra Erkens's picture
Dr Petra Erkens
Maastricht University

During the four years as a PhD-candidate (2008-2012) I participated in national and international interinstitutional cooperation programmes on the diagnosis and treatment of pulmonary embolism. My research concerning diagnosing pulmonary embolism was focused on the use of the Wells clinical decision rule combined with a point-of-care D-dimer testing to exclude pulmonary embolism in primary care. Furthermore, I visited the Ottawa Hospital Research Institute in Canada, which resulted in several papers on outpatient treatment of pulmonary embolism.

Currently, during my postdoc period (2013-present), I am involved in a large research project titled ‘Detecting and Diagnosis Atrial Fibrillation (D2AF): enhanced opportunistic case-finding in high risk patients from general practice and evaluating three ways of irregular pulse detection. A cluster randomized trial with nested diagnostic studies.’ Around 125 general practices in the Netherlands will be involved to evaluate the extra yield of cases of atrial fibrillation in patients of 65 years or older by a multifaceted intervention in primary care: a consistent diagnostic protocol (pulse irregularity, standard ECG; if indicated ambulant event recorder); and 2 promising new technologies: an electronic sphygmomanometer with AF-detection and a hand-held ECG monitoring device.

Furthermore, I have written a grant application aiming to develop a support tool for nurses specialized in atrial fibrillation to select, in collaboration with the patient, the most effective self-management tool to improve patient participation in and adherence to anticoagulant treatment. By improving self-management in anticoagulant treatment we eventually aim to reduce complications such as stroke, to optimize the patient’s quality of life and to minimize health care costs.

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