Department of General Practice, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
1. Chris van Weel page [5]
The Continuous Morbidity Registration Nijmegen: Background and history of a Dutch general practice database
Introduction: Building a record of continuous morbidity in real-life general practice. This paper provides the outline for the other articles. It addresses the methodology but also the strategy of building and retaining data collection in general practice. It describes the functioning of the Nijmegen practice-based research network. Objective: Learning from this experience for future morbidity monitoring and sentinel systems.
2. Henk Schers, Henk van den Hoogen, Hans Bor & Chris van Weel page [13]
What went and what came? Morbidity trends in general practice from the Netherlands
Forty years’ morbidity in general practice. This paper presents a basic overview of morbidity in the general practice population (incidence, prevalence) specified for sex, age, and social class, and referral to primary care and secondary care. The core of the paper: their trends over time, from 1967 to 2006. It focuses on a number of diseases that have declined or disappeared during this period and examples of diseases with increased incidence/prevalence.
3. Wil van den Bosch, Hans Bor & Willem van Gerwen page [25]
All in the family: Times are changing
Family medicine and disease patterns in families over generations. The database had originally been designed based on Frans Huygen's studies on family patterns in morbidity. This paper addresses the question as to whether patterns found in the 1970s can still be replicated in the early 21st century, analyzing the impact of the family on frequency of presenting minor illnesses in general practice.
4. Annemarie Uijen & Eloy van de Lisdonk page [28]
Multimorbidity in primary care: Prevalence and trend over the last 20 years
The very stuff of general practice. Chronic diseases and comorbidity. This paper presents the most important chronic diseases in general practice and analyses the extent of comorbidity/multimorbidity. The analysis is based on a classification of comorbidity: common causal mechanism comorbidity; comorbidity as complications; coincidental comorbidity; and intercurrent acute morbidity.
5. Toine Lagro, Doreth Theunissen, Sylvie Lo Fo Wong & Maria van den Muijsenberg page [33]
The importance of gender in health problems
Morbidity patterns with special emphasis on gender. Gender is an essential determinant of social outcomes, including health. Moreover, gender cannot be separated from other social identifiers such as ethnicity, age, or socio-economic status. Although the impact of ethnic diversity or socio-economic status on health can hardly be underestimated, gender plays a pivotal role within these social identifiers.
6. Tim Olde Hartman, Evelyn van Weel, Peter Lucassen, Eric van Rijswijk, Hiske van Ravesteijn, Lieke Franke & Hans Bor page [38]
Mental health problems and the presentation of minor illnesses: Data from a 30-year follow-up in general practice
Compared to controls, more patients with depression and anxiety disorder present minor illnesses. This could be due to their high attendance rate, altered illness behaviour, or to factors - e.g., stress - underlying both the development of depression or anxiety and the susceptibility to diseases.
7. Floris van de Laar, Eloy van de Lisdonk & Hans Bor page [44]
Prevalence of zebras in general practice: Data from the Continuous Morbidity Registration Nijmegen
Rare diseases in the Continuous Morbidity Registration Nijmegen (CMR). This paper focuses on morbidity episodes with a low prevalence (<0.5/1,000 patients), comparing the CMR-results with the Orphanet database of rare diseases. Moreover, methodological difficulties in the study of rare diseases in general practice are discussed.
8. Mark van der Wel, Wim de Grauw, Carel Bakx, Willem van Gerwen, Jan Mulder & Chris van Weel page [47]
The influence of guideline revisions on the process and outcome of hypertension management in general practice: A descriptive study
General practice matters, process versus outcome: longitudinal trends in hypertension management. Blood pressure reduction does not reach guideline targets in the majority of hypertensive patients. Longitudinal data from general practice records on trends in hypertension management and the influence of guideline changes are lacking.
9. Catharina van den Dungen, Nancy Hoeymans, Ronald Gijsen, Marjan van den Akker, Jos Boesten, Henk Brouwer, Hugo Smeets, Willem Jan van der Veen, Robert Verheij, Margot de Waal, François Schellevis & Gert Westert page [53]
What factors explain the differences in morbidity estimations among general practice registration networks in the Netherlands? A first analysis
External validity of the comprehensive network. Comparing the Nijmegen data with other registration networks in the Netherlands. This paper explains morbidity differences among Dutch GPRNs.
10. Douglas Fleming page [63]
Does it really matter? Evaluating the Continuous Morbidity Registration—The Nijmegen Project
A commentary by Douglas Fleming, Director of the Birmingham Research Unit of the Royal College of General Practitioners (RCGP), summarizing his view on the uniqueness/external validity of the Nijmegen data.