Frans Boch Waldorff

University of Copenhagen · Faculty of Health and Medical Sciences

Importance The past several decades have witnessed substantial changes in treatments that are particularly relevant for older patients. Objectives To assess changes in national-level incidence rates of fracture- and musculoskeletal-related (ie, arthritis-related) hip replacement procedures for individuals aged 40 to 104 years over a 23-year period...

UNSTRUCTURED Introduction Lifestyle interventions for weight loss do not result in long term weight reductions and may contribute to weight stigma. Weight neutral health has emerged as an alternative strategy to obtain physical, social, and mental health without any aim of weight loss. This protocol paper outlines the design and procedures for the...

Background Older patients account for most contacts in general practice. The contacts can be divided into five types: Face-to-face, telephone, e-mail, home visits, and chronic care reviews. Variations in contact types and frequencies across general practices can be caused by differences in patient populations, local circumstances, and individual pr...

Introduction Patients with complex multimorbidity face a high treatment burden and frequently have low quality of life. General practice is the key organisational setting in terms of offering people with complex multimorbidity integrated, longitudinal, patient-centred care. This protocol describes a pragmatic cluster randomised controlled trial to...

Objectives This study aims to evaluate the diagnostic accuracy and reliability of a new, brief questionnaire, ‘Brief Assessment of Impaired Cognition– Questionnaire’ (BASIC-Q) for detection of cognitive impairment, primarily developed for use in primary care. BASIC-Q has three components: Self-report, Informant report, and Orientation. Self-report...

Importance Hearing loss has been suggested as a risk factor for dementia, but there is still a need for high-quality research to better understand the association between these 2 conditions and the underlying causal mechanisms and treatment benefits using larger cohorts and detailed data. Objective To investigate the association between hearing lo...

Background Participating in research studies often involves interactions with healthcare professionals, potentially influencing the participant’s future help-seeking behaviour. We investigated whether participating in the Childhood Health Activity and Motor Performance School Study – Denmark (CHAMPS) (2008–2014), which involved telephone consultati...

Background Concussion may lead to persisting post-concussive symptoms affecting work ability and employment. This study examined the transitions between labour market states an individual can experience after the acute phase of concussion. The aim was to describe the incidence of favourable and adverse transitions between different labour market st...

Background Vision impairment can have an impact on cognition, health and social function. Vision loss may be avoided if detected early and treated promptly. Eye health is a minor topic in general practice, but the ongoing relationship between doctor and patient has the potential to assist the patient in navigating the healthcare system and guarante...

Multimorbidity is often defined as two or more long-term conditions, the definition may, however, vary. This review summarises various definitions of multimorbidity. The prevalence of multimorbidity in Denmark is between 7% and 29% depending on data sources and definition and is increasing with age; nonetheless most patients with multimorbidity are...

Introduction: In the US, opioids are commonly prescribed after arthroscopic knee surgery. We aimed to investigate opioid dispensing in relation to arthroscopic knee surgeries from 2006 to 2018 in Denmark. Methods: In Danish registries, we identified patients (≥ 15 years old) having arthroscopic knee surgery (anterior cruciate ligament (ACL) reco...

Introduction Out-of-hours primary care services cannot provide the same continuity and coordination of care as general practice. Thus, patients with high risk of complex care trajectories should, when possible, be treated by the general practitioner during daytime opening hours. This study aims to analyse the variation among general practices in th...

Introduction The number of people living with visual impairment is increasing. Visual impairment causes loss in quality of life and reduce self-care abilities. The burden of disease is heavy for people experiencing visual impairment and their relatives. The severity and progression of age-related eye diseases are dependent on the time of detection...

Background Many elderly people wish to die at home but end up dying at the hospital. If the patient wishes to die at home, palliative care provided by General Practitioners (GPs) may increase the chance of dying at home, however, there is a lack of knowledge on how GPs should provide palliative care. We aimed to identify roles, tasks and approaches...

Sports participation has potential to promote physical activity in youth. Unfortunately, sports participation and physical activity may decline from childhood to adolescence and into adulthood. Globally, only 20% of 13–15-year-olds meet the World Health Organisation recommendations for physical activity. This study aimed to investigate the 5-year t...

Introduction Polypharmacy is a common concern, especially in the older population. In some countries more that 50% of all individuals over 60 receive five or more drugs, most often due to multimorbidity and increased longevity. However, polypharmacy is associated with multiple adverse events, and more medication may not always be the answer. The te...

Background: Care staff often lack knowledge, confidence, skills, and competency to provide optimal care for people with dementia. Dementia education can increase staff competency and wellbeing along with the actual care of people with dementia. Several factors can affect the effectiveness of dementia education; however, it is not yet established w...

Background On 1 January 2018 a four-year test scheme concerning use of medicinal cannabis (MC) was enacted. It has recently been extended for four more years by the Danish Parliament permitting all Danish physicians to prescribe MC to their patients. Previous studies have shown that general practitioners (GPs) have varying prescription experience,...

Objectives: With the ageing of our population, it seems plausible that the prevalence of both dementia and multimorbidity will increase in the following decades. The aim of this study is to examine the trends in prevalence and incidence of registered dementia and trends in multimorbidity in patients with dementia in general practice in Flanders....

Background: The aims of this study were to examine the psychometric properties of the Brief Assessment of Impaired Cognition (BASIC) case-finding instrument in clinical settings focusing on 1) test-retest reliability, 2) discriminative validity of BASIC and its components for identification of Alzheimer's disease (AD) dementia and non-AD dementia,...

Background: On 1 January 2018 a four-year test scheme concerning use of medicinal cannabis (MC) was enacted. It has recently been extended for four more years by the Danish Parliament permitting all Danish physicians to prescribe MC to their patients. Previous studies have shown that general practitioners (GPs) have varying prescription experience,...

Background Physical training is increasingly used in rehabilitation for older people with dementia and several studies have documented positive results. Currently, welfare nations promote motion-based technology (MBT) at home to replace group training in various rehabilitation interventions. Research on the use of MBT by people with dementia is spa...

Introduction Dementia develops slowly and insidiously and causes cognitive impairment. The diagnosis is pivotal for relevant treatment and care. However, 50,000 people are estimated to have undiagnosed dementia in Denmark, while 36,000 are diagnosed. The municipalities offers a home visit to the population at the ages of 75 and 80 years to assess t...

Objective To adapt and partly validate a Danish online version of the patient-reported outcome measure (PROM) Oxford Physical Activity Questionnaire (“OPAQ”) and evaluate mobile phones and tablets as data capturing tool to identify potential problems and deficiencies in the PROM prior to implementation in the full study. Methods The OPAQ was trans...

Dementia is increasingly being recognised as a public health priority and poses one of the largest challenges we face as a society. At the same time, there is a growing awareness that the quest for a cure for Alzheimer's disease and other causes of dementia needs to be complemented by efforts to improve the lives of people with dementia. To gain a...

Background A spontaneous subarachnoid haemorrhage (SAH) is one of the most critical neurological emergencies a dispatcher can face in an emergency telephone call. No study has yet investigated which symptoms are presented in emergency telephone calls for these patients. We aimed to identify symptoms indicative of SAH and to determine the sensitivit...

Background An increasing number of countries legalise the use of medical cannabis or allow it for a narrow range of medical conditions. Physicians, and often the patients’ general practitioner, play a major role in implementing this policy. Many of them, however, perceive a lack of evidence-based knowledge and are not confident with providing patie...

Background: Few studies have investigated the importance of the time interval between contact to the emergency medical service and neurosurgical admission in patients with spontaneous subarachnoid haemorrhage. We hypothesised that longer time to treatment would be associated with an increased risk of death or early retirement. Methods: This was a r...

Objective To investigate the association between long term residential exposure to road traffic and railway noise and risk of incident dementia. Design Nationwide prospective register based cohort study. Setting Denmark. Participants 1 938 994 adults aged ≥60 years living in Denmark between 1 January 2004 and 31 December 2017. Main outcome meas...

Background and Aim Health-related quality of life (HRQoL) is impaired in patients with Crohn’s disease (CD). This study aimed to identify the impact of clinical disease activity on HRQoL in CD patients treated with biological agents. Methods Patients with moderate to severe active CD treated with biological agents in Denmark were included from 201...

Objective To examine the occurrence of and types of defensive medicine (DM), and the reasons for practicing DM in general practice. Design Prospective survey registration of consecutive consultations regarding defensive medicine defined as: Actions that are not professionally well founded but are carried out due to demands and pressure. The GPs re...

Introduction: Timely admission to a facility capable of providing highly specialised treatment is key in patients with spontaneous subarachnoid haemorrhage. We aimed to determine the time elapsed from the initial emergency telephone call to arrival at a neurosurgical department. Also, we aimed to determine the ambulance dispatch criteria used and...

Background: Usage of new technologies for physical training as a part of disease management and rehabilitation has grown in parallel with the decentralization of healthcare, shifting from skilled facility-to in-home care. However, little is known about the feasibility and efficacy of Motion-Based Technology (MBT) training at home for people with de...

Background When older multimorbid people are acutely hospitalized, continuity of care is a fundamental goal in the healthcare process. However, some acute hospitalized older multimorbid patients do not experience continuity of care. This phenomenon is explored using the theoretical framework of Jürgen Habermas “Theory of communicative action”. Met...

Importance Low socioeconomic status (SES) has been identified as a risk factor for the development of dementia. However, few studies have focused on the association between SES and dementia diagnostic evaluation on a population level. Objective To investigate whether household income (HHI) is associated with dementia diagnosis and cognitive severi...

Background: An increasing number of countries legalise the use of medical cannabis or allow it for a narrow range of medical conditions in patients. Physicians, and often the patients’ general practitioner, play a major role in the implementation of this policy, but many of them perceive a lack of evidence-based knowledge and may not be confident w...

PurposeThe purpose was to investigate inequalities in access to care among people with possible depression.Method In this nationwide register-based cohort study of 30,593 persons, we observed the association between socioeconomic position (SEP, education/income) and mental health care use (MHCU) four months before the date of first redeemed antidep...

Burnout among general practitioners (GPs) is a problem in many countries. Research indicates that burnout is less likely to occur among intrinsically motivated employees. Based on self-determination theory, we investigate 1) whether intrinsically motivated GPs are less burned out than their colleagues, and 2) whether the most intrinsically motivate...

Background Little is known about factors associated with a clinically relevant reduction in menopausal symptoms through a brief acupuncture approach for women with moderate-to-severe menopausal symptoms. Methods Post hoc analysis of a randomized controlled trial where participants were allocated to early versus late standardized acupuncture. Both...

PurposeDetermining life expectancy in patients with dementia are challenging. We aimed at studying the association between basic activities of daily living as measured by the Barthel Index at hospital admission and mortality among older patients with dementia.Methods All patients aged ≥ 65 years with diagnosed dementia in the population-based Natio...

Licensed physicians in Denmark are obliged to assess fitness to drive a car in patients suspected of impaired cognitive functions. Existing regulations stipulate, that fitness to drive can be assessed through screening of cognitive function using a test of orientation, clock-drawing and ability to recall three words. Evidence in support of this scr...

Background The aim of this study was to perform a preliminary validation of the Brief Assessment of Impaired Cognition (BASIC) ¹ and the Brief Assessment of Impaired Cognition Questionnaire (BASIC‐Q) ² for identification of mild cognitive impairment (MCI). Method A total of 163 socio‐demographically matched patients (MCI, n = 42, and dementia, n =...

Objective To introduce and document the recently established HESD (Hearing Examinations in Southern Denmark) database, including the necessary data preprocessing steps, and to describe the hearing loss (HL) characteristics of the study sample. Design Clinical auditory information has been collected for approximately 20 years in the state-funded cl...

Objectives: Patients with dementia have an increased 30-day mortality after hip fracture. We investigated clinical management including time to surgery, out-of-hours admission and surgery, surgery on weekends, surgery volume per ward, and anesthesia technique for this excess mortality risk. Method: This register- and population-based study compr...

Background The care needs for people with dementia (PWD) constantly needs adjustment which makes it difficult for nursing assistants (NA) to accommodate optimal care to PWD. Dementia education to NAs may increase staff skills, self-efficacy and care quality. The study aims to investigate NA's experience of self-efficacy and how it changes during de...

Background: Acute otitis media (AOM) is a common and most often self-limiting infection in childhood, usually managed in general practice. Even though antibiotics are only recommended when certain diagnostic and clinical criteria are met a high antibiotic prescription rate is observed. The study's objective was to analyse associations between pati...

Background Persons with dementia tend to be vulnerable to mobility challenges and hence face a greater risk of fall and subsequent fractures, morbidity, and mortality. Motion-based technologies (MBTs), also called sensor-based technologies or virtual reality, have the potential for assisting physical exercise and training as a part of a disease man...

Background Our objective was to investigate whether the effect of a brief and standardised acupuncture approach persists after the end of the acupuncture treatment (post-treatment effect) and whether the anticipation of future acupuncture treatment affects menopausal symptoms (pre-treatment effect). Method This study is a post hoc analysis of data...

Objective To investigate whether accreditation of general practice in Denmark promotes patient-reported quality of care and patient satisfaction. Design A national cluster randomised case control study based on an online version of the Danish Patients Evaluate Practice questionnaire. Mixed effects ordered logit regression models taking account of...

Background and aims: Patients with ulcerative colitis have reduced health-related quality of life compared to the general population. Current treatment strategy aims to reduce patients’ symptoms and increase health-related quality of life. We investigated which symptoms of ulcerative colitis correlate to decreased health-related quality of life. Me...

A critical question for policy makers in health care is whether external interventions have unintended consequences such as lowering professionals’ job satisfaction. We investigate whether a non-monetary incentive, in the form of mandatory accreditation, affects the job satisfaction of Danish GPs. Accreditation of general practice in Denmark was in...

Introduction: Age limits for diagnostics and treatments have been largely removed and replaced by an active diagnostic and treatment practice among the oldest old and has led to concerns about potential overtreatment during the last years of life. Methods: Use of prescription medication in the last years of life was assessed from 1995 to 2012 fo...

BACKGROUND Persons with dementia tend to be vulnerable to mobility challenges and hence face a greater risk of fall and subsequent fractures, morbidity, and mortality. Motion-based technologies (MBTs), also called sensor-based technologies or virtual reality, have the potential for assisting physical exercise and training as a part of a disease man...

Objectives The aim of this study was to validate the Brief Assessment of Impaired Cognition (BASIC) and the Brief Assessment of Impaired Cognition Questionnaire (BASIC‐Q) for identification of mild cognitive impairment (MCI) in a memory clinic setting. Methods 163 socio‐demographically matched patients (MCI, n = 42, and dementia, n = 121) and 83 c...

Background: Acute otitis media (AOM) is a common and most often self-limiting infection in childhood, usually managed in general practice. Even though antibiotics are only recommended when certain diagnostic and clinical criteria are met a high antibiotic prescription rate is observed. The study’s objective was to analyse associations between patie...

Background: Acute otitis media (AOM) is a common and most often self-limiting infection in childhood, usually managed in general practice. Even though antibiotics are only recommended when certain diagnostic and clinical criteria are met a high antibiotic prescription rate is observed. The study’s objective was to analyse associations between patie...

Background: Acute otitis media (AOM) is a common and most often self-limiting infection in childhood, usually managed in general practice. Even though antibiotics are only recommended when certain diagnostic and clinical criteria are met a high antibiotic prescription rate is observed. The study’s objective was to analyse associations between patie...

Objectives: Brief Assessment of Impaired Cognition (BASIC), that combines self- and informant report with cognitive testing, was previously found to be highly accurate in identification of dementia and cognitive impairment. The aim of the present study was to develop and validate of a questionnaire version of BASIC, the BASIC-Q, for use in communi...

Background: Half of the older persons in high-income counties are affected with multimorbidity and the prevalence increases with older age. To cope with both the complexity of multimorbidity and the ageing population health care systems needs to adapt to the aging population and improve the coordination of long-term services. The objectives of thi...

Background Half of the older persons in high-income counties are affected with multimorbidity and the prevalence increases with older age. To cope with both the complexity of multimorbidity and the ageing population health care systems needs to adapt to the aging population and improve the coordination of long-term services. The objectives of this...

Background Half of the older persons in high-income counties are affected with multimorbidity and the prevalence increases with older age. To cope with both the complexity of multimorbidity and the ageing population health care systems needs to adapt to the aging population and improve the coordination of long-term services. The objectives of this...

Background Half of the older persons in high-income counties are affected with multimorbidity and the prevalence increases with older age. To cope with both the complexity of multimorbidity and the ageing population health care systems needs to adapt to the aging population and improve the coordination of long-term services. The objectives of this...

Objectives: The aim of this study was to develop and validate a new brief and accurate case-finding instrument for dementia and cognitive impairment. Previous research indicates that combining cognitive tests with informant and/or patient report may improve accuracy in dementia case-finding. The Brief Assessment of Impaired Cognition (BASIC) integ...

Background Half of the older persons in high-income counties are affected with multimorbidity and the prevalence increases with older age. To cope with both the complexity of multimorbidity and the ageing population health care systems needs to adapt to the aging population and improve the coordination of long-term services. The objectives of this...

Background Failure to keep medical appointments results in inefficiencies and, potentially, in poor outcomes for patients. The aim of this study is to describe non-attendance rate and to investigate predictors of non-attendance among patients receiving hospital outpatient treatment for chronic diseases. Methods We conducted a historic, register-ba...

Objective To evaluate if perceived barriers to accessing mental healthcare (MHC) among individuals with symptoms of depression are associated with their socio-economic position (SEP). Design Cross-sectional questionnaire-based population survey from the Lolland-Falster Health Study (LOFUS) 2016–17 of 5076 participants. Participants The study incl...

Background The increasing prevalence of patients with multimorbidity in the general population affects the health-care system. There is a lack of knowledge of the proportion of patients attending multiple hospital outpatient specialty clinics simultaneously. Objective This study describes the development in the proportion of patients managed simul...

Objective: To investigate the efficacy of a standardised brief acupuncture approach for women with moderate-to-severe menopausal symptoms. Design: Randomised and controlled, with 1:1 allocation to the intervention group or the control group. The assessor and the statistician were blinded. Setting: Nine Danish primary care practices. Participa...

Background: We investigated the effect of economic assets on mortality in patients with dementia in a national cohort of elderly individuals aged 65 or older. Objective: To examine the effect of economic assets on mortality in patients with dementia. Methods: Incidence of dementia and all-cause mortality was analyzed with incidence rate ratios...

Background Patients with ulcerative colitis have reduced health-related quality of life compared with the general population. Current treatment strategy aims to reduce patients’ symptoms and increase health-related quality of life. We aimed to investigate which symptoms of ulcerative colitis, correlate to decreased health-related quality of life....

Introduction: The prevalence of dementia is estimated to increase due to a growing elderly population. Patients with dementia are vulnerable as they are less likely to consult their general practitioner (GP). According to Danish guidelines, they are considered frail and in need of a proactive approach in the form of an annual preventive home visit...

Livsstilsrelaterede sygdomme er en samfundsmaessig udfordring, som har stor betydning for borgernes livskvalitet og koster samfundet dyrt. Personer, der er storrygere, har et højt alkoholforbrug og fører en stillesiddende livsform, har naesten syv gange højere dødelighed end personer, der ikke ryger, drikker moderat og er fysisk aktive, og 80% af h...

Objective Examine whether the severity of symptoms of depression was associated with the type of mental healthcare treatment (MHCT) received, independent of socioeconomic position (SEP). Design Register-based 6-month follow-up study on participants from the Danish General Suburban Population Study (GESUS) 2010–2013, who scored the Major Depression...

In the original publication of this article, Table 3 was published incorrectly. The corrected table is shown below.

Objectives This study aims to analyse the associations between general practitioner (GP) retirement, job satisfaction and attitudes towards a mandatory accreditation scheme. External interventions such as mandatory accreditation schemes may be perceived negatively by GPs, causing early retirement from practice. In Denmark, almost half of the GPs ha...

Objective: To investigate the predictive value of subjective memory complaints (SMCs) for having a hospital-based diagnosis of a single depressive episode over a four-year follow-up period. Methods: A prospective register-based cohort study in general practice. All 17 practices in Inner city Copenhagen participated in the study. They had 40,865...

Objective: This paper investigated patients’ experiences of disease and self-care as well as perceptions of the general practitioner’s role in supporting patients with impaired self-care ability. Design: Qualitative interviews with 13 patients with type 2 diabetes, concurrent chronic diseases, and impaired self-care ability assessed by a general pr...

Aim: We used register-based data to estimate the effect of all-type dementia on road traffic accidents (RTAs) risk, combined with comorbidities or sedative medicines, among non-institutionalized older people in Denmark. Methods: The source population was all residents in Denmark aged 65 years and older, alive as of January 1, 2008 ( n = 853,228)...

Motivation crowding studies have demonstrated that external interventions can harm effort and performance through crowding out of intrinsic motivation, when interventions are perceived as lack of trust. However, motivation crowding theory also presents a much less investigated crowding in effect, which occurs when external interventions increase in...

Background As in other countries, Danish health authorities have introduced disease management programmes (DMPs) to improve care quality. These contain clinical practice guidelines (CPGs) and guidelines for patient stratification based on doctors’ assessments of disease severity and self-care. However, these programmes are challenged when patients...

Background: Practice facilitation is increasingly used to support guideline implementation and practice development in primary care and there is a need to explore how this implementation approach works in real-life settings. We focus on a facilitation intervention from the perspective of the visited practices to gain a more detailed understanding...

Background: The experience of menopausal symptoms is common and an adequate patient-reported outcome measure is crucial in studies where women are treated for these symptoms. The aims of this study were to identify a patient-reported outcome measure for bothersome menopausal symptoms and, in the absence of an adequate tool, to develop a new measur...

Introduction Institutionalized people with dementia have an increased risk of fall accidents, but little is known about whether this increased risk holds for home dwellers. Methods This register- and population-based study comprised 115,584 cases and 394,679 controls. Cases were individuals with any fall between 2009 and 2014, and matched with up...

Background: Social relationships are important to people and affect their quality of life, morbidity and mortality. The aim of this study was to examine the correlation between elderly patients' descriptions of their social relations and feelings of loneliness, and their general practitioners' assessments of these. Methods: Cross-sectional study...