Prescription of 10 (+1) drugsin the Belgian geriatric wards

On behalf of the College of Geriatric Medicineand experts

N. Van Den Noortgate, P.Meeus, O. Dalleur, B. Boland, JC Lemper, E Dejaeger, G Lambert, K

Cobbaert, S Higuet, P Hanotier, JP Baeyens

Data 01/12/2015

QI drugs project

• For 2015 , the College for Geriatric Medicine planned to give to the Belgian geriatric wards a feed-back on inpatient medication prescriptions

• The indicators were chosen on the base of STOPP-START (version 1) criteria and of the data available in the INAMI/RIZIV database

• The protocol was elaborated par N. van Van Den Noortgate (College) and P. Meeus (INAMI/RIZIV), and has been validated by the College cfr. QI drugs protocol

• P. Meeus and his team extracted the data, which were provided to the research team (NvdN, BB, JCL, OD) and at the College’s meetings in 2015 cfr these slides: QI drugs data

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Time-line

• Selection of inappropriate drug lists (college : 2/2015)• Selection of indicators (college : 2/2015)• Identification of the codes (team : 2/2015)• Protocole (team : 2/2015)• Methodological decisions (college 3 & 4/2015)

– Incusion : all patients aged 75 +, hospitalized in G units in 2013– Exclusion criteria

• patients staying at multiple units during one hospital stay• patients with strong opioïds during all stay• short stays (≤ 9 days)

– Unit of analysis : hospital stay strict in geriatric unit • Discussion of analyses (college 5, 6 & 9/2015)• Feed-back to the Glem’s/Lok’s representatives (17/11/ 2015)• Publication of results ( 12/2015)

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Methodology: some points

« potentially overuse » indicators are calculated on the last 6 days of the G stayN.B.  statins and antibiotics (not in STOPP.v1) were also

collected

« potentially underuse » indicators are calculated on the whole stay (anticoagulant and Vitamin D)

Two « global » indicators gathering: All psychotrops (benzo + antidepressants+ antipsychotics)All « potentially overuse » indicators

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Sample (2013): 45.086 G pure stays, (75+, min 9 days , without opioïds)

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nb st

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Men Women

75 80 85 90 Total men 75 80 85 90 Total womenVlaanderen 84585 51221 48172 32348 27250 1436 2855 3033 1870 9194 2328 5151 6155 4422 18056

WEST-VLAANDEREN 19443 12658 11779 7920 6655 377 657 748 459 2241 549 1257 1527 1081 4414OOST-VLAANDEREN 21150 12375 11715 8259 7252 333 784 800 508 2425 594 1405 1637 1191 4827ANTWERPEN 23357 13889 13142 8719 7262 362 735 794 516 2407 620 1370 1629 1236 4855LIMBURG 12712 7950 7414 4569 3741 260 477 443 213 1393 366 690 791 501 2348VLAAMS-BRABANT 7923 4349 4122 2881 2340 104 202 248 174 728 199 429 571 413 1612

brussel- bruxelles 15413 6850 6360 5283 4681 236 391 425 317 1369 440 847 1042 983 3312wallonie 36670 19738 18929 15377 13155 717 1286 1279 754 4036 1214 2701 3075 2129 9119

BRABANT-WALLON 1471 974 964 759 627 25 60 57 54 196 49 115 142 125 431LUXEMBOURG 2649 1354 1315 1144 969 60 104 106 55 325 75 170 249 150 644NAMUR 3666 1944 1927 1552 1317 59 107 146 88 400 101 261 316 239 917HAINAUT 14531 8413 8183 6959 5923 273 574 546 348 1741 496 1242 1407 1037 4182LIEGE 14353 7053 6540 4963 4319 300 441 424 209 1374 493 913 961 578 2945

Total général 136668 77809 73461 53008 45086 2389 4532 4737 2941 14599 3982 8699 10272 7534 30487

chapters

I. Potentially overuse1.Psychotrops

– Benzo– Tca– Ssri– antipsychotics

2.other potential overuses – NSAID– Ppi– Statin– Anticholinergics

II. Potentially underuse (vit D – Anticoagulant)

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(10) Benzo : 18 %

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10.Benzodiazepines (overuse ?) if long-term (i.e. > 1 month) and long-acting e.g. chlordiazepoxide, flurazepam, nitrazepam and benzodiazepines with long-acting metabolites e.g. diazepam [risk of prolonged sedation, confusion, impaired balance, falls].

% of patients on benzo % of patients on flunitrazepam WITHIN those with benzo At discharge

N05CD (benzo) or N05BA (benzo) N05CD03 (flunitrazepam)

ALL patients at discharge ALL patients at discharge

menTotal men women

Total women

Total général

Indicator 75 80 85 90 75 80 85 90nb stays 2389 4532 4737 2941 14599 3982 8699 10272 7534 30487 45086% stays with benzo at discharge 15% 15% 16% 13% 15% 19% 19% 20% 18% 19% 18%

(10) Benzo : 18 %

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(9) TCAs : 0,8 %

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9.Tricyclic antidepressants (TCAs) (overuse ?) with dementia [risk of worsening cognition]

% of patients on TCAs At discharge

N06AA (tricyclic: TCAs)

ALL patients at discharge

menTotal men women

Total women

Total général

Indicator 75 80 85 90 75 80 85 90nb stays 2389 4532 4737 2941 14599 3982 8699 10272 7534 30487 45086% stays with TCA at discharge 0,8% 0,6% 0,6% 0,4% 0,6% 1,3% 1,2% 0,9% 0,6% 1,0% 0,8%

(9) TCAs : 0,8 %

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(9b) SSRI : 8 %

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15. SSRI (overuse ? ) % patients with SSRI At discharge

N06AB ALL patients at discharge

menTotal men women

Total women

Total général

Indicator 75 80 85 90 75 80 85 90nb stays 2389 4532 4737 2941 14599 3982 8699 10272 7534 30487 45086% stays with SSRI at discharge 7% 7% 7% 5% 6% 9% 9% 8% 6% 8% 8%

(9b) SSRI : 8 %

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(11) Antipsychotics : 7 %

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11.Antipsychotics* (overuse ? ) l> 1 month as hypnotics

% of patients on antipsychotics At discharge

N05A (antipsychotics) ALL patients at discharge

% stays with antipsychotics at discharge 9% 9% 9% 8% 9% 7% 7% 7% 6% 7% 7%

(11) Antipsychotics : 7 %

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Psychotrops drugs (benzo, SSRI, TCA, antipsych): 26 %

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global indicator about neuro drugs including (+9 (TCA) +10(benzo)+11(antipsychotic) SSRI N06AB)

At discharge See Numerator 9 (TCA) +10 (benzo+11 apsychot)+ SSRI

All patients at discharge

menTotal men women

Total women

Total général

Indicator 75 80 85 90 75 80 85 90nb stays 2389 4532 4737 2941 14599 3982 8699 10272 7534 30487 45086% stays with psychotrops drugs at discharge 25% 24% 25% 22% 24% 28% 28% 28% 25% 27% 26%

Psychotropic drugs (benzo, SSRI, TCA, antipsych): 26 %

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(6) PPI : 21 %

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8. PPI (overuse ?) at treatment dose for peptic ulcer disease at full therapeutic dosage for > 8 weeks

% of patients with PPI At discharge

A02BC

ALL patients at discharge

menTotal men women

Total women

Total général

Indicator 75 80 85 90 75 80 85 90nb stays 2389 4532 4737 2941 14599 3982 8699 10272 7534 30487 45086% stays with PPI at discharge 20% 20% 20% 20% 20% 20% 21% 22% 21% 21% 21%

(6) PPI : 21 %

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(5) NSAIDs: 1,1 %

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5.NSAIDS (overuse ?)

% with NSAIDS At discharge

M01A (ANTIINFLAMMATORY AND ANTIRHEUMATIC PRODUCTS, NON-STEROIDS)

ALL patients at discharge

menTotal men women

Total women

Total général

Indicator 75 80 85 90 75 80 85 90nb stays 2389 4532 4737 2941 14599 3982 8699 10272 7534 30487 45086% stays with NSAID at discharge 1,6% 1,2% 1,1% 1,0% 1,2% 1,3% 1,0% 1,3% 0,9% 1,1% 1,1%

(5) NSAIDs: 1,1%

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Statins (10 %)

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16. Statins (overuse ? ) % patients with statins At discharge

C10AA, B, X ALL patients at discharge

menTotal men women

Total women

Total général

Indicator 75 80 85 90 75 80 85 90nb stays 2389 4532 4737 2941 14599 3982 8699 10272 7534 30487 45086% stays with statines at discharge 12% 12% 10% 6% 10% 13% 12% 9% 5% 9% 10%

Statins (10 %)

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(13) Anticholinergic (with score>3): 7 %

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13. Anticholinergic (overuse ? )

% patients with score 3 (see burden scale (score >3) Amitryptiline - TCA Doxepin and others related to TCAs Paroxetine Chlorphenamine and sedating antihistamins Hyoscine Olanzapine and other atypicals Oxybutinine At discharge

N06AA (Non-selective monoamine reuptake inhibitors) N06AB05 ( paroxetine-SSRI) R06AB04 (chlorphenamine) R06A (antihistamines for systemic use) N05CM (other hypnotics inclusive scopolamine – N05CM05) N05AH (diazepine) within N05AH03 (olanzapine) G04BD04 – oxybutynin)

ALL patients at discharge

menTotal men women

Total women

Total général

Indicator 75 80 85 90 75 80 85 90nb stays 2389 4532 4737 2941 14599 3982 8699 10272 7534 30487 45086% stays with anticholinergic drugs at discharge 8% 7% 7% 5% 6% 8% 7% 7% 5% 7% 7%

(13) Anticholinergic (with score>3): 7 %

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(13) Anticholinergic (with score>3): 7 %

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chapters

I. Potentially overuse1.Psychotrops

– Benzo– Tca– Ssri– antipsychotics

2.other potential overuses – NSAID– Ppi– Statin– Anticholinergics

II. Potentially underuse (vit D – Anticoagulant)

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SUMMARY: any potential overuse

Any potential (over)use : 41 %

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menTotal men women

Total women

Total général

Indicator 75 80 85 90 75 80 85 90nb stays 2389 4532 4737 2941 14599 3982 8699 10272 7534 30487 45086% stays with possible overuse at discharge 41% 40% 41% 37% 40% 42% 41% 42% 38% 41% 41%

Any potential (over)use : 41 %

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chapters

I. Potentially overuse1.Psychotrops2.other potential overuses II. Potentially underuse 1.vit D2.Anticoagulant

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(14) vitamin D : 50 %

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menTotal men women

Total women

Total général

Indicator 75 80 85 90 75 80 85 90nb stays 2389 4532 4737 2941 14599 3982 8699 10272 7534 30487 45086% stays with vit D 42% 43% 44% 45% 44% 53% 53% 54% 53% 53% 50%11. vitamin D Usual UNDERUSE during the stay

% patients with vit D during the stay (because UNDERUSE)

A11CB (vit A and D in combination), A11CC (vit D and analogues)) or A12AX (vit D+calcium)

All patients during stay

(14) vitamin D : 50 %

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(6) OACoag (VKA + NOAC) : 14 %(to be compared with Afib prevalence)

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menTotal men women

Total women

Total général

Indicator 75 80 85 90 75 80 85 90nb stays 2389 4532 4737 2941 14599 3982 8699 10272 7534 30487 45086% stays with Oantidiabetics (AVK+NOAC) 14% 16% 16% 12% 15% 13% 14% 14% 12% 14% 14%10.OAC (oral anticoagulant)

Usual UNDERUSE during the stay: % with oral anticoagulant. (VKA or NOAC) during the stay (because UNDERUSE)

B01AA (vitamin K antagonists) Or NOAC, especially B01AE07 (dabigatran) B01AX06 (rivaxoxaban)

All patients during stay

(6) OACoag (VKA + NOAC) : 14 %(to be compared with Afib prevalence)

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Antibiotics : 57 %

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17. Antibiotics (overuse ? ) % patients with AB During the stay

J01 ALL patients at discharge

menTotal men women

Total women

Total général

Indicator 75 80 85 90 75 80 85 90nb stays 2389 4532 4737 2941 14599 3982 8699 10272 7534 30487 45086% stays with AB 58% 58% 60% 64% 60% 51% 54% 57% 61% 56% 57%

Antibiotics : 57 %

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10 drugs selected by the College:USE in 45.086 geriatric patients

Potentially overuse•Neuro-psychotropic drugs

Benzodiazepines (10.) = 18 %TCAs (9a.) = 1 %SSRIs (9b.) = 7 %Antipsychotics (11.) = 7 %

Any Neuro-psy drug = 26 %•Other drugs

NSAID (5.) = 1 %PPI (6.) = 21 %Statins = 10%

Anticholinergic (13.) = 7 %

Potentially underuse

Vitamin D [vs. Osteoporosis] = 50 % (any day during the G stay)Oral anticoagulant [vs. AFib] = 14 %

N.B. Antibiotics during the stay = 57 %

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Overview PIP at G-ward (2013)

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Appendices: summary by ageclass and gender

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menTotal men women

Total women

Total général

Indicator 75 80 85 90 75 80 85 90nb stays 2389 4532 4737 2941 14599 3982 8699 10272 7534 30487 45086% stays with NSAID at discharge 1,6% 1,2% 1,1% 1,0% 1,2% 1,3% 1,0% 1,3% 0,9% 1,1% 1,1%% stays with PPI at discharge 20% 20% 20% 20% 20% 20% 21% 22% 21% 21% 20,6%% stays with TCA at discharge 0,8% 0,6% 0,6% 0,4% 0,6% 1,3% 1,2% 0,9% 0,6% 1,0% 0,8%% stays with benzo at discharge 15% 15% 16% 13% 15% 19% 19% 20% 18% 19% 17,8%% stays with antipsychotics at discharge 9% 9% 9% 8% 9% 7% 7% 7% 6% 7% 7,3%% stays with SSRI at discharge 7% 7% 7% 5% 6% 9% 9% 8% 6% 8% 7,5%% stays with psychotrops drugs at discharge 25% 24% 25% 22% 24% 28% 28% 28% 25% 27% 26,4%% stays with anticholinergic drugs at discharge 8% 7% 7% 5% 6% 8% 7% 7% 5% 7% 6,7%% stays with possible overuse at discharge 41% 40% 41% 37% 40% 42% 41% 42% 38% 41% 40,8%% stays with statines at discharge 12% 12% 10% 6% 10% 13% 12% 9% 5% 9% 9,6%% stays with Oantidiabetics (AVK+NOAC) 14% 16% 16% 12% 15% 13% 14% 14% 12% 14% 14,0%% stays with vit D 42% 43% 44% 45% 44% 53% 53% 54% 53% 53% 50,3%% stays with AB 58% 58% 60% 64% 60% 51% 54% 57% 61% 56% 57,5%

Appendices: summary by region and province

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Belgique 45086 1,2% 20% 0,8% 18% 7% 7% 7% 10% 14% 50% 26% 40% 56%

1. WEST-VLAANDEREN 6655 1,3% 11% 0,6% 13% 5% 3% 5% 6% 15% 49% 18% 28% 57%1. OOST-VLAANDEREN 7252 1,2% 10% 0,5% 12% 5% 3% 5% 6% 14% 45% 16% 25% 52%1. ANTWERPEN 7262 2,1% 27% 1,3% 20% 8% 9% 9% 12% 15% 57% 30% 50% 58%1. LIMBURG 3741 2,0% 30% 1,7% 26% 13% 10% 10% 18% 16% 41% 37% 56% 63%1. VLAAMS-BRABANT 2340 2,2% 23% 1,6% 18% 13% 7% 10% 11% 15% 46% 32% 49% 58%

2. BRUSSEL-HOOFDSTAD 4681 0,5% 19% 0,3% 16% 4% 8% 5% 7% 11% 47% 22% 35% 46%

3. BRABANT-WALLON 627 1,8% 16% 0,5% 18% 7% 8% 6% 9% 11% 45% 28% 39% 55%3. NAMUR 1317 0,8% 38% 1,1% 36% 11% 15% 11% 12% 9% 57% 47% 62% 66%3. LUXEMBOURG 969 0,4% 44% 1,5% 39% 17% 23% 13% 23% 9% 53% 58% 79% 61%3. HAINAUT 5923 0,6% 29% 0,5% 22% 7% 11% 7% 11% 11% 53% 32% 51% 60%3. LIEGE 4319 0,4% 10% 0,4% 14% 5% 5% 4% 6% 15% 54% 19% 27% 53%

Vlaanderen 27250 1,6% 18% 1,0% 17% 8% 6% 7% 10% 15% 49% 25% 39% 57%Brussel 4681 0,5% 19% 0,3% 16% 4% 8% 5% 7% 11% 47% 22% 35% 46%Wallonie 13155 0,6% 24% 0,6% 22% 8% 10% 7% 10% 12% 53% 31% 46% 58%

P5 0,0% 3% 0,0% 4% 0% 0% 1% 1% 7% 19% 6% 11% 38%P95 3,7% 50% 3,0% 44% 21% 23% 20% 31% 23% 85% 61% 86% 71%

Antwerpen

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71000931 620 1,1% 5,8% 0,3% 4,8% 1,5% 2,6% 2,6% 3,1% 18,2% 85,5% 8,2% 16,1% 53,4%71023695 158 8,9% 31,6% 1,9% 19,6% 0,0% 8,2% 7,6% 34,2% 16,5% 67,1% 25,9% 66,5% 33,5%71068237 383 0,3% 10,2% 0,3% 11,2% 2,1% 2,1% 2,6% 5,7% 18,0% 58,2% 14,6% 24,5% 48,6%71030823 267 3,4% 46,1% 3,7% 35,6% 18,0% 15,0% 22,1% 16,9% 12,0% 24,0% 53,2% 78,3% 49,8%71006374 572 0,5% 8,2% 0,0% 9,4% 2,3% 3,7% 2,4% 4,4% 17,5% 57,2% 12,8% 20,6% 58,2%71053686 354 0,3% 1,7% 0,0% 3,4% 0,8% 1,4% 0,3% 1,4% 16,1% 33,3% 5,1% 7,6% 61,0%71010235 354 0,8% 4,0% 0,0% 2,5% 3,4% 2,0% 2,5% 2,0% 16,9% 30,2% 7,6% 12,1% 63,3%71070910 316 0,3% 17,7% 0,6% 4,7% 1,9% 4,1% 3,2% 5,7% 25,0% 36,1% 10,4% 25,0% 69,6%71009740 561 1,4% 36,7% 0,9% 26,0% 17,6% 11,1% 18,4% 12,1% 13,9% 28,7% 44,2% 69,3% 50,8%71009938 1101 2,9% 37,4% 2,0% 26,1% 10,9% 12,4% 12,5% 23,1% 12,4% 67,8% 40,2% 70,3% 60,5%71002614 831 2,2% 36,5% 2,6% 29,4% 15,0% 15,0% 12,0% 13,7% 12,4% 63,9% 47,5% 69,2% 63,2%71068930 647 7,3% 50,2% 0,9% 32,5% 10,8% 10,2% 8,7% 7,1% 14,8% 45,3% 44,2% 73,7% 57,3%71031417 266 3,0% 27,4% 1,1% 5,6% 3,0% 8,6% 7,9% 15,4% 10,2% 56,0% 16,5% 45,9% 59,0%71010433 258 0,0% 5,4% 0,8% 4,3% 5,0% 0,0% 4,7% 2,3% 12,4% 72,1% 9,3% 15,9% 74,4%71071009 574 0,5% 39,9% 3,1% 44,3% 12,9% 25,1% 15,0% 22,3% 15,5% 78,2% 58,0% 81,9% 61,3%

Limburg

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71024388 1137 0,7% 4,9% 0,5% 6,0% 3,9% 2,1% 4,5% 2,2% 15,6% 36,9% 10,9% 16,7% 52,5%71071405 572 3,8% 58,2% 3,5% 38,6% 24,5% 21,7% 22,6% 28,8% 10,7% 40,9% 61,5% 90,2% 67,1%71037157 854 2,1% 30,7% 1,4% 33,5% 17,1% 8,3% 7,6% 14,3% 14,1% 44,6% 45,7% 65,3% 65,5%71071702 228 3,1% 21,5% 0,9% 18,4% 7,9% 5,3% 6,1% 12,3% 14,5% 23,7% 26,3% 47,8% 61,0%71071603 157 0,0% 4,5% 0,0% 4,5% 2,5% 0,0% 1,9% 0,0% 15,3% 59,9% 6,4% 11,5% 57,3%71071504 358 1,4% 46,9% 3,6% 49,2% 23,2% 19,8% 15,6% 38,3% 24,0% 58,9% 63,7% 87,4% 81,6%71071997 435 3,0% 57,9% 2,3% 35,9% 13,8% 18,4% 14,0% 47,8% 20,5% 34,5% 54,0% 87,6% 65,5%

Oost Vlanderen

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71001723 721 0,7% 23,6% 1,5% 18,9% 5,0% 9,7% 7,1% 16,8% 15,3% 31,9% 29,3% 53,3% 59,2%71029041 1009 0,6% 4,8% 0,2% 5,0% 2,0% 2,1% 1,7% 2,8% 17,3% 49,8% 8,3% 14,2% 45,6%71067049 319 0,3% 6,6% 0,6% 4,7% 0,6% 1,3% 2,5% 2,8% 20,7% 36,7% 6,6% 15,0% 63,9%71071306 308 0,0% 2,6% 0,6% 5,2% 1,3% 0,3% 1,9% 0,3% 9,4% 39,6% 6,5% 9,4% 53,9%71059527 962 1,5% 11,2% 0,5% 8,1% 5,4% 2,5% 4,2% 2,8% 14,3% 49,8% 14,2% 23,3% 58,8%71026566 120 2,5% 5,0% 0,0% 6,7% 6,7% 2,5% 2,5% 1,7% 2,5% 5,0% 15,0% 21,7% 55,8%71001228 459 0,4% 19,6% 1,3% 23,1% 12,6% 6,8% 13,1% 12,4% 14,4% 43,4% 32,9% 48,8% 59,0%71012611 1013 0,4% 22,5% 1,3% 13,2% 6,3% 5,1% 7,4% 9,9% 12,6% 34,9% 21,6% 41,6% 61,6%71017658 458 0,2% 3,5% 0,2% 4,4% 2,0% 0,9% 2,2% 1,1% 12,0% 61,1% 7,2% 11,8% 57,6%71055072 471 0,2% 18,9% 1,1% 17,4% 10,8% 5,7% 6,2% 15,7% 19,7% 69,9% 28,9% 41,6% 59,9%71021717 366 0,8% 6,8% 0,3% 9,3% 4,4% 2,2% 1,9% 3,3% 18,6% 20,5% 13,4% 21,6% 76,0%71017064 143 1,4% 4,2% 0,0% 5,6% 3,5% 0,7% 1,4% 2,8% 16,1% 39,2% 7,7% 12,6% 45,5%71013403 265 0,4% 8,3% 1,1% 11,3% 3,4% 0,4% 4,2% 3,8% 16,2% 37,7% 14,0% 22,6% 54,3%71003208 638 0,3% 6,0% 0,3% 4,1% 3,8% 2,7% 2,0% 1,4% 19,0% 62,2% 9,4% 14,6% 64,6%

Vlaams Brabant

43

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71010631 394 2,3% 32,7% 1,8% 20,1% 7,9% 7,9% 9,9% 13,5% 7,9% 31,7% 32,7% 57,4% 68,0%71020430 531 0,4% 16,9% 0,2% 16,0% 15,8% 6,6% 2,6% 9,0% 13,7% 35,4% 33,1% 45,2% 48,4%71010829 458 5,2% 35,4% 4,8% 29,9% 23,4% 10,7% 24,0% 11,6% 12,4% 67,2% 49,8% 71,2% 54,4%71032209 282 0,4% 15,2% 0,7% 17,4% 2,8% 7,8% 4,3% 10,3% 28,0% 79,1% 24,8% 40,1% 57,4%71071207 312 4,5% 25,0% 1,3% 15,4% 20,2% 9,0% 17,0% 19,6% 17,9% 32,7% 36,9% 58,0% 63,8%71010928 363 0,3% 7,2% 0,3% 4,4% 2,2% 0,8% 1,4% 1,7% 14,0% 35,8% 7,4% 14,6% 63,9%

West Vlaanderen

44

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71004988 1328 1,1% 4,8% 0,1% 9,9% 3,5% 2,0% 2,3% 1,5% 14,0% 70,8% 13,0% 17,8% 49,4%71039236 375 3,2% 6,1% 0,8% 9,3% 4,0% 1,9% 5,3% 6,1% 19,2% 52,3% 13,9% 22,9% 55,2%71014094 400 0,0% 8,0% 0,0% 5,8% 3,8% 2,5% 1,8% 3,3% 17,8% 65,3% 11,0% 18,3% 67,8%71052597 471 0,4% 11,9% 0,4% 13,2% 7,9% 5,1% 5,5% 6,2% 15,5% 71,8% 21,0% 29,9% 63,5%71039632 743 0,4% 10,2% 0,7% 14,7% 5,4% 3,8% 6,2% 6,5% 16,0% 21,4% 20,1% 30,0% 62,6%71031021 261 1,9% 12,3% 0,4% 5,7% 6,1% 1,5% 3,1% 2,7% 11,5% 24,9% 13,0% 24,9% 51,3%71039533 342 1,2% 46,5% 3,2% 46,2% 21,6% 15,8% 22,8% 38,3% 14,3% 36,5% 60,8% 84,8% 48,5%71039731 456 1,5% 6,4% 0,4% 7,2% 2,4% 1,3% 3,5% 3,7% 20,4% 16,2% 10,1% 20,4% 59,0%71000238 12 8,3% 0,0% 0,0% 16,7% 0,0% 0,0% 8,3% 0,0% 16,7% 8,3% 16,7% 25,0% 50,0%71011720 560 0,9% 7,9% 0,5% 12,3% 3,9% 1,1% 2,1% 1,8% 15,7% 43,4% 16,3% 22,9% 60,7%71037850 578 1,9% 10,4% 0,3% 12,1% 4,8% 1,9% 5,5% 5,0% 14,7% 38,8% 16,4% 27,5% 58,0%71005879 121 0,0% 5,0% 0,0% 3,3% 1,7% 0,0% 1,7% 5,8% 14,9% 99,2% 4,1% 9,9% 49,6%71012413 289 0,3% 7,3% 0,0% 5,9% 3,1% 1,0% 3,1% 2,4% 14,2% 94,5% 9,7% 19,4% 57,1%71005780 719 2,6% 13,6% 1,0% 17,5% 4,9% 3,8% 5,8% 11,1% 12,5% 35,6% 22,7% 36,9% 60,2%

Brussel

45

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71007661 277 0,0% 4,3% 0,4% 3,6% 1,1% 1,4% 2,9% 1,1% 15,2% 49,5% 6,1% 11,2% 60,3%71011027 420 0,2% 39,0% 0,0% 17,9% 6,9% 12,9% 6,2% 13,8% 13,6% 58,3% 31,4% 62,6% 69,8%71040820 103 0,0% 1,9% 0,0% 4,9% 0,0% 1,0% 2,9% 1,9% 10,7% 75,7% 5,8% 8,7% 35,0%71007760 68 0,0% 11,8% 0,0% 4,4% 2,9% 1,5% 2,9% 1,5% 23,5% 89,7% 7,4% 16,2% 44,1%71008750 573 0,0% 11,3% 0,0% 9,6% 4,5% 3,5% 2,8% 3,5% 13,3% 49,6% 13,8% 22,7% 53,2%71040622 30 0,0% 6,7% 0,0% 6,7% 0,0% 0,0% 0,0% 0,0% 23,3% 90,0% 6,7% 13,3% 50,0%71072393 363 1,4% 44,1% 1,1% 41,0% 12,1% 22,3% 14,0% 18,5% 8,3% 68,0% 57,9% 78,8% 60,6%71003802 194 0,0% 8,2% 0,0% 6,7% 0,5% 4,1% 1,5% 2,1% 11,9% 71,1% 10,3% 16,5% 42,3%71054775 332 0,3% 24,4% 0,9% 19,0% 3,3% 13,3% 6,9% 11,4% 17,8% 80,1% 29,5% 45,2% 32,2%71005384 91 0,0% 13,2% 0,0% 7,7% 0,0% 2,2% 0,0% 5,5% 16,5% 79,1% 8,8% 23,1% 40,7%71014391 112 0,9% 3,6% 0,0% 5,4% 1,8% 0,0% 0,9% 0,9% 18,8% 77,7% 7,1% 11,6% 51,8%71011126 1133 0,3% 8,6% 0,1% 7,1% 2,2% 3,5% 1,8% 1,7% 6,0% 17,9% 10,8% 16,0% 47,7%71033296 282 0,4% 11,7% 0,4% 8,5% 5,7% 1,1% 1,8% 1,4% 9,2% 59,9% 14,9% 24,5% 62,8%71005186 524 2,3% 49,0% 1,1% 43,5% 6,9% 20,2% 11,1% 21,2% 14,5% 59,5% 55,0% 82,3% 26,5%71040325 179 0,0% 8,4% 0,0% 14,5% 1,1% 2,8% 7,3% 1,1% 23,5% 48,0% 17,3% 29,1% 49,7%

Brabant Wallon, Namur, Luxembourg

46

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71004394 203 1,0% 34,0% 1,0% 25,6% 12,8% 18,2% 11,8% 18,7% 8,9% 16,7% 45,3% 63,1% 57,6%71034682 424 2,1% 8,0% 0,2% 14,6% 4,5% 3,8% 3,8% 4,7% 11,6% 58,0% 20,0% 27,4% 53,8%71024685 450 0,9% 46,2% 1,1% 40,2% 16,9% 20,4% 12,7% 18,4% 11,3% 35,6% 57,6% 81,3% 60,7%71016866 110 0,0% 20,0% 0,0% 18,2% 9,1% 12,7% 5,5% 21,8% 10,9% 57,3% 27,3% 40,0% 43,6%71016470 409 0,0% 48,2% 2,4% 44,0% 19,3% 29,1% 15,2% 28,9% 6,6% 71,6% 66,7% 86,8% 65,5%71000634 393 2,3% 58,3% 1,5% 66,9% 19,3% 26,0% 18,1% 24,2% 8,9% 77,6% 77,6% 92,9% 57,8%71070613 361 0,3% 12,2% 0,3% 15,5% 6,9% 4,2% 5,5% 4,7% 7,8% 24,7% 22,7% 28,0% 80,3%71010334 200 0,0% 49,0% 1,5% 19,5% 3,5% 19,5% 6,0% 10,5% 10,0% 77,5% 35,0% 60,0% 70,5%71026467 278 0,0% 47,8% 1,4% 39,6% 14,0% 14,4% 12,9% 6,5% 6,5% 53,2% 52,9% 77,3% 66,2%71003901 85 1,2% 3,5% 0,0% 9,4% 3,5% 2,4% 2,4% 1,2% 17,6% 67,1% 12,9% 17,6% 32,9%

Hainaut

47

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71032506 87 0,0% 41,4% 1,1% 28,7% 28,7% 21,8% 20,7% 19,5% 10,3% 55,2% 58,6% 77,0% 51,7%71071801 21 0,0% 9,5% 0,0% 9,5% 4,8% 0,0% 4,8% 0,0% 0,0% 71,4% 14,3% 19,0% 71,4%71040919 431 0,9% 38,1% 0,5% 33,4% 12,3% 15,5% 12,3% 26,9% 7,7% 37,1% 50,6% 78,7% 66,8%71001030 1146 0,0% 38,2% 0,5% 36,6% 7,2% 15,9% 6,9% 5,8% 10,2% 59,9% 48,4% 69,1% 65,9%71024982 160 0,0% 60,6% 0,0% 44,4% 18,1% 19,4% 8,1% 11,9% 12,5% 25,6% 57,5% 83,8% 46,3%71025477 429 0,0% 7,0% 0,2% 9,3% 1,9% 2,6% 1,6% 3,3% 10,0% 61,5% 12,1% 17,0% 74,6%71026665 667 0,9% 55,2% 0,4% 25,5% 7,6% 13,8% 10,2% 21,7% 7,2% 36,3% 38,4% 76,3% 66,9%71000733 210 0,0% 9,5% 0,0% 7,6% 3,3% 3,8% 2,4% 2,4% 12,4% 84,8% 12,9% 20,5% 59,0%71009641 669 1,5% 6,9% 0,3% 9,6% 3,0% 1,6% 3,0% 4,5% 14,8% 51,9% 13,6% 22,4% 51,4%71014688 779 0,1% 9,8% 0,1% 5,5% 3,3% 1,3% 1,8% 1,8% 13,7% 49,4% 9,9% 19,9% 49,9%71041018 393 0,8% 43,5% 0,8% 25,2% 7,9% 16,3% 8,7% 8,9% 12,2% 49,6% 39,7% 63,4% 64,1%71000832 97 3,1% 45,4% 0,0% 35,1% 10,3% 22,7% 6,2% 37,1% 7,2% 56,7% 56,7% 83,5% 57,7%71053488 480 1,0% 17,9% 1,3% 16,3% 11,0% 7,9% 8,8% 11,9% 10,2% 42,7% 26,0% 38,1% 52,1%71024784 308 1,3% 41,9% 1,9% 21,1% 10,4% 25,6% 10,7% 31,5% 17,2% 85,4% 46,4% 79,9% 50,3%71072492 46 0,0% 13,0% 0,0% 17,4% 8,7% 8,7% 4,3% 6,5% 10,9% 82,6% 26,1% 30,4% 37,0%

Liege

48

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71015282 645 1,6% 30,2% 1,9% 37,5% 16,4% 17,2% 8,7% 18,1% 16,7% 33,8% 55,5% 72,1% 59,7%71015876 137 0,7% 45,3% 0,7% 45,3% 21,2% 16,1% 17,5% 24,1% 14,6% 46,7% 63,5% 85,4% 64,2%71041216 1255 0,1% 4,3% 0,1% 7,7% 1,5% 1,8% 3,4% 2,3% 17,3% 70,8% 10,0% 15,5% 50,9%71070712 527 0,4% 5,3% 0,0% 7,6% 1,5% 1,3% 0,9% 1,5% 16,3% 67,2% 9,1% 14,8% 47,8%71003703 496 0,0% 2,0% 0,0% 7,7% 0,4% 0,8% 1,8% 2,4% 11,3% 25,6% 8,9% 13,1% 39,3%71002317 360 0,0% 2,5% 0,0% 5,6% 1,4% 1,4% 0,8% 0,8% 7,5% 70,6% 6,4% 7,8% 55,3%71004295 453 0,2% 4,9% 0,0% 9,1% 1,1% 1,5% 0,9% 1,8% 11,7% 71,3% 10,6% 14,3% 60,9%71006869 19 0,0% 15,8% 0,0% 15,8% 10,5% 5,3% 10,5% 5,3% 0,0% 26,3% 26,3% 36,8% 57,9%71001525 33 0,0% 9,1% 0,0% 3,0% 15,2% 15,2% 0,0% 3,0% 15,2% 33,3% 27,3% 36,4% 48,5%71002020 86 1,2% 46,5% 1,2% 47,7% 17,4% 27,9% 20,9% 23,3% 7,0% 80,2% 65,1% 89,5% 45,3%71000436 308 0,0% 6,8% 0,3% 7,1% 1,9% 2,3% 3,2% 3,2% 20,1% 8,8% 10,4% 15,6% 60,1%