| 1. |
- Alsén, Margot, et al.
(författare)
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Medicine self-poisoning and the sources of the drugs in Lund, Sweden
- 1994
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Ingår i: Acta Psychiatrica Scandinavica. - : Wiley. - 1600-0447 .- 0001-690X. ; 89:4, s. 255-261
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to investigate the prevalence of toxic agents in attempted and completed suicides. The purpose was also to explore the sources of the drugs taken by suicide attempters. Verbal information on drug intake was collected from 280 suicide attempters during 1987-1990 in the Lund-Orup catchment area. Information on the sources of the drugs was collected from 143 of these attempters. The study also includes toxicological screening from 73 fatal poisonings in southern Sweden during 1989. According to verbal information, the most common drugs used by suicide attempters were benzodiazepines (51%), analgesics (29%) and antidepressants (20%). In suicide attempters, diazepam and levomepromazine were reported more than expected from prescription data. Toxicological screenings of fatal poisonings showed that benzodiazepines were most common (55%), followed by analgesics (38%), mainly propoxyphene (29%) and antidepressants (30%), mainly amitriptyline (22%). Amitriptyline and diazepam were more commonly detected in completed suicides than expected from prescription data. The most common sources of drugs to attempted suicides were physicians, and especially psychiatrists. We therefore conclude that continuous information to physicians on drug overdose is important, and it is also important to introduce alternative strategies to prevent suicidal behaviour.
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| 2. |
- Frisk, Pia, et al.
(författare)
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Patients' experiences with generic substitution-a Swedish pharmacy survey
- 2010
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Ingår i: Pharmacy World & Science. - : Springer. - 0928-1231 .- 1573-739X. ; 32:5, s. 681-
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background and objective Generic substitution for reimbursed drugs was introduced in Sweden 1 of October 2002. Concerns have been expressed that generic substitution may compromise patient safety. This study aimed to evaluate how Swedish drug consumers experience generic substitution, more than 5 year after implementation. Design Survey study with an electronic questionnaire, offered to 1551 pharmacy customers/patients presenting with a prescription on one of the 2688 drugs included. The selected drugs constituted 75% of the total volume of dispensed drugs subjected to generic substitution in August 2007.Setting Fifty-eight Swedish community pharmacies. Main outcome measures Positive experiences with generic substitution; problems and their degree of seriousness; and the reported incidence of medication errors. Consumers’ suggestions of improvements to the generic substitution system were also captured. Results Of 1551 respondents (602 male, 949 female), 35% (n = 536) reported one or more positive experiences, the most common being the lower drug price. Sixty percent (n= 932) claimed they had not experienced any problems. Forty percent reported at least one problem related to substitution. Seven percent (n=109) reported medication errors attributed to generic substitution. Twenty-two percent (n=342) of the respondents offered suggestions for improvement. The most common suggestions were to revise the criteria for assessing interchangeability between brand-name and generic alternatives and to abolish substitution.Conclusions A majority of respondents do not experience any problems related to generic substitution. A sizeable minority experience problems, partly resulting in medication errors. Over- and undermedication, lack of compliance, and intake of wrong drug or of both the original and the generic were the problems most often reported. Future system changes should consider the importance of revised criteria for generic and brand name interchangeability.
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| 3. |
- Krigsman, Kristin, et al.
(författare)
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Refill non-adherence to repeat prescriptions leads to treatment gaps or to high extra costs.
- 2007
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Ingår i: Pharmacy World & Science. - : Springer Netherlands. - 0928-1231 .- 1573-739X. ; 29:1, s. 19-24
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To determine the nature and extent of undersupply and the economic consequences of oversupply of medication among non-adherent patients. METHODS: This study used copies of repeat prescriptions (= multiple dispensations), collected during 1 week in 2002 at 16 Swedish community pharmacies. For patients with a refill adherence below 80%, treatment gaps were defined as the number of days they had no drug available. The cost of drug oversupply (i.e., refill adherence > 120%) was calculated from the prices of the drug packages dispensed. RESULTS: The number of collected repeat prescriptions was 3,636. The median of treatment gaps among patients with a refill adherence below 80% was 53 days per 90-100 days treatment period and the corresponding median for oversupply was 40 days. The cost of oversupply for exempt patients (i.e., patients who have paid 1,800 SEK (Euro 196; US$ 243) per year for medicines) was 32,000 SEK (Euro 3,500; US$ 4,300) higher than for non-exempt patients. An extrapolation to all Sweden indicates that exemption from charges leads to an additional oversupply of about 142 million SEK (Euro 15 million; US$ 19 million) per year above that of non-exempt patients. CONCLUSION: Both undersupply and oversupply of prescribed medicines are common in Sweden. Patients with a refill adherence below 80% seem to have less than half of the prescribed treatment available. Oversupply or drug stockpiling occurs more frequently among exempt than among non-exempt patients, and this oversupply leads to high unnecessary costs.
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| 4. |
- Lindström, Kjell, 1946-, et al.
(författare)
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Can selective serotonin inhibitor drugs in elderly patients in nursing homes be reduced?
- 2007
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Ingår i: Scandinavian Journal of Primary Health Care. - London : Informa Healthcare. - 0281-3432 .- 1502-7724. ; 25:1, s. 3-8
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate whether treatment with selective serotonin reuptake inhibitors (SSRIs) could be withdrawn for elderly residents who had been on treatment for at least one year and to evaluate a method for systematic drug review. DESIGN: Open, prospective, interventional study. SETTING: Four counties in Sweden. SUBJECTS: Elderly residents at 19 nursing homes, with ongoing treatment with SSRIs for more than one year. MAIN OUTCOME MEASURES: Clinical evaluation, registration of drugs used and rating with Montgomery-Asberg Depression Rating Scale (MADRS). A semi-structured telephone interview with 15 participating physicians and 19 nurses. RESULTS: About one-third of all 822 residents in the nursing homes had ongoing antidepressant treatment, predominantly with SSRIs; 75% of them had been treated with SSRIs for at least one year and 119 (60%) of these were considered eligible for the study. The intervention was judged successful in 52% of these residents of whom 88% had a MADRS rating of less than 20 points. The GPs and the nurses experienced the method as practicable. CONCLUSIONS: Withdrawal of SSRI treatment was successful in the majority of cases. The MADRS may be a valuable addition to clinical evaluation when deciding whether to end or continue SSRI treatment.
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| 5. |
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| 6. |
- Andersson Höök, Lars, et al.
(creator_code:cre_t)
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Vältalighetens dubbla ansikte : Två svenska 1600-talsorationer om talekonstens politiska användning: Text – kontext – intertext. Inledning Nils Ekedahl. Textinledning, utgåva och översättning Annika Ström
- 2023. - 1
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Bok (refereegranskat)abstract
- Här presenteras två latinska orationer, hållna i Uppsala 1654. I centrum för dem står retorikens användbarhet som politiskt redskap. Tillsammans skildrar de en talekonst med dubbelt ansikte: medan den ena orationen utmålar retoriken som en försåtlig manipulationskonst framställer den andra den som fundamentet för varje civiliserat samhälle. Var retoriken ond eller god? Något entydigt svar ger inte orationerna.Vad som gör orationerna märkliga är att de kan läsas som inlägg i den politiska strid som i det fördolda rasade just vid denna tid, nämligen den nye svenske kungen Karl X Gustavs planer på att starta krig mot Polen. Samtidigt som orationerna demonstrerar renässansens syn på retoriken som politiskt verktyg ger de oväntade inblickar i tidens politiska opinionsbildning.
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| 7. |
- Ax, Fredrik, et al.
(författare)
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Electronically transmitted prescriptions not picked up at pharmacies in Sweden
- 2010
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Ingår i: Research in Social and Administrative Pharmacy. - : Elsevier BV. - 1551-7411 .- 1934-8150. ; 6:1, s. 70-77
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Tidskriftsartikel (refereegranskat)abstract
- Background: Electronic transmitted prescriptions (ETPs) became common after 1995 in Sweden; however, it is accompanied by a substantial increase in the number of prescriptions not picked up at pharmacies.Objective: To investigate the ‘‘no pick-up’’ rates of ETPs at pharmacies across type of drug and patient age and gender and the reasons patients’ report for no pick-up.Methods: A cross-sectional study examining no pick-up of ETPs transmitted during 3 months in 2002, and a mail survey of patients to determine the reasons for failure to pick-up in the county of Sormland, Sweden, with a population of 261,000, and 21 pharmacies. Chi-square tests were used for calculations of frequency differences among groups.Results: The overall no pick-up rate of ETPs was 2.5%; men had consistently higher rates than women. The highest rates were seen for adolescents and young adults. Rates were higher than average for antibiotics. About 60% of the answers indicated that prescriptions not picked up were duplicate prescriptions or not needed. ‘‘Unintentional nonadherence’’ was reported by one-fifth of patients.Conclusions: No pick-up rate in general was low (2.5%), but there were differences across patient age and sex, the rates being higher among adolescents and young adults. Duplicate prescriptions may explain a significant share of the abandoned prescriptions.
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| 8. |
- Bardage, Carola, et al.
(författare)
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Health care professionals’ perspectives on automated multi-dose drug dispensing
- 2014
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Ingår i: Pharmacy Practice. - 1885-642X .- 1886-3655. ; 12:4
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Tidskriftsartikel (refereegranskat)abstract
- Background: During the 1980s, manual repackaging of multi-dose medications from pharmacies in Sweden was successively substituted with automated multi-dose drug dispensing (MDD). There are few studies evaluating the consequences of automated MDD with regard to patient safety, and those that investigate this issue are not very extensive.Objectives: To investigate Swedish health care professionals’ perceived experience of automated MDD and its effects on patient adherence and patient safety.Methods: Three questionnaire forms, one for physicians, nurses, and assistant nurses/nursing assistants, were developed based on reviews of the literature and pilot testing of the questions in the intended target groups. The target groups were health professionals prescribing or administrating MDD to patients. A sample (every sixth municipality) was drawn from the sampling frame of Swedish municipalities, resulting in 40 municipalities, about 14% of all municipalities in Sweden. Email addresses of general practitioners were obtained from county councils, while the municipalities assisted in getting contact details for nurses, assistant nurses and nursing assistants. A total of 915 questionnaires were distributed electronically to physicians, 515 to nurses, and 4,118 to assistant nurses/nursing assistants. The data were collected in September and October 2012.Results: The response rate among physicians, nurses and assistant nurses/nursing assistants was 31%, 43% and 23%, respectively. The professionals reported that automated MDD reduces duplication of medication, contributes to correct dosages, helps patients take their medication at the right time, and reduces confusion among patients. Fifteen per cent of the physicians and about onethird of the nurses and assistant nurses/nursing assistants reported that generic substitution makes it more difficult for the patient to identify the various medicines available in the sachets. The physicians did, however, note that prescribing medicine to patients with automated MDD is complicated and can be a risk for patient safety. Both physicians and nurses requested more information on and training in automated MDD. They also asked for more medication reviews.Conclusions: The professionals generally had a positive attitude to automated MDD with regard to improved medication adherence, but said they believed that the electronic prescribing system posed a safety risk for patients.
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