| 1. |
- Eliasson, Björn, 1959, et al.
(författare)
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Persistence with IDegLira in Patients in Clinical Practice: A Nationwide Observational Study in Sweden
- 2020
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Ingår i: Diabetes Therapy. - : Springer Science and Business Media LLC. - 1869-6953 .- 1869-6961. ; 11, s. 1807-1820
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Tidskriftsartikel (refereegranskat)abstract
- Aims To explore persistence with insulin degludec/liraglutide (IDegLira) treatment, clinical characteristics and concomitant medications in a large population of patients in clinical practice. Methods This was an observational study in patients with type 2 diabetes (n = 2432) who initiated IDegLira between 26 May 2015 and 31 December 2017. Data were obtained from Swedish nationwide registers and linked on an individual level using unique Swedish personal identifiers. Dose calculations were made for patients with >= 180 days between the first and last collections of IDegLira prescription. Changes in clinical parameters were evaluated as change from the last observation during 12 months prior to the initiation date until +/- 90 days from the last collection of IDegLira. Results Pre-index regimens (index date being the date of filling the first prescription of IDegLira) included: multiple daily insulin injections (45.1%); insulin and glucagon-like peptide-1 receptor agonist (GLP-1 RA) (19.7%); long-acting insulins (11.8%); non-injectable therapy only (11.4%); GLP-1 RA only (9.8%); and no collection of diabetes medication during the 6-month pre-index period (2.3%). The majority of patients (94 and 84%) were persistent with IDegLira at 6 and 12 months, respectively. The most commonly used concomitant medication was metformin (69.4%). Mean daily dose was 33 dose steps. Overall, there was a mean decrease in HbA1c (approx. 10 mmol/mol [1%]) and body weight (- 1.1 kg). Improvements in HbA1c were observed regardless of pre-index treatment. Conclusion After 12 months, 84% of patients were persistent on IDegLira, with improved glycaemic control and reductions in body weight.
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| 2. |
- Andersson, Annika, 1981, et al.
(författare)
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Associations between leisure activities and binge drinking in adults: Findings from a Swedish newly sick-listed sample.
- 2014
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Ingår i: Work : A journal of Prevention, Assesment and rehabilitation. - 1051-9815 .- 1875-9270. ; 48:2, s. 143-153
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Leisure activities and drinking patterns are factors that can affect health and ability to return to work after a sick-leave. Associations between participation in leisure activities and binge drinking among sick-listed individuals have been paid little attention in the research literature. Objective: The aim of this study was to examine associations between leisure activities and binge drinking in a sample of newly sick-listed women and men. PARTICIPANTS: The study included 2,888 individuals aged 19-64 years. Methods: Cross-sectional questionnaire data from the Health Assets Project, Sweden, was used. Participation in 18 leisure activities was estimated. Binge drinking was defined as consuming alcohol at least once a month, and typically consuming five or more glasses. RESULTS: Among women aged 19-30 years who regularly went to concerts (OR 2.36) and wrote (OR 2.39) associations were found with binge drinking. Lower OR was found among women aged 31-64 who regularly went to the cinema (OR 0.43), out in the nature (OR 0.46) or participated in sports (OR 0.57). Among men, associations were found between socializing with friends and binge drinking in both age groups (OR 3.83 respectively 1.63). Among younger men who attended sporting events OR was 2.31, and among older men participating in religious communities OR was 0.28. CONCLUSIONS: This study contributes to understanding the interplay between leisure activities and health behavior. In particular, social activities in men were associated with binge drinking while the opposite was true for recreational activities in older women.
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| 3. |
- Andersson, Annika, 1981, et al.
(författare)
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Participation in leisure activities and binge drinking in adults – findings from a Swedish general population sample.
- 2012
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Ingår i: Addiction Research & Theory. - : Informa UK Limited. - 1606-6359 .- 1476-7392. ; 20:2, s. 172-182
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this cross-sectional study was to estimate the associations between participation in different leisure activities and binge drinking in Swedish adults. The study was based on a questionnaire in a general population sample (n=3567) of individuals aged 19–64 years old. Men and women were defined as binge drinkers if they reported that they had consumed alcohol at least once a month, and stated that at a typical drinking occasion they consumed five or more standard glasses (12g of alcohol). Multivariate analyses found associations between binge drinking and socializing with friends among men aged 19–30 years (odds ratio, OR 2.88), in the 31–64 years old age group (OR 1.87). Corresponding results was found in younger women (OR 2.36). A higher OR was also found for younger men who regularly attended sporting events as spectators (OR 1.83), and among respondents in the older age group who regularly played computer or video games (OR 2.11 for women and 1.61 for men). A lower OR for binge drinking was found for men who regularly participated in religious services in both age-groups. Lower prevalence of binge drinking among women was only found in the younger group among those who regularly participated in sports/athletics or other training (OR 0.51). Our findings suggest that prevention strategies could benefit from an everyday life approach, but also that different interventions should be used in relation to specific leisure activities.
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| 4. |
- Armannsdóttir, Brynja, et al.
(författare)
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Cumulative incidence of sickness absence and disease burden among the newly sick-listed, a cross-sectional population-based study.
- 2013
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Ingår i: BMC public health. - : Springer Science and Business Media LLC. - 1471-2458. ; 13:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Sickness absence is a public health problem with economic consequences for individuals and society. Although sickness absence and chronic diseases are correlated, few studies exist concerning the role of chronic disease in all-cause sickness absence. The aim was to assess the cumulative incidence of sickness absence and examine the accompanying burden of chronic diseases among the sick-listed. METHODS: A cross-sectional study was performed with data from 2008. Cumulative incidence of all-cause sickness absence (>=14 days) was calculated based on all newly sick-listed individuals (N = 12,543). The newly sick-listed sample and a randomized general population sample (n = 7,984) received a questionnaire (participation rates: 54% and 50%).To assess the burden of self-reported chronic diseases, standardized incidence ratios (SIR) were calculated. RESULTS: Estimated one-year cumulative incidence was 11.3% (95% CI: 11.2--11.3), 14.0% (13.9--14.1) for women and 8.6% (8.5--8.6) for men. Gender differences were consistent across all age groups, with highest cumulative incidence among women aged 51--64 years, 18.2% (18.0--18.5). For women, the burden of chronic disease was significantly higher for nine out of twelve disease groups, corresponding numbers for men were nine out of eleven disease groups (standardized for age and socio-economic status). Neoplastic diseases had the highest SIR with 4.3 (3.4--5.2) for women and 4.2 (2.8--5.6) for men. For psychiatric and rheumatic diseases the respective SIR's were 1.7 for women and 1.8 for men. The remaining disease groups had an elevated risk of 20-60% (SIR 1.2--1.6). The risk of reporting a co-morbidity was increased for women (SIR 1.4 (95% CI 1.4--1.5)) and men (SIR 1.5 (1.4--1.7)) among the sick-listed. CONCLUSIONS: Register data was used to estimate of the cumulative incidence of sickness absence in the general population. A higher burden of chronic disease among the newly sick-listed was found. Targeting long-term health problems may be an important public health strategy for reducing sickness absence.
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| 5. |
- Bjerkeli, Pernilla J., et al.
(författare)
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Refill Adherence in Relation to Substitution and the Use of Multiple Medications: A Nationwide Population Based Study on New ACE-Inhibitor Users
- 2016
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Ingår i: Plos One. - : Public Library of Science (PLoS). - 1932-6203. ; 11:5
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Tidskriftsartikel (refereegranskat)abstract
- Objective Generic substitution has contributed to economic savings but switching products may affect patient adherence, particularly among those using multiple medications. The aim was to analyse if use of multiple medications influenced the association between switching products and refill adherence to angiotensin-converting-enzyme (ACE) inhibitors in Sweden. New users of ACE-inhibitors, starting between 1 July 2006 and 30 June 2007, were identified in the Swedish Prescribed Drug Register. Refill adherence was assessed using the continuous measure of medication acquisition (CMA) and analysed with linear regression and analysis of covariance. The study population included 42735 individuals whereof 51.2% were exposed to switching ACE-inhibitor and 39.6% used multiple medications. Refill adherence was higher among those exposed to switching products than those not, but did not vary depending on the use of multiple medications or among those not. Refill adherence varied with age, educational level, household income, country of birth, previous hospitalisation and previous cardiovascular diagnosis. The results indicate a positive association between refill adherence and switching products, mainly due to generic substitution, among new users of ACE-inhibitors in Sweden. This association was independent of use of multiple medications.
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| 6. |
- Bäck, Annika, et al.
(författare)
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The Medication Adherence Report Scale (MARS-5) in a Swedish sample with bipolar disorder - a pilot study
- 2012
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Ingår i: The International Journal of Person Centered Medicine. - 2043-7730 .- 2043-7749. ; 2:2, s. 263-270
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To test the acceptability and reliability of the Swedish translation of the Medication Adherence Report Scale-5 (MARS-5) in a sample of patients who use mood stabilising medicines for bipolar disorder. A further aim was to compare the Swedish translation of the MARS-5 with the Swedish translation of the four-item scale Morisky Medication Adherence Scale (MMAS-4). Method: The study population (n=47, 70% women) was recruited through patient education sessions, at a Patient Association meeting, in Gothenburg, Sweden, as well as through advertisements on the home pages and newsletters of the Swedish patient associations. Participants received the Swedish translations of the MARS-5 and the MMAS-4, and questions on age, education, and country of birth. Reliability was examined for internal consistency (Cronbach’s α) and test-retest (intraclass correlation (ICC), MARS-5: Pearson’s correlation coefficient (r), MMAS-4: Spearman’s rho (ρ)). The acceptability of the MARS-5 was examined with a correlation analysis between the MARS-5 and the MMAS-4 and for face validity. Results: In the study population 53.3% were categorised as adherent with the MARS-5 and 82.6% using the MMAS-4. The value of Cronbach’s α was 0.66 for the MARS-5 and 0.37 for the MMAS-4. The test-retest of the MARS-5 resulted in r=0.90 and ICC=0.91. Corresponding values for the MMAS-4 were ρ=0.84 and ICC=0.85. The correlation between the MARS-5 and the MMAS-4 was 0.55. The face validity resulted in four comments regarding difficulties in answering the MARS-5. Conclusion: The Swedish translation of the MARS-5 ought to be used instead of the MMAS-4 to measure self-reported adherence in a Swedish sample with bipolar disorder. The MARS-5 showed good psychometric properties.
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| 7. |
- Hedenrud, Tove, 1967, et al.
(författare)
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Beliefs about medicines among Swedish pharmacy employees
- 2006
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Ingår i: International Conference on Behavioral Medicine, Bangkok, November 2006..
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Konferensbidrag (refereegranskat)abstract
- The aim was to describe beliefs about medicines among pharmacy employees. A further aim was to analyse whether these beliefs were associated with any background characteristics, such as age, professional category or medication use. The study was performed among pharmacy employees at 24 community pharmacies in Göteborg, Sweden. A majority of the 292 respondents were dispensing pharmacists. More than half of the respondents were aged 45 years or older and had worked in a pharmacy for 20 years or more. The respondents had a mean score for General Benefit of 4.31, 1.81 for General Harm and 3.49 for General Overuse. Each scale score ranged from 1 to 5. Compared to dispensing pharmacists, pharmacy technicians viewed medicines as more harmful; and compared to pharmacy technicians, pharmacists and dispensing pharmacists regarded medicines as more beneficial. Pharmacy employees with 30-34 years experience regarded medicines as less harmful compared to those who had worked 0-4 years. Compared to non-users, current users of prescription drugs regarded medicines as more beneficial. No confounders were detected for the three subscales. Pharmacy personnel expressed positive beliefs about medicines which may effect the communication with clients and, eventually, clients’ adherence to medicines. The reason for the difference between dispensing pharmacists and technicians remain unclear. Health professionals hold both professional and personal health beliefs, which could have an impact, not only on the type of information one considers important to communicate, but also the way it is communicated. With knowledge about potential differences in beliefs about medicines among pharmacy clients, pharmacy employees, doctors and nurses, we may be able to suggest measures in order to enhance adherence among users of medication.
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| 8. |
- Hensing, Gunnel, 1956, et al.
(författare)
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Harmful alcohol habits were no more common in a sample of newly sick-listed Swedish women and men compared to a random population sample.
- 2011
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Ingår i: Alcohol and Alcoholism. - : Oxford University Press (OUP). - 0735-0414 .- 1464-3502. ; 46:4, s. 471-7
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To estimate harmful alcohol habits in a sample of incident sick-listed individuals compared with a random sample from the general population taking social background, health and work-related factors into account. Methods: Data for this cross-sectional questionnaire study were collected in 2008 in the Västra Götaland region, Sweden. The study population (19–64 year olds) consisted of 2888 consecutive incident sick-leave sample (ISS) and 3567 individuals from a random population sample (RPS). The mailed questionnaire included Alcohol Use Disorder Identification Test and validated instruments on health and work-related factors. Socio-demographic data came from register data. Analyses were made with χ2 tests and logistic regression analyses. Results: No differences in prevalence of harmful alcohol habits were found between men in the ISS (22%) and the RPS (21%). Compared with women in the ISS, a higher proportion of women in the RPS were likely to report harmful alcohol habits [14 versus 9% (P < 0.001)]. This difference was confirmed in the logistic regression analyses where women in the RPS had higher odds of having harmful alcohol habits compared with women in the ISS [odds ratio (OR) = 1.54 (95% confidence interval (CI): 1.23–1.89)]. Even after controlling for significant confounders (age, low income, high self-reported health and high level of perceived symptoms), we found that the differences in harmful alcohol habits remained [OR = 1.44 (95% CI: 1.16–1.81)]. Conclusions: Harmful alcohol habits were no commoner in men and women who belonged to the sample of incident sick-leave cases. Future studies are needed to analyse the predictive value of harmful alcohol habits on sickness absence length and the time until return to work after sickness absence.
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| 9. |
- Holmgren, Kristina, 1955, et al.
(författare)
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Remain in Work-What Work-Related Factors Are Associated With Sustainable Work Attendance A General Population-Based Study of Women and Men
- 2014
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Ingår i: Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine. - 1536-5948. ; 56:3, s. 235-42
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To analyze if organizational climate and work commitment, demand and control, job strain, social support and physical demands at work are associated with remain in work (RIW), i.e. work attendance without sick-leave over 15 days per year. Methods: This Swedish cross-sectional study was based on 4,013 workers (19–64 years), randomly selected from a general population. Data was collected (2008) through postal questionnaire and registers. Results: Fair organizational climate, the combination of fair organizational climate and fair work commitment, high control and low physical demands was associated with RIW for women and men. Conclusions: This study adds to the rather scarce research findings on factors that promote RIW by identifying work organizational factors and physical prerequisites as being important. Preventive work to create a healthy work environment could be directed at improving organizational climate and reducing physical demands.
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| 10. |
- Holmgren, Kristina, 1955, et al.
(författare)
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The association between self-efficacy and sick-leave among men and women: a cross-sectional study of the general working population in Sweden
- 2014
-
Ingår i: Epidemiology Biostatistics and Public Health. - 2282-0930. ; 11:2
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aim of this study was to investigate if low self-efficacy was associated with increased risk for sickness absence, in a general population of employed women and men. The aim was also to analyse differences in self-efficacy concerning age, education, income, and socio-economic position. Methods: This cross-sectional study was based on data collected in western Sweden, 2008. The study population consisted of 2,900 employed sick-listed individuals (E-SL) and 2,649 random working population individuals (R-WP). Both mailed questionnaire, including the General Self-Efficacy Scale (GSE) and register data on age, education, income and socio-economic position were used. A continuous mean score of the total GSE was calculated for each individual. A low GSE-score indicated low general self-efficacy. Results: Lower general self-efficacy had an increased odds ratio (OR) of belonging to a sick-listed general working population among both men (OR=1.60; 95% CI 1.32–1.94) and women (OR=1.26; 95% CI 1.08–1.47). The OR remained significant after adjustments for socio-demographic variables. Yet, men in the R-WP and women in both the R-WP and E-SL with lower education, income or socio-economic position had lower general self-efficacy compared with those in each cohort with higher education, income or socio-economic position. Conclusions: Low self-efficacy was associated with increased probability to belong to a sick-listed general working population. Although more research is needed, it seems highly relevant to take both self-efficacy and socio-economic factors into account, in preventive and rehabilitation work targeting persons on sickness absence
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| 11. |
- Jönsson, Anna K, et al.
(författare)
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Influence of refill adherence method when comparing level of adherence for different dosing regimens
- 2014
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Ingår i: European Journal of Clinical Pharmacology. - : Springer Science and Business Media LLC. - 0031-6970 .- 1432-1041. ; 70:5, s. 589-597
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Tidskriftsartikel (refereegranskat)abstract
- To examine the impact of two methods when estimating refill adherence in patients using bisphosphonates with different dosing regimens. In the Swedish Prescribed Drug Register, 18,203 new users of bisphosphonates aged 18-85 years were identified between 1 July 2006 and 30 June 2007 and followed for a maximum of 2 years. The patients were categorised based on dosing regimen: one tablet daily, one tablet weekly, switching between these regimens, and other regimens. Refill adherence was estimated with Continuous measure of Medication Acquisition (CMA, adherent if CMA a parts per thousand yenaEuro parts per thousand 80 %) and the maximum gap method (adherent if gaps < 45 days). Differences in adherence between patients in the groups were assessed with logistic regression models controlling for confounding factors. The proportion of patients classified as adherent was higher using CMA compared with patients classified as adherent using the maximum gap method. Patients on one tablet weekly had significantly lower adherence compared with patients on one tablet daily in the main analyses of both methods (the maximum gap method: 73 % vs. 80 %; adjusted OR = 0.71; 95 % CI 0.57-0.89 and CMA: 84 % vs. 88 %, adjusted OR = 0.75; 95 % CI 0.57-0.99). Patients using the other two dosing regimens had significantly lower adherence compared with patients on one tablet daily using both methods. Choice of method has an impact on the estimates of refill adherence to bisphosphonates. Patients on one tablet weekly dosing had lower adherence compared with patients on one tablet daily dosing using both methods.
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| 12. |
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| 13. |
- Jörgensen, Tove, 1967, et al.
(författare)
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Beliefs about medicines among Swedish pharmacy employees.
- 2006
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Ingår i: Pharmacy world & science : PWS. - : Springer Science and Business Media LLC. - 0928-1231 .- 1573-739X. ; 28:4, s. 233-8
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to describe the beliefs about medicines among pharmacy employees. A further aim was to analyse whether these beliefs were associated with any background characteristics, such as age, professional category or medication use.
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| 14. |
- Lesén, Eva, 1982, et al.
(författare)
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A comparison of two methods for estimating refill adherence to statins in Sweden: the RARE project
- 2011
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Ingår i: Pharmacoepidemiology and Drug Safety. - : John Wiley and Sons. - 1053-8569 .- 1099-1557. ; 20:10, s. 1073-1079
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Tidskriftsartikel (refereegranskat)abstract
- Purpose To analyse and compare refill adherence to statins estimated with two different methods with a focus on sensitivity to definitions. less thanbrgreater than less thanbrgreater thanMethods Individuals aged 18-85 years who filled a statin prescription for the first time in 1.5 years during 1 January-30 June 2007 were followed until emigration or death or until 2 years after their first statin purchase. The data were collected via linkage between the Swedish Prescribed Drug Register, the National Patient Register and the Total Population Register. Days supply was estimated based on amount dispensed and prescribed dosage. Refill adherence was estimated with the continuous measure of medication acquisition (CMA) and the maximum gap method (cut-off 45days). The impact of altering definitions, for example, regarding hospitalisations, length of observation period and management of overlapping supply, was analysed. less thanbrgreater than less thanbrgreater thanResults The study included 36661 individuals (mean age 64 years, 47% women). The median proportion of days with statins was 95%, and 76% were classified as adherent with a cut-off at andgt;= 80% with CMA. With the maximum gap method, 65% were adherent. Disregarding hospitalisations did not alter the results. Emigration or death at least one year after statin initiation was associated with a lower adherence with both methods, and a shorter observation period and adding overlapping supply to the subsequent prescription increased the adherence estimates. less thanbrgreater than less thanbrgreater thanConclusions The choice of method and definitions, particularly regarding the management of overlapping supplies and the length of observation period, has a substantial impact on estimates of refill adherence to statins.
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| 15. |
- Lesén, Eva, 1982, et al.
(författare)
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Is the level of patient co-payment for medicines associated with refill adherence in Sweden?
- 2014
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Ingår i: European Journal of Public Health. - : Oxford University Press (OUP). - 1101-1262 .- 1464-360X. ; 24:1, s. 85-90
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Tidskriftsartikel (refereegranskat)abstract
- In the Swedish reimbursement scheme, the co-payment is based on the price of the product and decreases in a stepwise manner as the total accumulated co-payment increases. The aim of this study was to analyse how refill adherence in Sweden varies according to patient's co-payment level for medicines, with antiepileptic drug (AED) use as an example.
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| 16. |
- Lupattelli, A., et al.
(författare)
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Medication use in pregnancy: a cross-sectional, multinational web-based study
- 2014
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 4:2
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Tidskriftsartikel (refereegranskat)abstract
- Objectives Intercountry comparability between studies on medication use in pregnancy is difficult due to dissimilarities in study design and methodology. This study aimed to examine patterns and factors associated with medications use in pregnancy from a multinational perspective, with emphasis on type of medication utilised and indication for use. Design Cross-sectional, web-based study performed within the period from 1 October 2011 to 29 February 2012. Uniform collection of drug utilisation data was performed via an anonymous online questionnaire. Setting Multinational study in Europe (Western, Northern and Eastern), North and South America and Australia. Participants Pregnant women and new mothers with children less than 1year of age. Primary and secondary outcome measures Prevalence of and factors associated with medication use for acute/short-term illnesses, chronic/long-term disorders and over-the-counter (OTC) medication use. Results The study population included 9459 women, of which 81.2% reported use of at least one medication (prescribed or OTC) during pregnancy. Overall, OTC medication use occurred in 66.9% of the pregnancies, whereas 68.4% and 17% of women reported use of at least one medication for treatment of acute/short-term illnesses and chronic/long-term disorders, respectively. The extent of self-reported medicated illnesses and types of medication used by indication varied across regions, especially in relation to urinary tract infections, depression or OTC nasal sprays. Women with higher age or lower educational level, housewives or women with an unplanned pregnancy were those most often reporting use of medication for chronic/long-term disorders. Immigrant women in Western (adjusted OR (aOR): 0.55, 95% CI 0.34 to 0.87) and Northern Europe (aOR: 0.50, 95% CI 0.31 to 0.83) were less likely to report use of medication for chronic/long-term disorders during pregnancy than non-immigrants. Conclusions In this study, the majority of women in Europe, North America, South America and Australia used at least one medication during pregnancy. There was a substantial inter-region variability in the types of medication used.
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| 17. |
- Mårdby, Ann-Charlotte, 1976, et al.
(författare)
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Adherence to antidepressants among women and men described with trajectory models : a Swedish longitudinal study
- 2016
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Ingår i: European Journal of Clinical Pharmacology. - : Springer. - 0031-6970 .- 1432-1041. ; 72:11, s. 1381-1389
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study are to analyse adherence to antidepressant treatment over 2 years in Sweden among women and men who initiated treatment with citalopram and to identify groups at risk of non-adherence using trajectory models. The study population, including individuals 18-85 years who initiated citalopram use between 1 July 2006 and 30 June 2007, was identified in the Swedish Prescribed Drug Register and followed for 2 years. Adherence was estimated with continuous measure of medication acquisition (CMA) and group-based trajectory modelling, a method which describes adherence patterns over time by estimating trajectories of adherence and the individual's probability of belonging to a specific trajectory. The study population included 54,248 individuals, 64 % women. Mean CMA was 52 % among women and 50 % among men (p < 0.001). Five different adherence patterns (Trajectories) were identified. Similar proportion of women and men belonged to each Trajectory. Around 29 % of the women and 27 % of the men belonged to the Trajectory which showed full adherence throughout the 2-year study period. The other four Trajectories showed adherence that declined to different degrees and at different stages in time. Having low socioeconomic status was more common among individuals in Trajectories showing declining adherence than in the adherent Trajectory. Using trajectory modelling, five Trajectories describing different patterns of adherence to citalopram treatment over time were identified. A large proportion discontinued treatment early and having low socioeconomic status increased the risk of being non-adherent.
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| 18. |
- Mårdby, Ann-Charlotte, 1976, et al.
(författare)
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Apotekspersonals inställning till läkemedel
- 2005
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Ingår i: Läkemedelskongressens kongressbok 2005.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Introduktion och syfte Hälso- och sjukvårdspersonal har både professionella och personliga uppfattningar om hälsa. Detta får troligen betydelse både för den information man förmedlar samt på vilket sätt detta sker. Uppfattningars betydelsen i relation till följsamhet till behandling har påtalats [1,2]. Dock visade en finsk studie att apotekspersonalen inte var medvetna om vilken roll deras egna attityder spelade i kommunikationen med kunden [3]. Ett större projekt kommer att analysera och jämföra uppfattningar om läkemedel bland hälso- och sjukvårdspersonal samt patienter. Syftet med denna studie var att beskriva uppfattningar om läkemedel bland apotekspersonal. Metod Studien omfattade personal på 24 öppenvårdsapotek i Göteborg, vilka hade 372 anställda (apotekare, receptarier och apotekstekniker). En enkät delades ut i samband med varje apoteks informationsmöte. Den omfattade bakgrundsfrågor (ålder, yrke, antal år på apotek och läkemedelsanvändning) och den generella delen av Beliefs about Medicines Questionnaire (BMQ). Generella BMQ omfattar 12 frågor som besvaras på en 5-gradig skala. Resultat En majoritet av de 292 deltagarna var receptarier. Mer än hälften var 45 år eller äldre samt hade arbetat på apotek i 20 år eller mer. En högre andel av receptarierna, jämfört med apotekare och apotekstekniker, angav att de för närvarande använde receptbelagda läkemedel. Apotekspersonalens medelvärde för upplevd nytta (General Benefit) var 4,31 och medelvärdet för upplevd risk (General Harm) var 1,81. Apotekstekniker uppfattade risker med läkemedel i större utsträckning än receptarier. Receptarier och apotekare uppfattade nyttan med läkemedel i större utsträckning än apotekstekniker. Inga confounders kunde identifieras för någon av BMQ’s tre underkategorier. Slutsats Skillnaden i uppfattningar om läkemedel mellan yrkeskategorierna kan inte förklaras med de ingående variablerna. Likväl, de positiva uppfattningarna om läkemedel bland apotekspersonalen påverkar troligen kommunikationen med kunderna och, som en följd, följsamheten till behandling.
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| 19. |
- Mårdby, Ann-Charlotte, 1976, et al.
(författare)
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Are beliefs about medicines associated to self-reported adherence among pharmacy clients?
- 2006
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Ingår i: International Journal of Behavioral Medicine. ; 13:Supplement
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Purpose: To analyse if general beliefs about medicines were associated with adherence to medicines among pharmacy clients. Results: Questionnaire data about beliefs and adherence concerning medicines were collected from 324 clients (76% women) in seven community pharmacies in Göteborg, Sweden, 2004. The average age was 47 years (range 18-85) and 90% were born in Scandinavia. Almost half of the clients had a university degree. Questionnaires with missing answers from statements regarding beliefs about medicines and adherence were excluded from the analysis. The analysis included 265 clients of which 54% were considered non-adherent. Almost 40% of the clients stopped taking their medicines sometimes, often or always. A logistic regression analysis, with adherence as the dependent variable and three types of beliefs as independent variables, revealed that beliefs about medicines as something harmful was associated with non-adherence. Being born outside the Nordic countries was statistically significant and a potential confounder. However, the association remained between beliefs about medicines as something harmful and non-adherence. Conclusions: Beliefs about medicines as something harmful was associated to non-adherence to medicines among Swedish pharmacy clients. The association remained after controlling for the background variables. Proposals for action: All health service personnel should be aware of the importance of the patients’ risk-benefit beliefs concerning treatment and medication regimens. We ought to encourage patients to express their own thoughts as a base for the information process. This could help to increase adherence to medicines.
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| 20. |
- Mårdby, Ann-Charlotte, 1976, et al.
(författare)
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Beliefs about medicines among prescribing and non-prescribing nurses in Sweden.
- 2014
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Ingår i: Journal of Nursing Education and Practice. - : Sciedu Press. - 1925-4040 .- 1925-4059. ; 4:8, s. 153-61
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Tidskriftsartikel (refereegranskat)abstract
- Background: The beliefs patients and health care providers have about medicines are important for communication about medicines, which is a central tool for patient-centered care and the quality of care. This study aimed to analyze general beliefs about medicines among prescribing and non-prescribing nurses. Methods: In this cross-sectional study a survey (Beliefs about Medicines Questionnaire, socio-demographic factors, years of professional experience and the right to prescribe) was sent to 303 nurses in Region Västra Götaland, Sweden, in 2007 (response rate: 80.5%). Analyses were made with independent t-tests, analyses of variance and linear regressions. Results: The beliefs about medicines among nurse prescribers did not differ from those of non-prescribing nurses. Professional experience was, however, important for harmful beliefs about medicines. Non-prescribing nurses with 16-30 years of professional experience had more harmful beliefs about medicines compared with non-prescribing nurses with less professional experience. Conclusions: It is important to further examine the possible effects of education and professional experience on beliefs among nurses. During the communication between nurses and patients there is a need for increased awareness of the importance of professional experience for beliefs about medicines.
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| 21. |
- Mårdby, Ann-Charlotte, 1976, et al.
(författare)
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Beliefs about medicines among prospective and current pharmacy personnel
- 2004
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Ingår i: 1st Nordic Social Pharmacy and Health Services Research Conference.
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Konferensbidrag (refereegranskat)abstract
- Background According to earlier reports only 50 % of all patients are adherent to their medications. Increased adherence to medicines can reduce costs for society due to less hospitalization and sick leave (1). Beliefs about medicines are linked to adherence (2). Improved knowledge about beliefs may lead to new interventions aiming to capture misunderstandings, improve patients’ knowledge about medicines and thereby enhance their adherence. Objective To analyse beliefs about medicines among Swedish university students and pharmacy personnel. Method Beliefs about medicines questionnaire (BMQ) was used in two studies to analyze prospective and current pharmacy personnel in the autumn 2003. One study included first year students at Göteborg University (n=455); students in pharmacy, pharmaceutical bioscience, dispensing pharmacy, medicine, nursing and finance/accounting. The other study examined pharmacists, dispensing pharmacists and pharmacy technicians at 24 community pharmacies in Göteborg (n=306). BMQ is divided in a specific- and a general part. The general part was used here and measured beliefs in medicines’ harmful effects (General-Harm), beliefs in doctors’ over-prescribing (General-Overuse) and beliefs in medicines’ beneficial effects (General-Benefit) (3). Results A majority of the students were women and younger than 25 years. For all courses, the mean was over 4.0 for General-Benefit and below 2.5 for General-Harm. Pharmacy students had a significantly higher General-Overuse than students in medicine, dispensing pharmacy and finance/accounting. Over half of the pharmacy personnel were 45 years or older, had worked in a pharmacy at least 20 years and were dispensing pharmacists, respectively. As a whole, pharmacy personnel had means over 4.0 for General-Benefit and below 2.0 for General-Harm. Those who had worked in a pharmacy for 20-24 and 30-34 years had significantly lower mean for General-Harm than those who had worked for 0-4 years. Prospective and current dispensing pharmacists had the highest mean for General-Benefit and the lowest mean for General-Harm. Discussion Prospective and current pharmacy personnel saw medicines as beneficial rather than harmful. The study on pharmacy personnel showed that experience rather than education affected beliefs about medicines harmful effects. Students in medicine, nursing, pharmacy and dispensing pharmacy had similar beliefs about medicines. This may facilitate future team work as professionals, were they should be encouraged to discuss how to detect non-adherence, motivate patients in future treatments and how to use two-way communication with their patients. Pharmacy personnel have a positive view on medicines, and a study has shown that they dominate the communication at the counter (4). If pharmacy personnel assume that the client has the same beliefs about medicines as themselves, communication can be affected and questions important for the client might not be brought up. Conclusions Future and current pharmacy personnel considered medicines as beneficial and not very harmful. Future studies will answer if education can influence beliefs, and to what extent clients’ beliefs about medicines differ from those of the personnel.
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| 22. |
- Mårdby, Ann-Charlotte, 1976, et al.
(författare)
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Beliefs about medicines and self-reported adherence among pharmacy clients
- 2007
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Ingår i: Patient Education and Counseling. - : Elsevier BV. - 0738-3991. ; 69, s. 158-164
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To analyse any association between general beliefs about medicines and self-reported adherence among pharmacy clients. Further, to examine general beliefs about medicines by background variables. Methods: The data were collected by questionnaires including the general section of the Beliefs about Medicines Questionnaire (BMQ), the selfreporting Medication Adherence Report Scale (MARS) and the following background variables: gender, age, education, country of birth and medicine use. The General BMQ measures beliefs about medicines as something harmful (General-Harm), beneficial (General-Benefit) and beliefs about how doctors prescribe medicines (General-Overuse). Results: Of the 324 participating pharmacy clients, 54% were considered non-adherent. An association was found between General-Harm and adherence. Adherent behaviour and higher level of education were associated respectively with more beneficial and less harmful beliefs about medicines. Those born in the Nordic countries regarded medicines as more beneficial. Current users of herbal medicines and non-users of medicines were more likely to believe that doctors overprescribed medicines. Conclusions: General-Harm was associated with adherence to medication among Swedish pharmacy clients. Country of birth, education and medicine use influenced beliefs about medicines. Practice implications: Increased awareness of the patient’s beliefs about medicines is needed among healthcare providers. We should encourage patients to express their views about medicines in order to optimize and personalize the information process. This can stimulate concordance and adherence to medication.
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| 23. |
- Mårdby, Ann-Charlotte, 1976, et al.
(författare)
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Consumption of alcohol during pregnancy-A multinational European study
- 2017
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Ingår i: Women and Birth. - : Elsevier BV. - 1871-5192. ; 30:4
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Tidskriftsartikel (refereegranskat)abstract
- Background: Although single-country studies indicate alcohol consumption among some pregnant European women, it is difficult to interpret European differences. Few multinational studies exist using the same methodology. Aim: To estimate the proportion of women consuming alcohol during pregnancy in Europe, and to analyze whether between country variations could be explained by sociodemography and smoking. Methods: An anonymous online questionnaire was accessible for pregnant women and new mothers in 11 European countries during two months between October 2011 and February 2012 in each country. The questionnaire covered alcohol consumption, sociodemographic factors, and smoking habits during pregnancy. Descriptive analyses and logistic regression models were conducted. Findings: The study population consisted of 7905 women, 53.1% pregnant and 46.9% new mothers. On average, 15.8% reported alcohol consumption during pregnancy. The highest proportion of alcohol consumption during pregnancy was found in the UK (28.5%), Russia (26.5%), and Switzerland (20.9%) and the lowest in Norway (4.1%), Sweden (7.2%), and Poland (9.7%). When reporting alcohol consumption during pregnancy, 39% consumed at least one unit per month. In Italy, Switzerland, and the UK, over half consumed at least one alcohol unit per month. Higher education and smoking before pregnancy were predictors of alcohol consumption during pregnancy. Conclusions: Almost 16% of women resident in Europe consumed alcohol during pregnancy with large cross-country variations. Education and smoking prior to pregnancy could not fully explain the differences between the European countries. A united European strategy to prevent alcohol consumption during pregnancy is needed with focus on countries with the highest consumption. (C) 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
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| 24. |
- Mårdby, Ann-Charlotte, 1976, et al.
(författare)
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Different development of general beliefs about medicines during undergraduate studies in medicine, nursing and pharmacy
- 2009
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Ingår i: Patient Education and Counseling. - : Elsevier. - 0738-3991 .- 1873-5134. ; 75:2, s. 283-289
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To analyze differences in general beliefs about medicines between healthcare students and to see if health education was of importance to general beliefs about medicines.Method: The participants were students of medicine, pharmacy, pharmaceutical bioscience, dispensing pharmacy, nursing and economics (comparison group) at the University of Gothenburg. Data were collected twice in 2003 and 2005. A questionnaire was used comprising background questions and the general part of Beliefs about Medicines Questionnaire.Results: The questionnaire was completed by 460 of 642 (71.7%) first-year and 293 of 398 (73.6%) thirdyear students. Over 70% were women and two-thirds were under 25 years of age. Medical and pharmacy students saw medicines as less harmful than nursing students did. Stage of education was also important: third-yearmedical and pharmacy students saw medicines as more beneficial and less harmful than firstyear students did. Experience of medicine use was relevant to general beliefs about medicines.Conclusion: Different beliefs exist between healthcare professions owing to different types and stages of education, which could result in different messages being given to the patient.Practice implications: It is important to educate future healthcare professionals about the potential effect of beliefs on communication.
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| 25. |
- Mårdby, Ann-Charlotte, 1976, et al.
(författare)
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General beliefs about medicines among doctors and nurses in out-patient care: a cross-sectional study.
- 2009
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Ingår i: BMC family practice. - : Springer Science and Business Media LLC. - 1471-2296. ; 10
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Doctors and nurses are two natural partners in the healthcare team, but they usually differ in their perspectives on how to work for increased health. These professions may also have different beliefs about medicines, a factor important for adherence to medicines. The aim was to explore general beliefs about medicines among doctors and nurses. METHODS: Questionnaires were sent to 306 private practitioners (PPs), 298 general practitioners (GPs) and 303 nurses in the county of Västra Götaland, Sweden. The questionnaire included sociodemographic questions and the general part of the Beliefs about Medicines Questionnaire (BMQ), which measures the beliefs people have about medicines in general. General beliefs about medicines in relation to background variables were explored with independent t-tests and ANOVA analyses. Differences between occupations and influences of interaction variables were analysed with multiple linear regression models for general beliefs about medicines. RESULTS: The data collection resulted in 616 questionnaires (62.1% PPs; 61.6% GPs; 80.5% nurses). The majority of the PPs and 40% of the GPs were male but most of the nurses were female. The GPs' mean age was 47 years, PPs' 60 years and nurses' 52 years. Few nurses originated from non-Nordic countries while 15% of the PPs and 25% of the GPs did. Nurses saw medicines as more harmful and less beneficial than did PPs and GPs. These differences could not be explained by the included interaction variables. GPs with a Nordic background saw medicines as more beneficial and less harmful than did GPs with a non-Nordic background.Furthermore, GPs of non-Nordic origin were most likely to believe that medicines were overprescribed by doctors. CONCLUSION: Doctors were more positive about medicines than nurses. The differences in beliefs about medicines found between doctors and nurses could not be explained by any of the included interaction variables. These differences in beliefs may be useful in discussions among future and practising doctors and nurses to enhance understanding of each other's profession and teamwork.
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| 26. |
- Mårdby, Ann-Charlotte, 1976
(författare)
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General Beliefs about Medicines among Pharmacy Clients, Healthcare Students and Professionals - Group Differences and Association with Adherence
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: only about 50% of all medicines are used as the prescriber intended. If medicines are prescribed in an adequate way, an optimised adherence can decrease mortality and hospitalisation and improve health-related outcomes. Beliefs about medicines have been shown to be an important factor in adherence. Furthermore, beliefs can also bias the content of patient communication, which is central to patient-centred care. Research shows that it has been difficult to optimise adherence with existing knowledge. To increase the knowledge about pharmacy clients’ and healthcare professionals’ beliefs about medicines could be a new angle in adherence research. Aims: to examine general beliefs about medicines among Swedish pharmacy clients, healthcare students and professionals. A further aim was to analyse the association between general beliefs about medicines and self-reported adherence in pharmacy clients. Methods: the thesis is based on four quantitative, cross-sectional studies. Participants in the studies were pharmacy clients, healthcare students, doctors, nurses and pharmacy employees. The data collections were done through questionnaires including the general part of Beliefs about Medicines Questionnaire (BMQ), Medicine Adherence Report Scale (MARS) and background questions: sex, age, occupation, education, country of birth and own experience of medicines. Results: differences in general beliefs about medicines were found between pharmacy clients and practising healthcare professionals. Pharmacy clients believed medicines to be more harmful than practising healthcare professionals did. Doctors, pharmacists and dispensing pharmacists had more beneficial and less harmful beliefs about medicines compared with nurses. Similar patterns were seen for medical, pharmacy and nursing students. Furthermore, third-year medical and pharmacy students were more positive about medicines than first-year students were in these educations. Education, origin and own medicine use were important factors in general beliefs about medicines. Furthermore, beliefs about medicines as something harmful were associated with self-reported non-adherence in pharmacy clients. Conclusions: there were distinct differences in general beliefs about medicines between pharmacy clients and healthcare professionals. If these differences are not acknowledged there could be consequences for patient communication and the interrelationship between doctors, nurses and pharmacy employees. It is also important to increase knowledge about how general beliefs about medicines and adherence are associated. The results of this thesis can be used for future interventions and research aiming for improved adherence.
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| 27. |
- Mårdby, Ann-Charlotte, 1976, et al.
(författare)
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Harmful alcohol habits did not explain the social gradient of sickness absence in Swedish women and men
- 2014
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Ingår i: Epidemiology Biostatistics and Public Health. - 2282-0930. ; 11:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: the aim of this study was to examine the prevalence and socioeconomic distribution of harmful alcohol habits in sick-listed women and men, and whether the social gradient in sickness absence could be explained by the socioeconomic distribution of harmful alcohol habits. Methods: this cross-sectional questionnaire study included newly sick-listed individuals (n=2 798, 19-64 years, 66% women) from Sweden. The outcome variable, self-reported harmful alcohol habits, was measured with the Alcohol Use Disorder Identification Test. Registered socioeconomic variables (education, income, occupational class) were explanatory variables with age as confounder and selfreported health, symptoms, mental wellbeing, and self-efficacy as mediators. Chi2-tests and logistic regression models were applied. Results: 9% of sick-listed women and 22% of men had harmful alcohol habits. Women with a low annual income (≤149 000 SEK) had higher odds ratios (OR=2.47; 95% CI=1.43-4.27) of harmful alcohol habits than those with ≥300 000 SEK/year. The significance of low income remained when mediators were introduced into the logistic regression model (OR=2.03, 95% CI=1.13-3.65). In the model including age, income was no longer significant. Men with low income were more likely to have harmful alcohol habits than men with high income (OR=2.59; 95% CI=1.45-4.62). When mediators were included low income remained significant (OR=2.88; 95% CI=1.56-5.31). Income was no longer significant when age was introduced. Education and occupational status were not significant. ConclusionS: harmful alcohol habits were common among sick-listed women and men. The socioeconomic differences in harmful alcohol habits did not explain the social gradient in sickness absence.
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| 28. |
- Mårdby, Ann-Charlotte, 1976
(författare)
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Olika uppfattningar om läkemedel hos vårdgivare och patienter kan leda till ohälsa
- 2008
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Ingår i: Läkemedelskongressens kongressbok 2008.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Människors uppfattningar om läkemedel är viktiga för följsamheten till läkemedelsbehandlingar (1) och för patientkommunikationen (2). Tyvärr inser inte alla vårdgivare vikten patienters uppfattningar om läkemedel under mötet med patienten (3, 4) eller att de egna uppfattningarna kan vara en barriär under kommunikationen (3). Forskning har kunnat visa att det finns klara skillnader i uppfattningar om läkemedel mellan patienter och olika vårdgivare samt att flertalet faktorer är betydelsefulla för dessa uppfattningar (5). Om dessa skillnader inte uppmärksammas kan det få betydelse för patientkommunikationen samt för de inbördes relationerna mellan läkare, sjuksköterskor och apotekspersonal. I slutändan skulle detta kunna skapa läkemedelsrelaterade problem och ohälsa för patienten. 1.Vermeire E, Hearnshaw H, Van Royen P, Denekens J. Patient adherence to treatment: three decades of research. A comprehensive review. J Clin Pharm Ther 2001;26(5):331-42. 2.Ogden J. Doctor-patient communication and the role of health professionals' health beliefs. In: Health Psychology - a textbook. 3rd ed. Berkshire: Open University Press; 2004. p. 75-97. 3.Kansanaho HM, Puumalainen, II, Varunki MM, Airaksinen MS, Aslani P. Attitudes of Finnish community pharmacists toward concordance. Ann Pharmacother 2004;38(11):1946-53. 4.Stevenson FA, Gerrett D, Rivers P, Wallace G. GPs' recognition of, and response to, influences on patients' medicine taking: the implications for communication. Fam Pract 2000;17(2):119-23. 5.Mardby A-C. General Beliefs about Medicines among Pharmacy Clients, Healthcare Students and Professionals - Group Differences and Association with Adherence. Gothenburg: University of Gothenburg; 2008.
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| 29. |
- Mårdby, Ann-Charlotte, 1976, et al.
(författare)
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University students’ beliefs about medicines
- 2004
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Ingår i: Psychology & Health. ; 19:supplement, s. 165-166
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Konferensbidrag (refereegranskat)abstract
- Objective To investigate Swedish university students’ beliefs about medicines. Method Data was collected with Beliefs about medicine questionnaire (BMQ) among 642 registered first year students at Göteborg University in the autumn 2003. The students were studying pharmacy, medicine, nursing, dispensing pharmacy, pharmaceutical bioscience or finance/accounting. BMQ is divided in a specific- and a general part. The general part was used here and measured beliefs in medicines’ harmful effects (General-Harm), beliefs in doctors’ over-prescribing (General-Overuse) and beliefs in medicines’ beneficial effects (General-Benefit). Results The response-rate was 71.6 %. A majority of the students were women and younger than 25 years. Almost 85 % had prior experience with prescription medicines, 90.0 % with over-the-counter medicines and 37.4 % with herbal medicines. More women than men currently used medicines. Pharmacy students had a significantly higher General-Harm than students in medicine, dispensing pharmacy and finance/accounting. Mean values of BMQ was similar for students in pharmacy and pharmaceutical bioscience. Students in medicine and dispensing pharmacy had comparable means for the different subparts. All courses had high (>4.0) General-Benefit and a General-Harm below 3.0. Women had significantly higher General-Harm than men. General-Benefit showed that first year students in the university thought medicines were beneficial. Pharmacy students saw the largest risk with medicines and thought doctors often over-prescribed medicines. Students in medicine, nursing and dispensing pharmacy will have the most patient-related work. The results show that students in medicine and dispensing pharmacy have a higher confidence in medicines compared to nursing students. Conclusions First year students at the university think medicines are beneficial and not very harmful. Can university educations with focus on medicine and caring change beliefs in medicines?
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| 30. |
- Ogink, H., et al.
(författare)
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A strategic tool to improve long-term health outcomes in clinical practice: SHOR driver and association diagram
- 2020
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Ingår i: International Journal for Quality in Health Care. - : Oxford University Press (OUP). - 1353-4505 .- 1464-3677. ; 32:1, s. 20-27
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Tidskriftsartikel (refereegranskat)abstract
- Quality problem or issue: An over-arching principle of healthcare governance in Sweden is to achieve as much health for as many patients as possible given the available resources. With high life expectancy and increased years lived with non-communicable diseases, more effective interventions in prevention and control of non-communicable diseases are needed in order to ensure high-quality healthcare. Initial assessment: Few publications have described a generic and resource-effective method of implementing the perspective of health outcomes in relation to costs in a clinical Swedish university hospital context. To fill this gap, a generic method was developed at Sahlgrenska University hospital in Gothenburg, Sweden. Choice of solution: A System-based driver and association diagram of Health Outcomes in relation to available Resources (SHOR) was developed. The SHOR driver and association diagram comprised different perspectives: health, patient, process, research and cost perspectives. It enabled the translation from long-term health outcomes to applications in clinical practice. Implementation: Three patient groups exemplify the use and implementation of the method of SHOR association and driver diagram; bipolar disorder (psychiatry), primiparous women with spontaneous onset of labour, (obstetric care) and chronic obstructive pulmonary disease (somatic care). Evaluation:The SHOR driver and association diagram enabled a structure to monitor and support quality development towards maximised health outcomes in relation to available resources and associated total costs for a specific patient group. Lessons learned :This method has connected clinical practice, management and research and has been used for both strategic and operational purposes.
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