| 1. |
- Daniel, Maria, et al.
(författare)
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Effect of Myocardial Infarction With Nonobstructive Coronary Arteries on Physical Capacity and Quality-of-Life
- 2017
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Ingår i: American Journal of Cardiology. - : Elsevier BV. - 0002-9149 .- 1879-1913. ; 120:3, s. 341-346
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Tidskriftsartikel (refereegranskat)abstract
- Patients with myocardial infarction with nonobstructive coronary arteries (MINOCA), including Takotsubo syndrome (TS), are considered to have a better survival compared with those with coronary heart disease (CHD). Studies of patients with MINOCA measuring physical and mental function including matched control groups are lacking. The aim of this study was to determine the physical capacity and quality of life in patients with MINOCA. One-hundred patients with MINOCA along with TS (25%) were investigated from 2007 to 2011. A bicycle exercise stress test was performed 6 weeks after hospitalization and QoL was investigated by the Short Form Survey 36 at 3 months' follow-up. Both a healthy and a CHD group that were age and gender matched were used as controls. The MINOCA group had a lower physical capacity (139 ± 42 W) compared with the healthy control group (167 ± 53 W, p <0.001) but better than the CHD control group (124 ± 39 W, p = 0.023). Patients with MINOCA had lower physical and mental component summary scores compared with the healthy controls (p <0.001) and lower mental component summary (p = 0.012), mental health (p = 0.016), and vitality (p = 0.008) scores compared with the CHD controls. In conclusion, the findings of this first study on exercise capacity and QoL in patients with MINOCA showed both physical and mental distress from 6 weeks to 3 months after the acute event similar to CHD controls and in some perspectives even lower scores especially in the mental component of QoL.
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| 2. |
- Eneroth, Mari, et al.
(författare)
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A comparison of risk and protective factors related to suicide ideation among residents and specialists in academic medicine
- 2014
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 14, s. 271-
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Tidskriftsartikel (refereegranskat)abstract
- Background: Physicians have an elevated risk of experiencing suicidal thoughts, which might be due to work-related factors. However, the hierarchical work positions as well as work-related health differ among resident and specialist physicians. As such, the correlates of suicide ideation may also vary between these two groups. Methods: In the present study, work- and health-related factors and their association with suicidal thoughts among residents (n=234) and specialists (n=813) working at a university hospital were examined using cross-sectional data. Results: Logistic regression analysis showed that having supportive meetings was associated with a lower level of suicide ideation among specialists (OR=0.68, 95% CI: 0.50-0.94), while an empowering leadership was related to a lower level of suicide ideation among residents (OR=0.55, 95% CI: 0.32-0.94). Having been harassed at work was associated with suicidal ideation among specialists (OR=2.26, 95% CI: 1.31-3.91). In addition, sickness presenteeism and work disengagement were associated with suicide ideation in both groups of physicians. Conclusions: These findings suggest that different workplace interventions are needed to prevent suicide ideation in residents and specialists.
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| 3. |
- Eneroth, Mari, et al.
(författare)
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Reasons to quit among Swedish General Practitioners
- 2014
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Ingår i: International Conference on Physician Health: Milestones and transitions - Maintaining the balance. ; , s. 2-2
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: General practitioners play a crucial part in healthcare as they provide the continuity of care that can prevent illness, and they most often represent the patients first contact with health-care. A current problem is however that there is a lack of general practitioners in several countries. Recruitment of general practitioners from abroad is essential to ensure the publics physician access, but there are indications that this group has even greater quitting intentions than native-born physicians. The antecedents of turnover intentions may moreover differ in importance for native-born and foreign-born physicians respectively. Methods and participants: The authors examined five fundamental physician work factors in relation to intention to quit among native-born general practitioners (n=208), and foreign-born general practitioners (n=73) working in a primary care setting in a central area in Sweden. Linear regression analysis was performed with control for age and gender. The sample consisted of 64 % females. Results: Foreign-born general practitioners more often stated that they would quit today if they could than native-born practitioners (t278= 3,73, p = .001). Regression analysis revealed that pressure from patients was related to an increased intention to quit in both groups. In addition, vacancies and pressure from financial goals were related to a higher risk of wanting to quit among native-born general practitioners. HR-Primacy was associated with a decreased risk of turnover intentions among the native-born general practitioners, while control of work pace was highly related to a decreased risk of turnover intentions among foreign-born general practitioners. Conclusions: General practitioners primarily experience pressure from patients and financial goals of the care-unit, which may provoke intentions to quit. Study suggestions are that care-unit financial goals are set in consent with physicians, and that control of work pace is encouraged.
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| 4. |
- Eneroth, Mari, et al.
(författare)
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Threats or violence from patients was associated with turnover intention among foreign-born GPs - a comparison of four workplace factors associated with attitudes of wanting to quit one's job as a GP
- 2017
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Ingår i: Scandinavian Journal of Primary Health Care. - : Informa UK Limited. - 0281-3432 .- 1502-7724. ; 35:2, s. 208-213
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Tidskriftsartikel (refereegranskat)abstract
- Objective: General practitioners (GPs) are crucial in medical healthcare, but there is currently a shortage of GPs in Sweden and elsewhere. Recruitment of GPs from abroad is essential, but foreign-born physicians face difficulties at work that may be related to turnover intention, i.e. wanting to quit one's job. The study aims to explore the reasons to why foreign-born GPs may intend to quit their job. Design: Survey data were used to compare four work-related factors that can be associated with turnover intentions; patient-related stress, threats or violence from patients, control of work pace, and empowering leadership, among native-born and foreign-born GPs. These work-related factors were subsequently examined in relation to turnover intention among the foreign-born GPs by means of linear hierarchical regression analyses. The questionnaire consisted of items from the QPS Nordic and items constructed by the authors. Setting: A primary care setting in a central area of Sweden. Subjects: Native-born (n = 208) and foreign-born GPs (n = 73). Results: Turnover intention was more common among foreign-born GPs (19.2% compared with 14.9%), as was the experience of threats or violence from patients (22% compared with 3% of the native-born GPs). Threats or violence was also associated with increased turnover intention. Control of work pace and an empowering leadership was associated with reduced turnover intention.
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| 5. |
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| 6. |
- Fridner, Ann, et al.
(författare)
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Enhance physicians health through surevy feedback seminars
- 2013
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Objective: Four university hospitals started 2005 a comprehensive research program Health and Organization among University hospitals Physicians in four European countries - The HOUPE study. The project aims to provide a systematic comparison on how research activity, work conditions, gender equality, career advancement, impact on the health and wellbeing of physicians. Here we present data from Sweden and how we used them to conduct an intervention project to develop the working conditions and thereby enhance the health of physicians working.Methods: Cross sectional survey in 2005 (N = 1800) among university hospital physicians employed permanently more than one year. Measures: Physician Career Path Questionnaire (Fridner, 2004), General Health Questionnaire-12 (Goldberg and Williams, 1991), Oldenburg Burnout Inventory (Demerouti et al., 2001, 2003), Question About Suicidal Ideation and Attempted Suicide (Meehan et al, 1992), and selected scales from Questionnaire about Psychological and Social Factors at Work (Lindström et al, 2000). Survey feedback seminars with physicians working in one university hospital.Results: All employed physicians (2300), the hospital management and HR-consultants recieved a written report where the results from the survey were presented. 10 % of all physicians participated in a three hour survey feedback seminar. Researchers documented these seminars, and reports were distributed to all the physicians working in the clinic/clinics which enabled non-participating physicians to gain knowledge from the seminars. One summarising report from all the survey feedback seminars was written and distributed to all physicians.Conclusions: The seminars were emotionally charged since a lot of frustration could be spoken out, but also a serious listening when results of the physcians´health and results about harrassments among colleagues were presented. Each feed-back seminar ended with the physicians themselves made proposals as to how they wanted to change work conditions in their specific clinic.Comments: Overall, the research team gave 20 survey feedback meetings in collaboration with head of clinic and HR-consultants. Three hours is minum to keep up with the process it means to understand their health and work situation, and to be constructive in their cooperation in order to achieve change.
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| 7. |
- Fridner, Ann, et al.
(författare)
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From Awareness to Action Using the Survey Feedback Method
- 2014
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Ingår i: Journal of Health Science. - 2328-7136. ; 2:7, s. 325-329
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Tidskriftsartikel (refereegranskat)abstract
- Reports from European university hospitals show an increase in work-related mental strain. Four European university hospitals started a comprehensive research program called Health and Organisation among University hospitals Physicians in Europe—the HOUPE Study in the year 2003. Based on the results from the HOUPE study, the authors conducted an intervention project together with HR-consultants at one of the participating hospitals. A collected cross-sectional survey in 2005 among permanently employed academic physicians (N = 1800, response rate 60%) at Karolinska University Hospital in Sweden. Results from the study were used in survey feedback seminars (N = 250). This method is a way of systematic collection of data to process and give feedback to the organisation’s members in order to initiate organisational change. By providing results based on the total sample, on each division, and unpublished data from each clinic the authors aimed to improve physicians’ health and work satisfaction and thereby enhance the health of the physicians. Feedback seminars can arouse many emotions and might make people defensive. The role of resistance in the process of change is a paradox in that resistance slows down change. However, without resistance there will be no change at all. The authors conducted 20 feedback seminars of three hours duration where results were discussed relating mainly to the psychosocial work environment, psychological distress, and career paths, i.e., job demands, control at work, social interactions, leadership, commitment to the organisation, harassment at work, burnout, depression and suicide ideation. Altogether, 250 physicians participated in these meetings. To achieve acceptance for organisational change, data about relevant conditions in the organisation have to be processed in a systematic way in collaboration with all those who will benefit from changes, in concrete work units as divisions and clinics.
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| 8. |
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| 9. |
- Fridner, Ann, et al.
(författare)
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Possible reasons why female physicians publish fewer scientific articles than male physicians : A cross-sectional study
- 2015
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Ingår i: BMC Medical Education. - : Springer Science and Business Media LLC. - 1472-6920. ; 15
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Tidskriftsartikel (refereegranskat)abstract
- Background: The proportion of women in medicine is approaching that of men, but female physicians are still in the minority as regards positions of power. Female physicians are struggling to reach the highest positions in academic medicine. One reason for the disparities between the genders in academic medicine is the fact that female physicians, in comparison to their male colleagues, have a lower rate of scientific publishing, which is an important factor affecting promotion in academic medicine. Clinical physicians work in a stressful environment, and the extent to which they can control their work conditions varies. The aim of this paper was to examine potential impeding and supportive work factors affecting the frequency with which clinical physicians publish scientific papers on academic medicine.Methods: Cross-sectional multivariate analysis was performed among 198 female and 305 male Swedish MD/PhD graduates. The main outcome variable was the number of published scientific articles.Results: Male physicians published significantly more articles than female physicians p <. 001. In respective multivariate models for female and male physicians, age and academic positions were significantly related to a higher number of published articles, as was collaborating with a former PhD advisor for both female physicians (OR = 2.97; 95% CI 1.22–7.20) and male physicians (OR = 2.10; 95% CI 1.08–4.10). Control at work was significantly associated with a higher number of published articles for male physicians only (OR = 1.50; 95% CI 1.08–2.09). Exhaustion had a significant negative impact on number of published articles among female physicians (OR = 0.29; 95% CI 0.12–0.70) whilst the publishing rate among male physicians was not affected by exhaustion.Conclusions: Women physicians represent an expanding sector of the physician work force; it is essential that they are represented in future fields of research, and in academic publications. This is necessary from a gender perspective, and to ensure that physicians are among the research staff in biomedical research in the future.
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| 10. |
- Fridner, Ann, et al.
(författare)
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Why do General Practitioners Self-Diagnose and Self-Prescribe Drugs?
- 2016
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Ingår i: Book of Proceedings. - Nottingham, UK : European Academy of Occupational Health Psychology. - 9780992878627 - 9780992878634 ; , s. 203-203
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Konferensbidrag (refereegranskat)abstract
- Objective: Physicians tend to demonstrate inappropriate behavior when it comes to taking care of their own health. Self-prescribing or self-treatment seems to be practiced in many countries, and self-treated illnesses are found to be more common among general practitioners. For the physician such behavior is a threat to their own health, and as a consequence their patients might not be able to receive optimal health care. The purpose of this study is to examine the relationship between help seeking behavior, sickness presenteeism, exhaustion, and self- treatment among general practitioners.Method: This cross-sectional study was conducted in 2013 among GPs employed in one City Council in Sweden using a questionnaire on health and work factors. The criterion variable “To self-diagnose and self-treat” was measured with a single item from the Physician Career Path Questionnaire (PCPQ; Fridner, 2004). Exhaustion was measured with a scale from the Oldenburg Burnout Inventory, OLBI (α = .82; Demerouti et al., 2001, 2003). “Sickness presenteeism” and “Taking vacation due to stress” was measured with single items, also from the PCPQ (Fridner, 2004). For the analyses, we used hierarchical multiple regression.Results: Altogether 193 (63,9%) female GPs and 109 (36,1%) male GPs answered the questionnaire, a 44% response-rate. Among them 46,2% stated they had diagnosed and treated themselves for a condition for which they would have referred a patient to a specialist. Our regression analysis model revealed that those physicians who self-treated themselves were also significantly more sickness present at work. Adding to this, exhaustion among the GPs was also included in the model.Conclusions: This study shows that self-treatment is not an isolated behavior, but occurs together with exhaustion and sickness presenteeism, indicating a quite severe situation for their health, which would need to be investigated by other doctors than themselves. This needs to be further investigated and taken into account by the National Board of Health and Welfare, County Councils and Medical Associations, and for future physicians our medical schools.
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| 11. |
- Gustafsson Sendén, Marie, et al.
(författare)
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Gender differences in Reasons for Sickness Presenteeism - a study among GPs in a Swedish health care organization
- 2016
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Ingår i: Annals of Occupational and Environmental Medicine. - : Korean Society of Occupational and Environmental Medicine. - 2052-4374. ; 28
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Tidskriftsartikel (refereegranskat)abstract
- Background: It is common that physicians go to work while sick and therefore it is important to understand the reasons behind. Previous research has shown that women and men differ in health and health related behavior. In this study, we examine gender differences among general practitioners who work while sick.Methods: General practitioners (GP’s) working in outpatient care in a Swedish city participated in the study (n = 283; women = 63 %; response rate = 41 %). Data were obtained from a large web-based questionnaire about health and organization within primary care. Two questions about sickness presenteeism (going to work while sick) were included; life-long and during the past 12 months, and five questions about reasons. We controlled for general health, work-family conflict and demographic variables.Results: Female physicians reported sickness presenteeism more often than male physicians. Work-family conflict mediated the association between gender and sickness presenteeism.Women reported reasons related with “concern for others” and “workload” more strongly than men. Men reported reasons related with “capacity” and “money” more strongly than women. These differences are likely effects of gender stereotyping and different family-responsibilities.Conclusions: Gender socialization and gender stereotypes may influence work and health-related behavior. Because sickness presenteeism is related with negative effects both on individuals and at organizational levels, it is important that managers of health organizations understand the reasons for this, and how gender roles may influence the prevalence of sickness presenteeism and the reasons that female and male GPs give for their behavior.
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| 12. |
- Gustafsson Sendén, Marie, et al.
(författare)
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Gender influence on sickness presence in outpatient care
- 2014
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Ingår i: International Conference on Physician Health: Milestones and transitions - Maintaining the balance. ; , s. 64-65
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: In the health care sector sickness presence is common, and especially among physicians. Sickness presence is less studied than sickness absence but might have adverse effects for individual physicians, and for health care of patients (Wallace, et al, 2009). Previous research has shown that female physicians more often go to work while sick (Gustafsson et al., 2013). In this study, it is examined whether men and women also show different reasons for going to work while ill. Method and participants: The study was conducted within outpatient care in a large Swedish city (N = 283, women 64 %). The question studied were sickness presence in a long term perspective, during the last 12 months and reasons for going to work while sick (concern for colleagues; patients; workload; economy; and perceptions of own capability). Results: In a long-term perspective, women indicated that they went to work while sick more often than men, F (1,282) = 6.06, p = .014. Among the women, 37 % indicated that they often or very often go to work while ill. For men, this figure was 23.4 %. For the last 12 month, 50% of the women and 40% of the men had gone to work while sick more than two times (mean difference = ns.). Although men and women indicated similar reasons for going to work while sick, there were also interesting differences. Women indicated higher concerns for patients, and the workload as reasons for going to work while sick. On the other hand, men indicated economic concerns to a higher degree than women and that they were capable of going to work while sick. There were no gender differences in concerns for colleagues. Conclusions: Sickness presence might have severe consequences, both for physicians themselves and for patients and medical care. Knowing the reasons for why physicians go to work is important in order to counter these behaviors. It is also important to notice that sex roles are of relevance in this type of behavior. HR departments and managers within medical care need to address these questions thoroughly and to implement strategies to decrease sickness presence among physicians.
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| 13. |
- Loikas, Desirée, et al.
(författare)
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Does patient's sex influence treatment in primary care? Experiences and expressed knowledge among physicians : a qualitative study
- 2015
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Ingår i: BMC Family Practice. - London, UK : BioMed Central. - 1471-2296. ; 16
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Biological and sociocultural differences between men and women may play an important role in medical treatment. Little is known about the awareness of these differences among general practitioners (GPs) and if they consider such differences in their medical practice. The aim of this study was to explore GPs' perception of sex and gender aspects in medical treatment.METHODS: We conducted five focus group discussions (FGDs) with 29 physicians (mainly GPs) in Sweden. A discussion guide with semi-structured questions was used. All FGDs were audio-recorded and transcribed word-by-word. Data were analysed through inductive thematic analysis with no predetermined categories.RESULTS: Three main categories emerged from the data. The first category emphasised GPs' experiences of sex and gender differences in diagnosing and assessment of clinical findings. Medical treatment in men and women was central in the second category. The third category emphasised GPs' knowledge of sex differences in drug therapy.CONCLUSIONS: The GPs stated they had little knowledge of sex and gender differences in drug treatment, but gave multiple examples of how the patient's sex affects the choice of treatment. Sex and gender aspects were considered in diagnosing and in the treatment decision. However, once the decision to treat was made the choice of drug followed recommendations by local Drug and Therapeutics Committee, which were perceived to be evidence-based. In the analysis we found a gap between perceived and expressed knowledge of sex and gender differences in drug treatment indicating a need of education about this to be included in the curriculum in medical school and in basic and specialist training for physicians. Education could also be a tool to avoid stereotypical thinking about male and female patients.
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| 14. |
- Nero, Daniella, et al.
(författare)
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Personality Traits in Patients with Myocardial Infarction with Nonobstructive Coronary Arteries.
- 2019
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Ingår i: The American journal of medicine. - : Elsevier BV. - 1555-7162 .- 0002-9343. ; 132:3, s. 374-381
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to describe type A behavior pattern and trait anger in patients with myocardial infarction with nonobstructive coronary arteries (MINOCA) and compare them with patients with coronary heart disease and healthy controls. Type A behavior pattern and anger have been linked to coronary heart disease in previous studies. This is the first study to assess type A behavior pattern and trait anger in MINOCA patients.One hundred MINOCA patients, consecutively recruited during 2007-2011 at 5 coronary care units in Stockholm, were matched for sex and age to 100 coronary heart disease patients and 100 healthy controls. All participants completed the Bortner Rating Scale to quantify type A behavior pattern and the Spielberger Trait Anger Scale to quantify anger 3 months after the acute event.MINOCA patients' Bortner Rating Scale score was 70.9 ± 10.8 (mean ± SD) and Spielberger Trait Anger Scale score was 14 (12-17) (median; interquartile range). Coronary heart disease patients' Bortner Rating Scale score was 70.5 ± 10.2 and Spielberger Trait Anger Scale score was 14 (12-17). Healthy controls' Bortner Rating Scale score was 71.9 ± 9.1 and Spielberger Trait Anger Scale score was 13 (11-16).We found no significant differences in Bortner Rating Scale score and Spielberger Trait Anger Scale score among MINOCA, coronary heart disease patients, and healthy controls, regardless of whether total scores, subscales, or cutoffs were used to classify type A behavior pattern and trait anger. However, we cannot exclude the existence of an occasional episode of anger or mental stress in relation to the coronary event. This is the first study to assess type A behavior pattern and trait anger in patients with MINOCA, and future studies need to confirm the current findings before any firm conclusions can be made.
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| 15. |
- Wall, Maja, et al.
(författare)
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Suicidal ideation among surgeons in Italy and Sweden : a cross-sectional study
- 2014
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Ingår i: BMC Psychology. - : Springer Science+Business Media B.V.. - 2050-7283. ; 2, s. 53-
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Tidskriftsartikel (refereegranskat)abstract
- Background: Suicidal ideation is more prevalent among physicians, compared to the population in general, but little is known about the factors behind surgeons’ suicidal ideation. A surgeon’s work environment can be competitive and characterised by degrading experiences, which could contribute to burnout, depression and even thoughts of suicide. Being a surgeon has been reported to be predictor for not seeking help when psychological distressed. The aim of the present study was to investigate to what extent surgeons in Italy and Sweden are affected by suicidal ideation, and how suicidal ideation can be associated with psychosocial work conditions. Methods: A cross-sectional study of surgeons was performed in Italy (N=149) and Sweden (N=272), where having suicidal ideation was the outcome variable. Work-related factors, such as harassment, depression and social support, were also measured. Results: Suicidal ideation within the previous twelve months was affirmatively reported by 18% of the Italian surgeons, and by 12% of the Swedish surgeons in the present study. The strongest association with having recent suicidal ideation for both countries was being subjected to degrading experiences/harassment at work by a senior physician. Sickness presenteeism, exhaustion and disengagement were related to recent suicidal ideation among Italian surgeons, while role conflicts and sickness presenteeism were associated with recent suicidal ideation in the Swedish group. For both countries, regular meetings to discuss situations at work were found to be protective. Conclusions: A high percentage of surgeons at two university hospitals in Italy and Sweden reported suicidal ideation during the year before the investigation. This reflects a tough workload, including sickness presenteeism, harassment at work, exhaustion/disengagement and role conflicts. Regular meetings to discuss work situations might be protective.
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| 16. |
- Berglund, Annika, et al.
(författare)
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Factors facilitating or hampering nurses identification of stroke in emergency calls
- 2015
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Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 71:11, s. 2609-2621
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Tidskriftsartikel (refereegranskat)abstract
- Aims. To explore the factors that facilitate or hamper identification of stroke in emergency calls concerning patients with stroke who have fallen or been in a lying position.Background. Early identification of stroke in emergency calls is vital but can be complicated as the patients may be unable to express themselves and the callers generally are bystanders. In a previous study, we found presentation of fall or the patient being in a lying position to be the major problem in 66% of emergency calls concerning, but not dispatched as acute stroke.Design. A qualitative study using interpretive phenomenology.Methods. Analysis of transcribed emergency calls concerning 29 patients with stroke diagnoses at hospital discharge, in 2011 and presented with fall/lying position.Findings. Patients' ability to express themselves, callers' knowledge of the patient and of stroke, first call-takers' and nurses' authority, nurses' coaching and nurses' expertise skills facilitated or hindered the identification of stroke. Certain aspects are adjustable, but some are determined by the situation or on callers' and patients' abilities and thus difficult to change. Nurses' expertise skills were the only theme found to have a decisive effect of the identification of stroke on its own.Conclusion. To increase identification of stroke in emergency calls concerning stroke, the first call-takers' and nurses' action, competence and awareness of obstacles are crucial and if strengthened would likely increase the identification of stroke in emergency calls. In complicated cases, nurses' expertise skills seem essential for identification of stroke.
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| 17. |
- Berglund, Annika, et al.
(författare)
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Identification of stroke during the emergency call : a descriptive study of callers' presentation of stroke
- 2015
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Ingår i: BMJ Open. - London, UK : BMJ Publishing Group Ltd. - 2044-6055. ; 5:4
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To evaluate symptoms presented by the caller during emergency calls regarding stroke, and to assess if symptoms in the Face-Arm-Speech-Time Test (FAST) are related to identification of stroke.SETTING: Emergency calls to the Emergency Medical Communication Center (EMCC) concerning patients discharged with stroke diagnosis in a large teaching hospital in Stockholm, Sweden, in January-June 2011.PARTICIPANTS: The emergency calls of 179 patients who arrived at hospital by ambulance, and who were discharged with a stroke diagnosis and consented to participate were included in the study.OUTCOME MEASURES: Frequencies of stroke symptoms presented and a comparison of symptoms presented in calls with dispatch code stroke or other dispatch code.RESULTS: Of the 179 emergency calls analysed, 64% were dispatched as 'Stroke'. FAST symptoms, that is, facial or arm weakness or speech disturbances, were presented in 64% of the calls and were spontaneously revealed in 90%. Speech disturbance was the most common problem (54%) in all calls, followed by fall/lying position (38%) and altered mental status (27%). For patients with dispatch codes other than stroke, the dominating problem presented was a fall or being in a lying position (66%), followed by speech disturbance (31%) and altered mental status (25%). Stroke-specific symptoms were more common in patients dispatched as stroke. FAST symptoms were reported in 80% of patients dispatched as stroke compared with 35% in those dispatched as something else.CONCLUSIONS: This study implicates that fall/lying position and altered mental status could be considered as possible symptoms of stroke during an emergency call. Checking for FAST symptoms in these patients might uncover stroke symptoms. Future studies are needed to evaluate if actively asking for FAST symptoms in emergency calls presenting falls or a lying position can improve the identification of stroke.TRIAL REGISTRATION NUMBER: Stroke2010/703-31/2.
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| 18. |
- Dahlgren, Cecilia, et al.
(författare)
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Recording a diagnosis of stroke, transient ischaemic attack or myocardial infarction in primary healthcare and the association with dispensation of secondary preventive medication : a registry-based prospective cohort study
- 2017
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Ingår i: BMJ Open. - London, UK : BMJ Publishing Group Ltd. - 2044-6055. ; 7:9
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The aim of this study was to explore whether recording in primary care of a previously recorded hospital diagnosis was associated with increased patient utilisation of recommended medications.DESIGN: Registry-based prospective cohort study.SETTING AND PARTICIPANTS: 19 072 patients with a hospital discharge diagnosis of transient ischaemic attack (TIA), stroke or acute coronary syndrome from hospitals in Stockholm County 2010-2013 were included in the study.MAIN OUTCOME MEASURE: The outcome of the study was medication dispensation as a marker of adherence to recommended medications. Adherence was defined as having had at least two filled prescriptions in the third year following hospital discharge.RESULTS: Recording a diagnosis was associated with higher utilisation of all recommended medications with the exception of antihypertensives in patients with TIA. The differences between the groups with and without a recorded diagnosis remained after adjusting for age, sex, index year and visits to private practitioners. Dispensation of antithrombotics was high overall, 80%-90% in patients without a recorded diagnosis and 90%-94% for those with a diagnosis. Women with recorded ischaemic stroke/TIA/acute coronary syndrome were dispensed more statins (56%-71%) than those with no recorded diagnosis (46%-59%). Similarly, 68%-83% of men with a recorded diagnosis were dispensed statins (57%-77% in men with no recorded diagnosis). The rate of diagnosis recording spanned from 15% to 47% and was especially low in TIA (men 15%, women 16%).CONCLUSION: Recording a diagnosis of TIA/stroke or acute coronary syndrome in primary care was found to be associated with higher dispensation of recommended secondary preventive medications. Further study is necessary in order to determine the mechanisms underlying our results and to establish the utility of our findings.
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| 19. |
- Fridner, Ann, et al.
(författare)
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Survey on recent suicidal ideation among female university hospital physicians in Sweden and Italy (the HOUPE study) : Cross-sectional associations with work stressors
- 2009
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Ingår i: Gender Medicine. - : Elsevier USA. - 1550-8579. ; 6:1, s. 314-328
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Tidskriftsartikel (refereegranskat)abstract
- Background: Suicide rates among physicians are higher than in the general population, and rates among female physicians are particularly high. More female than male physicians report suicidal thoughts, with suicidal ideation being a well-recognized precursor of suicide. The urgent need to find the reasons for suicide risk in female physicians is underscored by society's increasing dependence on this group of health care providers. Objective: The aim of this paper was to identify potential risk and protective factors associated with recent suicidal ideation in female physicians. Methods: A cross-sectional survey analysis of work-related health, organizational culture, career paths, and working conditions was performed among permanently employed female physicians from the HOUPE (Health and Organisation among University Physicians in four European countries) study: 385 in Sweden and 126 in Italy. The main outcome measure was recent (within the prior 12 months) suicidal thoughts. Results: Overall, 13.7% and 14.3% of the participants from Sweden and Italy, respectively, reported suicidal thoughts within the prior 12 months. Among the physicians from Sweden, the most powerful mul-tivariate model for such thoughts included 2 independent variables related to work: degrading experiences/harassment at work (odds ratio [OR], 3.03; 95% CI, 1.48–6.23), and work meetings to discuss stressful situations (OR, 0.36; 95% CI, 0.19–0.69). The model included self-diagnosis and self-treatment as a significant factor. Work meetings to discuss stressful situations were also in the multivariate model for the Italian physicians (OR, 0.21; 95% CI, 0.05–0.86), together with being given work assignments without adequate resources (OR, 5.0; 95% CI, 1.32–18.8). Significant non-work-related factors in the Italian model were younger age and seeking professional help for depression or burnout. Conclusions: In both Sweden and Italy, work stressors have been identified that may increase the risk for suicide for female physicians. A potential protective factor was meetings to discuss stressful work experiences. These findings suggest that such meetings should be more broadly implemented.
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| 20. |
- Fridner, Ann, et al.
(författare)
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Work Environment and Recent Suicidal Thoughts Among Male University Hospital Physicians in Sweden and Italy : The Health and Organization Among University Hospital Physicians in Europe (HOUPE) Study
- 2011
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Ingår i: Gender Medicine. - : Elsevier BV. - 1550-8579 .- 1878-7398. ; 8:4, s. 269-279
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Tidskriftsartikel (refereegranskat)abstract
- Background: Male and female physicians are at elevated suicide risk. The work environment has become a focus of attention as a possible contributor to this risk. The potential association between work environment and suicidal thoughts has been examined among female physicians in several countries, and significant findings have been reported. Objective: The purpose of this study was to examine the role of the work environment in relation to suicidal thoughts among male university hospital physicians in 2 European countries. Methods: Cross-sectional multivariate analysis was performed to identify significant associations between work-related factors and suicide risk among male physicians from the Health and Organization among University Hospital Physicians in Europe (HOUPE) study. The dependent variable was termed recent suicidal thoughts, which includes having thought about suicide and/or having thought about specific ways to commit suicide within the previous year. Adjusted odds ratios (ORs) and CIs are reported. Results: Of the 456 Swedish (56%) and 241 Italian (39%) male physicians who participated, 12% of the physicians from each country reported affirmatively regarding recent suicidal thoughts. Degrading work experiences were associated with recent suicidal thoughts for the Swedish and Italian physicians (OR = 2.1; 95% CI, 1.01–4.5; OR = 3.3; 95% CI, 1.3–8.0, respectively). Role conflict was associated with recent suicidal thoughts among the Swedish physicians (OR = 1.6; 95% CI, 1.1–2.2). Support at work when difficulties arose appeared to be protective for the Swedish physicians (OR = 0.7; 95% CI, 0.5–0.96). Italian physicians with little control over working conditions had an increased risk of recent suicidal thoughts, whereas confidential discussions about work experiences appeared to be protective (OR = 0.6; 95% CI, 0.4–0.9). Conclusion: Attention should be paid to the work environment as it relates to suicide risk among male university hospital physicians, particularly to bolstering social support and preventing harassment.
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| 21. |
- Johnston, Nina, 1961-, et al.
(författare)
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Are we using cardiovascular medications and coronary angiography appropriately in men and women with chest pain?
- 2011
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Ingår i: European Heart Journal. - : Oxford University Press (OUP). - 0195-668X .- 1522-9645. ; 32:11, s. 1331-1336
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Tidskriftsartikel (refereegranskat)abstract
- Aims The main purpose of the present study was to analyse the contemporary use of cardiovascular medications and diagnostic coronary angiography in men and women with suspected coronary artery disease (CAD). Furthermore, we examined the association of outcomes (death, myocardial infarction, repeat coronary angiography, procedural complications) with angiographic findings.Methods All patients with stable chest pain (n = 12 200) referred for a first-time elective diagnostic coronary angiography during 2006-08 and registered in the Swedish Coronary Angiography and Angioplasty Register (SCAAR) were included. Significant CAD was defined as ≥50% luminal narrowing in any epicardial coronary artery.Results In the youngest age group (≤59 years), more women than men (78.8 vs. 42.3%, P< 0.001) had normal/non-significant CAD, whereas more men had either left-main or three-vessel disease (18.2 vs. 4.2%, P < 0.001). Event rates were similarly low for men and women with normal/non-significant CAD, except for a higher procedural complication rate in women. Prior to angiography, fewer women than men with high-risk features were prescribed aspirin (83 vs. 86.1%, P = 0.001).Conclusion In women, normal/non-significant CAD was highly prevalent, especially among younger women, and associated cardiovascular event rates were low. In men, findings of advanced disease were more common than in women, even younger men. Fewer high-risk women than men were initially prescribed aspirin. The observed sex differences suggest a need for improved identification of women appropriate for investigation with coronary angiography, earlier diagnostics in men, and heightened attention in the evidence-based use of aspirin in risk patients, especially women.
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| 22. |
- Johnston, Nina, et al.
(författare)
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Do clinical factors explain persistent sex disparities in the use of acute reperfusion therapy in STEMI in Sweden and Canada?
- 2013
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Ingår i: European Heart Journal. - : Oxford University Press (OUP). - 2048-8726 .- 2048-8734. ; 2:4, s. 350-358
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Tidskriftsartikel (refereegranskat)abstract
- AIMS:This study examined clinical factors associated with sex differences in the use of acute reperfusion therapy (fibrinolysis or primary percutaneous coronary intervention) in ST-elevation myocardial infarction (STEMI) patients, and the interaction between sex and these factors in Sweden and Canada.METHODS:Patients with STEMI in Sweden (n=32,676 from the Register of Information and Knowledge about Swedish Heart Intensive Care Admissions) were compared with similar patients in Canada (n=3375 from the Canadian Global Registry of Acute Coronary Events) for the period 2004-2008.RESULTS:Unadjusted vs. age-adjusted odds ratios (OR) for no reperfusion (women vs. men) were for Sweden 1.57 (95% CI 1.49-1.64) vs. 1.14 (95% CI 1.08-1.20), and for Canada 1.61 (95% CI 1.39-1.87) vs. OR 1.18 (95% CI 1.01-1.39). Sex differences persisted after multivariable adjustments (including prehospital delay, atypical symptoms, diabetes), factors for which no interaction with sex was found. Among women <60 years, adjusting for atypical symptoms in Canada and angiographic data in Sweden made the greatest contribution to explaining observed sex differences.CONCLUSIONS:In both countries, acute reperfusion therapy in STEMI was used less often in women than in men. Factors associated with these sex differences appear to differ between older and younger women. Targeted interventions are needed to optimize care for women with STEMI, as well as sex- and age-stratified reporting of quality indicators to assess their effectiveness.
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| 23. |
- Johnston, Nina, et al.
(författare)
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Effect of Gender on Patients With ST-Elevation and Non-ST-Elevation Myocardial Infarction Without Obstructive Coronary Artery Disease
- 2015
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Ingår i: American Journal of Cardiology. - : Elsevier BV. - 0002-9149 .- 1879-1913. ; 115:12, s. 1661-1666
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to compare the prognoses of patients with ST-segment elevation myocardial infarction (STEMI) and those with non-ST-segment elevation myocardial infarction (NSTEMI) without obstructive coronary artery disease (CAD) and the risk associated with gender for future cardiovascular events. The study population was selected from 95,849 patients who underwent coronary angiography for myocardial infarction from 2005 to 2010 and registered in the Swedish Coronary Angiography and Angioplasty Registry (SCAAR). Outcome analyses, including all-cause death, myocardial infarction, congestive heart failure, stroke, and revascularization, were performed in 2,268 patients with STEMI and 10,904 with NSTEMI without obstructive CAD (<50% stenosis). Hazard ratios and 95% confidence intervals comparing women with men were calculated for events, adjusting for cardiovascular risk factors and age. Nonobstructive CAD was found in 7% of patients with STEMI (6% men, 10% women) and in 17% of those with NSTEMI (11% men, 28% women). During a median follow-up of 2.6 years, 8% of patients with STEMI and 5% of those with NSTEMI died. Gender-associated differences in risk were observed in patients with NSTEMI, with adjusted hazard ratios lower in women than men for mortality (hazard ratio 0.90, 95% confidence interval 0.50 to 0.73) and congestive heart failure (hazard ratio 0.61, 95% confidence interval 0.52 to 0.72). In the 2 groups, women underwent less revascularization. In conclusion, nonobstructive CAD was more common in patients with NSTEMI than those with STEMI, as well as in women compared with men. Long-term mortality in patients with nonobstructive CAD was higher after STEMI than NSTEMI. The gender differences in outcomes suggest gender differences in the underlying pathogenesis of myocardial infarction without obstructive CAD.
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| 24. |
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| 25. |
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| 26. |
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| 27. |
- Loikas, Desirée, et al.
(författare)
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Differences in drug utilisation between men and women : a cross-sectional analysis of all dispensed drugs in Sweden
- 2013
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Ingår i: BMJ Open. - London, UK : BMJ Publishing Group Ltd. - 2044-6055. ; 3:5
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Ascertain the extent of differences between men and women in dispensed drugs since there is a lack of comprehensive overviews on sex differences in the use of prescription drugs.DESIGN: Cross-sectional population database analysis.METHODS: Data on all dispensed drugs in 2010 to the entire Swedish population (9.3 million inhabitants) were obtained from the Swedish Prescribed Drug Register. All pharmacological groups with ambulatory care prescribing accounting for >75% of the total volume in Defined Daily Doses and a prevalence of >1% were included in the analysis. Crude and age-adjusted differences in prevalence and incidence were calculated as risk ratios (RRs) of women/men.RESULTS: In all, 2.8 million men (59%) and 3.6 million women (76%) were dispensed at least one prescribed drug during 2010. Women were dispensed more drugs in all age groups except among children under the age of 10. The largest sex difference in prevalence in absolute numbers was found for antibiotics that were more common in women, 265.5 patients (PAT)/1000 women and 191.3 PAT/1000 men, respectively. This was followed by thyroid therapy (65.7 PAT/1000 women and 13.1 PAT/1000 men) and antidepressants (106.6 PAT/1000 women and 55.4 PAT/1000 men). Age-adjusted relative sex differences in prevalence were found in 48 of the 50 identified pharmacological groups. The pharmacological groups with the largest relative differences of dispensed drugs were systemic antimycotics (RR 6.6 CI 6.4 to 6.7), drugs for osteoporosis (RR 4.9 CI 4.9 to 5.0) and thyroid therapy (RR 4.5 CI 4.4 to 4.5), which were dispensed to women to a higher degree. Antigout agents (RR 0.4 CI 0.4 to 0.4), psychostimulants (RR 0.6 CI 0.6 to 0.6) and ACE inhibitors (RR 0.7 CI 0.7 to 0.7) were dispensed to men to a larger proportion.CONCLUSIONS: Substantial differences in the prevalence and incidence of dispensed drugs were found between men and women. Some differences may be rational and desirable and related to differences between the sexes in the incidence or prevalence of disease or by biological differences. Other differences are more difficult to explain on medical grounds and may indicate unequal treatment.
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| 28. |
- Loikas, Desirée, et al.
(författare)
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Sex and Gender Differences in Thromboprophylactic Treatment of Patients With Atrial Fibrillation After the Introduction of Non-Vitamin K Oral Anticoagulants
- 2017
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Ingår i: American Journal of Cardiology. - : Elsevier. - 0002-9149 .- 1879-1913. ; 120:8, s. 1302-1308
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Tidskriftsartikel (refereegranskat)abstract
- To examine sex differences in thromboprophylaxis in patients with atrial fibrillation before and after the introduction of non-vitamin K oral anticoagulants, we performed a cross-sectional registry study based on anonymized individual-level patient data of all individuals with a diagnosis of nonvalvular atrial fibrillation (International Classification of Diseases, Tenth Revision code I48) in the region of Stockholm, Sweden (2.2 million inhabitants), in 2011 and 2015, respectively. Thromboprophylaxis improved considerably during the period. During 2007 to 2011, 23,198 men and 18,504 women had an atrial fibrillation diagnosis. In 2011, more men than women (53% men vs 48% women) received oral anticoagulants (almost exclusively warfarin) and more women received aspirin only (35% women vs 30% men), whereas there was no sex difference for no thromboprophylaxis (17%). During 2011 to 2015, 27,237 men and 20,461 women had a diagnosis of atrial fibrillation. Compared with the earlier time period, a higher proportion used oral anticoagulants (71% women vs 70% men), but fewer women ≥80 years received anticoagulants (67% women vs 72% men), more women received aspirin (15% women vs 13% men), and fewer women had no thromboprophylaxis (15% women vs 17% men). Patients with co-morbidities potentially complicating oral anticoagulant use used more oral anticoagulant in 2015 compared with 2011. The sex differences observed in 2011 with fewer women using oral anticoagulants had disappeared in 2015 except in women 80 years and older and in patients with complicated co-morbidity.
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| 29. |
- Løvseth, Lise Tevik, et al.
(författare)
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Confidentiality as a barrier to support seeking among physicians : The influence of psychosocial work factors in four European hospitals (The HOUPE study)
- 2014
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Ingår i: Work. - : IOS Press. - 1051-9815 .- 1875-9270. ; 49:1, s. 113-121
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Tidskriftsartikel (refereegranskat)abstract
- Background: Concerns about protecting patient's privacy can interfere with proper stress adaptation which isassociated with physician's health. It is important to investigate relevant organizational confounders to this phenomenon to enable interventions that can ameliorate the subjective burden of patient confidentiality. Objectives: This study investigatesfactors in the psychosocial work environment that can explain patient confidentiality's prominence in social support seeking among physicians, and if these factors covary differently with support seeking according to country. Participants: University hospital physicians in four European cities (N=2095) in Sweden, Norway, Iceland and Italy participated in a cross-sectional survey. Methods: Questionnaire comprised items on psychosocial work environment, basic socio-demographics, presence of formal and informal meetings at work, and measurement of confidentiality as a barrier for support. Resultats: High role conflict, availability of formal or informal meetings, lack of control over decisions, and lack of control over work pace were predictors of confidentiality as a barrier to support. There were differences between countries in how these factors covaried with confidentiality as a barrier to support. High role conflict was the strongest predictor of confidentiality as a barrier to support across all samples. Conclusions: Psychosocial work factors predicted confidentiality as a barrier to support seeking among physicians. It is important to create routines and an organizational framework that ensures both the patient's right to privacy and physician's ability to cope with emotional demanding situations from work.
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| 30. |
- Maas, Angela H. E. M., et al.
(författare)
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Practice points in gynecardiology : Abnormal uterine bleeding in premenopausal women taking oral anticoagulant or antiplatelet therapy
- 2015
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Ingår i: Maturitas. - Amsterdam, Netherlands : Elsevier. - 0378-5122 .- 1873-4111. ; 82:4, s. 355-359
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Tidskriftsartikel (refereegranskat)abstract
- A growing number of premenopausal women are currently using antithrombotic and/or (dual) antiplatelet therapy for various cardiovascular indications. These may induce or exacerbate abnormal uterine bleeding and more awareness and knowledge among prescribers is required. Heavy and irregular menstrual bleeding is common in women in their forties and may have a variety of underlying causes that require different treatment options. Thus using anticoagulants in premenopausal women demands specific expertise and close collaboration between cardiovascular physicians and gynecologists. In this article we summarize the scope of the problem and provide practical recommendations for the care for young women taking anticoagulants and/or (dual) antiplatelet therapy. We also recommend that more safety data on uterine bleeding with novel anticoagulants in premenopausal women should be obtained.
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| 31. |
- Neves-E-Castro, Manuel, et al.
(författare)
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EMAS position statement: The ten point guide to the integral management of menopausal health.
- 2015
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Ingår i: Maturitas. - : Elsevier BV. - 1873-4111 .- 0378-5122. ; 81:1, s. 88-92
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Tidskriftsartikel (refereegranskat)abstract
- With increased longevity and more women becoming centenarians, management of the menopause and postreproductive health is of growing importance as it has the potential to help promote health over several decades. Women have individual needs and the approach needs to be personalised. The position statement provides a short integral guide for all those involved in menopausal health. It covers diagnosis, screening for diseases in later life, treatment and follow-up.
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| 32. |
- Pingel, Birgit, et al.
(författare)
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HOUPE-RAPPORTEN 2009 : Om ojämställdheten bland läkare - rapport från HOUPE-studien i Sverige
- 2009
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- HOUPE-projektet, Health and Organisation among University Hospital Physicians in Europe, är ett internationellt forskningsprojekt med syftet att förebygga arbetsrelaterad ohälsa bland läkare på universitetssjukhus. Deltagande länder är Sverige, Norge, Island och Italien. I HOUPE-projektet analyseras olika samband mellan läkares arbetsvillkor och hälsa. I den svenska delen av projektet är jämställdhet en viktig aspekt i arbetsvillkoren. Betoningen på jämställdhet motiverades speciellt av de kvinnliga läkarnas sämre hälsa och därmed långa sjukskrivningar. Ambitionen för projektets genomförande har varit att alla moment i forskningsprocessen ska styras av demokratiska hänsynstaganden vilket bland annat inneburit att HOUPE- projektets forskningsresultat implementerats i organisationen genom återkopplingsmöten. Vid återkopplingsmötena hade läkarna möjlighet att dels samtala kring resultaten, dels ge förslag på hur man skulle kunna komma tillrätta med de förhållanden på klinikerna som lett till att många läkare uppfattar sig utsatta för alltför hög stress. Sammanlagt deltog tio procent av läkarkåren i återkopplingsmöten. Några av de minst diskuterade aspekterna på arbetsmiljön var utbrändhet, mobbing och jämställdhet. Läkarnas syn på jämställdhetsfrågan var, att den i regel inte utgjorde något problem, men om det förekom så var problematiken kopplad till kvinnors sätt att vara.
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| 33. |
- Rydberg, Diana M., et al.
(författare)
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Sex differences in spontaneous reports on adverse bleeding events of antithrombotic treatment
- 2014
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Ingår i: European Journal of Clinical Pharmacology. - : Springer. - 0031-6970 .- 1432-1041. ; 70:1, s. 117-126
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To explore if sex differences are found in spontaneously reported adverse events for clopidogrel, low-dose aspirin and warfarin treatment in routine care.METHODS: A cross-sectional analysis combining data on bleeding events from the Swedish Spontaneous Adverse Drug Event Reporting System (SWEDIS) with data from the National Prescribed Drug register. Bleeding event reports from 1999 to 2010 and 2005 to 2010 were adjusted to the number of prescriptions and the number of exposed patients respectively among women and men. Co-medication and co-prescription were analysed.RESULTS: More men were dispensed clopidogrel although the reported bleeding event risk after adjustment for number of patients exposed was higher in women (RR 1.40; 95 % CI, 1.00-1.96). The difference disappeared when adjusting for the number of prescriptions (RR 0.99; 95 % CI, 0.71-1.39). The reported bleeding event risk with low-dose aspirin was lower in women, adjusted for patients exposed (RR 0.80; 95 % CI, 0.66-0.97). For warfarin, no sex difference in bleeding event reports could be found (RR 1.01; 95 % CI, 0.87-1.17).CONCLUSIONS: This ecological comparison of bleeding reports and dispensed prescriptions showed a signal towards a higher prevalence of bleeding reports in women on clopidogrel treatment while the opposite was found for low-dose aspirin. For warfarin, no significant sex difference was seen regarding bleeding event reports, suggesting individualised dosing being an important factor. Men were more commonly prescribed antithrombotic combinations, and this was reflected by a larger proportion of bleeding reports including more than one antithrombotic agent.
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| 34. |
- Rydberg, Diana M., et al.
(författare)
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Sex differences in spontaneous reports on adverse drug events for common antihypertensive drugs
- 2018
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Ingår i: European Journal of Clinical Pharmacology. - : Springer. - 0031-6970 .- 1432-1041. ; 74:9, s. 1165-1173
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To explore sex differences in spontaneously reported adverse drug events (ADEs) for antihypertensives in routine care.METHODS: A cross sectional analysis combining number of reports from the national pharmacovigilance database with data from the Swedish Prescribed Drug Register, from 2005 to 2012 for ACE inhibitors (ACE-I) and angiotensin receptor blockers (ARB), with or without thiazide, diuretics (thiazides, potassium-sparing agents, sulfonamides, aldosterone antagonists), selective betablockers, and dihydropyridine calcium-channel-blockers (DHPs). The total number of reports was adjusted to exposed patients and dispensed DDDs among women and men. Dose exposures, co-medications, and co-prescriptions were also analyzed.RESULTS: In women, a higher prevalence of ADE-reports was seen in ACE-I (odds ratio, OR 1.21; 95% CI 1.09-1.35), ACE-I-combinations (OR 1.61; 1.44-1.79), ARB-combinations (OR 2.12; 1.47-3.06), thiazides (OR 1.78; 1.33-2.39), diuretics and potassium-sparing agents (OR 1.62; 1.22-2.17), and DHPs (OR 1.40; 1.17-1.67), with a potential linkage to dose exposure. For aldosterone antagonists, we observed a higher prevalence of ADE reports in men (OR 0.75; 0.59-0.97) but without any sex difference in dose exposure.CONCLUSIONS: This ecological study of reported ADEs showed a higher prevalence of reports in women in six out of ten groups of antihypertensive drugs, and this may potentially be linked to dose exposure. Aldosterone antagonists was the only group with a higher prevalence of ADE-reports in men with a similar dose exposure between women and men.
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| 35. |
- Schenck-Gustafsson, Karin, et al.
(författare)
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Hjärtsvikt
- 2005
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Ingår i: Läkemedelsboken 2005/2006. - Stockholm : Apoteket AB. - 918557452X ; , s. 239-249
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Bokkapitel (populärvet., debatt m.m.)
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| 36. |
- Schenck-Gustafsson, Karin, et al.
(författare)
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Hjärtsvikt
- 2009
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Ingår i: Läkemedelsboken. - Lund : BTJ Tryck AB.
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 37. |
- Schenck-Gustafsson, Karin, et al.
(författare)
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Hjärtsvikt
- 2007
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Ingår i: Läkemedelsboken 2007/2008. - Stockholm : Apoteket AB. - 9185574570 ; , s. 243-253
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Bokkapitel (populärvet., debatt m.m.)
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| 38. |
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