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- Bjerkeli, Pernilla J., et al.
(author)
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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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In: Plos One. - : Public Library of Science (PLoS). - 1932-6203. ; 11:5
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Journal article (peer-reviewed)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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- Mårdby, Ann-Charlotte, 1976, et al.
(author)
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Adherence to antidepressants among women and men described with trajectory models : a Swedish longitudinal study
- 2016
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In: European Journal of Clinical Pharmacology. - : Springer. - 0031-6970 .- 1432-1041. ; 72:11, s. 1381-1389
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Journal article (peer-reviewed)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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- Mårdby, Ann-Charlotte, 1976, et al.
(author)
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Consumption of alcohol during pregnancy-A multinational European study
- 2017
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In: Women and Birth. - : Elsevier BV. - 1871-5192. ; 30:4
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Journal article (peer-reviewed)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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