| 151. |
- Abbott, Allan, et al.
(författare)
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Analgesic prescriptions received by patients before commencing the BOA model of care for osteoarthritis: a Swedish national registry study with matched reference and clinical guideline benchmarking
- 2022
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 1745-3682. ; 93, s. 51-58
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose - Swedish clinical guidelines for osteoarthritis (OA) prioritize patient education, exercise, and-if necessary-weight reduction before considering adjunct pharmacological intervention. Contrariwise, we investigated the proportion and type of dispensed analgesic prescriptions in Sweden received by patients during 3 years before commencing non-pharmacological primary care interventions for OA (2008-2016) compared with the general population. Furthermore, we analyzed the proportion of analgesic prescriptions dispensed before (2008-2012) compared with after (2012-2016) guideline publication in terms of concordance with clinical guideline recommendations. Patients and methods - Patients with hip or knee OA (n = 72,069) from the Better Management of OA national quality register receiving non-pharmacological interventions in primary care between 2008 and 2016 were included (OA cohort). An age, sex, and residence matched reference cohort (n = 216,207) was formed from the Swedish Total Population Register. Based on a period 3 years prior to inclusion in the OA cohort, Swedish Prescribed Drug Register data was linked to both the OA and reference cohorts. Results - Compared with the reference cohort, a distinctly larger proportion of the OA cohort had dispensed prescriptions for most types of analgesics, increasing exponentially each year prior to commencing non-pharmacological intervention. Since guideline publication, the proportion of the OA cohort having no dispensed prescription analgesics prior to non-pharmacological primary care intervention concordantly increased by 5.0% (95% CI 4.2-5.9). Furthermore, dispensed prescriptions concordantly decreased for non-selective NSAIDs -8.6% (CI -9.6 to -7.6), weak opioids -6.8% (CI -7.7 to -5.9), glucosamine -9.5% (CI -9.8 to -8.8). and hyaluronic acid -1.6% (CI -1.8 to -1.5) but discordantly increased for strong opioids 2.8% (CI 2.1-3.4) and glucocorticoid intra-articular injection for hip OA 2.1% (CI 1.0-3.1). Interpretation - In Sweden, dispensed prescription of analgesics commonly occurred before initiating non-pharmacological primary care interventions for OA but reduced modestly after guideline publication, which prioritizes non-pharmacological before pharmacological interventions. Additional modest improvements occurred in the stepped-care prioritization of analgesic prescription types. However, future strategies are required to curb an increase of strong opioids prescription for OA and glucocorticoid intra-articular injection for hip OA.
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| 152. |
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| 153. |
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| 154. |
- Abbott, Allan, et al.
(författare)
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Leg pain and psychological variables predict outcome 2-3 years after lumber fusion surgery
- 2011
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Ingår i: European spine journal. - : Springer. - 0940-6719 .- 1432-0932. ; 20:10, s. 1626-1634
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Tidskriftsartikel (refereegranskat)abstract
- Prediction studies testing a thorough range of psychological variables in addition to demographic, work-related and clinical variables are lacking in lumbar fusion surgery research. This prospective cohort study aimed at examining predictions of functional disability, back pain and health-related quality of life (HRQOL) 2-3 years after lumbar fusion by regressing nonlinear relations in a multivariate predictive model of pre-surgical variables. Before and 2-3 years after lumbar fusion surgery, patients completed measures investigating demographics, work-related variables, clinical variables, functional self-efficacy, outcome expectancy, fear of movement/(re)injury, mental health and pain coping. Categorical regression with optimal scaling transformation, elastic net regularization and bootstrapping were used to investigate predictor variables and address predictive model validity. The most parsimonious and stable subset of pre-surgical predictor variables explained 41.6, 36.0 and 25.6% of the variance in functional disability, back pain intensity and HRQOL 2-3 years after lumbar fusion. Pre-surgical control over pain significantly predicted functional disability and HRQOL. Pre-surgical catastrophizing and leg pain intensity significantly predicted functional disability and back pain while the pre-surgical straight leg raise significantly predicted back pain. Post-operative psychomotor therapy also significantly predicted functional disability while pre-surgical outcome expectations significantly predicted HRQOL. For the median dichotomised classification of functional disability, back pain intensity and HRQOL levels 2-3 years post-surgery, the discriminative ability of the prediction models was of good quality. The results demonstrate the importance of pre-surgical psychological factors, leg pain intensity, straight leg raise and post-operative psychomotor therapy in the predictions of functional disability, back pain and HRQOL-related outcomes.
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| 155. |
- Abbott, Allan, et al.
(författare)
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Patient’s experience post-lumbar fusion regarding back problems, recovery and expectations in terms of the international classification of functioning, disability and health.
- 2011
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Ingår i: Disability and Rehabilitation. - : Taylor & Francis. - 0963-8288 .- 1464-5165. ; 33:15-16, s. 1399-1408
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE:To describe within the context of the International Classification of Functioning, Disability and Health (ICF), patient's experiences post-lumber fusion regarding back problems, recovery and expectations of rehabilitation and to contrast with the content of outcome measures and the ICF low back pain (LBP) core sets.METHODS:The study has a cross-sectional and retrospective design and involves 20 lumbar fusion patients. Using the ICF, qualitative content analysis of semi-structured interviews 3-6 months post-surgery was performed. This was compared with the ICF related content of the Oswestry Disability Index (ODI), Medical Outcome Study Short Form 36 (SF-36), European Quality of Life Questionnaire (EQ5D) and the ICF LBP core sets.RESULTS:Patient's experiences were most frequently linked to psychological, sensory, neuromusculoskeletal and movement related body function chapters of the ICF. The most frequently linked categories of activity and participation were mobility, domestic activities, family relationships, work, recreation and leisure. Environmental factors frequently linked were the use of analgesics, walking aids, family support, social security systems, health care systems and labour market employment services.CONCLUSIONS:This study highlights important ICF related aspects of patient's experiences post-lumber fusion. The use of the comprehensive ICF core sets is recommended in conjunction with ODI, SF-36 and the EQ5D for a broader analysis of patient outcomes post-lumbar fusion.
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| 156. |
- Abbott, Allan, 1978-, et al.
(författare)
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Understanding the role of diabetes in the osteoarthritis disease and treatment process: a study protocol for the Swedish Osteoarthritis and Diabetes (SOAD) cohort
- 2019
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Ingår i: Bmj Open. - : BMJ. - 2044-6055. ; 9:12
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Tidskriftsartikel (refereegranskat)abstract
- Introduction Osteoarthritis (OA) is the most common form of arthritis and a leading cause of disability worldwide. Metabolic comorbidities such as type II diabetes occur with a higher rate in people with OA than in the general population. Several factors including obesity, hyperglycaemia toxicity and physical inactivity have been suggested as potential links between diabetes and OA, and have been shown to negatively impact patients' health and quality of life. However, little is known on the role of diabetes in determining the outcome of non-surgical and surgical management of OA, and at the same time, how different OA interventions may affect diabetes control. Thus, the overall aim of this project is to explore (1) the impact of diabetes on the outcome of non-surgical and surgical OA treatments and (2) the impact of non-surgical and surgical OA treatments on diabetes control. Methods and analysis The study cohort is based on prospectively ascertained register data on a national level in Sweden. Data from OA patients who received a first-line non-surgical intervention and are registered in the National Quality Register for Better Management of Patients with Osteoarthritis will be merged with data from the Swedish Knee and Hip Arthroplasty Registers and the National Diabetes Register. Additional variables regarding patients' use of prescribed drugs, comorbidities, socioeconomic status and cause of death will be obtained through other national health and population data registers. The linkage will be performed on an individual level using unique personal identity numbers. Ethics and dissemination This study received ethical approval (2019-02570) from the Swedish Ethical Review Authority. Results from this cohort will be submitted to peer-reviewed scientific journals and reported at the leading national and international meetings in the field.
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| 157. |
- Abbott, Benjamin W., et al.
(författare)
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Biomass offsets little or none of permafrost carbon release from soils, streams, and wildfire : an expert assessment
- 2016
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Ingår i: Environmental Research Letters. - : IOP Publishing. - 1748-9326. ; 11:3
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Tidskriftsartikel (refereegranskat)abstract
- As the permafrost region warms, its large organic carbon pool will be increasingly vulnerable to decomposition, combustion, and hydrologic export. Models predict that some portion of this release will be offset by increased production of Arctic and boreal biomass; however, the lack of robust estimates of net carbon balance increases the risk of further overshooting international emissions targets. Precise empirical or model-based assessments of the critical factors driving carbon balance are unlikely in the near future, so to address this gap, we present estimates from 98 permafrost-region experts of the response of biomass, wildfire, and hydrologic carbon flux to climate change. Results suggest that contrary to model projections, total permafrost-region biomass could decrease due to water stress and disturbance, factors that are not adequately incorporated in current models. Assessments indicate that end-of-the-century organic carbon release from Arctic rivers and collapsing coastlines could increase by 75% while carbon loss via burning could increase four-fold. Experts identified water balance, shifts in vegetation community, and permafrost degradation as the key sources of uncertainty in predicting future system response. In combination with previous findings, results suggest the permafrost region will become a carbon source to the atmosphere by 2100 regardless of warming scenario but that 65%-85% of permafrost carbon release can still be avoided if human emissions are actively reduced.
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| 158. |
- Abbott, Max, et al.
(författare)
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Cadre conceptuel du jeu préjudiciable: Une collaboration internationale, troisième édition
- 2018
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Si le jeu est souvent considéré comme un divertissement ou un loisir, pour certaines personnes, qu’il s’agisse de familles ou d’individus, voire de la société en général, il peut avoir des répercussions graves. Depuis des décennies, les effets préjudiciables du jeu font l’objet d’études visant à comprendre les distinctions entre la pratique du jeu et le parcours de vie des problèmes liés au jeu. Le présent ouvrage élabore un cadre conceptuel complet et pertinent au niveau international du « jeu préjudiciable » qui identifie les préjudices au-delà d’une vue basée sur les symptômes et aborde une série de facteurs liés aux risques pour la population, de même qu’aux effets sur la communauté et la société. Les facteurs répertoriés dans le cadre représentent des éléments majeurs liés au jeu et sont tantôt spécifiques (environnement de jeu, exposition, types et ressources), tantôt généraux (culturels, sociétaux, psychologiques et biologiques). Le Cadre a été créé par une équipe internationale de spécialistes interdisciplinaires dans le but de faciliter la compréhension du jeu préjudiciable. Il reflète l’état des connaissances liées aux facteurs d’influence du jeu préjudiciable et a pour but secondaire de servir de guide au développement de programmes de recherche futurs et à l’éducation des personnes chargées de prendre des décisions en matière de jeu préjudiciable. Situé à Guelph, en Ontario (Canada), l’organisme Gambling Research Exchange Ontario ou GREO, anciennement Ontario Problem Gambling Research Centre (OPGRC) a facilité l’élaboration du présent Cadre conceptuel sur le jeu préjudiciable et demeurera responsable d’assurer la mise à jour de celui-ci.
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| 159. |
- Abbott, Max, et al.
(författare)
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Conceptual Framework of Harmful Gambling: An International Collaboration
- 2013
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- While seen by many as a form of leisure and recreation, gambling can have serious repercussions for individuals, families, and society as a whole. The harmful effects of gambling have been studied for decades to attempt to understand individual differences in gambling engagement and the life- course of gamblingrelated problems. In this publication, we present a comprehensive, internationally relevant conceptual framework of “harmful gambling” that moves beyond a symptoms-based view of harm and addresses a broad set of factors related to population risk, community and societal effects. Interactive factors represented in the framework represent major themes in gambling that range from specific (gambling environment, exposure, types, and resources) to general (cultural, social, psychological, and biological). This framework has been created by international and interdisciplinary experts from a variety of stakeholder perspectives - including researchers, treatment providers, operators, policy makers, and individuals and their families - to facilitate an understanding of harmful gambling. It not only reflects the state of knowledge as it relates to factors influencing harmful gambling, but also acts to guide the development of future research programs and educate policy makers on issues related to harmful gambling. The Ontario Problem Gambling Research Centre (Guelph, Ontario, Canada) has facilitated the development of the Conceptual Framework of Harmful Gambling and is committed to updating it over time.
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| 160. |
- Abbott, Max, et al.
(författare)
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Conceptual Framework of Harmful Gambling: An International Collaboration (Revised Edition)
- 2015
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Although it is seen by many as a form of leisure and recreation, gambling can have serious repercussions for individuals, families, and society as a whole. The harmful effects of gambling have been studied for decades in an attempt to understand individual differences in gambling engagement and the life-course of gambling-related problems. In this publication, we present a comprehensive, internationally relevant conceptual framework of “harmful gambling” that moves beyond a symptoms-based view of harm and addresses a broad set of factors related to population risk, community and societal effects. Interactive factors depicted in the framework represent major themes in gambling that range from specific (gambling environment, exposure, types, and resources) to general (cultural, social, psychological, and biological). The framework has been created by international interdisciplinary experts and stakeholders— including researchers, treatment providers, operators, policy makers, as well as individuals and their families—in order to facilitate an understanding of harmful gambling. It reflects the state of knowledge related to factors influencing harmful gambling; and serves a secondary purpose as a guide for the development of future research programs and education of policy makers on issues related to harmful gambling. Gambling Research Exchange Ontario (GREO) (formerly the Ontario Problem Gambling Research Centre (OPGRC) located in Guelph, Ontario, Canada) has facilitated the development of the Conceptual Framework of Harmful Gambling and will retain responsibility for keeping it up-to-date.
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