| 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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