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| 2. |
- Fagerlind, Hanna, et al.
(författare)
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Patient-physician communication during oncology consultations
- 2008
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Ingår i: Psycho-Oncology. - : Wiley. - 1057-9249 .- 1099-1611. ; 17:10, s. 975-985
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aim of this study was to characterize the content of patient-physician communication in standard oncology care. METHODS: The sample consisted of 19 patients with gastrointestinal cancer. The consultations were audio-recorded, transcribed verbatim, and analyzed according to qualitative content analysis. RESULTS: The analysis resulted in seven main categories: Disease and treatment, Healthcare planning, Everyday living, Psychological well-being, Coping with disease, Expressions of concerns and feelings, and Other aspects of communication. The main focus during the consultations was on disease and treatment. Physicians tended to concentrate on response to treatment and types and severity of side effects and how to treat them. More patient-centered subjects of psychosocial character like coping and psychological well-being were discussed only briefly, if at all. CONCLUSIONS: This study adds to the information given by the existing communication analysis systems, and hence we suggest a development of the psychosocial content categories of those systems to make them more valid.
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| 3. |
- Kettis, Åsa, et al.
(författare)
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Genetic research and donation of tissue samples to biobanks. What do potential sample donors in the Swedish general public think?
- 2006
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Ingår i: European Journal of Public Health. - : Oxford University Press (OUP). - 1101-1262 .- 1464-360X. ; 16:4, s. 433-440
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aim of this study was to identify perceptions of the general public regarding research involving human tissues; to assess the public's willingness to donate samples to biobanks; and to identify factors associated with the willingness to donate samples. Methods: Cross-sectional survey. Postal questionnaires to a random sample of the general public in Sweden, 18-80 years of age (n = 6000) in October 2002 (response rate 49.4%; n = 2928). Results: A majority of the respondents had a positive attitude towards genetic research. Their trust in authorities' capability to evaluate the risks and benefits of genetic research varied. Individual university/hospital-based researchers received the greatest trust, while the county councils (health care providers), and the Swedish Parliament received the lowest trust. Most respondents (86.0%) would donate a linked blood sample for research purposes. Another 3.0% would provide an anonymous sample. In total, 78% of the respondents would agree to both donation and storage. The most common motive was benefit of future patients. The majority was indifferent to the funding source for the research and would delegate this judgment to the research ethics committee. After adjusting for covariates, those more likely to donate a sample were middle-aged, had children, had personal experience of genetic disease, were blood donors, had a positive attitude toward genetic research, and had trust in experts/institutions. Conclusions: The majority of the general public is willing to donate a sample to a biobank. The willingness is mainly driven by altruism, and depends on the public being well-informed and having trust in experts and institutions.
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| 4. |
- Kettis, Åsa, et al.
(författare)
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Patients'and doctors' views of using the schedule for individual quality of life in clinical practice.
- 2007
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Ingår i: JOURNAL OF SUPPORTIVE ONCOLOGY. - 1544-6794. ; 5:6, s. 281-287
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Tidskriftsartikel (refereegranskat)abstract
- This study explored patients’ and oncologists’ perceptions ofusing a computer-administered, individualized quality-of-life (QOL) in-strument to support an oncologic consultation. Twenty patients with gas-trointestinal cancer (50% female; mean age 60 years) at two hospitals inSweden completed the Schedule for the Evaluation of Individual Quality ofLife-Direct Weight (SEIQoL–DW) and the Disease-Related (DR) SEIQoL-DWand brought the results to the consultation. Afterwards, interviews wereconducted with all patients and six of eight doctors. All interviews wereaudiotaped, transcribed, and analyzed using an interpretivist approach.Most patients and doctors believed that the instrument would facilitatedetection of patients’ areas of concern and would support monitoringof patients’ QOL. This tool may empower the patient, give the doctor abroader picture of the patient, and influence clinical decision-making. TheSEIQoL-DW may be a systematic method of stimulating patient-centeredcare. It apparently encourages patients to reflect upon their own situationand allows them to be seen as whole persons. However, further quantita-tive evaluation of the intervention’s outcomes is required.
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| 5. |
- Kettis, Åsa, et al.
(författare)
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Perceptions of potential donors in the Swedish public towards information and consent procedures in relation to use of human tissue samples in biobanks : a population-based study
- 2007
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 35:2, s. 148-156
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To assess the Swedish public's preferences for information and consent procedures when being asked for permission to use previously collected tissue samples for new research studies. Methods: Cross-sectional study employing postal questionnaires to a random sample of the Swedish general public (n = 6,000) in October 2002-February 2003. The response rate was 49% (n = 2,928). This paper includes only respondents who reportedly would approve of samples being taken and stored (n = 2,122). Results: When potential tissue sample donors in the general public have to strike a balance between the values at stake, i.e. the autonomy of the donor versus the research value, most (72%) prefer general consent, i.e. where consent is asked for at the outset only. They want the research ethics committee (REC) alone to decide on the use of stored samples, and they would allow storage as long as the sample is useful for research. The minority of respondents who were in favour of specific consent were more likely to be young, well educated, have negative experiences of healthcare and low trust in healthcare authorities. Conclusions: The majority of the Swedish general public prefer general consent, and are thus willing to delegate some decisions to the RECs. However, preferences for information and consent procedures depend on the context, e.g. the risks for the donor and the purpose of the research. If feasible, procedures should be differentiated according to the preferences of individual donors, thus protecting the interests of both the minority and the majority.
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| 6. |
- Kettis, Åsa, et al.
(författare)
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The role of dermatologists, nurses and pharmacists in chronic dermatological treatment: patient and provider views and experiences.
- 2006
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Ingår i: Acta dermato-venereologica. - : Medical Journals Sweden AB. - 0001-5555 .- 1651-2057. ; 86:3, s. 202-8
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Tidskriftsartikel (refereegranskat)abstract
- Effectively co-ordinated treatment support from healthcare providers (doctors, nurses and pharmacists) may improve patients' adherence to treatment. The objective of this study was to identify patients' and providers' perceptions of the roles of different healthcare providers in dermatological treatment. Focus groups were used in two types of fora: patients with chronic dermatological diseases (n =2x6) and healthcare providers (n =2x6), including doctors, nurses and pharmacists working in dermatological care. Data were analysed according to the Consensual Qualitative Research approach. The respondents viewed the roles of the providers as complementary, but poorly co-ordinated. Treatment support is provided mainly by the nurse. During the doctor's appointment, diagnosis and treatment decisions are often prioritized, leaving limited time for treatment support. The pharmacist's provision of support is constrained by the lack of privacy and clinical history of individual patients. The most apparent "gap" in the chain of treatment support was between the pharmacist and the other providers. There was a wish for improved interprofessional collaboration to avoid giving conflicting advice. There is a need to improve interprofessional collaboration in dermatology, in order to optimize treatment support in clinical practice.
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| 7. |
- Krigsman, Kristin, et al.
(författare)
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Adherence to multiple drug therapies : Refill adherence to concomitant use of diabetes and asthma/COPD medication
- 2007
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Ingår i: Pharmacoepidemiology and Drug Safety. - : Wiley. - 1053-8569 .- 1099-1557. ; 16:10, s. 1120-1128
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Tidskriftsartikel (refereegranskat)abstract
- PurposeTo investigate whether patients with drugs for two chronic diseases, type 2 diabetes and asthma/chronic obstructive pulmonary diseases (COPD), showed the same refill adherence pattern in relation to their drug treatments during a 3-year period.MethodsPatients 50 years and older who had been dispensed diabetes and asthma/COPD drugs in the county of Jämtland during 2001-2003 were included. The refill adherence was calculated based either on prescribed dosage or defined daily dose (DDD). A patient profile graph for each patient was constructed including the date of each dispensation and the time period covered by the dispensed drugs. For each patient, the dispensation pattern and the treatment persistency over time were determined.ResultsIn total, 56 patients were included in the study. Satisfactory refill adherence was found for 68% of the repeat prescriptions for diabetes drugs and for 42% of the repeat prescriptions for asthma/COPD drugs. About half (52%; 29/56) of the patients showed the same dispensation patterns for both diabetes and asthma/COPD drugs, and 86% (25/29) of these patients had a satisfactory refill adherence. However, there was no correlation or agreement regarding the dispensation patterns for diabetes and asthma/COPD drugs.ConclusionsPatients showed higher refill adherence for their diabetes drugs than their asthma/COPD drugs. Our hypothesis that patients with satisfactory refill adherence to antihyperglycaemic drugs would also have satisfactory refill adherence to asthma/COPD drugs, was not supported.
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| 8. |
- Krigsman, Kristin, et al.
(författare)
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Refill adherence by the elderly for asthma/chronic obstructive pulmonary disease drugs dispensed over a 10-year period
- 2007
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Ingår i: Journal of Clinical Pharmacy and Therapeutics. - : Hindawi Limited. - 0269-4727 .- 1365-2710. ; 32:6, s. 603-611
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The objective was to survey prescription refill adherence for preventive asthma/chronic obstructive pulmonary disease (COPD) medication dispensed to patients 60 years and older over a 10-year period. Methods: A retrospective analysis was conducted based on a Swedish pharmacy record database in the county of Jämtland for the years 1994-2003. Satisfactory refill adherence was set as dispensed refills covering 80-120% of the prescribed treatment time for inhaled corticosteroids, combination products of adrenergics and steroids and anticholinergics. Results and discussion: Only 28% (n=160) of the repeat prescriptions for inhaled corticosteroids had been dispensed with a satisfactory refill adherence, 59% showed an undersupply and 12% showed an oversupply. There was no difference in refill adherence in relation to age and gender. However, during the 10-year study period repeat prescriptions being dispensed for 2-4 years showed higher satisfactory refill adherence than those being dispensed for <2 years. Conclusions: Our study shows that over half of the repeat prescriptions for inhaled corticosteroids dispensed to patients over 60 years showed an undersupply. Therefore, it is likely that elderly patients on long-term therapy have a non-optimal drug use of their preventive asthma/COPD medication
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| 9. |
- Krigsman, Kristin, et al.
(författare)
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Refill adherence for patients with asthma and COPD: comparison of a pharmacy record database with manually collected repeat prescriptions
- 2007
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Ingår i: Pharmacoepidemiology and Drug Safety. - : Wiley. - 1053-8569 .- 1099-1557. ; 16:4, s. 441-448
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Tidskriftsartikel (refereegranskat)abstract
- PurposeTo compare refill adherence data based on two different methods of data capturing, that is, manually collected repeat prescriptions and a pharmacy record database.MethodsThe study comprised a comparison of adherence data from manually collected repeat prescriptions of asthma and chronic obstructive pulmonary disease (COPD) drugs with fixed dosages dispensed in 2002 and the corresponding data from a pharmacy record database. Data were collected in the county of Jämtland in Sweden. Refill adherence was calculated for the different collection methods.ResultsData from 285 manually collected repeat prescriptions for asthma/COPD drugs for 2002 showed that 35% of the prescribings had been satisfactory refilled, while 42% showed an undersupply and 23% an oversupply. The pharmacy record database had 490 prescribings for asthma/COPD drugs registered in 2002, 28% of these had a satisfactory refill adherence, while 43% showed an undersupply, and 29% an oversupply. Based on the database it could be shown that 11% of the individuals had used more than one repeat prescription of the same medicine during 2002. Based on the pharmacy record database for 1999-2002, it was shown that 29% of the prescribings had been satisfactory refilled whereas undersupply increased (53%) and oversupply decreased (18%) as compared to the 1-year data.ConclusionsRefill adherence determined from manually collected repeat prescriptions and from a pharmacy record database did not differ for a 1-year period. Four-year data might give a better overview of patients' refill adherence than 1-year data.
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| 10. |
- Krigsman, Kristin, 1979-
(författare)
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Refill Adherence to Long-Term Drug Treatment with a Focus on Asthma/COPD Medication
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Most patients are non-adherent with their medication sometimes, i.e. that they do not always use their medicines as prescribed. This might result in both under- and overuse and can lead to therapy failure, resulting in both unnecessary suffering and high costs. Therefore, medication adherence should be as high as possible. The aims of this thesis were to investigate the refill adherence to long-term drug treatment, especially for patients with asthma and chronic obstructive pulmonary disease (COPD), and to study treatment gaps for patients with undersupply and drug costs for patients with oversupply. Further aims were to compare different methods for assessing refill adherence and analyse whether the same patient has the same refill adherence pattern to two different chronic drug treatments, i.e. diabetes and asthma/COPD. The thesis shows that satisfactory refill adherence (80-120% of the prescribed dose) was 57% for repeat prescriptions with long-term drug treatment; undersupply was 21% and oversupply 22%. Patients with undersupply were without drugs more than half of the prescribed treatment time and the median oversupply for 90-100 days dispensation interval was 28 days. Patients who were exempt from charges had significantly higher oversupply than non-exempt patients and that leads to unnecessary cost for society. The level of satisfactory refill adherence for repeat prescriptions dispensed for asthma/COPD was on average 30%. The same low level was displayed for the elderly, where undersupply was more common than oversupply. Assessments of refill adherence during a one-year period gave the same results irrespective of whether the repeat prescriptions were from an individual pharmacy record database or were manually collected at a pharmacy.Patients with concomitant use of diabetes and asthma/COPD drugs do not have the same dispensation pattern for both drug types. The introduction of patient profiles as a new approach to complement the calculated refill adherence needs to be further studied in larger and more divergent populations. In the future, the new national pharmacy record database in Sweden has opened up for larger studies and will be valuable when studying patterns of drug utilization.
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