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- Bondesson, Elisabeth, et al.
(författare)
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Utilization of healthcare and prescription medicines after non-pharmacological interventions for depression - A 3-year register follow-up of an RCT in primary care
- 2022
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Ingår i: Preventive Medicine Reports. - : Elsevier. - 2211-3355. ; 25
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Tidskriftsartikel (refereegranskat)abstract
- Depression is a common, recurrent disorder. There is a need for readily available treatments with few negative side effects, that demands little resources and that are effective both in the short- and long term. Our aim was to investigate the long-term effectiveness of two different interventions; physical exercise and internet-based cognitive behavioural therapy (internet-CBT), compared to usual care in patients with mild to moderate depression in a Swedish primary care setting. We performed a register-based 3-year follow-up study of participants in the randomized controlled trial REGASSA (n = 940) using healthcare utilization and dispensed medicines as outcomes. We found no difference between the three groups regarding proportion of participants consulting healthcare due to mental illness or pain during follow-up. Regarding number of consultations, there was no difference between the groups, except for consultations related to pain. For this outcome both treatment arms had significantly fewer consultations compared to usual care, during year 2-3, the risk ratio (RR) for physical exercise and internet-CBT was 0.64 (95% CI = 0.43-0.95) and 0.61 (95% CI = 0.41-0.90), respectively. A significantly lower proportion of patients in both treatment arms were dispensed hypnotics and sedatives year 2-3 compared to the usual care arm, RR for both physical exercise and internet-CBT was 0.72 (95% CI = 0.53-0.98). No other differences between the groups were found. In conclusion, considering long-term effects, both physical exercise and internet-CBT, being resource-efficient treatments, could be considered as appropriate additions for patients with mild to moderate depression in primary care settings.
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| 2. |
- Ghafouri, Bijar, et al.
(författare)
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Swedish Chronic Pain Biobank : protocol for a multicentre registry and biomarker project
- 2022
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Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 12:11
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: About 20% of the adult population have chronic pain, often associated with psychological distress, sick leave and poor health. There are large variations in the clinical picture. A biopsychosocial approach is used in investigation and treatment. The concept of personalised medicine, that is, optimising medication types and dosages for individual patients based on biomarkers and other patient-related factors, has received increasing attention in different diseases but used less in chronic pain. This cooperative project from all Swedish University Hospitals will investigate whether there are changes in inflammation and metabolism patterns in saliva and blood in chronic pain patients and whether the changes correlate with clinical characteristics and rehabilitation outcomes.METHODS AND ANALYSIS: Patients at multidisciplinary pain centres at University Hospitals in Sweden who have chosen to participate in the Swedish Quality Registry for Pain Rehabilitation and healthy sex-matched and age-matched individuals will be included in the study. Saliva and blood samples will be collected in addition to questionnaire data obtained from the register. From the samples, proteins, lipids, metabolites and micro-RNA will be analysed in relation to, for example, diagnosis, pain characteristics, psychological distress, body weight, pharmacological treatment and clinical rehabilitation results using advanced multivariate data analysis and bioinformatics.ETHICS AND DISSEMINATION: The study is approved by the Swedish Ethical Review Authority (Dnr 2021-04929) and will be conducted in accordance with the declaration of Helsinki.The results will be published in open access scientific journals and in popular scientific relevant journals such as those from patient organisations. Data will be also presented in scientific meetings, meeting with healthcare organisations and disseminated in different lecturers at the clinics and universities.
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| 3. |
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| 4. |
- Grelz, Henrik, et al.
(författare)
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Prevalence of long-term opioid therapy in a chronic non-cancer pain population attending a university-based tertiary pain clinic in Sweden. A cross-sectional study
- 2022
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1651-2081. ; 54
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Opioid therapy has become a common treatment for chronic pain despite accumulating evidence regarding harm and the lack of data to support efficacy for long-term treatments. The prevalence of opioid treatments in Swedish patients with chronic non-cancer pain is unknown. Hence, the present study aimed to assess a short-term period prevalence of prescribed opioid-use and long-term opioid therapy (LTOT) in a population with complex chronic non-cancer pain.METHOD: The study population consisted of 1613 patients suffering from chronic non-cancer pain and referred to a university-based tertiary pain clinic in Sweden during 2015-2017. Data from a 360-day period prior to consultation were extracted from the Swedish Quality Registry for Pain Rehabilitation (SQRP) and Swedish Prescribed Drug Register (SPDR). Milligram morphine equivalents per day (MME/day) for dispensed opioids were analysed for a 90-day period preceding consultation and long-term opioid therapy (LTOT) was determined for the entire 360-day period.RESULTS: The 90-day prevalence was 38% (CI 36-40,8) and the 360-day prevalence was 22.3% (n=360 with CI 20.4-24.4).CONCLUSION: The prescribing rates of opioids in a Swedish population with complex non-cancer chronic pain were high; two in five patients were dispensed an opioid within a 90-day period prior to consultation.
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