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- Axelsson, Malin, et al.
(författare)
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Differences in diagnostic patterns of obstructive airway disease between areas and sex in Sweden and Finland : The Nordic EpiLung Study
- 2021
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Ingår i: Journal of Asthma. - : Taylor & Francis. - 0277-0903 .- 1532-4303. ; 58:9, s. 1196-1207
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate the current prevalence of physician-diagnosed obstructive airway diseases by respiratory symptoms and by sex in Sweden and Finland. Method: In 2016, a postal questionnaire was answered by 34,072 randomly selected adults in four study areas: Västra Götaland and Norrbotten in Sweden, and Seinäjoki-Vaasa and Helsinki in Finland. Results: The prevalence of asthma symptoms was higher in Norrbotten (13.2%), Seinäjoki-Vaasa (14.8%) and Helsinki (14.4%) than in Västra Götaland (10.7%), and physician-diagnosed asthma was highest in Norrbotten (13.0%) and least in Västra Götaland (10.1%). Chronic productive cough was most common in the Finnish areas (7.7-8.2 % versus 6.3-6.7 %) while the prevalence of physician-diagnosed chronic bronchitis (CB) or chronic obstructive pulmonary disease (COPD) varied between 1.7-2.7% in the four areas. Among individuals with respiratory symptoms, the prevalence of asthma was most common in Norrbotten, while a diagnosis of COPD or CB was most common in Västra Götaland and Seinäjoki-Vaasa. More women than men with respiratory symptoms reported a diagnosis of asthma in Sweden and Seinäjoki-Vaasa but there were no sex differences in Helsinki. In Sweden, more women than men with symptoms of cough or phlegm reported a diagnosis of CB or COPD, while in Finland the opposite was found. Conclusion: The prevalence of respiratory symptoms and corresponding diagnoses varied between and within the countries. The proportion reporting a diagnosis of obstructive airway disease among individuals with respiratory symptoms varied, indicating differences in diagnostic patterns both between areas and by sex.
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| 2. |
- Axelsson, Malin, et al.
(författare)
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Sleep disturbances and physical inactivity impair health related quality of life in adult asthmatics
- 2017
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: Sleep disturbances and physical inactivity have only sparsely been studied in relation to health related quality of life (HRQL) in adult asthmatics. Aim: to investigate sleep disturbances and physical inactivity in relation to HRQL in adult asthmatics. Method: The sample (n=737), aged between 21 and 85 years, selected from the OLIN-studies participated in structured interviews about respiratory health, sleep, physical activity and questionnaires on mental and physical HRQL. Results: Sleep disturbances were more common in asthmatics than in non-asthmatics: snoring (p=0.018), difficulties falling asleep (p=0.025), many nocturnal awakenings (p=0.001), daytime sleepiness (p=0.001), early awakenings (p=0.002). Lower mental HRQL was found in asthmatics with difficulties falling asleep (p=0.001), in asthmatics reporting daytime sleepiness (p=0.010) than asthmatics without sleep disturbances. Lower physical HRQL was found in asthmatics with daytime sleepiness (p=0.002), early awakenings (p=0.001) and many nocturnal awakenings (p=0.039) than asthmatics without these sleep disturbances. Lower physical HRQL was found in physically inactive asthmatics than in physically active asthmatics (p=0.034). Physical activity (p=0.008) and asthma control (p=0.049) were stronger predictors of low physical HRQL than sleep disturbances. Difficulties falling asleep (p=0.001) and many nocturnal awakenings (p=0.04) were identified as negative predictors of mental HRQL while asthma control was a non-significant predictor. Conclusion: Helping adult asthmatics to improve their sleeping habits and to increase their physical activity will have a positive impact on their HRQL. Malin Axelssona, Mai Leanderb, Helena Backmanc, Linnea Hedmanc, Eva Rönmarkc a Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden b Department of Medical Sciences, Respiratory Medicine and Allergology, Uppsala University, Uppsala, Sweden c Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, The OLIN Unit, Umeå University, Umeå, Sweden
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| 5. |
- Axelsson, Malin, 1964-, et al.
(författare)
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Underdiagnosis and misclassification of COPD in Sweden - A Nordic Epilung study
- 2023
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Ingår i: Respiratory Medicine. - : Elsevier. - 0954-6111 .- 1532-3064. ; 217
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The prevalence of COPD tends to level off in populations with decreasing prevalence of smoking but the extent of underdiagnosis in such populations needs further investigation.Aim: To investigate underdiagnosis and misclassification of COPD with a focus on socio-economy, lifestyle determinants and healthcare utilization.Method: The 1839 participants were selected from two ongoing large-scale epidemiological research programs: The Obstructive Lung Disease in Northern Sweden Studies and the West Sweden Asthma Study. COPDGOLD was defined according to the fixed post-bronchodilator spirometric criteria FEV1/FVC<0.70 in combination with respiratory symptoms. Results: Among the 128 participants who fulfilled the criteria for COPDGOLD, the underdiagnosis was 83.6% (n = 107) of which 57.9% were men. The undiagnosed participants were younger, had higher FEV1% of predicted and less frequently a family history of bronchitis. One in four of the undiagnosed had utilized healthcare and had more frequently utilized healthcare due to a burden of respiratory symptoms than the general population without COPD. Underdiagnosis was not related to educational level. Misclassification of COPD was characterized by being a woman with low education, ever smoker, having respiratory symptoms and having a previous asthma diagnosis.Conclusion: In the high income country Sweden, the underdiagnosis of COPD was highly prevalent. Reduced underdiagnosis can contribute to risk factor modification, medical treatment and self-management strategies in early stages of the disease, which may prevent disease progression and improve the quality of life among those affected. Therefore, there is a need to increase the use of spirometry in primary care to improve the diagnostic accuracy.
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| 6. |
- Backman, Helena, et al.
(författare)
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Decreased COPD prevalence in Sweden after decades of decrease in smoking
- 2020
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Ingår i: Respiratory Research. - : Springer Nature. - 1465-9921 .- 1465-993X. ; 21
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundCOPD has increased in prevalence worldwide over several decades until the first decade after the millennium shift. Evidence from a few recent population studies indicate that the prevalence may be levelling or even decreasing in some areas in Europe. Since the 1970s, a substantial and ongoing decrease in smoking prevalence has been observed in several European countries including Sweden. The aim of the current study was to estimate the prevalence, characteristics and risk factors for COPD in the Swedish general population. A further aim was to estimate the prevalence trend of COPD in Northern Sweden from 1994 to 2009.MethodsTwo large random population samples were invited to spirometry with bronchodilator testing and structured interviews in 2009–2012, one in south-western and one in northern Sweden, n = 1839 participants in total. The results from northern Sweden were compared to a study performed 15 years earlier in the same area and age-span. The diagnosis of COPD required both chronic airway obstruction (CAO) and the presence of respiratory symptoms, in line with the GOLD documents since 2017. CAO was defined as post-bronchodilator FEV1/FVC < 0.70, with sensitivity analyses based on the FEV1/FVC < lower limit of normal (LLN) criterion.ResultsBased on the fixed ratio definition, the prevalence of COPD was 7.0% (men 8.3%; women 5.8%) in 2009–2012. The prevalence of moderate to severe (GOLD ≥ 2) COPD was 3.5%. The LLN based results were about 30% lower. Smoking, occupational exposures, and older age were risk factors for COPD, whereof smoking was the most dominating risk factor. In northern Sweden the prevalence of COPD, particularly moderate to severe COPD, decreased significantly from 1994 to 2009, and the decrease followed a decrease in smoking.ConclusionsThe prevalence of COPD has decreased in Sweden, and the prevalence of moderate to severe COPD was particularly low. The decrease follows a major decrease in smoking prevalence over several decades, but smoking remained the dominating risk factor for COPD.
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| 7. |
- Bashir, Muwada Bashir Awad, et al.
(författare)
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Computational phenotyping of obstructive airway diseases: protocol for a systematic review
- 2022
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Ingår i: Systematic Reviews. - : Springer Nature. - 2046-4053. ; 11:1
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Forskningsöversikt (refereegranskat)abstract
- Background: Over the last decade, computational sciences have contributed immensely to characterization of phenotypes of airway diseases, but it is difficult to compare derived phenotypes across studies, perhaps as a result of the different decisions that fed into these phenotyping exercises. We aim to perform a systematic review of studies using computational approaches to phenotype obstructive airway diseases in children and adults.Methods and analysis: We will search PubMed, Embase, Scopus, Web of Science, and Google Scholar for papers published between 2010 and 2020. Conferences proceedings, reference list of included papers, and experts will form additional sources of literature. We will include observational epidemiological studies that used a computational approach to derive phenotypes of chronic airway diseases, whether in a general population or in a clinical setting. Two reviewers will independently screen the retrieved studies for eligibility, extract relevant data, and perform quality appraisal of included studies. A third reviewer will arbitrate any disagreements in these processes. Quality appraisal of the studies will be undertaken using the Effective Public Health Practice Project quality assessment tool. We will use summary tables to describe the included studies. We will narratively synthesize the generated evidence, providing critical assessment of the populations, variables, and computational approaches used in deriving the phenotypes across studiesConclusion: As progress continues to be made in the area of computational phenotyping of chronic obstructive airway diseases, this systematic review, the first on this topic, will provide the state of the art on the field and highlight important perspectives for future works.Ethics and dissemination: No ethical approval is needed for this work is based only on the published literature and does not involve collection of any primary or human data.
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| 8. |
- Eriksson, Berne, et al.
(författare)
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Pattern of Cardiovascular Comorbidity in COPD in a Country with Low-smoking Prevalence: Results from Two-population-based Cohorts from Sweden
- 2018
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Ingår i: Copd-Journal of Chronic Obstructive Pulmonary Disease. - : Informa UK Limited. - 1541-2555 .- 1541-2563. ; 15:5, s. 454-463
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Tidskriftsartikel (refereegranskat)abstract
- Cardiovascular diseases are the most common comorbidities in COPD, due to common risk factors such as smoking. The prevalence of current smokers in Sweden has decreased over four decades to around 10%. The aim of the present study was to investigate the prevalence, distribution and associations of cardiovascular comorbidities in COPD by disease severity in two large areas of Sweden, both with low-smoking prevalence. Data from clinical examinations in 2009-2012, including spirometry and structured interview, from two large-scale population studies, the West Sweden Asthma Study (WSAS) and the OLIN Studies in Northern Sweden, were pooled. COPD was defined using post-bronchodilator spirometry according to the fixed ratio FEV1/FVC <0.70 and the lower limit of normal (LLN5th percentile) of the ratio of FEV1/FVC. Of the 1839 subjects included, 8.7% and 5.7% had COPD according to the fixed ratio and the LLN criterion. Medication for heart disease or hypertension among those with moderate-to-severe COPD was more common than among those without COPD (fixed ratio definition of COPD: 51% vs. 23%, p < 0.001; LLN definition: 42% vs. 24%, p = 0.002). After adjusting for known risk factors for COPD, including smoking, age, socio-economic status, and occupational exposure for gas, dust and fumes, only heart failure remained significantly, and independently, associated with COPD, irrespective of the definitions of COPD. Though a major decrease in smoking prevalence, the pattern of cardiovascular comorbidities in COPD still remains similar with previously performed studies in Sweden and in other Westernized countries as well.
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| 9. |
- Jansson, Sven-Arne, et al.
(författare)
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Life-years lost due to asthma
- 2019
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Ingår i: European Respiratory Journal. - Sheffield : European Respiratory Society (ERS). - 0903-1936 .- 1399-3003. ; 54:Suppl. 63
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 10. |
- Jansson, Sven-Arne, et al.
(författare)
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Life-years lost due to asthma and COPD
- 2020
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Ingår i: European Respiratory Journal. - : European Respiratory Society (ERS). - 0903-1936 .- 1399-3003. ; 56:Suppl 64
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background: Quality-adjusted life-years (QALYs) is commonly used in health-economic evaluations. QALY-weights combine health status and time into one measure.Aims: To investigate the association between multimorbidity and QALY-weights among adults with asthma and COPD.Methods: Within the OLIN-studies in northern Sweden, a random sample was invited to a postal questionnaire survey. A random sample of 1016 responders was invited to clinical examinations and interviews in 2009 (737 participated, ages 21-86 years), of which 605 completed the health-related quality of life (HRQL) questionnaire SF-36. QALY-weights were derived from the SF-36 data using the SF-6D tool via the standard gamble method. The SF-6D scores are equivalent to QALY-weights with low values representing poor health and the score one representing perfect health.Results: Of the 605 participants, 74 had current asthma, 81 had COPD (FEV1/FVC<0.7), 66 had heart disease, 30 had diabetes, 30 had rheumatic disease, and 160 had hypertension. There was an association between an increasing number of morbid conditions and lower QALY-weights (p<0.001). The mean QALY-weight tended to be lower among subjects with asthma compared to COPD, 0.77 and 0.81, respectively (p=0.078). Subjects with COPD and two or more non-respiratory conditions had significantly lower QALY-weights compared to subjects with COPD alone (0.75 vs.0.83, p=0.016). No significant difference in QALY-weights was found among asthmatics with versus without other non-respiratory conditions.Conclusions: Subjects with asthma tended to have lower QALY-weights compared to subjects with COPD. Having two or more non-respiratory conditions affected the QALY-weight negatively among subjects with COPD but not among subjects with asthma.
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