Identifying factors explaining practice variation in secondary stroke prevention in primary care: a cohort study based on all patients with ischaemic stroke in the Stockholm region

↓ Direkt till sidans innehåll
↓ Direkt till sidans sekundära innehåll (sidomenyn)

Sökning: WFRF:(Carlsson Jakob) > Identifying factors...

LIBRIS Formathandbok (Information om MARC21)

Fältnamn	Indikatorer	Metadata
000		04902naa a2200469 4500
001		oai:DiVA.org:oru-102368
003		SwePub
008		221124s2022 \| \|\|\|\|\|\|\|\|\|\|\|000 \|\|eng\|
009		oai:prod.swepub.kib.ki.se:151387462
024	7	a https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-1023682 URI
024	7	a https://doi.org/10.1136/bmjopen-2022-0642772 DOI
024	7	a http://kipublications.ki.se/Default.aspx?queryparsed=id:1513874622 URI
040		a (SwePub)orud (SwePub)ki
041		a engb eng
042		9 SwePub
072	7	a ref2 swepub-contenttype
072	7	a art2 swepub-publicationtype
100	1	a Wolf, Mariau Department of Neurobiology and Care Sciences and Society, Division of Family Medicine and Primary Care, Karolinska Institutet, Stockholm, Sweden; Academic Primary Health Care Centre, Stockholm, Sweden4 aut
245	1 0	a Identifying factors explaining practice variation in secondary stroke prevention in primary care :b a cohort study based on all patients with ischaemic stroke in the Stockholm region
264		c 2022-11-21
264	1	b BMJ Publishing Group Ltd,c 2022
338		a print2 rdacarrier
500		a Funding agency:Fund for Rehabilitation and Medical research (Fonden för Rehabilitering och medicinsk forskning, FRF)
520		a OBJECTIVES: The aim of this study was to describe the practice variation in dispensation of secondary stroke preventive drugs among patients at different primary care centres (PCCs) in Stockholm region and to identify factors that may explain the variation.DESIGN: Cohort study using administrative data from the Stockholm region.SETTING: Stockholm Health Care Region, Sweden, serving a population of 2.3 million inhabitants, hospital and PCC data.PARTICIPANTS: All patients (n=9761) with ischaemic stroke treated in hospital from 1 July 2009 to 30 June 2014 were included. Of these, 7562 patients registered with 187 PCCs were analysed. Exclusion criteria were; deceased patients, age <18, haemorrhagic stroke and/or switching PCC.PRIMARY AND SECONDARY OUTCOME MEASURES: As primary outcome the impact of PCC organisation variables and patient characteristics on the dispensation of statins, antiplatelets, antihypertensives and anticoagulants were analysed. Secondarily, the unadjusted practice variation of preventive drug dispensation of 187 PCCs is described.RESULTS: There was up to fourfold practice variation in dispensation of all secondary preventive drugs. Factors associated with a lower level of dispensed statins were privately run PCCs (OR 0.91 (95% CI 0.82 to 1.00)) and the patient being woman. Increased statin use was associated with a higher number of specialists in family medicine (OR 1.03 (95% CI 1.01 to 1.05)) and a higher proportion of patients registered with a specific physician (OR 1.37 (95% CI 1.11 to 1.68)). Women had on average a lower number of dispensed antihypertensives.CONCLUSIONS: A high practice variation for dispensation of all secondary preventive drugs was observed. Patient and PCC level factors indicating good continuity of care and high level of general practitioner education were associated with higher use of statins. Findings are of importance to policymakers as well as individual providers of care, and more research and actions are needed to minimise inequality in healthcare.
650	7	a MEDICIN OCH HÄLSOVETENSKAPx Medicinska och farmaceutiska grundvetenskaperx Samhällsfarmaci och klinisk farmaci0 (SwePub)301042 hsv//swe
650	7	a MEDICAL AND HEALTH SCIENCESx Basic Medicinex Social and Clinical Pharmacy0 (SwePub)301042 hsv//eng
653		a Audit
653		a clinical pharmacology
653		a epidemiology
653		a primary care
653		a quality in health care
653		a stroke
700	1	a Hasselström, Jakob K.u Karolinska Institutet4 aut
700	1	a Carlsson, Axelu Karolinska Institutet4 aut
700	1	a von Euler, Mia,d 1967-u Örebro universitet,Institutionen för medicinska vetenskaper,Department of Neurology and Rehabilitation4 aut0 (Swepub:oru)mavr
700	1	a Hasselström, Janu Department of Neurobiology and Care Sciences and Society, Division of Family Medicine and Primary Care, Karolinska Institutet, Stockholm, Sweden; Academic Primary Health Care Centre, Stockholm, Sweden4 aut
710	2	a Karolinska Institutetb Department of Neurobiology and Care Sciences and Society, Division of Family Medicine and Primary Care, Karolinska Institutet, Stockholm, Sweden; Academic Primary Health Care Centre, Stockholm, Sweden4 org
773	0	t BMJ Opend : BMJ Publishing Group Ltdg 12:11q 12:11x 2044-6055
856	4	u https://doi.org/10.1136/bmjopen-2022-064277y Fulltext
856	4 8	u https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-102368
856	4 8	u https://doi.org/10.1136/bmjopen-2022-064277
856	4 8	u http://kipublications.ki.se/Default.aspx?queryparsed=id:151387462

Hitta via bibliotek

BMJ Open (Sök värdpublikationen i LIBRIS)

Till lärosätets databas

Hitta mer i SwePub

Av författaren/redakt...: Wolf, Maria; Hasselström, Jak ...; Carlsson, Axel; von Euler, Mia, ...; Hasselström, Jan

Om ämnet

MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Medicinska och f ...; och Samhällsfarmaci ...

Artiklar i publikationen: BMJ Open

Av lärosätet: Örebro universitet; Karolinska Institutet

Sök utanför SwePub

Sök vidare i:: Google; Google Book Search; Google Scholar

Kungliga biblioteket hanterar dina personuppgifter i enlighet med EU:s dataskyddsförordning (2018), GDPR. Läs mer om hur det funkar här.
Så här hanterar KB dina uppgifter vid användning av denna tjänst.

LIBRIS.kb.se