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Åstrand, Bengt
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Holmgren, C., Abdon, N. J., Bergfeldt, L., Edvardsson, N., Herlitz, J., Karlsson, T., . . . Åstrand, B. (2020). Out-of-hospital cardiac arrest: Causes according to autopsy and electrocardiography - Analysis of 781 patients with neither hospital care nor prescribed medication during the preceding two years. Resuscitation, 150(May), 65-71
Åpne denne publikasjonen i ny fane eller vindu >>Out-of-hospital cardiac arrest: Causes according to autopsy and electrocardiography - Analysis of 781 patients with neither hospital care nor prescribed medication during the preceding two years
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2020 (engelsk)Inngår i: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 150, nr May, s. 65-71Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Background: There is a knowledge gap regarding aetiology of and potential for predicting out-of-hospital cardiac arrest (OHCA) among individuals whoare healthy before the event.Aim: To describe causes of OHCA and the potential for predicting OHCA in apparently healthy patients.Methods: Patients were recruited from the Swedish Register of Cardiopulmonary Resuscitation from November 2007 to January 2011. Inclusioncriteria were: OHCA with attempted CPR but neither dispensed prescription medication nor hospital care two years before the event The registerincludes the majority of patients suffering OHCA in Sweden where cardiopulmonary resuscitation (CPR) was attempted. Medication status was definedby linkage to the Swedish Prescribed Drug Register. Cause of death was assessed based on autopsy and the Swedish Cause of Death Register.Prediction of OHCA was attempted based on available electrocardiograms (ECG) before the OHCA event.Results: Altogether 781 individuals (16% women) fulfilled the inclusion criteria. Survival to 30 days was 16%. Autopsy rate was 72%. Based on autopsy,70% had a cardiovascular aetiology and 59% a cardiac aetiology. An ECG recording before the event was found in 23% of cases. The ECG wasabnormal in 22% of them.Conclusion: Among OHCA victims who appeared to be healthy prior to the event, the cause was cardiovascular in the great majority according toautopsy findings. A minority had a preceding abnormal ECG that could have been helpful in avoiding the event.

sted, utgiver, år, opplag, sider
Elsevier, 2020
Emneord
Out-of-hospital cardiac arrest, Aetiology, Medication, Healthy
HSV kategori
Forskningsprogram
Naturvetenskap, Medicin
Identifikatorer
urn:nbn:se:lnu:diva-95415 (URN)10.1016/j.resuscitation.2020.02.040 (DOI)000531907700011 ()32199902 (PubMedID)2-s2.0-85082839187 (Scopus ID)
Tilgjengelig fra: 2020-06-04 Laget: 2020-06-04 Sist oppdatert: 2021-05-07bibliografisk kontrollert
Holmgren, C. M., Abdon, N. J., Bergfeldt, L. B., Edvardsson, N. G., Herlitz, J. D., Karlsson, T., . . . Åstrand, B. (2014). Changes in Medication Preceding Out-of-hospital Cardiac Arrest Where Resuscitation Was Attempted. Journal of Cardiovascular Pharmacology, 63(6), 497-503
Åpne denne publikasjonen i ny fane eller vindu >>Changes in Medication Preceding Out-of-hospital Cardiac Arrest Where Resuscitation Was Attempted
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2014 (engelsk)Inngår i: Journal of Cardiovascular Pharmacology, ISSN 0160-2446, E-ISSN 1533-4023, Vol. 63, nr 6, s. 497-503Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Objective: To describe recent changes in medication preceding out-of-hospital cardiac arrest (OHCA) where resuscitation was attempted. Methods: OHCA victims were identified by the Swedish Cardiac Arrest Register and linked by means of their unique 10-digit personal identification numbers to the Prescribed Drug Register. We identified new claimed prescriptions during a 6-month period before the OHCA compared with those claimed in the period 12 to 18 months before. The 7-digit Anatomical Therapeutical Chemical codes of individual drugs were used. The study period was November 2007-January 2011. Results: OHCA victims with drugs were (1) older than those who did not claim any drugs in any period (70 +/- 16 years vs. 54 +/- 22 years, P < 0.001), (2) more often women (34% vs. 20%, P < 0.001), and (3) had more often a presumed cardiac etiology (67% vs. 54%, P < 0.001). The OHCA victims were less likely to have ventricular tachycardia/ventricular fibrillation as the first recorded ;rhythm (26% vs. 33%, P < 0.001) or to survive 1 month (9% vs. 17%, P < 0.0001). New prescriptions were claimed by 5122 (71%) of 7243 OHCA victims. The most frequently claimed new drugs were paracetamol (acetaminophen) 10.3%, furosemide 7.8%, and omeprazole 7.6%. Of drugs known or supposed to cause QT prolongation, ciprofloxacin was the most frequent (3.4%) altogether; 16% had a new claimed prescription of a drug included in the "qtdrugs.org" lists. Conclusions: Most OHCA victims had new drugs prescribed within 6 months before the event but most often intended for diseases other than cardiac. No claims can be made as to the causality.

Emneord
out-of-hospital cardiac arrest, QT prolongation, medication, torsade de pointes
HSV kategori
Forskningsprogram
Biomedicinsk vetenskap, Farmakologi
Identifikatorer
urn:nbn:se:lnu:diva-36090 (URN)10.1097/FJC.0000000000000073 (DOI)000337360200003 ()2-s2.0-84902257272 (Scopus ID)
Tilgjengelig fra: 2014-07-17 Laget: 2014-07-17 Sist oppdatert: 2019-08-28bibliografisk kontrollert
Öhlund, S.-E., Åstrand, B. & Petersson, G. (2012). Improving interoperability in ePrescribing. Interactive Journal of Medical Research, 1(2), Article ID e17.
Åpne denne publikasjonen i ny fane eller vindu >>Improving interoperability in ePrescribing
2012 (engelsk)Inngår i: Interactive Journal of Medical Research, E-ISSN 1929-073X, Vol. 1, nr 2, artikkel-id e17Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Background: The increased application of eServices in health care, in general, and ePrescribing (electronic prescribing) in particular, have brought quality and interoperability to the forefront. The application of standards has been put forward as one important factor in improving interoperability. However, less focus has been placed on other factors, such as stakeholders’ involvement and the measurement of interoperability. An information system (IS) can be regarded to comprise an instrument for technology-mediated work communication. In this study, interoperability refers to the interoperation in the ePrescribing process, involving people, systems, procedures and organizations. We have focused on the quality of the ePrescription message as one component of the interoperation in the ePrescribing process.

Objective: The objective was to analyze how combined efforts in improving interoperability with the introduction of the new national ePrescription format (NEF) have impacted interoperability in the ePrescribing process in Sweden, with the focus on the quality of the ePrescription message.

Methods: Consecutive sampling of electronic prescriptions in Sweden before and after the introduction of NEF was undertaken in April 2008 (pre-NEF) and April 2009 (post-NEF). Interoperability problems were identified and classified based on message format specifications and prescription rules.

Results: The introduction of NEF improved the interoperability of ePrescriptions substantially. In the pre-NEF sample, a total of 98.6% of the prescriptions had errors. In the post-NEF sample, only 0.9% of the prescriptions had errors. The mean number of errors was fewer for the erroneous prescriptions: 4.8 in pre-NEF compared to 1.0 in post-NEF.

Conclusions: We conclude that a systematic comprehensive work on interoperability, covering technical, semantical, professional, judicial and process aspects, involving the stakeholders, resulted in an improved interoperability of ePrescriptions.

sted, utgiver, år, opplag, sider
JMIR Publications, 2012
HSV kategori
Forskningsprogram
Hälsovetenskap
Identifikatorer
urn:nbn:se:lnu:diva-44778 (URN)10.2196/ijmr.2089 (DOI)000218914100013 ()
Tilgjengelig fra: 2015-06-18 Laget: 2015-06-18 Sist oppdatert: 2024-02-23bibliografisk kontrollert
Hovstadius, B., Åstrand, B., Petersson, G. & Persson, U. (2011). Acquisition cost of dispensed drugs for individuals with multiple medications – a register-based study. Health Policy, 101(2), 153-161
Åpne denne publikasjonen i ny fane eller vindu >>Acquisition cost of dispensed drugs for individuals with multiple medications – a register-based study
2011 (engelsk)Inngår i: Health Policy, ISSN 0168-8510, E-ISSN 1872-6054, Vol. 101, nr 2, s. 153-161Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Background:

The total drug sales has increased substantially during the last decades. The increase is assumed to be associated with the observed increase in the individual use of several different drugs, the so-called multiple medications.

 

Objective:

To analyse the acquisition cost of dispensed prescription drugs for individuals with multiple medications in a national population.

 

Study design, setting and participants:

An individual based register study of all dispensed prescription drugs (DP) in Sweden in 2006, including 6.2 million individuals. As an indicator of multiple medications, five or more dispensed prescription drugs (DP≥5) during a 12-month period was applied. For comparison, ten or more (DP≥10) and fifteen and more (DP≥15) dispensed drugs during a 12-month period were used.

 

Results:

The total acquisition cost of dispensed drugs in Sweden in 2006 was SEK 23.2 billion, (corresponding to EUR 2.5 billion 2006). Individuals with DP≥5 (24.5% of total population) accounted for 78.8% of the total drug cost, and individuals with DP≥10 (8.6% of population) and DP≥15 (3.0% of population) accounted for 46.3% and 23.2% respectively.

 

Individuals with DP>5 younger than 70 years of age (corresponding to 64.9% all individuals with DP>5) accounted for 64.7% of the total acquisition cost for all with DP>5.The highest total drug cost for individuals with DP>5 was displayed in the age group 60-69 followed by 70-79 and 50-59 years, 21.5%, 19.8%, and 17.4%, respectively.

 

The average acquisition cost per daily defined dosage (DDD) generally decreased with increasing age. For individuals with DP≥5, the average cost per DDD decreased from SEK 8.04 to SEK 2.27 (-72%) for the age group 10-19 to 90 years and above. The highest average cost per DDD was observed for individuals with DP≥10.

 

The drug cost for women with DP≥5 (corresponding to 60.9% all individuals with DP>5) represented 56.0% of the total cost. Men with DP≥5 (corresponding to 39.1% all individuals with DP>5) represented 44.0% of the total cost.

 

For individuals with DP≥5, the average cost per DDD was SEK 4.31 (corresponding to EUR 0.46 2006), for women 4.08, and for men 4.62.

 

Conclusion:

Individuals with ten or more drugs accounted for almost half of the acquisition costs of dispensed drugs. In order to reduce the risks for adverse drug reactions, interactions and inappropriate drug us, interventions with focus on reduction of the number of prescription drugs for the small group of patients with many different drugs, may therefore also give a substantial reduction of the total drug costs.

HSV kategori
Forskningsprogram
Naturvetenskap, Biomedicinsk vetenskap
Identifikatorer
urn:nbn:se:lnu:diva-2185 (URN)10.1016/j.healthpol.2011.03.003 (DOI)000292671300006 ()2-s2.0-79957992695 (Scopus ID)
Tilgjengelig fra: 2010-04-07 Laget: 2010-04-07 Sist oppdatert: 2022-07-13bibliografisk kontrollert
Hammar, T., Nyström, S., Petersson, G., Åstrand, B. & Rydberg, T. (2011). Patients satisfied with e-prescribing in Sweden: a survey of a nationwide implementation. Journal of pharmaceutical health services research, 2(2), 97-105
Åpne denne publikasjonen i ny fane eller vindu >>Patients satisfied with e-prescribing in Sweden: a survey of a nationwide implementation
Vise andre…
2011 (engelsk)Inngår i: Journal of pharmaceutical health services research, ISSN 1759-8885, Vol. 2, nr 2, s. 97-105Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Objective

To evaluate Swedish patients’ attitudes towards e-prescribing, including the transfer of e-prescriptions, electronic storing of prescriptions and mail-order prescriptions.

Methods

This study was a nationwide survey of attitudes among Swedish patients and was conducted as a postal questionnaire. The questionnaire was developed for the purpose of thisstudy and aimed to evaluate respondents’ views concerning e-prescribing, electronic storingof e-prescriptions and mail-order prescriptions from aspects including safety, personal benefits and effectiveness. A study population of 1500 individuals meeting the inclusioncriteria was randomly selected from a database of individuals in Sweden storing prescriptions electronically (n = 5 840 599).The response rate was 52% (739/1429).

Key findings

The vast majority of the respondents had a positive attitude towards e-prescriptions (85%, 628/739) and electronic storing of prescriptions (86%, 633/739), andregarded e-prescriptions to be safe (79%, 584/739), creating benefits for them (78%, 576/739) and promoting faster dispensing (69%, 512/739). Significant differences in attitudes towards e-prescriptions and electronic storing of prescriptions were detected between age groups. Patients storing all their prescriptions electronically had a more positive attitudetowards both e-prescriptions and electronic storing of prescriptions compared to patientswho stated they had paper prescriptions. The most common suggestion (n = 27) for improvement was to extend the information given about the services.

Conclusion

Our nationwide survey showed that a vast majority of Swedish patients had positive attitudes towards e-prescriptions and electronic storing of prescriptions. However, a need for extended information regarding e-prescribing was identified.

Emneord
community pharmacy, electronic prescribing, health informatics, information technology, patient satisfaction, prescriptions
HSV kategori
Forskningsprogram
Naturvetenskap, Biomedicinsk vetenskap
Identifikatorer
urn:nbn:se:lnu:diva-13961 (URN)10.1111/j.1759-8893.2011.00040.x (DOI)2-s2.0-84860390021 (Scopus ID)
Tilgjengelig fra: 2011-08-30 Laget: 2011-08-30 Sist oppdatert: 2017-01-19bibliografisk kontrollert
Hovstadius, B., Åstrand, B. & Petersson, G. (2010). Assessment of regional variation in polypharmacy. Pharmacoepidemiology and Drug Safety, 19(4), 375-383
Åpne denne publikasjonen i ny fane eller vindu >>Assessment of regional variation in polypharmacy
2010 (engelsk)Inngår i: Pharmacoepidemiology and Drug Safety, ISSN 1053-8569, E-ISSN 1099-1557, Vol. 19, nr 4, s. 375-383Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

PURPOSE: To assess polypharmacy in a population with emphasis on regions. METHODS: We studied the individual-based data of all dispensed prescription drugs (DP) during a 3-month study period in Sweden 2006. As an indicator of polypharmacy, five or more (DP > or = 5) different drugs (substances) dispensed were applied. For analysis, we used comparisons of prevalence, correlation of prevalence of polypharmacy with different socioeconomic variables, and a novel weighted polypharmacy index. RESULTS: The national prevalence of polypharmacy, DP > or = 5, was 10.5% (inter-regional variation 9.1-12.1%). The regional variation in the prevalence of polypharmacy was largest for the age groups > or =90 (45.6-59.1%), 80-89 (46.1-53.4%) and 70-79 years (33.1-38.0%). The national prevalence of excessive polypharmacy, DP > or = 10, was 2.2% (inter-regional variation 1.9-2.6%). The regional variation in prevalence of excessive polypharmacy was largest for the age groups > or =90 (9.8-22.3%), 80-89 (11.4-17.1%) and 70-79 years (7.0-9.4%). We found a fairly strong positive correlation between polypharmacy and the age group > or =70 years (r = 0.84 for men and 0.71 for women). The novel weighted polypharmacy index indicated regional differences in the internal distribution of the prevalence of dispensed drugs for individuals with polypharmacy. CONCLUSION: Our findings indicate that the observed regional differences in the prevalence of polypharmacy partly can be explained by the regional age distribution in Sweden. The use of the novel weighted polypharmacy index indicated regional differences in drug therapy for individuals with polypharmacy.

HSV kategori
Forskningsprogram
Hälsovetenskap, Hälsoinformatik
Identifikatorer
urn:nbn:se:lnu:diva-2114 (URN)10.1002/pds.1921 (DOI)000276929100007 ()20191596 (PubMedID)2-s2.0-77950874919 (Scopus ID)
Tilgjengelig fra: 2010-04-06 Laget: 2010-04-06 Sist oppdatert: 2022-07-13bibliografisk kontrollert
Hovstadius, B., Hovstadius, K., Åstrand, B. & Petersson, G. (2010). Increasing polypharmacy: an individual-based study of the Swedish population 2005-2008.. BMC Clinical Pharmacology, 10, Article ID: 16
Åpne denne publikasjonen i ny fane eller vindu >>Increasing polypharmacy: an individual-based study of the Swedish population 2005-2008.
2010 (engelsk)Inngår i: BMC Clinical Pharmacology, ISSN 1472-6904, Vol. 10, s. Article ID: 16-Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

BackgroundAn increase in the use of drugs and polypharmacy have been displayed over time in spite of the fact that polypharmacy represents a well known risk factor as regards patients' health due to the adverse drug reactions, drug-drug interactions, and low adherence to drug therapy arising from polypharmacy. For policymakers, as well as for clinicians, it is important to follow the developing trends in drug use and polypharmacy over time. We wanted to study if the prevalence of polypharmacy in an entire national population has changed during a 4-year period.MethodsBy applying individual-based data on dispensed drugs, we have studied all dispensed prescribed drugs for the entire Swedish population during four 3-month periods 2005-2008. Five or more (DP ≥5) and ten or more (DP ≥10) dispensed drugs during the 3-month period was applied as the cut-offs indicating the existence of polypharmacy and excessive polypharmacy respectively.ResultsDuring the period 2005-2008, the prevalence of polypharmacy (DP≥5) increased by 8.2% (from 0.102 to 0.111), and the prevalence of excessive polypharmacy (DP≥10) increased by 15.7% (from 0.021 to 0.024).In terms of age groups, the prevalence of polypharmacy and excessive polypharmacy increased as regards all ages with the exception of the age group 0-9 years. However, the prevalence of excessive polypharmacy displayed a clear age trend, with the largest increase for the groups 70 years and above. Furthermore, the increase in the prevalence of polypharmacy was, generally, approximately twice as high for men as for women. Finally, the mean number of dispensed drugs per individual increased by 3.6% (from 3.3 to 3.4) during the study period.ConclusionsThe prevalence of polypharmacy and excessive polypharmacy, as well as the mean number of dispensed drugs per individual, increased year-by-year in Sweden 2005-2008.

HSV kategori
Forskningsprogram
Data- och informationsvetenskap, Informatik
Identifikatorer
urn:nbn:se:lnu:diva-10097 (URN)10.1186/1472-6904-10-16 (DOI)21122160 (PubMedID)2-s2.0-78649591902 (Scopus ID)
Tilgjengelig fra: 2011-01-17 Laget: 2011-01-17 Sist oppdatert: 2017-12-11bibliografisk kontrollert
Hovstadius, B., Tågerud, S., Petersson, G. & Åstrand, B. (2010). Prevalence and therapeutic intensity of dispensed drug groups for individuals with multiple medications: a register-based study of 2.2 million individuals. Journal of Pharmaceutical Health Services Research, 1(4), 145-155
Åpne denne publikasjonen i ny fane eller vindu >>Prevalence and therapeutic intensity of dispensed drug groups for individuals with multiple medications: a register-based study of 2.2 million individuals
2010 (engelsk)Inngår i: Journal of Pharmaceutical Health Services Research, ISSN 1759-8885, Vol. 1, nr 4, s. 145-155Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Objectives  To assess the prevalence and the therapeutic intensity of dispensed drug groups for individuals receiving multiple medications.

Methods  The individual-based data of all dispensed outpatient prescriptions in Sweden in 2006 were analysed. Five or more dispensed drugs (DP ≥ 5) during a 12-month period were applied as an indicator of multiple medications. The drugs were categorized according to the second level of the World Health Organization's Anatomic, Therapeutic, Chemical classification. The defined daily dosage per individual during 12 months was applied as an indicator of the therapeutic intensity.

Key findings  For the 2.2 million individuals with DP ≥ 5, the drug groups with the highest prevalences were antibacterials (48.2%), analgesics (40.3%), psycholeptics (35.9%), antithrombotic agents (33.4%) and beta-blocking agents (31.7%). As examples, the level of prevalence increased with age for analgesics, psycholeptics, antithrombotic agents and diuretics, and decreased with age for antibacterials, drugs for obstructive airway diseases and antihistamines for systemic use. Substantial differences in the level of prevalence between women and men were observed for several drug groups; for example, thyroid therapy (13.3 vs 3.6%), psychoanaleptics (26.3 vs 18.2%), drugs used in diabetes (9.1 vs 15.7%) and lipid-modifying agents (18.1 vs 30.7%). Generally, the therapeutic intensity increased with the increasing number of dispensed drugs. For a third of the most common drug groups, the therapeutic intensity increased with an increasing age above the 60–69-year age group.

Conclusion  The number of drugs taken not only increases the potential risks associated with multiple drug use, but also increases the potential burden of an increased therapeutic intensity, especially for older people. The reported findings may enlighten physicians and healthcare stakeholders concerning the complex patterns of multiple drug use in the entire population and the associated expenses. The findings may also be used as a base for interventions aiming to bring about the most appropriate and balanced prescription of medicines to individuals with multiple diseases.

sted, utgiver, år, opplag, sider
Royal Pharmaceutical Society, 2010
Emneord
Aged, Drug therapy, Drug utilization, Prescription drugs, Polypharmacy, Registries
HSV kategori
Forskningsprogram
Biomedicinsk vetenskap, Farmakologi
Identifikatorer
urn:nbn:se:lnu:diva-2268 (URN)10.1111/j.1759-8893.2010.00029.x (DOI)2-s2.0-79953733150 (Scopus ID)
Tilgjengelig fra: 2010-04-07 Laget: 2010-04-07 Sist oppdatert: 2018-01-12bibliografisk kontrollert
Hammar, T., Nyström, S., Petersson, G., Rydberg, T. & Åstrand, B. (2010). Swedish pharmacists value ePrescribing: a survey of a nation-wide implementation. Journal of Pharmaceutical Health Services Research, 1(1), 23-32
Åpne denne publikasjonen i ny fane eller vindu >>Swedish pharmacists value ePrescribing: a survey of a nation-wide implementation
Vise andre…
2010 (engelsk)Inngår i: Journal of Pharmaceutical Health Services Research, ISSN 1759-8885, Vol. 1, nr 1, s. 23-32Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Objective

To evaluate Swedish pharmacists’ attitudes towards ePrescribing, including thetransfer of ePrescriptions, electronic storing of prescriptions and mail-order prescriptions.

Method

This study was conducted as a web-based survey among 500 randomly selectedSwedish community pharmacists. The questionnaire included open-ended questions,multiple-choice questions and statements to which respondents gave their degree ofagreement on a six-point Likert-type rating scale. Free-text answers were categorized intothe most commonly mentioned opinions. Differences in respondents’ general characteristicsand their level of satisfaction with ePrescribing were tested for significance using χ2test. The survey had a response rate of 52% (259/500). 96% (248/259) of the respondentswere female, and 76% (196/259) were aged 40–64 years.

Key findings

Swedish community pharmacists were generally satisfied with ePrescribing(98%, 253/259). No significant (P > 0.05) difference in the general satisfaction could beexplained by the respondents’ age, gender or years in practice. A majority of the respondentsregarded ePrescriptions and electronic storing of prescriptions as being safe for patients (95 and93% respectively), providing patient benefits (96 and 95% respectively), being cost-effectivefor the pharmacy (92 and 91% respectively) and contributing to better communication andrelationships with both patients and prescribers (62–88%). The positive aspects of ePrescribingmost frequently mentioned in free-text answers were being safe (72%, 187/259) and timesaving(55%, 143/259). However, several weaknesses with ePrescribing were also describedby the respondents, as well as suggestions for improvement.

Conclusion

Our nationwide survey of Swedish community pharmacists’ attitudestowards ePrescribing shows that pharmacists are generally satisfied with it, including thetransfer of ePrescriptions, electronic storing of prescriptions and to a lower degree mailorderprescriptions.

sted, utgiver, år, opplag, sider
Wiley-Blackwell, 2010
Emneord
community pharmacies, electronic prescribing, health informatics, information technology, pharmacists, prescriptions
HSV kategori
Forskningsprogram
Hälsovetenskap, Hälsoinformatik
Identifikatorer
urn:nbn:se:lnu:diva-2178 (URN)10.1211/jphsr/01.01.0012 (DOI)
Tilgjengelig fra: 2010-04-06 Laget: 2010-04-06 Sist oppdatert: 2017-01-19bibliografisk kontrollert
Åstrand, B., Montelius, E., Petersson, G. & Ekedahl, A. (2009). Assessment of ePrescription quality: an observational study at three mail-order pharmacies. BMC Medical Informatics and Decision Making, 9(1), Article number: 8
Åpne denne publikasjonen i ny fane eller vindu >>Assessment of ePrescription quality: an observational study at three mail-order pharmacies
2009 (engelsk)Inngår i: BMC Medical Informatics and Decision Making, E-ISSN 1472-6947, Vol. 9, nr 1, s. Article number: 8-Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Background: The introduction of electronic transfer of prescriptions (ETP) or ePrescriptions in ambulatory health care has been suggested to have a positive impact on the prescribing and dispensing processes. Thereby, implying that ePrescribing can improve safety, quality, efficiency, and cost-effectiveness. In December 2007, 68% of all new prescriptions were transferred electronically in Sweden. The aim of the present study was to assess the quality of ePrescriptions by comparing the proportions of ePrescriptions and non-electronic prescriptions necessitating a clarification contact (correction, completion or change) with the prescriber at the time of dispensing.

Methods: A direct observational study was performed at three Swedish mail-order pharmacies which were known to dispense a large proportion of ePrescriptions (38–75%). Data were gathered on all ePrescriptions dispensed at these pharmacies over a three week period in February 2006. All clarification contacts with prescribers were included in the study and were classified and assessed in comparison with all drug prescriptions dispensed at the same pharmacies over the specified period.

Results: Of the 31225 prescriptions dispensed during the study period, clarification contacts were made for 2.0% (147/7532) of new ePrescriptions and 1.2% (79/6833) of new non-electronic prescriptions. This represented a relative risk (RR) of 1.7 (95% CI 1.3–2.2) for new ePrescriptions compared to new non-electronic prescriptions. The increased RR was mainly due to 'Dosage and directions for use', which had an RR of 7.6 (95% CI 2.8–20.4) when compared to other clarification contacts. In all, 89.5% of the suggested pharmacist interventions were accepted by the prescriber, 77.7% (192/247) as suggested and an additional 11.7% (29/247) after a modification during contact with the prescriber.

Conclusion: The increased proportion of prescriptions necessitating a clarification contact for new ePrescriptions compared to new non-electronic prescriptions indicates the need for an increased focus on quality aspects in ePrescribing deployment. ETP technology should be developed towards a two-way communication between the prescriber and the pharmacist with automated checks of missing, inaccurate, or ambiguous information. This would enhance safety and quality for the patient and also improve efficiency and cost-effectiveness within the health care system.

HSV kategori
Forskningsprogram
Biomedicinsk vetenskap, Farmakologi
Identifikatorer
urn:nbn:se:hik:diva-621 (URN)10.1186/1472-6947-9-8 (DOI)
Tilgjengelig fra: 2010-11-23 Laget: 2009-04-17 Sist oppdatert: 2022-05-10bibliografisk kontrollert
Organisasjoner