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Throfast, V., Hellström, L., Hovstadius, B., Petersson, G. & Ericson, L. (2019). e-Learning for the elderly on drug utilization: a pilot study. Health Informatics Journal, 25(2), 227-239
Open this publication in new window or tab >>e-Learning for the elderly on drug utilization: a pilot study
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2019 (English)In: Health Informatics Journal, ISSN 1460-4582, E-ISSN 1741-2811, Vol. 25, no 2, p. 227-239Article in journal (Refereed) Published
Abstract [en]

This study explores the attitudes of elderly people to the use of electronic educational technology (e-learning) on drug utilization, with particular emphasis on the layout, usability, content, and level of knowledge in the tool. e-Learning modules were evaluated by a group of elderly people (aged ⩾65 years, n = 16) via a questionnaire comprising closed and open-ended questions. Both qualitative and quantitative analyses of the responses showed mostly positive reviews. The results indicate that the e-learning modules are a suitable tool for distributing information and education and that they can be managed by elderly individuals who are familiar with computers, allowing them to learn more about medication use.

Place, publisher, year, edition, pages
Sage Publications, 2019
Keywords
aged, computer-assisted instruction, drug utilization, e-learning, education
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Health and Caring Sciences, Health Informatics
Identifiers
urn:nbn:se:lnu:diva-74242 (URN)10.1177/1460458217704245 (DOI)000468931800001 ()28464726 (PubMedID)2-s2.0-85065640411 (Scopus ID)
Available from: 2018-05-09 Created: 2018-05-09 Last updated: 2019-08-29Bibliographically approved
Ericson, L., Hovstadius, B., Carlsson, M., Petersson, G. & Wanby, P. (2017). A cost analysis of systematic vitamin D supplementation in the elderly versus supplementation based on assessed requirements. Journal of Aging Research and Healthcare, 2(2), 13-22
Open this publication in new window or tab >>A cost analysis of systematic vitamin D supplementation in the elderly versus supplementation based on assessed requirements
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2017 (English)In: Journal of Aging Research and Healthcare, ISSN 2474-7785, Vol. 2, no 2, p. 13-22Article in journal (Refereed) Published
Abstract [en]

Hypovitaminosis D is common among older people and treatment with vitamin D is associated with reduced risk of falls and fractures. This paper provides a cost analysis of assessing the vitamin D status of and providing the pharmaceuticals for elderly citizens in Kalmar County, Sweden (population approximately 230,000). Four hypothetical interventions were analyzed: (a) systematic vitamin D/calcium supplementation to all elderly (≥75 years), (b) assessment of vitamin D status in elderly and supplementation to those with insufficient levels, (c) systematic vitamin D/calcium supplementation to all nursing-home residents, and (d) assessment of vitamin D status in nursing-home residents and supplementation to those with insufficient levels. The calculations were based on an estimated reduction in overall costs due to the assessed number of hip fractures after vitamin D/calcium supplementation. The annual net economic benefit of vitamin D/calcium supplementation was estimated at (a) €304,000, (b) €860,000, (c) €755,000, and (d) €740,000. The provision of systematic vitamin D supplementation to nursing-home residents would provide a substantial net economic benefit to society and assessment of the vitamin D status before starting supplementation does not seem to be necessary. Although assessment of all elderly citizens would be more comprehensive, the true proportion with insufficient vitamin D levels in the general population is uncertain and to reaching consensus on the most advantageous daily vitamin D intake, vitamin D blood levels are necessary. Also, systematic supplementation to all elderly would result in other outcomes that could be worth the cost, but that remains to be evaluated.

Place, publisher, year, edition, pages
Valley Cottage, NY: Open Access Pub, 2017
Keywords
Vitamin D, Supplementation, Screening, Cost, Frail elderly
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Health and Caring Sciences; Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-67953 (URN)10.14302/issn.2474-7785.jarh-17-1724 (DOI)
Projects
Betydelsen av bra D-vitaminstatus för äldres hälsa
Funder
The Kamprad Family Foundation, 20130084
Available from: 2017-09-14 Created: 2017-09-14 Last updated: 2019-09-05Bibliographically approved
Ericson, L., Magnusson, L. & Hovstadius, B. (2017). Societal costs of fetal alcohol syndrome in Sweden. European Journal of Health Economics, 18(5), 575-585
Open this publication in new window or tab >>Societal costs of fetal alcohol syndrome in Sweden
2017 (English)In: European Journal of Health Economics, ISSN 1618-7598, E-ISSN 1618-7601, Vol. 18, no 5, p. 575-585Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To estimate the annual societal cost of fetal alcohol syndrome (FAS) in Sweden, focusing on the secondary disabilities thought feasible to limit via early interventions.

METHODS: Prevalence-based cost-of-illness analysis of FAS in Sweden for 2014. Direct costs (societal support, special education, psychiatric disorders and alcohol/drug abuse) and indirect costs (reduced working capacity and informal caring), were included. The calculations were based on published Swedish studies, including a register-based follow-up study of adults with FAS, reports and databases, and experts.

RESULTS: The annual total societal cost of FAS was estimated at €76,000 per child (0-17 years) and €110,000 per adult (18-74 years), corresponding to €1.6 billion per year in the Swedish population using a prevalence of FAS of 0.2 %. The annual additional cost of FAS (difference between the FAS group and a comparison group) was estimated at €1.4 billion using a prevalence of 0.2 %. The major cost driver was the cost of societal support.

CONCLUSIONS: The cost burden of FAS on the society is extensive, but likely to be underestimated. A reduction in the societal costs of FAS, both preventive and targeted interventions to children with FAS, should be prioritized. That is, the cost of early interventions such as placement in family homes or other forms of housing, and special education, represent unavoidable costs. However, these types of interventions are highly relevant to improve the individual's quality of life and future prospects, and also, within a long-term perspective, to limit the societal costs and personal suffering.

Place, publisher, year, edition, pages
Springer, 2017
Keywords
FAS, Direct costs, Indirect costs, Cost of illness
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-56721 (URN)10.1007/s10198-016-0811-4 (DOI)000401738400005 ()27279344 (PubMedID)2-s2.0-84976288746 (Scopus ID)
Available from: 2016-09-26 Created: 2016-09-26 Last updated: 2017-07-19Bibliographically approved
Hammar, T., Nilsson, A.-L. & Hovstadius, B. (2016). Patients' views on electronic patient information leaflets. Pharmacy Practice, 14(2), Article ID 702.
Open this publication in new window or tab >>Patients' views on electronic patient information leaflets
2016 (English)In: Pharmacy Practice, ISSN 1885-642X, E-ISSN 1886-3655, Vol. 14, no 2, article id 702Article in journal (Refereed) Published
Abstract [en]

Background: Information in society and in health care is currently undergoing a transition from paper to digital formats, and the main source of information will probably be electronic in the future. Objective: To explore patients’ use and perceptions of the patient information leaflet included in the medication package, and their attitude towards a transition to an electronic version. Methods: The data was collected during October to November 2014 among individuals in South-Eastern Sweden, using a questionnaire (n=406, response rate 78%) and interviews (n=15). Results: The questionnaire showed that the majority of the respondents (52%) occasionally read the patient information leaflet, 37% always read it, and 11% never read it. Almost half of the patients (41%) were positive towards reading the patient information leaflet electronically while 32% were hesitant and 26% neutral. A majority of the patients would request to get the patient information leaflet printed at the pharmacy if it was not included in the package. There were differences in attitude related to age and gender. The interviews showed that patients had mixed views on a transition to an electronic patient information leaflet. The patients perceived several positive aspects with an electronic patient information leaflet but were concerned about elderly patients. Conclusion: Although many were positive towards reading the patient information leaflet electronically, the majority prefer the patient information leaflet in paper form. Providing appropriate and useful eHealth services for patients to access the patient information leaflet electronically, along with education, could prepare patients for a transition to electronic patient information leaflet. © 2016, Grupo de Investigacion en Atencion Farmaceutica. All rights reserved.

Keywords
Drug labeling, Patient education as topic, Patient medication knowledge, Pharmacies, Qualitative research, Surveys and questionnaires, Sweden, Telemedicine
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-56181 (URN)10.18549/PharmPract.2016.02.702 (DOI)2-s2.0-84976449634 (Scopus ID)
Available from: 2016-09-02 Created: 2016-08-31 Last updated: 2017-05-17Bibliographically approved
Hovstadius, B., Ericson, L. & Magnusson, L. (2015). Barn som anhöriga: ekonomisk studie av samhällets långsiktiga kostnader. Kalmar: Nationellt kompetenscentrum anhöriga, Linnéuniversitetet
Open this publication in new window or tab >>Barn som anhöriga: ekonomisk studie av samhällets långsiktiga kostnader
2015 (Swedish)Report (Other academic)
Abstract [sv]

Att barn och unga lever i hem med missbruk och/eller allvarlig sjukdom medför direkta och indirekta kostnader för samhället på kort och lång sikt. Denna hälsoekonomiska studie är en beräkning av samhällets årliga kostnad för den andel av befolkningen som vuxit upp som barn som anhörig till förälder med psykisk sjukdom eller missbruk av alkohol eller narkotika.

Place, publisher, year, edition, pages
Kalmar: Nationellt kompetenscentrum anhöriga, Linnéuniversitetet, 2015. p. 32
Series
Nka Barn som anhöriga ; 2015:8
National Category
Other Health Sciences
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-61368 (URN)9789187731280 (ISBN)
Available from: 2017-03-14 Created: 2017-03-14 Last updated: 2017-05-17Bibliographically approved
Ericson, L., Hovstadius, B. & Magnusson, L. (2015). Hälsoekonomisk studie av barn och vuxna med fetalt alkoholsyndrom. Kalmar: Nationellt kompetenscentrum anhöriga
Open this publication in new window or tab >>Hälsoekonomisk studie av barn och vuxna med fetalt alkoholsyndrom
2015 (Swedish)Report (Other academic)
Abstract [sv]

Att barn och unga lever i hem med missbruk och/eller allvarlig sjukdom medför direkta och indirekta kostnader för samhället på kort och lång sikt. Denna hälsoekonomiska studie är en beräkning av samhällets årliga kostnad för den andel av befolkningen som vuxit upp som barn som anhörig till förälder med psykisk sjukdom eller missbruk av alkohol eller narkotika.

Place, publisher, year, edition, pages
Kalmar: Nationellt kompetenscentrum anhöriga, 2015. p. 40
Series
Nka Barn som anhöriga ; 2015:10
National Category
Other Health Sciences
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-61367 (URN)9789187731303 (ISBN)
Available from: 2017-03-14 Created: 2017-03-14 Last updated: 2017-05-17Bibliographically approved
Nilsson, A.-L. & Hovstadius, B. (2015). Pilotstudie - webbutbildningen: Läkemedelsbehandling av äldre för AT-läkare. eHälsoinstitutet, Linnéuniversitetet
Open this publication in new window or tab >>Pilotstudie - webbutbildningen: Läkemedelsbehandling av äldre för AT-läkare
2015 (Swedish)Report (Other academic)
Abstract [sv]

Socialstyrelsen har under 2014 tagit fram en webbutbildning för att förbättra AT-läkares kompetens inom området läkemedelsbehandling av äldre. I juni 2014 uppdrog Socialstyrelsen åt eHälsoinstitutet att under hösten 2014 genomföra en utvärdering huruvida webbutbildningen stärker AT-läkarnas kompetens inom området.

Utvärderingen genomfördes som en kontrollerad studie, där studiepopulationen (AT-läkare som tidigare inte hade genomgått webbutbildningen) delades in i två grupper; en interventionsgrupp och en kontrollgrupp. Båda grupperna besvarade en webbenkät som bestod av bakgrundsfrågor och 20 kunskapsfrågor som hämtats från webbutbildningens kunskapstest inom modulerna allmänmedicin och internmedicin. Kunskapsfrågorna var både flersvarsfrågor och ensvarsfrågor. För att få rätt på flervalsfrågorna krävdes att alla rätta alternativ var ifyllda.

Totalt besvarade 90 AT-läkare enkäten, 67 i kontrollgruppen och 23 i interventionsgruppen (svarsfrekvens 16%). I genomsnitt fick svarande i interventionsgruppen 9,5 rätt svar och svarande i kontrollgruppen 7,7 rätt svar. Frågorna skiljer sig i svårighetsgrad utifrån antal rätta svar och sex frågor särskilde sig genom att visa på mer markanta skillnader i resultat mellan grupperna.

Utvärderingen visar att den valda utvärderingsmetoden och genomförandet fungerar och ger trots en relativt låg svarsfrekvens resultatet att de AT-läkare som genomgått webbutbildningen får ett bättre resultat i kunskapstestet än de som inte genomgått utbildningen. En framtida utvärdering som görs efter det att webbutbildningen integrerats in i AT-läkarnas ordinarie utbildning, antas kunna säkra en hög svarsfrekvens och då ge statistiskt signifikanta resultat.

Place, publisher, year, edition, pages
eHälsoinstitutet, Linnéuniversitetet, 2015. p. 11
Keywords
webbutbildning, läkemedelsbehandling av äldre, AT-läkare, eHälsoinstitutet, utvärdering, webbenkät
National Category
Health Sciences
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-62517 (URN)
Projects
Pilotstudie - Webbutbildning läkemedelsbehandling av äldre för AT-läkare
Funder
Swedish National Board of Health and Welfare
Available from: 2017-04-19 Created: 2017-04-19 Last updated: 2017-05-29Bibliographically approved
Hammar, T., Hovstadius, B., Lidström, B., Petersson, G. & Eiermann, B. (2014). Potential drug related problems detected by electronic expert support system in patients with multi-dose drug dispensing.. International Journal of Clinical Pharmacy, 36(5), 943-952
Open this publication in new window or tab >>Potential drug related problems detected by electronic expert support system in patients with multi-dose drug dispensing.
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2014 (English)In: International Journal of Clinical Pharmacy, ISSN 2210-7703, E-ISSN 2210-7711, Vol. 36, no 5, p. 943-952Article in journal (Refereed) Published
Abstract [en]

Background Drug related problems (DRPs) are frequent and cause suffering for patients and substantial costs for society. Multi-dose drug dispensing (MDDD) is a service by which patients receive their medication packed in bags with one unit for each dose occasion. The clinical decision support system (CDSS) electronic expert support (EES) analyses patients’ prescriptions in the Swedish national e-prescription repository and provides alerts if potential DRPs are detected, i.e. drug–drug interactions, duplicate therapy, drug-disease contraindications, high dose, gender warnings, geriatric, and paediatric alerts. Objective To analyse potential DRPs in patients with MDDD, detected by means of EES. Setting A register study of all electronically stored prescriptions for patients with MDDD in Sweden (n = 180,059) March 5–June 5, 2013. Method Drug use and potential DRPs detected in the study population during the 3 month study period by EES were analysed. The potential DRPs were analysed in relation to patients’ age, gender, number of drugs, and type of medication. Main outcome measure Prevalence of potential DRPs measured as EES alerts. Results The study population was on average 75.8 years of age (±17.5, range 1–110) and had 10.0 different medications (±4.7, range 1–53). EES alerted for potential DRPs in 76 % of the population with a mean of 2.2 alerts per patient (±2.4, range 0–27). The older patients received a lower number of alerts compared to younger patients despite having a higher number of drugs. The most frequent alert categories were drug–drug interactions (37 % of all alerts), duplicate therapy (30 %), and geriatric warnings for high dose or inappropriate drugs (23 %). Psycholeptics, psychoanaleptics, antithrombotic agents, anti-epileptics, renin-angiotensin system agents, and analgesics represented 71 % of all drugs involved in alerts. Conclusions EES detected potential DRPs in the majority of patients with MDDD. The number of potential DRPs was associated with the number of drugs, age, gender, and type of medication. A CDSS such as EES might be a useful tool for physicians and pharmacists to assist in the important task of monitoring patients with MDDD for potential DRPs.

Place, publisher, year, edition, pages
Springer, 2014
Keywords
Clinical decision support system, Drug–drug interactions, Drug related problems, Multi-dose drug dispensing, Pharmacoepidemiology, Sweden
National Category
Social and Clinical Pharmacy
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-37165 (URN)10.1007/s11096-014-9976-z (DOI)000343647000012 ()24974220 (PubMedID)2-s2.0-84911383016 (Scopus ID)
Available from: 2014-09-22 Created: 2014-09-22 Last updated: 2018-01-11Bibliographically approved
Hovstadius, B., Petersson, G., Hellström, L. & Ericson, L. (2014). Trends in Inappropriate Drug Therapy Prescription in the Elderly in Sweden from 2006 to 2013: Assessment Using National Indicators. Drugs & Aging, 31(5), 379-386
Open this publication in new window or tab >>Trends in Inappropriate Drug Therapy Prescription in the Elderly in Sweden from 2006 to 2013: Assessment Using National Indicators
2014 (English)In: Drugs & Aging, ISSN 1170-229X, E-ISSN 1179-1969, Vol. 31, no 5, p. 379-386Article in journal (Refereed) Published
Abstract [en]

Background Medication for elderly patients is often complex and problematic. Several criteria for classifying inappropriate prescribing exist. In 2010, the Swedish National Board of Health and Welfare published the document "Indicators of appropriate drug therapy in the elderly" as a guideline for improving prescribing for the elderly. Objective The aim of this study was to assess trends in the prescription of inappropriate drug therapy in the elderly in Sweden from 2006 to 2013 using national quality indicators for drug treatment. Methods Individual-based data on dispensed prescription drugs for the entire Swedish population aged >= 65 years during eight 3-month periods from 2006 to 2013 were accumulated. The data were extracted from the Swedish Prescribed Drug Register. Eight drug-specific quality indicators were monitored. Results For the entire population studied (n = 1,828,283 in 2013), six of the eight indicators showed an improvement according to the guidelines; the remaining two indicators (drugs with anticholinergic effects and excessive polypharmacy) remained relatively unchanged. For the subgroup aged 65-74 years, three indicators showed an improvement, four indicators remained relatively unchanged (e.g. propiomazine, and oxazepam) and one showed an undesirable trend (anticholinergic drugs) according to guidelines. For the older group (aged >= 75 years), all indicators except excessive polypharmacy showed improvement. Conclusion According to the quality indicators used, the extent of inappropriate drug therapy in the elderly decreased from 2006 to 2013 in Sweden. Thus, prescribers appear to be more likely to change their prescribing patterns for the elderly than previously assumed.

National Category
Pharmaceutical Sciences Geriatrics
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-34475 (URN)10.1007/s40266-014-0165-5 (DOI)000335146000006 ()2-s2.0-84900829669 (Scopus ID)
Available from: 2014-05-28 Created: 2014-05-28 Last updated: 2018-01-11Bibliographically approved
Hovstadius, B. & Petersson, G. (2013). The impact of increasing polypharmacy on prescribed drug expenditure: A register-based study in Sweden 2005-2009.. Health Policy, 109(2), 166-174
Open this publication in new window or tab >>The impact of increasing polypharmacy on prescribed drug expenditure: A register-based study in Sweden 2005-2009.
2013 (English)In: Health Policy, ISSN 0168-8510, E-ISSN 1872-6054, Vol. 109, no 2, p. 166-174Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES:

To analyse the impact of the observed increase in the prevalence in polypharmacy on the development of prescribed drug expenditure (PDE) in a national population during five years.

METHODS:

A register-based study of all prescribed drugs and PDE for the entire Swedish population during a 3-month period in 2005 and 2009, respectively. The prevalence of "polypharmacy" and "excessive polypharmacy" was defined as the proportion of patients receiving five or more (PD≥5) and ten or more (PD≥10) prescribed drugs during a 3-month period, respectively.

RESULTS:

Between 2005 and 2009, the prevalence of polypharmacy increased by 8.3% (from 11.1% to 12.0%), and the prevalence of excessive polypharmacy by 9.9% (from 2.4% to 2.6%). Total PDE increased by 4.8% in real prices. For the group of patients with polypharmacy and excessive polypharmacy, PDE increased by 6.2%, and 7.3%, respectively. A simulation, in which the increase in polypharmacy was neutralised, resulted in no increase in total PDE.

CONCLUSIONS:

The increase in the prevalence of polypharmacy has a substantial impact on the increase in PDE and can explain the entire increase in PDE in Sweden during 2005 to 2009. For clinicians and healthcare stakeholders, it is important to monitor and guidance the further development in multiple medication therapy, so that the cost associated with increasing polypharmacy will not exceed its benefits.

Place, publisher, year, edition, pages
Elsevier, 2013
Keywords
Drug cost, dispensed drugs, polypharmacy, register
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-22724 (URN)10.1016/j.healthpol.2012.09.005 (DOI)000314445600009 ()2-s2.0-84872290816 (Scopus ID)
Available from: 2012-12-06 Created: 2012-12-06 Last updated: 2018-02-19Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-6648-8702

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