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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)
Available from: 2018-05-09 Created: 2018-05-09 Last updated: 2019-06-13Bibliographically approved
Stevenson-Ågren, J., Israelsson, J., Petersson, G. & Bath, P. (2018). Factors influencing the quality of vital signs data in electronic health records: a qualitative study. Journal of Clinical Nursing, 27(5-6), 1276-1286
Open this publication in new window or tab >>Factors influencing the quality of vital signs data in electronic health records: a qualitative study
2018 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 5-6, p. 1276-1286Article in journal (Refereed) Published
Abstract [en]

Aims and objectives

To investigate reasons for inadequate documentation of vital signs in an electronic health record.

Background

Monitoring vital signs is crucial to detecting and responding to patient deterioration. The ways in which vital signs are documented in electronic health records have received limited attention in the research literature. A previous study revealed that vital signs in an electronic health record were incomplete and inconsistent.

Design

Qualitative study.

Methods

Qualitative study. Data were collected by observing (68 hr) and interviewing nurses (n = 11) and doctors (n = 3), and analysed by thematic analysis to examine processes for measuring, documenting and retrieving vital signs in four clinical settings in a 353-bed hospital.

Results

We identified two central reasons for inadequate vital sign documentation. First, there was an absence of firm guidelines for observing patients’ vital signs, resulting in inconsistencies in the ways vital signs were recorded. Second, there was a lack of adequate facilities in the electronic health record for recording vital signs. This led to poor presentation of vital signs in the electronic health record and to staff creating paper “workarounds.”

Conclusions

This study demonstrated inadequate routines and poor facilities for vital sign documentation in an electronic health record, and makes an important contribution to knowledge by identifying problems and barriers that may occur. Further, it has demonstrated the need for improved facilities for electronic documentation of vital signs.

Relevance to clinical practice

Patient safety may have been compromised because of poor presentation of vital signs. Thus, our results emphasised the need for standardised routines for monitoring patients. In addition, designers should consult the clinical end-users to optimise facilities for electronic documentation of vital signs. This could have a positive impact on clinical practice and thus improve patient safety.

Place, publisher, year, edition, pages
New Jersey: John Wiley & Sons, 2018
Keywords
Vital signs, patient safety, electronic health records
National Category
Other Medical Sciences not elsewhere specified
Research subject
Health and Caring Sciences, Health Informatics
Identifiers
urn:nbn:se:lnu:diva-70319 (URN)10.1111/jocn.14174 (DOI)000428419400087 ()29149483 (PubMedID)
Available from: 2018-01-31 Created: 2018-01-31 Last updated: 2019-03-05Bibliographically approved
Johansson Östbring, M., Eriksson, T., Petersson, G. & Hellström, L. (2018). Motivational Interviewing and Medication Review in Coronary Heart Disease (MIMeRiC): Intervention Development and Protocol for the Process Evaluation. JMIR Research Protocols, 7(1), 1-12, Article ID e21.
Open this publication in new window or tab >>Motivational Interviewing and Medication Review in Coronary Heart Disease (MIMeRiC): Intervention Development and Protocol for the Process Evaluation
2018 (English)In: JMIR Research Protocols, ISSN 1929-0748, E-ISSN 1929-0748, Vol. 7, no 1, p. 1-12, article id e21Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Trials of complex interventions are often criticized for being difficult to interpret because the effects of apparently similar interventions vary across studies dependent on context, targeted groups, and the delivery of the intervention. The Motivational Interviewing and Medication Review in Coronary heart disease (MIMeRiC) trial is a randomized controlled trial (RCT) of an intervention aimed at improving pharmacological secondary prevention. Guidelines for the development and evaluation of complex interventions have recently highlighted the need for better reporting of the development of interventions, including descriptions of how the intervention is assumed to work, how this theory informed the process evaluation, and how the process evaluation relates to the outcome evaluation.

OBJECTIVE: This paper aims to describe how the intervention was designed and developed. The aim of the process evaluation is to better understand how and why the intervention in the MIMeRiC trial was effective or not effective.

METHODS: The research questions for evaluating the process are based on the conceptual model of change processes assumed in the intervention and will be analyzed by qualitative and quantitative methods. Quantitative data are used to evaluate the medication review in terms of drug-related problems, to describe how patients' beliefs about medicines are affected by the intervention, and to evaluate the quality of motivational interviewing. Qualitative data will be used to analyze whether patients experienced the intervention as intended, how cardiologists experienced the collaboration and intervention, and how the intervention affected patients' overall experience of care after coronary heart disease.

RESULTS: The development and piloting of the intervention are described in relation to the theoretical framework. Data for the process evaluation will be collected until March 2018. Some process evaluation questions will be analyzed before, and others will be analyzed after the outcomes of the MIMeRiC RCT are known.

CONCLUSIONS: This paper describes the framework for the design of the intervention tested in the MIMeRiC trial, development of the intervention from the pilot stage to the complete trial intervention, and the framework and methods for the process evaluation. Providing the protocol of the process evaluation allows prespecification of the processes that will be evaluated, because we hypothesize that they will determine the outcomes of the MIMeRiC trial. This protocol also constitutes a contribution to the new field of process evaluations as made explicit in health services research and clinical trials of complex interventions.

Place, publisher, year, edition, pages
JMIR Publications, 2018
Keywords
coronary artery disease, quality of health care, medication adherence, medication therapy management, pharmacist
National Category
Social and Clinical Pharmacy
Research subject
Biomedical Sciences, Pharmacology
Identifiers
urn:nbn:se:lnu:diva-71384 (URN)10.2196/resprot.8660 (DOI)000432915700019 ()29382630 (PubMedID)
Available from: 2018-03-06 Created: 2018-03-06 Last updated: 2019-05-20Bibliographically approved
Johansson Östbring, M., Eriksson, T., Petersson, G. & Hellström, L. (2018). Motivational Interviewing and Medication Review in Coronary Heart Disease (MIMeRiC): Protocol for a Randomized Controlled Trial Investigating Effects on Clinical Outcomes, Adherence, and Quality of Life. JMIR Research Protocols, 7(2), 1-15, Article ID e57.
Open this publication in new window or tab >>Motivational Interviewing and Medication Review in Coronary Heart Disease (MIMeRiC): Protocol for a Randomized Controlled Trial Investigating Effects on Clinical Outcomes, Adherence, and Quality of Life
2018 (English)In: JMIR Research Protocols, ISSN 1929-0748, E-ISSN 1929-0748, Vol. 7, no 2, p. 1-15, article id e57Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Preventive treatment goals for blood pressure and cholesterol levels continue to be unmet for many coronary patients. The effect of drug treatment depends on both its appropriateness and the patients' adherence to the treatment regimen. There is a need for adherence interventions that have a measurable effect on clinical outcomes.

OBJECTIVE: This study aims to evaluate the effects on treatment goals of an intervention designed to improve patient adherence and treatment quality in secondary prevention of coronary heart disease. A protocol for the prespecified process evaluation of the trial is published separately.

METHODS: The Motivational Interviewing and Medication Review in Coronary heart disease (MIMeRiC) trial is a prospective, randomized, outcomes-blinded trial designed to compare individualized follow-up by a clinical pharmacist using motivational interviewing (MI) and medication review with standard follow-up. Patients were randomized to 2 groups after stratification according to their beliefs about medicines. After standard follow-up at the cardiology clinic, patients in the intervention group are seen individually by a clinical pharmacist 2 to 5 times as required over 7 months, at the clinic. The pharmacist reviews each patient's medication and uses MI to manage any problems with prescribing and adherence. The primary study outcome is the proportion of patients who have reached the treatment goal for low-density lipoprotein cholesterol by 12 months after discharge. Secondary outcomes are the effects on patient adherence, systolic blood pressure, disease-specific quality of life, and health care use.

RESULTS: The protocol for this study was approved by the Regional Ethics Committee, Linköping, in 2013. Enrollment started in October 2013 and ended in December 2016 when 417 patients had been included. Follow-up data collection will conclude in March 2018. Publication of the primary and secondary outcome results from the MIMeRiC trial is anticipated in 2019.

CONCLUSIONS: The MIMeRiC trial will assess the effectiveness of an intervention involving medication reviews and individualized support. The results will inform the continued development of support for this large group of patients who use preventive medicines for lifelong treatment. The design of this adherence intervention is based on a theoretical framework and is the first trial of an intervention that uses beliefs about medicines to individualize the intervention protocol.

TRIAL REGISTRATION: ClinicalTrials.gov NCT02102503; https://clinicaltrials.gov/ct2/show/NCT02102503 (Archived by WebCite at http://www.webcitation.org/6x7iUDohy).

Place, publisher, year, edition, pages
JMIR Publications, 2018
Keywords
coronary artery disease, medication adherence, medication therapy management, pharmacist, randomized controlled trial
National Category
Social and Clinical Pharmacy
Research subject
Biomedical Sciences, Pharmacology
Identifiers
urn:nbn:se:lnu:diva-71385 (URN)10.2196/resprot.8659 (DOI)000432916000005 ()29463490 (PubMedID)
Funder
The Kamprad Family Foundation
Available from: 2018-03-06 Created: 2018-03-06 Last updated: 2019-05-20Bibliographically approved
Stevenson-Ågren, J., Israelsson, J., Nilsson, G., Petersson, G. & Bath, P. A. (2018). Vital sign documentation in electronic records: the development of workarounds. Health Informatics Journal, 24(2), 206-215
Open this publication in new window or tab >>Vital sign documentation in electronic records: the development of workarounds
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2018 (English)In: Health Informatics Journal, ISSN 1460-4582, E-ISSN 1741-2811, Vol. 24, no 2, p. 206-215Article in journal (Refereed) Published
Abstract [en]

Workarounds are commonplace in health care settings. An increase in the use of electronic health records (EHR) has led to an escalation of workarounds as health care professionals cope with systems which are inadequate for their needs. Closely related to this, the documentation of vital signs in EHR has been problematic. The accuracy and completeness of vital sign documentation has a direct impact on the recognition of deterioration in a patient’s condition. We examined work flow processes to identify workarounds related to vital signs in a 372-bed hospital in Sweden. In three clinical areas a qualitative study was performed with data collected during observations and interviews and analysed through thematic content analysis. We identified paper workarounds in the form of hand-written notes and a total of eight pre-printed paper observation charts. Our results suggested that nurses created workarounds to allow a smooth workflow and to ensure patients safety.

Place, publisher, year, edition, pages
Sage Publications, 2018
Keywords
electronic health records, healthcare professionals, patient safety, vital signs, workarounds
National Category
Health Care Service and Management, Health Policy and Services and Health Economy Information Systems
Research subject
Health and Caring Sciences, Health Informatics
Identifiers
urn:nbn:se:lnu:diva-55697 (URN)10.1177/1460458216663024 (DOI)000432068300008 ()27542887 (PubMedID)
Available from: 2016-08-22 Created: 2016-08-22 Last updated: 2019-03-05Bibliographically 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.

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: 2019-03-20Bibliographically approved
Bravo, G., Laitinen, M., Levin, M., Löwe, W. & Petersson, G. (2017). Big Data in Cross-Disciplinary Research: J.UCS Focused Topic. Journal of universal computer science (Online), 23(11), 1035-1037
Open this publication in new window or tab >>Big Data in Cross-Disciplinary Research: J.UCS Focused Topic
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2017 (English)In: Journal of universal computer science (Online), ISSN 0948-695X, E-ISSN 0948-6968, Vol. 23, no 11, p. 1035-1037Article in journal, Editorial material (Other academic) Published
National Category
Computer and Information Sciences
Research subject
Computer and Information Sciences Computer Science
Identifiers
urn:nbn:se:lnu:diva-72044 (URN)000429070900003 ()2-s2.0-85045057959 (Scopus ID)
Available from: 2018-03-30 Created: 2018-03-30 Last updated: 2019-05-28Bibliographically approved
Weyns, D., Caporuscio, M., Axelsson, C. & Petersson, G. (2017). BoConnect – Reliable Assistive Technologies to Empower Elderly People to Live Independently Longer.
Open this publication in new window or tab >>BoConnect – Reliable Assistive Technologies to Empower Elderly People to Live Independently Longer
2017 (English)Report (Other academic)
Abstract [en]

BoConnect was a multi-disciplinary collaborative research project between Linnaeus University and Växjö and Kalmarmunicipalities in Sweden. The project had a budget of 3 MSEK; it stated Jan. 2015 and ended Dec. 2016.The project studied reliable assistive technologies to support elderly people. In contrast to existing work in this areathatis often limited to small-scale technology-driven pilots that are poorly embedded in the social living context, the BoConnect project took a holistic perspective on assistive technologies and put user needs and reliability of the solutions in focus, both from a technological and organizational perspective. This report summarizes the main results of the project.

Publisher
p. 2
National Category
Software Engineering
Identifiers
urn:nbn:se:lnu:diva-62014 (URN)
Projects
BoConnect
Funder
The Kamprad Family Foundation
Available from: 2017-03-31 Created: 2017-03-31 Last updated: 2018-01-13Bibliographically approved
Caporuscio, M., Weyns, D., Andersson, J., Axelsson, C. & Petersson, G. (2017). IoT-enabled Physical Telerehabilitation Platform. In: Proccedings of the International Workshop on Engineering IoT Systems: Architectures, Services, Applications, and Platforms. Paper presented at IEEE International Conference on Software Architecture (ICSA 2017), Göteborg 3-7 April 2017 (pp. 112-119). IEEE
Open this publication in new window or tab >>IoT-enabled Physical Telerehabilitation Platform
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2017 (English)In: Proccedings of the International Workshop on Engineering IoT Systems: Architectures, Services, Applications, and Platforms, IEEE, 2017, p. 112-119Conference paper, Published paper (Refereed)
Abstract [en]

Physical telerehabilitation services over the Internet allow physiotherapists to engage in remote consultation with patients at their homes, improving the quality of care and reducing costs. Traditional visual approaches, such as webcams and videophones, are limited in terms of precision of assessment and support for assistance with exercises. In this paper, we present a Physical Telerehabilitation System (PTS) that enhances video interaction with IoT technology to monitor the position of the body of patients in space and provide smart data to physiotherapists and users. We give an overview of the architecture of the PTS and evaluate (i) its usability based on a number of interviews and focus groups with stakeholders, and (ii) its technical efficiency based on a series of measurements. From this evaluation, we derive a number of challenges for further improvement of the PTS and outline a possible solution based on a microservices architecture.

Place, publisher, year, edition, pages
IEEE, 2017
National Category
Information Systems Other Health Sciences
Research subject
Health and Caring Sciences, Health Informatics
Identifiers
urn:nbn:se:lnu:diva-61631 (URN)10.1109/ICSAW.2017.43 (DOI)000413089000021 ()978-1-5090-4793-2 (ISBN)
Conference
IEEE International Conference on Software Architecture (ICSA 2017), Göteborg 3-7 April 2017
Available from: 2017-03-22 Created: 2017-03-22 Last updated: 2018-04-26Bibliographically approved
Stevenson-Ågren, J., Petersson, G., Israelsson, J. & Bath, P. (2017). Reasons for poor vital sign documentation in electronic health records: A qualitative study. In: European Society of Cardiology Congress, Barcelona, 26-30 August, 2017: . Paper presented at European Society of Cardiology (ESC) Congress, Barcelona, 2017.
Open this publication in new window or tab >>Reasons for poor vital sign documentation in electronic health records: A qualitative study
2017 (English)In: European Society of Cardiology Congress, Barcelona, 26-30 August, 2017, 2017Conference paper, Poster (with or without abstract) (Refereed)
Keywords
Patient safety, vital signs, electronic health records
National Category
Other Medical Sciences not elsewhere specified
Research subject
Health and Caring Sciences, Health Informatics
Identifiers
urn:nbn:se:lnu:diva-70321 (URN)
Conference
European Society of Cardiology (ESC) Congress, Barcelona, 2017
Available from: 2018-01-31 Created: 2018-01-31 Last updated: 2018-09-07Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-4295-7201

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