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  • 1. Arin, M
    et al.
    Petersson, Göran
    Attityder kring psykiatri - en minienkät1977In: MOTPOL - tidskrift för sjukvårdsdebatt, Vol. 8, p. 152-153Article in journal (Other academic)
  • 2.
    Axelsson, Clara
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Byrman, Gunilla
    Linnaeus University, Faculty of Arts and Humanities, Department of Swedish Language.
    Petersson, Göran
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Skoglund, Astrid
    Linnaeus University, Faculty of Arts and Humanities, Department of Swedish Language.
    Stevenson-Ågren, Jean
    Linnaeus University, Faculty of Arts and Humanities, Department of Languages.
    "Det kan bli så mycket fel": Förstudie om barnmorskors upplevelser av kommunikation med gravida kvinnor utan funktionell behärskning av svenska.2016Report (Other academic)
  • 3. Bacci, E
    et al.
    Bertrand, C
    Geppetti, P
    Baker, J
    Nadel, J
    Laitinen, A L
    Petersson, Göran
    University of California, USA.
    Budesonide inhibits plasma extravasation induced by capsaicin and by substance P in the rat nasal mucosa1993In: Regulatory Peptides, Vol. 49, p. 159-166Article in journal (Refereed)
  • 4. Berglund, M
    et al.
    Nilsson, C
    Révay, Peter
    University of Kalmar, School of Communication and Design.
    Petersson, Göran
    University of Kalmar, School of Human Sciences. University of Kalmar, eHealth Institute, School of Human Sciences, University of Kalmar,.
    Nilsson, Gunilla
    University of Kalmar, School of Human Sciences.
    Nurses´ and nurse students´demands of functions and usability in a PDA2007In: International Journal of Medical Informatics, Vol. 76, p. 530-537Article in journal (Refereed)
  • 5. Bertrand, C
    et al.
    Geppetti, P
    Baker, J
    Petersson, Göran
    University of California, USA.
    Piedimonte, G
    Nadel, J A
    Role of peptidases and NK1 receptors in vascular extravasation induced by bradykinin in rat nasal mucosa1993In: Journal of Applied Physiology, Vol. 74, p. 2456-2461Article in journal (Refereed)
  • 6. Brattmo, M
    et al.
    Lindberg, S
    Wihl, J-Å
    Petersson, Göran
    University Hospital, Malmö.
    Malm, L
    Allergic rhinitis and atopy in 18-year-old students2002In: American Journal of Rhinology, Vol. 16, p. 323-327Article in journal (Refereed)
  • 7.
    Bravo, Giangiacomo
    et al.
    Linnaeus University, Faculty of Social Sciences, Department of Social Studies.
    Laitinen, Mikko
    Linnaeus University, Faculty of Arts and Humanities, Department of Languages.
    Levin, Magnus
    Linnaeus University, Faculty of Arts and Humanities, Department of Languages.
    Löwe, Welf
    Linnaeus University, Faculty of Technology, Department of computer science and media technology (CM), Department of Computer Science.
    Petersson, Göran
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Big Data in Cross-Disciplinary Research: J.UCS Focused Topic2017In: Journal of universal computer science (Online), ISSN 0948-695X, E-ISSN 0948-6968, Vol. 23, no 11, p. 1035-1037Article in journal (Other academic)
  • 8.
    Broberg Danielsson, Hanna
    et al.
    Linnaeus University, Faculty of Technology, Department of Informatics.
    Nilsson, Anna-Lena
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Petersson, Göran
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Utvärdering av eHälsa - 10 års erfarenhet2014In: Vitalis - Nordens ledande eHälsomöte 2014: Vetenskapliga papers presenterade vid Vitalis konferens, Svenska Mässan, Göteborg, 8-10 april 2014, 2014Conference paper (Refereed)
    Abstract [en]

    Hälso- och sjukvården har gjort omfattande satsningar på införande av IT-stöd för att få en bättre, säkrare och effektivare vård. IT-stöden ger dock inte alltid de avsedda effekterna och utvärdering blir då ett viktigt instrument i förbättringsarbetet. Vi har gjort en studie av 26 utvärderingsprojekt vid eHälsoinstitutet senaste 10 åren och kartlagt medarbetarnas erfarenheter av att utvärdera eHälsa. Dessa resultat kommer att användas för att förbättra metodik för utvärdering av eHälsa.

  • 9.
    Caporuscio, Mauro
    et al.
    Linnaeus University, Faculty of Technology, Department of Computer Science.
    Weyns, Danny
    Linnaeus University, Faculty of Technology, Department of Computer Science. Katholieke University Leuven, Belgium.
    Andersson, Jesper
    Linnaeus University, Faculty of Technology, Department of Computer Science.
    Axelsson, Clara
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Petersson, Göran
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    IoT-enabled Physical Telerehabilitation Platform2017In: Proccedings of the International Workshop on Engineering IoT Systems: Architectures, Services, Applications, and Platforms, IEEE, 2017, p. 112-119Conference 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.

  • 10.
    Carlsson, Martin
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry. Kalmar County Hospital.
    Wanby, Par
    Kalmar County Hospital.
    Brudin, Lars
    Linköping University ; Kalmar County Hospital.
    Lexne, Erik
    Kalmar County Hospital.
    Mathold, Karin
    Kalmar County Hospital.
    Nobin, Rebecca
    Kalmar County Hospital.
    Ericson, Lisa
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Nordqvist, Ola
    Kalmar County Council.
    Petersson, Göran
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Older Swedish Adults with High Self-Perceived Health Show Optimal 25-Hydroxyvitamin D Levels Whereas Vitamin D Status Is Low in Patients with High Disease Burden2016In: Nutrients, ISSN 2072-6643, E-ISSN 2072-6643, Vol. 8, no 11, article id 717Article in journal (Refereed)
    Abstract [en]

    Controversy pervades the definition of adequate and optimal vitamin D status. The Institutes of Medicine have recommended serum 25(OH) D levels above 50 nmol/L based upon evidence related to bone health, but some experts, including the Endocrine Society and International Osteoporosis Foundation, suggest a minimum serum 25(OH) D level of 75 nmol/L to reduce the risk of falls and fractures in older adults. In a cross-sectional study, we compared vitamin D status in people >= 75 years selected from four groups with a frailty phenotype, combined with a control group free from serious illness, and who considered themselves completely healthy. Only 13% of the 169 controls were vitamin D deficient (S-25(OH) D) < 50 nmol/L), in contrast with 49% of orthopedic patients with hip fractures (n = 133), 31% of stroke patients (n = 122), 39% of patients visiting the hospital's emergency department >= 4 times a year (n = 81), and 75% of homebound adult residents in long-term care nursing homes (n = 51). The mean vitamin D concentration of the healthy control group (74 nmol/L) was similar to a suggested optimal level based on physiological data and mortality studies, and much higher than that of many officially recommended cut-off levels for vitamin D deficiency (< 50 nmol/L). The present study provides a basis for planning and implementing public guidelines for the screening of vitamin D deficiency and vitamin D treatment for frail elderly patients.

  • 11. Donnér, M
    et al.
    Edholm, B
    Jeppsson, A
    Petersson, Göran
    Sjöhagen, K
    Vinge, E
    Är de stomiopererade "vandrande dass"?1976In: Landstingens tidskrift, Vol. 11, p. 28-30Article in journal (Other academic)
  • 12. Dørup, J
    et al.
    Bach-Gansmo, E
    Booth, A
    Krarup, J N
    Petersson, Göran
    Lund university.
    Schroeder, T
    Stensaas, S
    Winding, O
    Carlile, S
    Fischer, M
    Patino, J
    Nattestad, A
    World Federation for Medical Education (WFME) Guidelines for using computers in medical education1998In: Medical Education, Vol. 32 (Revised 2001), p. 205-208Article in journal (Refereed)
  • 13.
    Ekman, Elisabet
    et al.
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Petersson, Göran
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Tågerud, Sven
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Bäckström, Martin
    Awareness among nurses about reporting of adverse drug reactions in Sweden2012In: Drug, Healthcare and Patient Safety, ISSN 1179-1365, E-ISSN 1179-1365, Vol. 4, p. 61-66Article in journal (Refereed)
    Abstract [en]

    Background: The purpose of this study was to investigate awareness among nurses regarding their new role as reporters of adverse drug reactions in Sweden and factors that may influence reporting by nurses.

    Methods: In 2007, all nurses were included in the adverse drug reaction reporting scheme in Sweden. A questionnaire was sent to 753 randomly selected nurses in September 2010.

    Results: Of the 453 (60%) responding nurses, 265 (58%) were aware that nurses were included in the reporting of adverse drug reactions. Sixty-one nurses (14%) stated that they had reported an adverse drug reaction. Fifteen percent (n = 70) of the respondents had received training about reporting of adverse drug reactions. Almost one third of these (n = 21, 30%) had reported an adverse drug reaction on at least one occasion. Among nurses without training, a smaller proportion (n = 40, 11%, P < 0.05) had reported an adverse drug reaction on at least one occasion. The two factors considered most important by nurses for reporting were the severity of the adverse drug reaction and if the reaction was to a newly approved drug. A majority of the nurses (n = 397, 88%) were interested in a training course in pharmacology as part of their ongoing professional development. One third (32%) of all nurses stated that one reason for not reporting a suspected adverse drug reaction was that the physician responsible did not regard the reaction necessary to report.

    Conclusion: We found that more than half of the study population of nurses in Sweden were aware of their new role as reporters of adverse drug reactions, but few of the responding nurses had reported an adverse drug reaction. Given that training seems to be associated with high reporting frequency, we suggest more training in pharmacovigilance for nurses.

  • 14.
    Ericson, Lisa
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Hammar, Tora
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Schönström, Nils
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Petersson, Göran
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Stakeholder consensus on the purpose of clinical evaluation of electronic health records is required2017In: Health Policy and Technology, ISSN 2211-8837, E-ISSN 2211-8845, Vol. 6, no 2, p. 152-160Article in journal (Refereed)
    Abstract [en]

    Objective

    To explore the purpose and performance of clinical evaluation of electronic health records (EHRs) among stakeholders in order to identify any need for regulatory actions or guidelines.

    Methods

    This was a qualitative study of information collected in semi-structured interviews (n=28) of representatives of the five largest EHR vendors in Sweden, healthcare provider IT managers, users, and representatives of national authorities.

    Results

    We found a difference between the stated purpose of clinical evaluation of EHRs by the authorities and the perception of the purpose by the vendors, IT managers, and the users. The respondents gave divergent answers about the medical purpose of the application: e.g. availability of data, overview and documentation, patient safety, process efficiency, decision support, a working tool, and an aid to communication and follow-up. Several vendors found it difficult to put the term clinical evaluation in its specific context, instead referring to literature reviews, risk analyses, risk-management processes, acceptance tests, test facilities, pilot tests, and proven experience.

    Conclusions

    Stakeholders need to agree on a mutually acceptable, consistent method to guide regulatory decisions. The lack of consensus regarding the purpose and performance of clinical evaluation of EHRs could impact negatively on a safe and efficient documentation in healthcare. Thus, there is a need for more consistent use of terms and concepts in, and a more systematic approach to, clinical evaluation of EHRs. To ensure that the implementation of IT in healthcare meets expectations, delivers the desired outcome, and does not create new problems, it should be evaluated.

  • 15.
    Ericson, Lisa
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Hovstadius, Bo
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Carlsson, Martin
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry. Kalmar County Hospital.
    Petersson, Göran
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Wanby, Pär
    Kalmar County Hospital.
    A cost analysis of systematic vitamin D supplementation in the elderly versus supplementation based on assessed requirements2017In: Journal of Aging Research and Healthcare, ISSN 2474-7785, Vol. 2, no 2, p. 13-22Article in journal (Refereed)
    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.

  • 16.
    Ericson, Lisa
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Schönström, Nils
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Petersson, Göran
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Klinisk utvärdering av medicinska informationssystem: Fokus på elektroniska patientjournalsystem2014Report (Other academic)
    Abstract [sv]

    Vården blir allt mer beroende av effektiva och ändamålsenliga informationssystem. Många system har införts utan närmare prövning och kontroll av den kliniska nyttan till skillnad mot införande av nya läkemedel. Medicinska informationssystem är en medicinteknisk produkt och ska följa dess regelverk, till exempel ha en uttalad avsedd användning som inbegriper patientnyttan. Att regelverket för medicintekniska produkter även gäller för medicinska informationssystem har dock i vissa delar haft svårt att slå igenom hos tillverkarna som, bland annat, har skyldighet att genomföra kliniska utvärderingar. För att förbättra genomslagskraften av regelverket uppdrog Läkemedelsverket åt eHälsoinstitutet att kartlägga kunskapen om och följsamheten till regelverket avseende klinisk utvärdering.

    Syftet med föreliggande studie var primärt att ta fram ett beslutsunderlag för hur klinisk utvärdering av medicinska informationssystem bör gå till, med fokus på elektroniska patientjournalsystem, och sekundärt att konkretisera de krav som ska vara uppfyllda för systemen och att undersöka vilken information som är lämplig i en framtida vägledning. För att lösa detta preciserades flera målfrågeställningar vilka berörde vad klinisk utvärdering av patientjournalsystem innebär och syftar till, varför det är nödvändigt, hur de genomförs, om de överensstämmer med regelverket och hur de bör genomföras.

    Totalt 28 semistrukturerade intervjuer genomfördes med tillverkare, IT-förvaltare, användare och nationella företrädare, med kommentarer från en referensgrupp.

    Respondenterna var positiva till att diskutera klinisk utvärdering och till att frågan belystes, men tyckte att frågeställningarna var komplexa och svåra att besvara samt att termer och begrepp uppfattades svåra att förstå. Det kunde upplevas abstrakt och svårt att kliniskt utvärdera ett medicinskt informationssystem jämfört med mer hårdvarubaserad medicinteknisk apparatur.

    Det medicinska syftet och den avsedda användningen med journalsystemet ska definieras av tillverkaren, vilka också var tydliga med att beskriva detta, medan IT-förvaltarna och användarna inte visste vad tillverkarna angivit för medicinskt syfte. Trots att IT-förvaltarna och användarna var osäkra på tillverkarnas beskrivning av det medicinska syftet hade de ändå en ganska tydlig uppfattning om vad det medicinska syftet med systemen är eller kanske snararare vilket/vilka behov de borde uppfylla enligt användaren. Syfte och behov upplevdes gå i vartannat och beskrevs bland annat med orden tillgänglighet, överblick, dokumentation, patientsäkerhet, effektivitet, beslutsstöd, arbetsverktyg, kommunikation och uppföljning.

    Flera av tillverkarna hade svårt att koppla begreppet klinisk utvärdering till patientjournalsystem och hade svårt att sätta begreppet i ett sammanhang. Tillverkarna förknippade istället sina svar till vad man faktiskt använder sig av såsom litteraturstudier, riskanalys, riskhanteringsprocess, acceptanstest, testmiljö, pilottest och beprövad erfarenhet.

    Till skillnad från vad som gäller för läkemedel har införandet av medicinska informationssystem inga tydligt definierade faser. Ett sätt att förtydliga och förenkla klinisk utvärdering av medicinska informationssystem skulle vara att göra en tydlig fasindelning, som blir lätt att kontrollera. Utifrån våra intervjuer skulle faserna kunna innehålla följande steg:

    • Teoretisk del – litteraturstudier, intervjuform
    • Utvecklingsfasen – riskanalys, riskhanteringsprocess, acceptanstest
    • Testmiljö – standardiserade användningsfall/testfall
    • Pilottest – skarp miljö i liten skala under översikt
    • Breddinförande
    • Uppföljning
    • Beprövad erfarenhet

    Sammanfattningsvis har vi funnit stora variationer i tolkningen av klinisk utvärdering av medicinska informationssystem och ett stort behov av förslag till att stärka den kliniska utvärderingen. Våra rekommendationer i det framtida arbetet med klinisk utvärdering av medicinska informationssystem är att ta fram:

    • Enhetliga definitioner av termer och begrepp
    • Gemensamt regelverk med tydliga riktlinjer
    • Förenklad vägledning anpassad till svenska förhållanden
    • Specifik utbildning kring avsedd användning och regelverkens tillämpning
    • Branschöverenskommelser
    • Tydliga krav vid tillsyn

    Föreliggande rapport avser att bidra till att både förtydliga tolkningen av regelverket och underlätta följsamheten och förhoppningen är att rapporten ska kunna användas i en framtida vägledning avseende klinisk utvärdering av medicinska informationssystem.

  • 17. Fogelberg, M
    et al.
    Petersson, Göran
    University of Kalmar, School of Human Sciences. University of Kalmar, eHealth Institute, School of Human Sciences, University of Kalmar,.
    Medicinens språk2006Book (Other academic)
  • 18.
    Hammar, Tora
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Ekedahl, Anders
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Petersson, Göran
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Implementation of a shared medication list: physicians’ views on availability, accuracy and confidentiality2014In: International Journal of Clinical Pharmacy, ISSN 2210-7703, E-ISSN 2210-7711, Vol. 36, no 5, p. 933-942Article in journal (Refereed)
    Abstract [en]

    Background Physicians, patients and others involved need to have accurate information on patients’ current drug prescriptions available, and have that information protected from unauthorized access. During the past decade, many counties in Sweden have implemented regionally shared medication lists within health care. Objective The aim of this study was to describe physicians’ views on changes in accuracy, availability and confidentiality in the transition from local medication lists to a regionally shared medication list. Setting Health care units in four different counties of Sweden after the transition from local medication lists to a regionally shared medication list. The shared medication list was an integrated part of the electronic health record system in the respective counties, but the system and implementation process varied. Methods Physicians (n = 7) with experience of transition from local medication lists to a regionally shared medication list were interviewed in a semi-structured manner. Main outcome measure: Physicians’ views on changes in information risks, focusing on accuracy, availability and confidentiality. Results The transition from local medication lists to a shared medication list increased the availability of information: from being time consuming or not possible to access from other care givers to most information being available in one place. A regionally shared medication list was perceived as having the potential to provide a greater accuracy of information, but not always: the shared medication list was perceived as more complete but with more non-current drugs. On the other hand, a shared medication list implied an increased risk of violating patient privacy, placing greater demands on IT security in order to protect the confidentiality of information. Conclusion Physicians perceived a regionally shared medication list to increase the availability of information about current prescriptions and potentially the accuracy but may decrease the confidentiality of information. To implement a shared medication list, we recommend providing clear description of responsibilities and routines for normal activities as well as back-up routines, consider IT-security and data protection early, involve patients to improve the accuracy of the list as well as to monitor and evaluate the implementation.

  • 19.
    Hammar, Tora
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Hovstadius, Bo
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Lidström, Bodil
    Swedish EHlth Agcy, Stockholm, Sweden.
    Petersson, Göran
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Eiermann, Birgit
    Karolinska Inst ; Swedish EHlth Agcy, Stockholm, Sweden.
    Potential drug related problems detected by electronic expert support system in patients with multi-dose drug dispensing.2014In: International Journal of Clinical Pharmacy, ISSN 2210-7703, E-ISSN 2210-7711, Vol. 36, no 5, p. 943-952Article in journal (Refereed)
    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.

  • 20.
    Hammar, Tora
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Lidström, Bodil
    Swedish eHealth Agency.
    Petersson, Göran
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Gustafson, Yngve
    Umeå University.
    Eiermann, Birgit
    Karolinska Institutet ; Swedish eHealth Agency.
    Potential drug-related problems detected by electronic expert support system: physicians’ views on clinical relevance2015In: International Journal of Clinical Pharmacy, ISSN 2210-7703, E-ISSN 2210-7711, Vol. 37, no 5, p. 941-948Article in journal (Refereed)
    Abstract [en]

    Background Drug-related problems cause suffering for patients and substantial costs. Multi-dose drug dispensing is a service in which patients receive their medication packed in bags with one unit for each dose occasion. The electronic expert support system (EES) is a clinical decision support system that provides alerts if potential drug-related problems are detected among a patients’ current prescriptions, including drug–drug interactions, therapy duplications, high doses, drug-disease interactions, drug gender warnings, and inappropriate drugs and doses for geriatric or pediatric patients. Objective The aim of the study was to explore physicians’ views on the clinical relevance of alerts provided by EES. Furthermore we investigated if physicians performed any changes in drug treatment following the alerts and if there were any differences in perceived relevance and performed changes between different types of alerts and drugs. Setting Two geriatric clinics and three primary care units in Sweden. Method Prescribed medications for patients (n = 254) with multi-dose drug dispensing were analyzed for potential drug-related problems using EES. For each alert, a physician assessed clinical relevance and indicated any intended action. A total of 15 physicians took part in the study. Changes in drug treatment following the alerts were later measured. The relationship between variables was analyzed using Chi square test. Main outcome measure Physicians’ perceived clinical relevance of each alert, and changes in drug treatment following the alerts. ResultsPhysicians perceived 68 % (502/740) of EES alerts as clinically relevant and 11 % of all alerts were followed by a change in drug treatment. Clinical relevance and likelihood to make changes in drug treatment was related to the alert category and substances involved in the alert. Conclusion In most patients with multi-dose drug dispensing, EES detected potential drug-related problems, with the majority of the alerts regarded as clinically relevant and some followed by measurable changes in drug treatment.

  • 21.
    Hammar, Tora
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Nyström, Sofie
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences. Apoteket AB (National Corporation of Swedish Pharmacies), Stockholm.
    Petersson, Göran
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Rydberg, Tony
    Åstrand, Bengt
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Swedish pharmacists value ePrescribing: a survey of a nation-wide implementation2010In: Journal of Pharmaceutical Health Services Research, ISSN 1759-8885, Vol. 1, no 1, p. 23-32Article in journal (Refereed)
    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.

  • 22.
    Hammar, Tora
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences. Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Nyström, Sofie
    Apoteket AB (National Corporation of Swedish Pharmacies), SE-118 81 Stockholm, Sweden..
    Petersson, Göran
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Åstrand, Bengt
    Apoteket AB (National Corporation of Swedish Pharmacies), SE-118 81 Stockholm, Sweden..
    Rydberg, Tony
    Apoteket AB (National Corporation of Swedish Pharmacies), SE-118 81 Stockholm, Sweden..
    Patients satisfied with e-prescribing in Sweden: a survey of a nationwide implementation2011In: Journal of pharmaceutical health services research, ISSN 1759-8885, Vol. 2, no 2, p. 97-105Article in journal (Refereed)
    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.

  • 23.
    Hammar, Tora
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Ohlson, Mats
    Med Prod Agcy, Uppsala.
    Hanson, Elizabeth
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Petersson, Göran
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Implementation of information systems at pharmacies – a case study from the re-regulated pharmacy market in Sweden2015In: Research in Social and Administrative Pharmacy, ISSN 1551-7411, E-ISSN 1934-8150, Vol. 11, no 2, p. E85-E99Article in journal (Refereed)
    Abstract [en]

    Background

    When the Swedish pharmacy market was re-regulated in 2009, Sweden moved from one state-owned pharmacy chain to several private pharmacy companies, and four new dispensing systems emerged to replace the one system that had previously been used at all Swedish pharmacies for more than 20 years.

    Objectives

    The aim of this case study was to explore the implementation of the new information systems for dispensing at pharmacies.

    Methods

    The vendors of the four dispensing systems in Sweden were interviewed, and a questionnaire was sent to the managers of the pharmacy companies. In addition, a questionnaire was sent to 350 pharmacists who used the systems for dispensing prescriptions.

    Results

    The implementation of four new dispensing systems followed a strict time frame set by political decisions, involved actors completely new to the market, lacked clear regulation and standards for functionality and quality assurance, was complex and resulted in variations in quality. More than half of the pharmacists (58%) perceived their current dispensing system as supporting safe dispensing of medications, 26% were neutral and 15% did not perceive it to support a safe dispensing. Most pharmacists (80%) had experienced problems with their dispensing system during the previous month. The pharmacists experienced problems included reliability issues, usability issues, and missing functionality.

    Conclusion

    In this case study exploring the implementation of new information systems for dispensing prescriptions at pharmacies in Sweden, weaknesses related to reliability, functionality and usability were identified and could affect patient safety. The weaknesses of the systems seem to result from the limited time for the development and implementation, the lack of comprehensive and evidence-based requirements for dispensing systems, and the unclear distribution of quality assurance responsibilities among involved stakeholders.

  • 24.
    Hammar, Tora
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Petersson, Göran
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Receptexpeditionssystem i Sverige2012Report (Other academic)
    Abstract [sv]

    Det här är en slutrapport på ett forskningsprojekt som eHälsoinstitutet genomfört på uppdrag av Läkemedelsverket. Syftet var att på ett övergripande sätt kartlägga funktion och kvalitetssäkring av receptexpeditionssystem (RES) i Sverige för att underlätta framtida kvalitetsarbete och den fortsatta tillsynen av apoteken. RES avser den programvara som är avsedd och krävs för apoteksföretagens expediering av recept samt direktåtkomst och momentan uppdatering av uppgifter i de register som hanteras av APSE.

    Information har samlats in från systemleverantörer, apoteksföretags ledning, farmaceuter som arbetar med RES på apotek, och Apotekens Service AB (APSE). Det finns idag fyra olika RES på den svenska marknaden: Pharma Logica (Logica), PharmaSuite (Visma Retail), Rex (Apoteket AB) och Maxx (Receptum). De viktigaste utgångspunkterna för systemtillverkarna vid skapande av RES har varit lagar, förordningar och föreskrifter, instruktioner och krav från APSE, tidigare receptexpeditionssystem samt apoteksföretagens krav och önskemål.

    Det fanns variationer i hur systemen var kvalitetssäkrade samt nomenklaturen kring detta. Gemensamt för alla RES var dock att kvalitetssäkringen görs på flera nivåer: hos systemleverantör, hos APSE och hos apoteksföretaget. Alla systemleverantörer har ett nära samarbete med apoteksföretagen som använder deras system, har stöd till användarna av systemet och får feedback om eventuella problem och önskemål. Alla nya RES har genomgått en prövning av gränssnitt och format av APSE innan de har blivit godkända att användas av ett apoteksföretag. När systemleverantörerna har gjort förändringar i sitt system har även dessa genomgått en prövning. APSEs prövning av RES innebär att säkerställa att apoteksföretagen använder ett RES vars gränssnitt och format fungerar korrekt mot APSEs tjänsteplattform.

    Omregleringen av apoteksmarknaden med fler inblandade aktörer i kombination med utveckling av helt nya RES har varit inte varit helt problemfri. En rad problem kopplade till RES har påvisats i projektet, varav många har varit kopplade till den tidspress som funnits fram tills ATS (det RES som användes av alla apotek innan omreglering) inte längre fick användas. Andra problem har varit otydlig ansvarsfördelning, avsaknad av tydliga krav och enhetlig tolkning av lagar. För inblandade parter har det varit problematiskt när APSEs roll inte varit helt klar och definierad.

    En enkätundersökning bland farmaceuter som använder de olika RES visade att majoriteten av farmaceuterna ansåg att det fungerade bra att expediera recept med respektive RES, att RES stödjer en säker receptexpedition och att de fått tillräcklig utbildning för att använda RES. Majoriteten ansåg att deras aktuella RES hade funktioner som de saknade i ATS, och att de inte skulle vilja gå tillbaka till att använda ATS. Över 80 % hade dock den senaste månaden upplevt någon typ av problem med sitt RES. De vanligast angivna problemen eller bristerna med RES var låsningar, buggar eller driftstopp, att systemet var långsamt och att det saknade vissa önskvärda funktioner.

    Studien visade att användningen av elektroniskt expertstöd (EES) på apotek är låg, delvis på grund av att de flesta farmaceuter inte har EES integrerat i sitt RES. Andra orsaker till den låga användningen av EES är att farmaceuterna saknade utbildning eller kunskap om hur det ska användas och att det tar för mycket tid. Samtidigt lyfter flera farmaceuter upp styrkor med EES och en önskan om att använda EES i högre utsträckning.

    Genom forskningsprojektet framkom att det finns ett behov av riktlinjer eller krav för vad ett RES bör uppfylla, både när det gäller funktioner, användbarhet och kvalitetssäkring. Som ett steg i det krävs en enhetlig tolkning av tillämpligt regelverk. Ett RES utgör en viktig roll för en patientsäker expedition av läkemedel och ett RES ska vara utformat så att det inte kan orsaka eller bidra till fel eller problem vid expeditioner, underlättar och säkrar kvaliteten på receptöverföringen och att det fungerar som ett stöd för att förhindra felexpeditioner.

    Det finns även ett behov av tydligt tillverkarregelverk, nomenklatur och ansvarsfördelning för att skapa mer tillförlitliga RES och därigenom ge en förbättrad patientsäkerhet. Denna studie skulle kunna tjäna som underlag för fortsatt arbete med detta.

  • 25.
    Hellström, Lina
    et al.
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Höglund, P
    Bondesson, Å
    Petersson, Göran
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Eriksson, T
    Clinical implementation of systematic medication reconciliation and review as part of the Lund Integrated Medicines Management model – impact on all cause emergency department revisits2012In: Journal of Clinical Pharmacy and Therapeutics, ISSN 0269-4727, E-ISSN 1365-2710, Vol. 37, no 6, p. 686-692Article in journal (Refereed)
    Abstract [en]

    What is known and objective: Interventions involving medication reconciliation and review by clinical pharmacists can reduce drug-related problems and improve therapeutic outcomes. The objective of this study was to examine the impact of routine admission medication reconciliation and inpatient medication review on emergency department (ED) revisits after discharge. Secondary outcomes included the combined rate of post-discharge hospital revisits or death.

    Methods: This prospective, controlled study included all patients hospitalised in three internal medicine wards in a university hospital, between January 1 2006 and May 31 2008. Medication reconciliation on admission and inpatient medication review, conducted by clinical pharmacists in a multiprofessional team, were implemented in these wards at different times during 2007 and 2008 (intervention periods). A discharge medication reconciliation was undertaken in all the study wards, during both control and intervention periods. Patients were included in the intervention group (n=1216) if they attended a ward with medication reconciliation and review, whether they had received the intervention or not. Control patients (n=2758) attended the wards before implementation of the intervention. 

    Results: No impact of medication reconciliation and reviews on ED revisits (hazard ratio [HR], 0.95; 95% confidence interval [CI], 0.86-1.04) or event-free survival (HR, 0.96; 95% CI, 0.88-1.04) was demonstrated. In the intervention group, 594 patients (48.8%) visited the ED, compared to 1416 (51.3%) control patients. In total, 716 intervention (58.9%) and 1688 (61.2%) control patients experienced any event (ED visit, hospitalisation or death). Because the time to a subsequent ED visit was longer for the control as well as the intervention groups in 2007 than in 2006 (p<0.05), we re-examined this cohort of patients; the proportion of patients revisiting the ED was similar in both groups in 2007 (p=0.608).

    What is new and conclusion: Routine implementation of medication reconciliation and reviews on admission and during the hospital stay did not appear to have any impact on ED revisits, rehospitalisations or mortality over six months' follow-up.  

  • 26.
    Hellström, Lina
    et al.
    University of Kalmar, eHealth Institute, School of Human Sciences, University of Kalmar,.
    Waern, Karolina
    University of Kalmar, eHealth Institute, School of Human Sciences, University of Kalmar,.
    Montelius, Emelie
    University of Kalmar, eHealth Institute, School of Human Sciences, University of Kalmar,.
    Åstrand, Bengt
    University of Kalmar, School of Pure and Applied Natural Sciences.
    Rydberg, Tony
    University of Kalmar, eHealth Institute, School of Human Sciences, University of Kalmar,.
    Petersson, Göran
    University of Kalmar, eHealth Institute, School of Human Sciences, University of Kalmar,.
    Physicians' attitudes towards ePrescribing: evaluation of a Swedish full-scale implementation2009In: BMC Medical Informatics and Decision Making, ISSN 1472-6947, E-ISSN 1472-6947, Vol. 9, no August, p. Article number: 37-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The penetration rate of Electronic Health Record (EHR) systems in health care is increasing. However, many different EHR-systems are used with varying ePrescription designs and functionalities. The aim of the present study was to evaluate experienced ePrescribers' attitudes towards ePrescribing for suggesting improvements. METHODS: Physicians (n = 431) from seven out of the 21 Swedish health care regions, using one of the six most widely implemented EHR-systems with integrated electronic prescribing modules, were recruited from primary care centers and hospital clinics of internal medicine, orthopaedics and surgery. The physicians received a web survey that comprised eight questions on background data and 19 items covering attitudes towards ePrescribing. Forty-two percent (n = 199) of the physicians answered the questionnaire; 90% (n = 180) of the respondents met the inclusion criteria and were included in the final analysis. RESULTS: A majority of the respondents regarded their EHR-system easy to use in general (81%), and for the prescribing of drugs (88%). Most respondents believed they were able to provide the patients better service by ePrescribing (92%), and regarded ePrescriptions to be time saving (91%) and to be safer (83%), compared to handwritten prescriptions. Some of the most frequently reported weaknesses were: not clearly displayed price of drugs (43%), complicated drug choice (21%), and the perception that it was possible to handle more than one patient at a time when ePrescribing (13%). Moreover, 62% reported a lack of receipt from the pharmacy after successful transmission of an ePrescription. Although a majority (73%) of the physicians reported that they were always or often checking the ePrescription a last time before transmitting, 25% declared that they were seldom or never doing a last check. The respondents suggested a number of improvements, among others, to simplify the drug choice and the cancellation of ePrescriptions. CONCLUSION: The Swedish physicians in the group studied were generally satisfied with their specific EHR-system and with ePrescribing as such. However, identified weaknesses warrant improvements of the EHR-systems as well as of their implementation in the individual health care organisation.

  • 27. Holm-Sjögren, L
    et al.
    Carlsson, G
    Hållberg, Å
    Lebolt, L
    Malmqvist, G
    Karlsson, L
    Petersson, Göran
    Utveckling av nätburen flexibel utbildning inom hälso- och sjukvård och omsorg2001Report (Other academic)
  • 28.
    Hovstadius, Bo
    et al.
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Hovstadius, Karl
    Åstrand, Bengt
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Petersson, Göran
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Increasing polypharmacy: an individual-based study of the Swedish population 2005-2008.2010In: BMC Clinical Pharmacology, ISSN 1472-6904, Vol. 10, p. Article ID: 16-Article in journal (Refereed)
    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.

  • 29.
    Hovstadius, Bo
    et al.
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Petersson, Göran
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Adherence, therapeutic intensity, and the number of dispensed drugs2011In: Pharmacoepidemiology and Drug Safety, ISSN 1053-8569, E-ISSN 1099-1557, Vol. 20, no 12, p. 1255-1261Article in journal (Refereed)
    Abstract [en]

    Purpose

    To estimate non-adherence in relation to the therapeutic intensity (TI) and the number of dispensed drugs per individual and studywhether the TI can be used as an estimator of non-adherence with an increasing number of drugs.

    Methods

    The study comprised an individual-based register of all dispensed outpatient prescriptions in Sweden in 2006, including6.2 million individuals. The applied definition of drug was the chemical entity or substance comprising the fifth level in the World HealthOrganisation’s Anatomic, Therapeutic, Chemical classification. The defined daily dosage per individual during 12 months was applied asan indicator of the TI.

    Results

    We found a positive linear relation between the TI and the increasing number of dispensed drugs per individual, both for men andwomen. We found a slightly diminishing TI with an increasing number of drugs only for the age groups above 70 years, at a level above 13drugs per individual.

    Conclusions

    The linear relationship between the TI and the increasing number of dispensed drugs per individual provides poor support forusing decreasing TI as an estimator of non-adherence. The low rate of cost-related non-adherence in Sweden might contribute to explainingthe linear relationship.

  • 30.
    Hovstadius, Bo
    et al.
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Petersson, Göran
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Factors leading to excessive polypharmacy.2012In: Clinics in Geriatric Medicine, ISSN 0749-0690, E-ISSN 1879-8853, Vol. 28, no 2, p. 159-172Article in journal (Refereed)
    Abstract [en]

    There are numerous risk factors for patients to develop excessive polypharmacy. The most prominent risk factors are associated with sociodemographics and the patients’ conditions. Risk factors associated with patient behavior, such as patient’s self medication with all types of medications, have not been observed to the same extent but might be at the same level of importance for patients developing excessive polypharmacy. Risk factors related to physicians, and the interaction between patient and physician, are studied to a much lesser extent. The few studies conducted regarding the large variation in physicians’ individual prescribing practices, in terms of polypharmacy, add another perspective to the complexity of the area. Interventions aiming to improve communication between GP and hospital specialist, to create support systems for medical reviews that include all patients’ medications, and to improve the knowledge of multiple prescribing might have the largest potential to better manage excessive polypharmacy.

  • 31.
    Hovstadius, Bo
    et al.
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Petersson, Göran
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Non-adherence to drug therapy and drug acquisition costs in a national population: a patient-based register study2011In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 11, article id 326Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Patients' non-adherence to drug therapy is a major problem for society as it is associated with reduced health outcomes. Generally, approximately only 50% of patients with chronic disease in developed countries adhere to prescribed therapy, and the most common non-adherence refers to chronic under-use, i.e. patients use less medication than prescribed or prematurely stop the therapy. Patients' non-adherence leads to high additional costs for society in terms of poor health. Non-adherence is also related to the unnecessary sale of drugs. The aim of the present study was to estimate the drug acquisition cost related to non-adherence to drug therapy in a national population.

    METHODS:

    We constructed a model of the drug acquisition cost related to non-adherence to drug therapy based on patient register data of dispensed out-patient prescriptions in the entire Swedish population during a 12-month period. In the model, the total drug acquisition cost was successively adjusted for the assumed different rates of primary non-adherence (prescriptions not being filled by the patient), and secondary non-adherence (medication not being taken as prescribed) according to the patient's age, therapies, and the number of dispensed drugs per patient.

    RESULTS:

    With an assumption of a general primary non-adherence rate of 3%, and a general secondary non-adherence rate of 50%, for all types of drugs, the acquisition cost related to non-adherence totalled SEK 11.2 billion (€ 1.2 billion), or 48.5% of total drug acquisition costs in Sweden 2006.With the assumption of varying primary non-adherence rates for different age groups and different secondary non-adherence rates for varying types of drug therapies, the acquisition cost related to non-adherence totalled SEK 9.3 billion (€ 1.0 billion), or 40.2% of the total drug acquisition costs.When the assumption of varying primary and secondary non-adherence rates for a different number of dispensed drugs per patient was added to the model, the acquisition cost related to non-adherence totalled SEK 9.9 billion (€ 1.1 billion), or 42.6% of the total drug acquisition costs.

    CONCLUSIONS:

    Our estimate indicates that drug acquisition costs related to non-adherence represent a substantial proportion of the economic resources in the health care sector. A low rate of primary non-adherence, combined with a high rate of secondary non-adherence, contributes to a large degree of unnecessary medical spending. Thus, efforts of different types of interventions are needed to improve secondary adherence.

  • 32.
    Hovstadius, Bo
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Petersson, Göran
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    The impact of increasing polypharmacy on prescribed drug expenditure: A register-based study in Sweden 2005-2009.2013In: Health Policy, ISSN 0168-8510, E-ISSN 1872-6054, Vol. 109, no 2, p. 166-174Article in journal (Refereed)
    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.

  • 33.
    Hovstadius, Bo
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Petersson, Göran
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Hellström, Lina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Ericson, Lisa
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Trends in Inappropriate Drug Therapy Prescription in the Elderly in Sweden from 2006 to 2013: Assessment Using National Indicators2014In: Drugs & Aging, ISSN 1170-229X, E-ISSN 1179-1969, Vol. 31, no 5, p. 379-386Article in journal (Refereed)
    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.

  • 34.
    Hovstadius, Bo
    et al.
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Tågerud, Sven
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Petersson, Göran
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Åstrand, Bengt
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Prevalence and therapeutic intensity of dispensed drug groups for individuals with multiple medications: a register-based study of 2.2 million individuals2010In: Journal of Pharmaceutical Health Services Research, ISSN 1759-8885, Vol. 1, no 4, p. 145-155Article in journal (Refereed)
    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.

  • 35.
    Hovstadius, Bo
    et al.
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Åstrand, Bengt
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Petersson, Göran
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Assessment of regional variation in polypharmacy2010In: Pharmacoepidemiology and Drug Safety, ISSN 1053-8569, E-ISSN 1099-1557, Vol. 19, no 4, p. 375-383Article in journal (Refereed)
    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.

  • 36.
    Hovstadius, Bo
    et al.
    University of Kalmar, eHealth Institute, School of Human Sciences, University of Kalmar,.
    Åstrand, Bengt
    University of Kalmar, eHealth Institute, School of Human Sciences, University of Kalmar,.
    Petersson, Göran
    University of Kalmar, eHealth Institute, School of Human Sciences, University of Kalmar,.
    Dispensed drugs and multiple medications in the Swedish population: an individual-based register study2009In: BMC Clinical Pharmacology, ISSN 1472-6904, Vol. 9, no May, p. Article number: 11-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND

    Multiple medications is a well-known potential risk factor in terms of patient's health. The aim of the present study was to estimate the prevalence of dispensed drugs and multiple medications in an entire national population, by using individual based data on dispensed drugs.

    METHODS

    Analyses of all dispensed out-patient prescriptions in 2006 from the Swedish prescribed drug register. As a cut-off for multiple medications, we applied five or more different drugs dispensed (DP >or= 5) at Swedish pharmacies for a single individual during a 3-month, a 6-month, and a 12-month study period. For comparison, results were also calculated with certain drug groups excluded.

    RESULTS

    6.2 million individuals received at least one dispensed drug (DP >or= 1) during 12 months in 2006 corresponding to a prevalence of 67.4%; 75.6% for females and 59.3% for males. Individuals received on average 4.7 dispensed drugs per individual (median 3, Q1-Q3 2-6); females 5.0 (median 3, Q1-Q3 2-7), males 4.3 (median 3, Q1-Q3 1-6).The prevalence of multiple medications (DP >or= 5) was 24.4% for the entire population. The prevalence increased with age. For elderly 70-79, 80-89, and 90-years, the prevalence of DP >or= 5 was 62.4, 75.1, and 77.7% in the respective age groups. 82.8% of all individuals with DP >or= 1 and 64.9% of all individuals with DP >or= 5 were < 70 years. Multiple medications was more frequent for females (29.6%) than for males (19.2%). For individuals 10 to 39 years, DP >or= 5 was twice as common among females compared to males. Sex hormones and modulators of the genital system excluded, reduced the relative risk (RR) for females vs. males for DP >or= 5 from 1.5 to 1.4. The prevalence of DP >or= 1 increased from 45.1 to 56.2 and 67.4%, respectively, when the study period was 3, 6, and 12 respectively months and the corresponding prevalence of DP >or= 5 was 11.3, 17.2, and 24.4% respectively.

    CONCLUSION

    The prevalence of dispensed drugs and multiple medications were extensive in all age groups and were higher for females than for males. Multiple medications should be regarded as a risk in terms of potential drug-drug interactions and adverse drug reactions in all age groups.

  • 37.
    Hovstadius, Bo
    et al.
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Åstrand, Bengt
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Petersson, Göran
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Persson, Ulf
    Institute of Economic Research, School of Economics and Management, University of Lund.
    Acquisition cost of dispensed drugs for individuals with multiple medications – a register-based study2011In: Health Policy, ISSN 0168-8510, E-ISSN 1872-6054, Vol. 101, no 2, p. 153-161Article in journal (Refereed)
    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.

  • 38.
    Johannesson, Eva
    et al.
    Linköping University.
    Olsson, Mats
    Linköping University.
    Petersson, Göran
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Silén, Charlotte
    Karolinska Institutet.
    Learning Features in Computer Simulation Skills Training2010In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 10, no 5, p. 268-273Article in journal (Refereed)
    Abstract [en]

    New simulation tools imply new opportunities to teach skills and train health care professionals. The aim of this study was to investigate the learning gained from computer simulation skills training. The study was designed for optimal educational settings, which benefit student-centred learning. Twenty-four second year undergraduate nursing students practised intravenous catheterization with the computer simulation program CathSim. Questionnaires were answered before and after the skills training, and after the skills examination. When using CathSim, the students appreciated the variation in patient cases, the immediate feedback, and a better understanding of anatomy, but they missed having an arm model to hold. We concluded that CathSim was useful in the students’ learning process and skills training when appropriately integrated into the curriculum. Learning features to be aware of when organizing curricula with simulators are motivation, realism, variation, meaningfulness and feedback.

  • 39.
    Johansson, Pauline
    et al.
    University of Kalmar, School of Human Sciences.
    Lindquist, Anna
    Saveman, Britt-Inger
    University of Kalmar, School of Human Sciences.
    Petersson, Göran
    University of Kalmar, School of Human Sciences. University of Kalmar, eHealth Institute, School of Human Sciences, University of Kalmar,.
    Nilsson, Gunilla
    University of Kalmar, School of Human Sciences.
    Handdator för sjuksköterskor – en studie om innehåll, funktioner och användbarhet (Konferens abstrakt)2007In: Scandinavian Health Informatics and Terminology Conference 2007 Proceedings, Kalmar, Sweden, 2007Conference paper (Refereed)
  • 40.
    Johansson, Pauline
    et al.
    University of Kalmar, School of Human Sciences.
    Nilsson, Gunilla
    University of Kalmar, School of Human Sciences.
    Petersson, Göran
    University of Kalmar, School of Human Sciences. University of Kalmar, eHealth Institute, School of Human Sciences, University of Kalmar,.
    A mobile pharmaceutical decision support system – a useful tool for district nurses? (Conference, poster abstract)2009In: The 14th International Symposium for Health Information Management Research (ISHIMR 2009), Kalmar, Sweden: Högskolan i Kalmar , 2009Conference paper (Refereed)
  • 41.
    Johansson, Pauline
    et al.
    University of Kalmar, eHealth Institute, School of Human Sciences, University of Kalmar,.
    Petersson, Göran
    University of Kalmar, eHealth Institute, School of Human Sciences, University of Kalmar,.
    Nilsson, Gunilla
    University of Kalmar, eHealth Institute, School of Human Sciences, University of Kalmar,.
    A mobile medicine decision support system for district nurses.2009In: Studies in Health Technology and Informatics: Connecting Health and Humans - Proceedings of NI2009 - The 10th International Congress on Nursing Informatics / [ed] Saranto, K., Flatley Brennan, P., Park, H-A., Tallberg, M., & Ensio, A., IOS Press , 2009, p. 516-520Conference paper (Refereed)
    Abstract [en]

    Inappropriate use of medicines increases the risk of hospital admissions for the elderly. Not only does this lead to unnecessary suffering for the patients but also incurs a great financial cost to the society. A medicine decision support system in a Personal Digital Assistant (PDA), with a barcode reader, can provide an overview of the patients' complete medicine use, and detect unsuitable drugs and drug combinations. Focusing on the elderly, our aim was to evaluate if a mobile medicine decision support system with a barcode reader is useful and user-friendly for nurses in home care. The participants received a comprehensive overview from the patients' medicine use and noted drug-drug interactions, therapeutic duplications and warnings for drugs unsuitable for elderly people. The nurses regarded that the decision support system increased prevention and safety, was useful and user-friendly. Our findings suggest that most of the content and functions were regarded as important. Therefore, this decision support system might be a useful tool for district nurses.

  • 42.
    Johansson, Pauline
    et al.
    University of Kalmar, eHealth Institute, School of Human Sciences, University of Kalmar,.
    Petersson, Göran
    University of Kalmar, eHealth Institute, School of Human Sciences, University of Kalmar,.
    Nilsson, Gunilla
    University of Kalmar, eHealth Institute, School of Human Sciences, University of Kalmar,.
    A mobile pharmaceutical decision support system – a useful tool for district nurses?2008Conference paper (Refereed)
  • 43.
    Johansson, Pauline
    et al.
    University of Kalmar, School of Human Sciences.
    Petersson, Göran
    University of Kalmar, School of Human Sciences. University of Kalmar, eHealth Institute, School of Human Sciences, University of Kalmar,.
    Nilsson, Gunilla
    University of Kalmar, School of Human Sciences.
    A mobile pharmaceutical decision support system – a useful tool for district nurses? (Conferense abstract)2008In: Scandinavian Health Informatics and Terminology Conference 2008 Proceedings, Kalmar, Sweden, 2008Conference paper (Refereed)
  • 44.
    Johansson, Pauline
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Petersson, Göran
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Nilsson, Gunilla
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Experience of using a personal digital assistant in nursing practice – a single case study2011In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 19, no 7, p. 855-862Article in journal (Refereed)
    Abstract [en]

    Aim The aim of this study was to describe one nurse’s experience of using a personal digital assistant (PDA) in nursing practice.

    Background Nurses handle large amounts of information and a PDA may contain valuable information that nurses need in their daily work.

    Methods In this qualitative single case study, data were collected through an open-ended interview with one registered nurse and were analysed by content analysis.

    Results The findings show that the PDA provides immediate access to information anywhere and at anytime, with advantages for both the nurse and for her patients. The PDA increased her confidence and efficiency in practice; it was easier to keep up-to-date and spend more time with the patient. Furthermore, the PDA was perceived as improving patient safety and patient participation.

    Conclusions The PDA requires improved content and more functions. Ease of use should also be improved. This study indicates that PDAs could be valuable and may inspire further research.

    Implications for nursing management The incorporation of a multifunctional PDA is an important issue for nursing management, as it could both change and provide new possibilities for nursing practice. The use of PDAs could also aid decision-making, improve patient safety and benefit patient outcomes.

  • 45.
    Johansson, Pauline
    et al.
    University of Kalmar, School of Human Sciences.
    Petersson, Göran
    University of Kalmar, School of Human Sciences. University of Kalmar, eHealth Institute, School of Human Sciences, University of Kalmar,.
    Nilsson, Gunilla
    University of Kalmar, School of Human Sciences.
    Handdator för sjuksköterskestudenter – ett hjälpmedel inom verksamhetsförlagd utbildning2008In: Nätverk och utveckling (NU2008). Lärande i en ny tid - samtal om undervisning i högre utbildning. Proceedings NU2008, Kalmar, Sverige, 2008Conference paper (Other academic)
  • 46.
    Johansson, Pauline
    et al.
    University of Kalmar, School of Human Sciences.
    Petersson, Göran
    University of Kalmar, School of Human Sciences. University of Kalmar, eHealth Institute, School of Human Sciences, University of Kalmar,.
    Nilsson, Gunilla
    University of Kalmar, School of Human Sciences.
    LIF e-reader: Utvärderingsrapport slutversion 2009-02-032009Report (Other academic)
  • 47.
    Johansson, Pauline
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Petersson, Göran
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Nilsson, Gunilla
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Nursing students' experience of using a personal digital assistant (PDA) in clinical practice: an intervention study2013In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 33, no 10, p. 1246-1251Article in journal (Refereed)
    Abstract [en]

    Background

    A personal digital assistant (PDA) is a multifunctional information and communication tool allowing nursing students to keep up to date with expanding health related knowledge.

    Objectives

    This study was aimed at exploring nursing students' experience of using a PDA in clinical practice.

    Method

    In this intervention study, nursing students (n=67) used PDAs during a period of 15weeks, replied to questionnaires, and participated in focus group interviews.

    Results

    The PDA was found to support nursing students in clinical practice and to have the potential to be a useful tool with benefits for both the patients and for the students. The PDA was regarded as useful, and was presumed to imply increased confidence and time savings, and contribute to improved patient safety and quality of care.

    Conclusions

    With available mobile technology, nursing students would be able to access necessary information, independent of time and place. Therefore, it is important that stakeholders and educators facilitate the use of PDAs to support nursing students during their clinical practice, in order to prepare them for their future work, and to continuously improve the safety and quality of healthcare.

  • 48.
    Johansson, Pauline
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Petersson, Göran
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Nilsson, Gunilla
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Personal digital assistant with a barcode reader - a medical decision support system for nurses in home care.2010In: International Journal of Medical Informatics, ISSN 1386-5056, E-ISSN 1872-8243, Vol. 79, no 4, p. 232-242Article in journal (Refereed)
    Abstract [en]

    Introduction: Inappropriate medication among elderly people increases the risk of adverse drug–drug interactions, drug-related falls and hospital admissions. In order to prevent these effects it is necessary to obtain a profile of the patients’ medication. A personal digital assistant (PDA) can be used as a medical decision support system (MDSS) to obtain a profile of the patients’ medication and to check for inappropriate drugs and drug combinations, and to reduce medication errors.Aim: The aim of the present study was to evaluate nurses’ experiences of using a MDSS in a PDA with a barcode reader, in order to obtain profiles of the patients’ medication, regarding drug–drug interactions, therapeutic duplications, and warnings for drugs unsuitable for elderly in home care.Methods: The LIFe-reader® is a MDSS in a PDA with a barcode reader. By scanning the drug packages in the patients’ home, the LIFe-reader® obtained profiles of the patients’ medication and checked for drug–drug interactions, therapeutic duplications and warnings for drugs unsuitable for elderly people. The LIFe-reader® also contained, e.g. drug information and medical reference works. Nurses (n = 15) used the LIFe-reader® for five weeks during their nursing home care practice assignment. The nurses answered questionnaires about the content and functions of the LIFe-reader® before, during and after the nursing home care practice assignment, and were interviewed in focus groups. Descriptive statistics were used and content analysis was applied for qualitative data.Results: By using the LIFe-reader®, the majority of the nurses found it easy to obtain profiles of the patients’ medication and check for drug–drug interactions, therapeutic duplications and warnings for drugs unsuitable for elderly people. Most nurses regarded the LIFe-reader® to reduce drug-related risks of falling, and some thought it could reduce the drug-related admissions to hospitals. The scanning function was described as easy and time saving, although not always possible to use. The LIFe-reader® was regarded as a useful and user-friendly MDSS, but more content and functions were requested.Conclusions: We found that the LIFe-reader® has the potential to be a useful and user-friendly MDSS for nurses in home care when obtaining profiles of the patients’ medication regarding drug–drug interactions, therapeutic duplications and warnings for drugs unsuitable for elderly. A regular scanning of the patients’ drugs in their home might support nurses and general practitioners (GPs) in reducing the inappropriate use of drugs. If the LIFe-reader® should be used in a larger scale among nurses, more content and functions are necessary.

  • 49.
    Johansson, Pauline
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Petersson, Göran
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Saveman, Britt-Inger
    Institutionen för omvårdnad, Umeå universitet .
    Nilsson, Gunilla
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Experience of mobile devices in nursing practice2012In: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 32, no 4, p. 50-54Article in journal (Refereed)
    Abstract [en]

    Background: In nursing care, the steady increase of healthrelated information implies that there is need for useful tools thateasily provide mobile access to accurate information.Aim: This study is aimed at exploring nurses’ and nursingstudents’ experience of using a mobile device in nursing practice,with the emphasis on usefulness, information retrieval, savingtime, patient safety, the quality of care, and confidence in thework performed.Methods: In this descriptive intervention study, registered nurses(RN) (n=14) and nursing students (NS) (n=7) used mobiledevices in nursing practice during a period of 15 weeks, andreplied to questionnaires prior to and after the intervention.Results and conclusion: We found that the mobile device wasperceived as useful and was presumed to imply increased confidenceand time savings, and to contribute to improved patientsafety and quality of care by enhancing access to necessaryinformation. To facilitate nursing practice, mobile devicesadjusted for technical, statutory, cultural, and language countryspecificconditions, should be further developed and implementedfor RNs and NSs. Furthermore, future research shouldinclude the end-users’ views.

  • 50.
    Johansson, Pauline
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Petersson, Göran
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Saveman, Britt-Inger
    Umeå universitet.
    Nilsson, Gunilla
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Using advanced mobile devices in nursing practice - the views of nurses and nursing students2014In: Health Informatics Journal, ISSN 1460-4582, E-ISSN 1741-2811, Vol. 20, no 3, p. 220-231Article in journal (Refereed)
    Abstract [en]

    Advanced mobile devices allow registered nurses and nursing students to keep up-to-date with expanding health-related knowledge but are rarely used in nursing in Sweden. This study aims at describing registered nurses’ and nursing students’ views regarding the use of advanced mobile devices in nursing practice. A cross-sectional study was completed in 2012; a total of 398 participants replied to a questionnaire, and descriptive statistics were applied. Results showed that the majority of the participants regarded an advanced mobile device to be useful, giving access to necessary information and also being useful in making notes, planning their work and saving time. Furthermore, the advanced mobile device was regarded to improve patient safety and the quality of care and to increase confidence. In order to continuously improve the safety and quality of health care, advanced mobile devices adjusted for nursing practice should be further developed, implemented and evaluated in research.

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