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  • 1.
    Abdul Hadi, Roza
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Avvikelser i receptlistan: En intervjustudie med patienter på apotek2021Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Medications are used to treat, cure, or relieve symptoms of diseases, but there is a risk with the use of medications. Drug-related-problems are known to increase morbidity and mortality. Incorrect medical list and discrepancies in these lists can lead to drug-related problems as side effects, hospitalization, non-compliance, drug interactions and overtreated or undertreated patients. Discrepancies can be for example: more prescriptions than necessary, outdated prescriptions, i.e., medicines that will not be used, prescriptions with incorrect dosing and missing prescriptions i.e., medicines used by patients that cannot be seen in the medication list.

    Purpose:  The aim of this study was to investigate discrepancies in the Swedish prescription list "My saved prescriptions at the pharmacy". The secondary aim was to investigate how common it is to use this prescription list or the dosage label on the medicine packaging to know which medicines to use and which dosage.

    Methods: The data collection was performed by four pharmacy students at seven pharmacies in Sweden over a period of three weeks during Jan-Feb. 2021 where the prescription list was investigated together with patients to identify any discrepancies. The study included patients who was over 18 years old, spoke Swedish, had three or more prescribed drugs, and agreed to participate. 

    Results A total of 215 patients were interviewed, where 61% had one or more discrepancies in their medication list. A total of 1717 prescriptions were analyzed, of which 10% were double prescriptions (n = 167), 8% outdated prescriptions (n = 141) and 3% prescriptions with the wrong dosage (n = 42). When analyzing the primary sources of information used by patients to know which medicine to use, the printout of the list "my saved prescriptions at the pharmacy” dominated (n = 72).  Most used information source to know drug dosage was the dosage label on the medicine packaging (n = 112).

    Conclusions: It is important to have an updated and correct information in the medication list, to prevent drug-related-problems caused by discrepancies. It becomes even more important when we see that the medication list "My saved prescriptions at the pharmacy" and dosage label (containing the same information in the medication list), are the most used primary sources by patients to know which drug to use and in what dosage. Finally, results show a relationship between the number of prescribed drugs and the number of discrepancies that occur, and therefore we see more discrepancies in elderly patients who are usually ill and are being treated for several diseases. 

    There are opportunities for further research to study e.g., which drug-related-problems are caused by discrepancies in the medication list as well as the degree of danger in these problems. 

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  • 2.
    Asmar Talani, Aryoutha
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Att sätta ut läkemedel: En förstudie kring behovet av ett elektroniskt beslutstöd2020Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Background: Polypharmacy implies that the patient uses several drugs at the same time. This is an issue among the elderly population. This issue is associated with different risks such as: increased risk of falling injuries, side effects and hospitalization. All these indicate the need to facilitate clinical decision making with the aim to reduce prescription of inappropriate drugs, avoidance of medication errors and support the use of evidence-based medicine. There is also a lack of support and guidelines for drug withdrawal. Such withdrawal of drugs requires time, knowledge and care.

    Aim: The study objective is to examine the need for developing an electronic clinic decision support system for drug withdrawal. Furthermore, this study aims to examine the obstacles of drug withdrawal and the requirements of developing such a decision support system. To that end, two aims have been defined. The first aim is to examine the potential user’s demands of an electronic clinical decision support system for drug withdrawal, and the second is to examine how the potential knowledge database should be structured.

    Method: This qualitative study consists of semi-structured interviews with doctors and pharmacists. A qualitative content analysis was performed as a method for processing of the empirical data which was collected through a targeted selection.

    Results: The results indicate that there is a need to develop a clinical decision support system for drug withdrawal. There’s little, if any, guidelines or resources to further pursue drug withdrawal studies. The structure and usability of database in clinical practice need to be ensured from the outset.

    Conclusion: This study provides several aspects on the difficulty of withdrawing medicines. Doctors need fast, simple and up-to-date information, filtered, summarized and synthesized from reliable sources. The information is preferably integrated into pre-existing medical record systems. Therefore, a need-based assessment analysis should be conducted early in the developmental process.  This is to ensure the expected benefits of an electronic clinical decision support system.

  • 3.
    Bejmar, Sofie
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Aktuella recept?: En intervjustudie om avvikelser i apotekens receptlistor2021Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Around two thirds of the Swedish population use prescripted drugs and usage usually increases with age. Along with increasing age and more prescriptions, the risk of side effects and interactions also increases. Drug-related problems (DRP) causes suffering of inviduals and is also associated with high costs for the society. A previous study has shown that discrepancies in prescription lists are common, which can pose a significant risk of DRP. Accurate drug information increases the chance that the right medicine will be dispensed at the right time, at the right dose, to the right person and that the patient will use it correctly.

    Aim: The aim of this study was to investigate the presence of discrepancies in prescription lists, defined as outdated prescriptions, duplicates, incorrect dosage and uncertainty, as well as the extent to which prescriptions for current drug treatment were missing. The secondary purpose was to investigate how sure pharmacy customers felt about their medicine – what medicine to use, how to use them and why.

    Methods: An interview study was conducted at nine pharmacies, in six different cities in Sweden, during spring 2021. Inclusion criteria were pharmacy customers over the age of 18 who picked up medicines for themselves, spoke Swedish and had three or more prescriptions. Exclusion criteria were customer with multidose-dispensed drugs (ApoDos) or an agent. An interview guide was used together with a printing of the prescription list for pharmaceutical review. Written informed consent was obtained from the participants before the start of the interview.

    Result: 485 people met the inclusion criteria. The loss was 232 people (48 %). Out of 253 participants, 63,2 % had at least one discrepancy in prescription list and the number of discrepancies ranged from 1-16 per person for these. Only 36,8 % of participants had a completely correct prescription list. Out of a total of 2084 prescriptions, 463 prescriptions (22 %) had some form of discrepancy, the most common of which was “Duplicates” (n = 195) and “Outdated prescription” (n = 193), followed by “Incorrect dosage” (n = 71) and “Uncertainty” (n = 4). 86 participants (34 %) lacked a prescription for current treatment, a total of 131 prescriptions were missing. Participants felt very confident about their drug use. 83,8 % felt completely confident about which medicines to use, 95,3 % about how to use them and 88,9 % about why.

    Conclusions: The conclusions that can be drawn from this study are that discrepancies are quite common in the prescription lists as discrepancies were found in every fifth prescription. The most frequent discrepancies were outdated prescriptions and duplicates thus increasing the risk for medication errors and/or overdoses. Around one third of the participants were missing some prescriptions. These discrepancies in prescription lists can be a huge problem and also a safety issue if the patients rely solely on this information in the lists. Moreover, this study also showed that, in spite of the discrepancies, the patients felt very sure about which medicine to use and also how to use them and why.

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  • 4.
    Bergman, Frida
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Förskrivningskollen utifrån vårdpersonalens perspektiv2022Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    The purpose of the National medication list is to provide healthcare, pharmacies, and the patient with the same picture of the prescribed and dispensed medications of a patient. Förskrivningskollen is a back-up system that healthcare professionals can use until their own electronic health record systems are adapted to the National prescription register. No previous study covers Förskrivningskollen and this phase in the implementation of the National medication list. 

    The aim this master’s thesis is to examine healthcare professionals experience and perception of Förskrivningskollen, which can identify benefits, barriers, and possible risks with the system. The study applied a mixed methods approach, with user statistics from Förskrivningskollen and a survey with open and closed questions. The respondents of the survey (n=288) were healthcare professionals who were users or potential users of the system. The analysis of the qualitative data was conducted using inductive content analysis.

    The result showed that there are high expectations on the National medication list but also many concerns. The knowledge about Förskrivningskollen was low and there was an uncertainty regarding the regulations and work routines linked to the system. There have been seven different healthcare professions among the users of the system up until January 2022. There is a small number of users of Förskrivningskollen in relation to the potential set of users. The result shows that a lack of interoperability with the electronic health record made Förskrivningskollen time consuming to use and could lead to a risk of insufficient documentation. Respondents described that the list was not sufficiently updated and that Förskrivningskollen could lead to a sense of false security. Most of the clinical pharmacist states that Förskrivningskollen has helped to facilitate their work with medication reconciliation. The physicians were more divided in their perceived benefit, some described benefit when prescribing drugs with risk of addiction, some others preferred using other systems such as NPÖ or Pascal.  

    This study showed that there is a need for information on and clarification regarding ways of working and regulations linked to Förskrivningskollen and the National medication list. The perceived problems of the healthcare staff concerning the National medication list is important to consider in the future implementation. 

  • 5.
    Bladh, Emil
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Säkerhet vid val av apotek: Enkätundersökning om kunskap och uppfattningar om symboler för godkänt apotek2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Aim: The aim of the degree project is to examine individual’s knowledge about symbols for approved pharmacy and how such a marking and other factors affect their choice of pharmacy from a safety perspective.

    Introduction: In a survey made by the Swedish Medical Products Agency (MPA) from 2008, 51 illegal websites targeting Swedish pharmacy customers were found. These websites illegally sold prescription pharmaceuticals without the requirement of a prescription from their customers. Shopping on illegal internet pharmacies can have great risks like contaminated drugs, lack of information about the drugs or that the drugs never gets delivered. To lower the risk that pharmacy customers accidently buys medications from the illegal online pharmacies, two symbols have been created for Swedish pharmacy customers, one by the MPA (figure 1) and one by the European Commission (figure 2). The idea is that the customer is supposed to click on one of the symbols on an online pharmacy’s website which is linked to a list for approved online pharmacies at the website of the MPA. If the customer finds the name and web address of the pharmacy on that list, the customer will know that the pharmacy is approved. But if the name and address isn’t found on the list, the pharmacy can be illegal, and the customer should avoid from shopping from the pharmacy.

    Material and methods: An electronic questionnaire with 10 question (Appendix A) was created in regard of the aim and sent out via the social platform “Facebook” through the students Facebook account. The survey included questions about which factors, from a security perspective, that influence the respondents to choose an online pharmacy and the respondents’ knowledge about the two symbols for controlling if an online pharmacy is approved. The results were analysed at a group level so that no individuals could be identified.

    Results and Discussion: The survey showed that a majority of the respondents had seen the Swedish symbol for approved pharmacy (figure 1) from the MPA (n=44, 59 %). However, a majority did not know what it means (n=57 or 77 %). Regarding the EU-symbol for approved pharmacy (figure 2), it turned out that most of the respondents had not seen it (n=58, 78 %) and even more didn’t know what it means (n=62, 84 %). The respondents in the study controlled pharmacies in different ways, for example making their own assessment if an online pharmacy seems safe (n=21, 51 %) or that they choose an online pharmacy that they have seen on some sort of commercial (n=17, 41 %) (Table II). For some it wasn’t something they thought about (n=10, 24 %) (Table II).

    Conclusions: The conclusion is that most of the respondents had seen the Swedish symbol for approved pharmacy but did not know what it means. Few respondents had seen the EU-symbol for approved pharmacy and even fewer knew what it means. The most common factors influencing the respondents’ choice of a pharmacy, from a security perspective, was by making their own assessment if the online pharmacy seems safe or choose a pharmacy which they have seen from a commercial. For some of the respondents, it wasn’t something they considered when choosing pharmacy.

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    Säkerhet vid val av apotek
  • 6.
    Carlsson, Carina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    En enkätstudie om apotekskunders syn på och kännedom om farmaceuters användning av elektroniskt expertstöd, EES2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Drugs are an essential part of health care today. They improve and extend the lives of many people. If drugs are wrongfully combined or given in inaccurate dose, it may lead to poorer quality of life, hospital admissions and even deaths. Drug-related problems cost society a large amount of money each year.

    To minimize these problems, there are now electronic decision supports that doctors and pharmacists can use. At all pharmacies in Sweden, the electronic expert support system available. The EES analyzes electronic prescriptions and doses prescribed and indicates if it detects any potential drug-related problems. Such risks may be that the customer has several drugs with the same effect, drug interactions or that the drug is inappropriate due to age. For children, there are special warnings that may be that the doctor on the prescription has prescribed a higher dose of the drug against what is commonly given to a child.

    The purpose of the study was to investigate pharmacy customers view of and knowledge about pharmacist use of EES. Data were collected via surveys for 100 hours at several different pharmacies in Sweden.

    The vast majority of pharmacy customers did not know of EES, only one fifth of the survey respondents knew what EES meant. Consent from the customer is required for the pharmacist to use EES when dispensing drugs and one third of the customers did not know if they agreed to this or not. Half of the customers did not know if the pharmacist used EES when the drugs were dispensed. Most of the customers also did not know whether their drug dispensing would be safer, if they would get better advice if the EES was used or if they wanted the pharmacist to use EES as a tool in the prescription expedition.

    The study shows that pharmacy customers' views and knowledge about the use of  EES by pharmacists are limited. The reason for this may be that it takes extra time for pharmacists to inform customers about what EES means and ask them for consent that the expert support should be used in the prescription expedition. Many times the pharmacist is experiencing a shortage of time to do this. The reason why EES is not used may be because the pharmacist does not feel adequately educated in how the decision support works and therefore chooses not to use it. It may also be due to communication difficulties such as language problems, hearing impairment or the customer's reduced cognitive ability.

    There is a need for communicative improvements between the customer and the pharmacist so that the pharmacists will increase the use of EES when dispensing drugs. There is also a need for pharmacists to get education in how EES works and how to use the decision support. If this is done, it will provide the customer with a better drug use with reduced risk of side effects and drug-related problems.

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  • 7.
    Dalsten Hjort, Anna
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Sjuksköterskors erfarenhet av strukturerad dokumentation i primärvården2023Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Svensk sjukvård har stora pågående förändringar som att flertalet av regionerna håller på att byta ut sina informationssystem. I bytet av informationssystem ska dokumentationen bli mer strukturerad och standardiserad för att den ska bli mer effektiv, säker och av högre kvalité. En del av astma- och KOL-sjuksköterskor arbetar redan idag med en strukturerad dokumentationsmall då en del av deras dokumentationsinformation över går över till kvalitetsregistret Luftvägsregistret. Att undersöka deras erfarenheter kan ge värdefull kunskap inför en bredare implementering. 

    Syfte: Att undersöka sjuksköterskors erfarenheter av strukturerad dokumentation i primärvården i mötet med astma- och KOL-patienter med fokus på patientsäkerhet, jämlik vård, tidssparande arbetssätt, vårdkvalitet, professioners autonomi.

    Metod: Semistrukturerade intervjuer genomfördes med nio astma-och KOL-sjuksköterskor som arbetade i primärvården och hade ett befintligt informationssystem som möjliggjorde direktöverföring till Luftvägsregistret. Deduktiv ansats användes med de bärande begreppen: patientsäkerhet, tidssparande arbetet, vårdkvalitet, jämlik vård, professioners autonomi användes när materialet bearbetades med hjälp av kvalitativ innehållsanalys.

    Resultat: Resultatet visade sammanfattningsvis att strukturerad dokumentation kan vara ett stöd för sjuksköterskorna i deras dagliga vardag då dokumentationsmallen hjälpte dem att komma ihåg vad de skulle fråga patienten om. Dokumentationsmallen upplevdes som omfattande och kunde vara tidskrävande som ny men efter ett tag var erfarenheten att den var tidssparande. Nationella riktlinjer och standardiserade dokumentationsmallar upplevdes av de flesta som stödjande att ge patienterna en god vård. Det krävs dock en yrkesprofessionalitet som yttrar sig i erfarenhet och kunskap för att veta när de kan frångå riktlinjer och hoppa över sökord i strukturerade dokumentationsmallar. 

    Slutsats: Sjuksköterskors erfarenheter av att arbeta med strukturerad dokumentation visar fördelar men också utmaningar när det gäller patientsäkerhet, jämlik vård, tidssparande arbetssätt, vårdkvalitet samt professioners autonomi. Resultatet från studien tillsammans med det teoretiska ramverket kan bidra med underlag till det kommande implementeringsarbetet.

  • 8.
    Drajem, Veronica
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Apotekskunders uppfattning om trygghet med sina läkemedel och behandling. Hur de erhållit information om dessa samt deras kunskap om EES.: - En enkätundersökning om det förekommer skillnader mellan olika åldersgrupper på apoteket2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Abstract

    Pharmacists have for many years been an important part of health care. They have rescued many people from diseases and poisoning. It´s important that they ensure the right drug, dosage and administration in right time for each customer. Elderly people usually have more prescribes than younger which increases the risk of interactions.

    Poor compliance may result in increased morbidity or premature death. There are several reasons why treatment is not followed. Lack of information about the treatment of disease or information about the medications for both indication and side effects are some of them

    At all pharmacies in Sweden, EES, Electronic Expert Support, is available. The introduction of e-prescription in the 21st century has enabled an additional safety check for the pharmacist, using Electronic Expert Support (EES) for dispatching prescriptions. The current recipe is compared with other prescriptions where there are withdrawals and the prescriptions where there should be pharmaceuticals left to consume. If there is a risk of incorrect dose, double prescription, age warning, interactions, gender specific or if drug affecting disease, a signal is given at EES control showing strength and action that may, should be done.

    The purpose of the study was to investigate customers perception of advice at the pharmacy and if the use and knowledge of the EES (Elektroniskt Expertstöd) differed between different age groups. The survey was conducted using data collection from seven pharmacies located in five locations spread across Sweden. The collection was conducted for about 100 hours and generated in 277 participants. All participation was voluntary and anonymous. The participants were divided into three age groups: 40 years or younger, 41-60 and over 60 years. The collected data was analyzed by using IBM SPSS and a chi2 test was performed to see if there were any significant differences between the age-groups. The result was compiled and demonstrated in excel diagrams.

    There was no significant difference between the groups in terms of safety and information they received about their drugs. Most people received information about their medicines by the doctor, pharmacist or by reading the package leaflet. However, there was some difference regarding the use of the Internet in a search for information retrieval among those over 60 years. This may be due to lack of internet knowledge or physical impairment. There was also a significant difference when it came to the question of calling 1177 for information on medicines, where people 40 years or younger, called more often than other groups. This may be because they usually have younger children and may need advice regarding illness or injuries.

    There was a significant difference between the age-groups in consent to use EES were elderly people had consented more often. Elderly people usually have more drug prescribes than younger and therefore is it more useful for people over 60 years. The risk of interactions increases with the number of drugs.

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  • 9.
    Grahn, Karin
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Hur uppfattar farmaceuter tillgänglig information om patienters aktuella läkemedel och hur ser de på övergången till en gemensam nationell läkemedelslista?2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Doctors, nurses, pharmacists, patients and next of kin are all parts of the chain that is needed to make sure that the use of medication is safe and appropriate for the patient. That many people involved and in many different settings can make the use of medication difficult to manage. In the year 2014 there were 102 913 130 prescriptions made out to patients in Sweden. Up to the year 2014 850 000 corrections had been made to prescriptions with faults in them by pharmacists each year. To correct prescriptions is an essential part of the pharmacist’s obligations and responsibility, a responsibility that is regulated in Swedish law. The pharmacist is the last part of the chain that has the possibility to adjust anything that is wrong with medications and the use of it before it is in the patient’s own hands. The access to a nationally shared medication list for all involved parties might solve some of the problems that faces the responsible parties when it comes to dealing with patients and their new and ongoing medications and in that way be able to increase the safety around mediation for the patient in need. Although the survey conducted as part of this paper focuses on pharmacists the background tries to explain in what way the different professions come in contact with medicines and how they would perhaps benefit from a shared list. The paper also tries to give a little insight to what kind of problems there could be related to prescriptions. In Sweden we have come a rather long way in the use of computers and the use of internet in the field of eHealth compared to other countries. The paper tries to show how the problem surrounding prescription of medicine is handled in the other countries of Scandinavia. Earlier studies have been conducted that looks at shared lists from the doctors view and also studies have been conducted that looks upon eHealth for patients partly in view of shared medication lists. No studies have been found that looks specifically at how pharmacists feel about it and how such a list would benefit them in their work to secure patient safety, hence this paper. In order to reach the papers purpose a survey was performed with pharmacists employed at different pharmacies in the southern part of Sweden. The result of the survey showed that there are indeed problems with prescriptions in the prescription repository and the majority of the pharmacists agreed that a shared medication list could help them in their work to secure patient safety when releasing prescribed medication. Although the pharmacist agreed for the most part in the benefits of such a list they did not know if it would solve all problems, which is for the future to decide.

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  • 10.
    Gustafsson, Julia
    et al.
    Linnaeus University, Faculty of Technology, Department of Informatics.
    Englund, Hanna
    Linnaeus University, Faculty of Technology, Department of Informatics.
    Diabetesmottagningars perspektiv på implementering av webbtidbokning: En studie om diabetesmottagningars förutsättningar och motsättningar vid en implementering av webbtidbokningar.2017Independent thesis Basic level (degree of Bachelor), 180 HE creditsStudent thesis
    Abstract [en]

    The authors of this bachelor thesis have completed the information logistics program and they had the will to influence the ongoing technical development in health care. The different diabetes receptions in Sweden works in different speeds with the development of e-health services such as web-based bookings. The three County Councils Blekinge, Kronoberg and Kalmars opinions about the introduction of web-based bookings were collected through interviews with twelve diabetes nurses from nine receptions. The purpose was to find out what conditions and contradictions that the employees of the receptors had experienced at the time of introduction or when the decision about the introduction was made. The purpose was also to show some tips and advice for receptions that is planning to introduce web-based bookings.

    The theory Diffusion of Innovations was used to analyze the results based on factors such as the innovations attributes, time for implementation, communication channels that were used and the social systems effect on the implementation. Even though four of the total nine receptions had introduced, or plans on introducing web-based bookings, none of them had actually implemented web-based bookings into a permanent change where the technology is used as planned. The failure to implement web-based bookings could be due to the many contradictions that has been pointed out by the informants. One of the most significant contradictions was the complexity because the majority of the informants considered the technology to be difficult to learn, hard to grasp that web-based bookings was, and hard to understand what it would be used for. This could have been happened due to the fact that the employees did not have a chance to test or observe the system before the introduction. Another crucial contradiction was the lack of demand of web-based bookings from the receptions patients. This is an interesting result because the informants also described many benefits from the patient's point of view. The results of this study also showed some benefits and tips for a successful implementation. Some good conditions was the physical communication regarding web-based bookings and the introduction, that the managers and management showed support for the change and that the receptions saw a need for web-based bookings and they also considered the technology to have more advantageous than the prior art. The authors also suggest that further studies as to why patients choose not to use e-health services, such as web-based bookings, even though they are available.

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  • 11.
    Götrick, Fanny
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Kan elektroniska påminnelser förbättra följsamheten till läkemedel hos patienter som långtidmedicineras?2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Adherence to a treatment is when the patient follows the planned treatment. A lower adherence can be when the patient is not taking their medication on time or the correct dose, not renew their prescriptions or that the patient is not following the recommendations of the treatment affecting their health. It is not unusual that the adherence is 50 % or lower in patients with chronic conditions. This affects the result of the treatment and cost the society a lot of money. A low degree of adherence is not always something the patient chooses, it can be because of forgetfulness or ignorance about their disease and its treatment. Adverse effects and attitudes about the treatment are factors that can make the patient unwilling to take their medication as prescribed.

    Mobile phones and smartphones increase in popularity all over the world and they can be an opportunity to affect adherence in patients with chronic conditions. Reminders and information can easily be sent out to a lot of patient to a low cost.

    The aim of this study was to find out if electronic reminders could increase adherence to treatment. The 5 studies that were chosen for this study analyzed if only reminders could affect the adherence or if reminders with information about the treatment and the patient’s condition could affect adherence.

    The result show that only reminders doesn’t affect adherence in patients with tuberculosis but for patients with acute coronary syndrome are electronic reminders effective for increase adherence to treatment with drugs. Increased understanding for the sickness and its treatment can possibly increase the adherence. Therefore education through mobile phone and reminders can be a good option to increase adherence among patients with chronic diseases.

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  • 12.
    Halilovic, Muratka
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Kranskärlssjuka patienters attityd och följsamhet till läkemedelsbehandling: En kvantitativ undersökning om läkemedelsanvändning2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Brister i läkemedelsföljsamheten är ett världsomfattande problem. Varannan kroniskt sjuk patient följer inte sin läkemedelsordination. Trots starka bevis på att förebyggande behandlingar efter akut kranskärlssjukdom är effektiva har det i undersökningar visats att följsamheten till dessa mediciner är låg. Låg följsamhet leder till negativa hälsoeffekter; ökade hälso- och sjukvårdskostnader och ökad dödlighet. Syftet med denna studie var att undersöka attityder och följsamhet till läkemedel hos patienter med kranskärlssjukdom. Vidare skulle sambandet mellan olika faktorer hos patienterna och deras attityd och följsamhet till läkemedel undersökas.

    Studien baserades på enkätundersökningar och ingick som en delstudie i ett större forskningsprojekt ”God läkemedelsanvändning för äldre i Småland (GLAS)”. Till analysen samlades enkäter och journaluppgifter från totalt 91 kranskärlssjuka patienter. Enkäterna var BMQ-Specific (attityd till hjärtläkemedel) och MMAS-8 (följsamhet till kolesterolsänkande läkemedel). 

    Av 91 patienter som deltog var 75 % män. Medelåldern var 69 år (SD = 8,704 år) och genomsnittligt antal regelbundna läkemedel per patient var 7,2 (SD =2,419). En femtedel av patienterna hade stark oro om användningen av förskrivna hjärtläkemedel och 28 % hade bristande följsamhet till kolesterolsänkande läkemedel. De patienter som hade positiv attityd till sin medicin var också de som var mest följsamma.

    Slutsatser som kan dras av studien är att attityder till läkemedel är en viktig del i hur patienter väljer att följa eller inte följa sin behandlingsregim. Resultaten från studien kan komma att användas till att utveckla insatser för att förbättra patienters läkedelsföljsamhet och behandlingsresultat.

  • 13.
    Hartmann, Kirsten
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Barns upplevelser av att leva med diagnosen diabetes mellitus typ 1: en systematisk litteraturstudie2010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    För barn som har fått diabetes mellitus typ 1 betyder diagnosen en del förändringar och inskränkningar i vardagen eftersom vardagen behöver förändras både utifrån deras sociala, fysiska men också mentala perspektiv. För att som sjuksköterska kunna stödja barn och deras familjer är det av betydelse att ha kunskap om hur barnen upplever situationen med sin sjukdom. Syftet med denna litteraturstudie är att beskriva barns upplevelser av att leva med diabetes mellitus typ 1. Metoden som har använts är en systematisk litteraturstudie baserad på sju vetenskapliga artiklar som hittades i databaserna Cinahl, PsycINFO, Pubmed och Elin@lnu.se samt via manuella sökningar. För att säkerställa artiklarnas kvalitet gjordes en kvalitetsgranskning. Analysen har genomförts med inspiration av en kvalitativ innehållsanalys. Huvudresultaten visar att barnen var oroliga och rädda att drabbas av komplikationer. Många av dem kände sig begränsade i vardagen på grund av de rutiner som finns kring diabetesbehandlingen. Viktiga faktorer för att barnen skulle känner sig trygga var stödet av familjer, vänner och skolpersonal, men även kunskap om diabetes och dess behandling som sjuksköterskan tillhandahåller i form av diabetesutbildning.

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  • 14.
    Holmén, Joacim
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Do I want an app for that?: Patients’ experiences of using a smartphone app for distance monitoring of depression2023Independent thesis Advanced level (degree of Master (Two Years)), 80 credits / 120 HE creditsStudent thesis
    Abstract [en]

    Background: Non-adherence to pharmaceutical antidepressant treatment is common among patients suffering from depression. This can lead to a deterioration of depressive symptoms with a potential need for hospitalization and increased healthcare costs as an effect. Previous studies have shown that automatic self-monitoring systems through digital applications can be effective in increasing adherence to treatment. 

    Aim: Explore patients’ experiences of using a smartphone app on a daily basis for the first four weeks after being prescribed an antidepressant.

    Method: A qualitative descriptive study. Ten patients were recruited from an outpatient psychiatric clinic in Sweden. In connection to inclusion a nurse assisted with the installation of a digital application called Seno. Nine patients, seven females and two men ranging between 18–40 years, completed the study. Individual semi-structured interviews were conducted after using the app for four to six weeks. Recorded data was transcribed and analysed using qualitative content analysis.

    Results: The participants experienced that a digital application could be valuable as an augmentation to antidepressant treatment, but with room for improvement. Adherence was positively affected by a daily reminder and the application’s ease-of-use, but was negatively affected by technical issues, cognitive impairments and a lack of flexibility to tailor the content according to individual needs. The positive experience of visually presented data in graphs was a key finding and was found beneficial for self-awareness as well as for the patient-physician relationship, and engagement to continue using the application. Participants expressed no concerns regarding the safety of their health data when using the application.

    Conclusion: A digital solution for self-monitoring of depressive symptoms and adherence to medication can be found useful and is tolerated by patients when being prescribed, or making a change, in pharmaceutical antidepressant treatment. Several factors can impact the usability of, and engagement in, the digital application and need to be considered when designing this kind of solution. This indicates that there is a need for user involvement early on in the design process.

  • 15.
    Israelsson, Anne
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    I hur stor utsträckning använder patienter vid apotek receptfria läkemedel tillsammans med sina förskrivna läkemedel?: En intervjustudie vid apotek2021Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Medications are used to prevent, cure and treat different kinds of diseases. The use of medicines by the patients should be according to the prescription from a physician. For safe and appropriate prescribing of medications the physicians should be able to get information about all of a patients’ current medications, to avoid drug-drug interactions. Beside the prescribed medicines patients can use medications without a prescription, so called Over-the-Counter (OTC) medicines. OTC-medicines are used in the same way as prescribed medicines, but the patient needs to read the included package leaflet to know how the medicines should be used. In year 2020, 65 % of the population in Sweden received prescribed medicines. Physicians, pharmacists and patient use different electronical medication lists to know what medicines the patient is using. The lists are not always updated with the latest information because not all of the electronic journal systems are linked together which can be seen as a risk for patient safety. Many patients have OTC-medicines at home and many use it frequently. One of the risk with OTC-medicines is that drug-drug interactions can occur with the patient’s prescribed medicines or other OTC-medicines and cause adverse drug reactions (ADR). In Sweden 44 % of the medication packages is OTC-medicines.

    Objective: To analyze the extent of OTC-medicines are used together with prescribed medication in different ages and genders.

    Methods: A structured interview study that was done with patients visiting pharmacies who had three or more recipes at their medication list, could talk Swedish and was collecting medication for themselves. The structured interviews were performed at pharmacies and included questions about their use of different kind of medication lists and if they use any OTC-medicines. Together with the patient the list was checked for errors or non-current medications. The results were analyzed using descriptive statistics. 

    Results: A total of 215 patients were interviewed, where 63 % were women. The largest age group was patients born in the 1940’s followed by patients born in the 1950’s and 1960’s. OTC-medicines were used by 53 % of the patients in the study who all had at least three prescribed medications and the use were almost the same for men (51 %) and women (53 %.) The most frequent users of OTC-medicines were patients born in the 1970’s and younger. The proportion of patient’s using OTC-medicines were reduced by the age of the patient. The most frequently used OTC-medicines were medication for pain and fever followed by vitamins and minerals. The use of OTC-medicines was most frequent used by patients who had four or less prescriptions medications on their medication list.  

    Conclusions: In the study OTC-medicines were used by the majority of the patients who also have several prescribed medications. Men and women use OTC-medicines in almost the same amount in the total population, but there are some differences in the age’s categories. Physicians and pharmacists need to have an updated and correct medication list. The new nationally shared medication was recently implemented, aiming to improve patient safety. Medication use could be further improved if the shared medication list also would include OTC-medicines used, hopefully this can be implemented in the in the future. 

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  • 16.
    Ivana, Cindric
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Apotekskunders uppfattning gällande information om aktuella läkemedel och läkemedelsbehandling2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Pharmaceuticals have been developed as long as humanity has suffered from diseases. It is something today’s people take for granted and is associated with strict rules as well as social initiatives.

    The purpose of pharmacies has developed from being an authoritarian part in healthcare to focusing on the customer and their needs. This particular role for pharmacies is one of the main focuses in this candidate thesis. A survey was performed at seven different pharmacies located at seven different sites in Sweden. The survey illuminates relevant questions around the dialogue between the customer and pharmacist.

    The communication between pharmacist and customer is an important aspect in the process of a purchase, because medicine has become more advanced and precise. The communication is a complicated procedure that requires to be mastered by pharmacists and also by customers at a specific point in time and place. This interplay creates customer satisfaction.

    The result showed that customers were generally reassured with the treatment of their medicine. The pharmacist gave relevant and enough information according to the answers on the survey. It showed that doctors still have the most trust amongst customers regarding the medicine information, thereafter the pharmacist. Possibly the reason for this depends on the relations between doctors and patients compared to pharmacists and customers.

    Even though pharmacists today have a major role when it comes to medical treatment and customers are satisfied, it is still common that they search for information in other ways. Digitalisation will probably affect this subject.

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  • 17.
    Johansen, Anders
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    AI-baserad egenbehandling för patienter med ländryggsmärta: -en systematisk litteraturstudie2024Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Inledning: Ländryggsmärta är en vår tids vanligaste förekommande åkommor som drabbar cirka 70% av befolkningen och den förekommer med hög samsjuklighet och högt personligt lidande. Den genererar hög samhällelig kostnad på grund av hög sjukfrånvaro, förlorad produktivitet och höga sjukvårdskostnader och bara i Sverige beräknas den kosta 7,8 miljarder kronor. Behandlingen som har högst evidens är rehabiliteringen där patienten själv är aktiv. Med den senaste tidens digitala tekniska utveckling har vården kunnat nå ut till fler patienter och patienten själv har hamnat i centrum. Med alltmer integrering av AI-modeller i den senaste tekniken så finns det verktyg som kan individualisera behandlingen. Litteraturöversiktens syfte är att beskriva resultat, utfallsmått och kvalitet i publicerade interventionsstudier om egenbehandling med AI-teknik hos vuxna ländryggspatienter.

    Metod: Till sin design är studien en systematisk litteraturöversikt. Den är systematisk för att det finns ett metodologiskt protokoll för litteratursökningen samt en strukturerad kvalitetsgranskning av utvalda artiklar. Nyckelord har lokaliserats och tre databaser har sökts igenom. Kvalitetsgranskningen utfördes med hjälp av SBU:s mallar. Vid analysen användes en narrativ syntes som metod där resultatet extraherades från utvalda artiklar och syntetiserades till ett gemensamt resultat under respektive utfallsmått. Slutligen genomfördes en evidensgradering av den aktuella studiens resultat på respektive utfallsmått. 

    Resultat: Efter litteratursökning och urvalsprocessen lokaliserades 15 artiklar. Samtliga artiklar var kliniska interventionsstudier varav 10 av dem var RCT och övriga var enarmade kliniska studier. Artiklarna visade att AI-baserad vård hade ett förbättrande resultat för patientgruppen på smärta, funktionsnivå och psykosocialt mående. Vid utfallsmåttet smärta sågs en svag trend att det var bättre än sedvanlig vård och bland funktionsnivå sågs en mycket svag trend.  

    Diskussion: Forskningsfältet är ännu prematurt och det saknas välgjorda RCT- studier. Det saknas även standarder inom forskningsfältet kring gränsvärde för AI och det finns ett gap mellan vetenskapen kring AI och vad sjukvården faktiskt behöver i det dagliga arbetet. Modifierade implementeringsteorier inriktade speciellt mot AI behöver användas av den framtida forskningen för att bemöta gapet, och utmaningar finns kring transparens, tillit, förklarbarhet, dataskydd och etik. Slutsats: Studien ger en svag indikation på att AI- baserad egenbehandling vid ländryggsmärta är lika bra eller bättre än sedvanlig vård vad gäller förbättring av smärta hos ländryggspatienter. Studien indikerar också att funktionsnivån blir bättre med AI-baserad behandling med en mycket svag trend mot att det är bättre än sedvanlig vård. Studien visar också att det psykosociala måendet blir bättre men ej bättre en sedvanlig vård. Dock är evidensgraderingen låg till mycket låg. 

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  • 18.
    Johansson, Angelica
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Behovet av en strategisk behörighetsstyrning för att skydda patientens integritet: En kvalitativ beskrivande innehållsanalys av regionernas styrande dokument för elektronisk åtkomst till patientuppgifter2021Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Vid upprepade tillfällen har Integritetsskyddsmyndighetens tillsyn funnit brister i vårdgivares efterlevnad av juridiska krav som avser dokumenterad behörighets-styrning och behörighetsgrundande behovs- och riskanalys. Dessutom har tillsyn identifierat fall där hälso- och sjukvårdspersonal haft mer behörigheter än vad arbetsuppgiften kräver, vilket medför att patienter saknar det integritetsskydd de har rätt till. Bristerna kan tyda på en osäkerhet hos vårdgivare avseende hur dessa juridiska krav bör tillämpas i praktiken. Därför är studiens syfte att sammanfatta hur regionerna beskriver tillåten åtkomst till patientuppgifter och behörighetsgrundande behovs- och riskanalys i sina styrande dokument. Studien ska dessutom lyfta fram förslag på hur en behörighetsgrundande behovs- och riskanalys kan genomföras och dokumenteras.

    Arbetet har bedrivits som en deskriptiv kvalitativ studie med en induktiv ansats, vilken utifrån empiririska data ska besvara studiens frågeställningar. De empiriska data som insamlats avser textuella data i form av styrande dokument som erhållit från 17 av de 21 regionerna genom begäran om allmän handling. För dataanalys av dessa styrande dokument har en konventionell innehållsanalys valt som metod, som på manifest nivå sammanställt innehållet i dessa styrande dokument. Resultatet diskuteras därefter utifrån Integritetsskyddsmyndighetens vägledning samt Da Veiga och Eloffs ramverk för styrning av informationssäkerhet.

    Resultatet visar både likheter och skillnader i regionernas styrande dokument, exempelvis återfinns beskrivning om tillåten och otillåten åtkomst till patient-uppgifter hos samtliga regioner. Den största likheten avser dock beskrivning av verksamhetschefens ansvar för medarbetarnas behörigheter samt behovs- och riskanalys, där det sista skiljer sig markant från Integritetsskyddsmyndighetens vägledning vilken anger att behovs- och riskanalys ska ske på en strategisk nivå. Resultatet visar dessutom att det inte finns någon generell metod hos regionerna som kan rekommenderas för genomförande och dokumentation av den behörighets-grundande behovs- och riskanalysen. Däremot kan Integritetsskyddsmyndighetens vägledning utgöra ett stöd vid genomförandet av en strategisk behovs- och riskanalys.

    Slutsatsen är att en behörighetspolicy, tillsammans med en strategisk behovs- och riskanalys, skulle kunna ge stöd vid utformning av en ändamålsenlig och enhetlig behörighetsstruktur. Dessutom kan behörighetspolicyn, tillsammans med resultatet av den strategiska behovs- och riskanalysen, kunna utgöra underlag för krav vid upphandling, utveckling och anpassning av vårdinformationssystem. Genom att kombinera behörighetspolicy och en strategisk analys skulle vårdgivaren kunna uppnå en behovs- och riskbaserad behörighetsstyrning som i slutänden leder till trygghet för patienten utifrån både ett patientsäkerhets- och integritetsperspektiv. 

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  • 19.
    Jonasson, Åsa
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Petersson, Maria
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Törst hos patienter som behandlas med hemodialys2010Independent thesis Basic level (degree of Bachelor), 15 credits / 22,5 HE creditsStudent thesis
    Abstract [sv]

     

    Bakgrund

    : Andelen njursjuka som är i behov av hemodialys ökar ständigt. I stort sett alla dessa patienter lider av törst. Att vara njursjuk och under dialysbehandling innebär stränga restriktioner i hur mycket vätska patienterna bör inta. Den kraftiga törsten kan leda till att patienterna intar så mycket vätska att dialysbehandlingen blir en fara. För att de inte ska riskera sin hälsa behöver patienten stöd i hanterandet av törst. Syfte: Syftet med studien var att belysa hanteringen av törst hos patienter som behandlas med hemodialys. Metod: En systematisk litteraturstudie av endast vetenskapliga artiklar användes som metod och sökningar gjordes i PubMed och Cinahl. 10 artiklar valdes ut, kvalitetsgranskades och analyserades. Resultat: Törst hos hemodialyspatienter upplevs som ett lidande. Hur väl patienterna hanterar vätskerestriktioner och törst beror på bland annat graden av törst, motivationsgrad, sjukdomsstadiet och patientens ålder. Patienter med stor självdisciplin har lättare att hålla sig till de ordinerade vätskerestriktionerna och utstå törsten. Slutsats: I slutänden är det när patienter tar ett eget ansvar och utvecklar egna egenvårdsstrategier som de framgångsrikt kan utstå törsten som följer med hemodialysbehandlingens vätskerestriktioner. Utöver att ge sedvanlig information bör sjuksköterskor stödja hemodialyspatienter att hitta egna copingstrategier, speciellt barn och ungdomar.

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  • 20.
    Juhlin, Madeleine
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Elektroniskt expertstöd ur kundens perspektiv: En enkätstudie om kundens kännedom och inställning till EES2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Abstract

    Medicines are substances used to prevent, alleviate or cure diseases which is an important part of health care. The role of the pharmacist in the healthcare chain is important because they are the patients last contact with healthcare professionals. After this contact they must assume responsibility over their own treatment. The pharmacist's responsibility is to make sure that the patient has received essential information about their drugs and to check that the prescribed dose is correct.

    The increased digitalization of society brings an opportunity for the patients to increase participation and understanding of their drug treatment.

    Decision support systems are different methods used to obtain a basis for decision making. Pharmacists use these systems to check if prescriptions are correct, for example by ensuring that the right medication, in the correct dose, has been prescribed to the right patient at the right time.

    In Sweden there is a decision support system called elektroniskt expertstöd (EES). This system offers pharmacy customers further drug control in addition to other controls that are available through the pharmacy's other systems. The benefit of this system is that the pharmacist has better support in detecting incorrect doses, interactions, duplicate medications and if the drug is inappropriate for the patient's gender or age. When the system alerts, the pharmacist makes an assessment which may be discussed with the patient or the physician if needed.

    Purpose

    The purpose of this survey study was to investigate what the pharmacy customers knows about EES and the pharmacists use of the system.

    Method

    Before the study started, approval from the southeast ethic committee was obtained which said that there were no ethical barriers for the performance of the study. The surveys were handed out to anyone who would receive prescriptions at different pharmacies in Luleå, Grängesberg, Värnamo, Kalmar and Torsås. The common goal was to spend 20 hours of handing out surveys per student. The results were put together and analyzed in IBM SPSS Statistics with descriptive statistics. 

    Results and discussion

    The results show that most of the respondents did not know about EES and did not know if the pharmacists are using this support system. The results also show that most of the respondents had not given their consent to EES and did not know if EES could support the pharmacists work. More than half of the survey population answered “do not know” on a question asking if they wanted the pharmacist to use EES when dispensing drugs. Almost a quarter of the total population wanted the pharmacist to use EES and close to three quarters of the total population had no knowledge of the system. This could mean that the customers who have knowledge wants the system to be used. A reason for wanting the system to be used without having knowledge of it could be that customers trust it is beneficial for themselves and for the pharmacists. Building trust and showing care in each customer meeting is important to make the customer susceptible to information. Sufficient information can lead to better compliance in drug treatments. Before the pharmacist can use EES for the first time the customer must consent. Although it was a few years since the introduction of EES into pharmacies, some pharmacists find it difficult to connect customers to the system. It is a relatively new way of working with drug analysis at the pharmacies in Sweden. More practice in the system could provide increased use of it and help the pharmacists decision making.  

    Conclusion

    Only a small proportion of the pharmacy customers have knowledge of EES. But even so, one fourth of them wanted the system to be used to analyze their medication which is considered positive.

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  • 21.
    Jönsson, Sanna
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Implementeringen av Nationella läkemedelslistan ur tre perspektiv - med hjälp av mjukt systemtänkande2023Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    On 1 May 2021, the Act (2018:1212) on the national medication list came into effect. The National Medication List (NLL) is supposed to provide a comprehensive and updated list of the patient's prescribed and dispensed medicines to the healthcare, pharmacies and the patient. The actors concerned experience various concerns linked to the implementation of NLL and there does not seem to be any common, concrete target image.

    The aim of the study is to explore experiences and perceptions of the implementation of the National Medication List using soft systems thinking. The study used techniques within Soft Systems Methodology. As a complement, qualitative content analysis was used. Three semi-structured group interviews with 2-5 participants, based on a strategic selection, from each perspective of authority, pharmacy and healthcare were carried out.

    From the three perspectives asked, there is a consensus that the idea of ​​NLL is good in essence, but there is no common picture of when NLL will be implemented or how it will work then. The different perspectives have different prerequisites for implementing NLL and have reached different stages of implementation. The biggest challenges seem to be for the healthcare perspective, where the technology described around NLL is far from the working processes that exist today, and it is unclear how different laws cooperate. 

    Regarding how it will work with NLL in December 2025, there is a consensus that changed working processes will be required in order for the benefits of NLL to be realized, but perceptions of how and when that will occur diverge. There are perceptions that the full implementation of NLL will not be carried out in December 2025. The future desires regarding NLL also differ between the different perspectives. 

    It is not possible to implement NLL with solely a technical focus. More focus is required on working processes and how they are affected. More research is needed into how perceived problems and obstacles can be solved and studies to evaluate the implementation and to measure results and effects of NLL are needed too.

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  • 22.
    Karpestam, Björn
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Prescribing Patterns to Children and Adolescents (10-19 years) in Sweden during 2006-2011: A Registry Study with Focus on Drugs Acting on the Nervous System2012Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Children and adolescents are a group among which the data on efficacy and safety of drugs is particularly scarce. This has consequences that can lead to adverse effects. The recent increase in utilization of specialized psychiatric care among young men and women in Sweden may influence drug utilization because the Swedish guidelines for treating neuropsychiatric disorders in youth include medical treatment. Using de-personalized prescription data from The Swedish Prescribed Drug Registry for the years 2006-2011 to estimate period prevalence of drug use for males and females aged 10-19 years; trends in prescribing were analyzed on a national as well as a regional level. The prevalence of both overall (+ 2.6 %) and ATC N (+ 51 %) drug use has increased for the age group 10-19 years during the years 2006-2011. In general, the increase was greater for males than for females, and the number of prescriptions increased generally more than the number of individuals getting a prescription dispensed. Hypnotic/sedative drugs increased most for males (> 200 %) and for females drugs used to manage ADHD increased the most (> 350 %). There were considerable differences in both prevalence and change in prevalence of drug use between various regions.

  • 23.
    Larsson, Ulrika Maria
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Djurägares källor till läkemedelsinformation2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Information om läkemedel som skall användas till djur erhålls skriftligt från den bipacksedel som i Sverige måste finns med i alla läkemedelsförpackningar, samt muntligt från veterinärer och farmaceuter. Läkemedelsinformation kommuniceras även elektroniskt genom olika webbplatser på Internet, bland annat www.fass.se. Syftet med detta arbete var att undersöka djurägares nyttjande av bipacksedeln och andra informationskällor när de hämtar ut läkemedel på recept till sitt djur. Metoden som användes var en enkät i pappersform, vilken besvarades av 80 djurägare som under januari och februari 2018 kom till apotek för att köpa receptbelagd medicin till djuret. Resultatet visade att flertalet djurägare, 52,5 %, alltid läser bipacksedeln till läkemedlet som deras djur skall behandlas med, att 37,5 % läser den ibland och att 10,0 % aldrig läser den. De två källorna till information om djurets läkemedel som flest ägare använder sig av är veterinären och bipacksedeln. Elektroniska informationskällor utnyttjas sällan. Ägare till djur av olika slag använder skilda läkemedelskällorna i samma utsträckning. Djurägares ålder eller kön kunde inte sägas ha betydelse för användandet. Slutsatsen som drogs var att bipacksedeln är djurägares näst viktigaste informationskälla om läkemedel, efter veterinären. Det fanns likheter, men också skillnader i individers användande av läkemedelsinformation till djur och till egna läkemedel. Det återstår att undersöka olika informationskällors roll och betydelse för läkemedelsbehandling av djur.

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  • 24.
    Lundin, Andreas
    Linnaeus University, Faculty of Technology, Department of Informatics.
    Användbarhet och designprinciper i ett webbaserat gränssnitt2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Projektet startade på uppdrag av eHälsoinstitutet i Kalmar. Syftet var att ta fram ett webbaserat utbildningsgränssnitt för äldre läkemedelsanvändare. Arbetets omfattning har inneburit att ta designa ett gränssnitt som skall uppfylla vissa krav för användbarhet inom olika kriterier. Problemets utgångspunkt har varit att försöka undersöka vilka faktorer som kan stimulera och vara viktiga för användbarhet i gränssnitt emot en äldre målgrupp med åldersrelaterade svårigheter. För att belysa problemet har olika metoder åtagits såsom Normans designprinciper, gestaltlagar, observationer och intervjuer. Med hjälp av dessa har intressant data kunnat tas fram som senare analyserat, utvärderats och visualiserats.

    Resultaten har genererat intressanta företeelser om användbarhet utifrån flera perspektiv. En del har varit konkreta, medan andra mer abstrakta. Vad som framkommit av betydelse är att designprinciper får anses vara en viktig källa för god användbarhetsdesign och positiva upplevelser för de äldre. 

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  • 25.
    Malmberg, Sandra
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Hälsoappar till diabetespatienter - hur effektivt är det som hjälp vid behandling och förebyggande av diabetes?2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Diabetes is a chronicle disease and can be divided in to two types of diabetes, diabetes type 2 and diabetes type 1. The treatment for diabetes type 2 is often just a lifestyle change involving exercise and diet. But you can also treat it with oral medication and sometimes insulin. Diabetes type 1 is always treated with insulininjections. To improve treatment, prevent disease and to inform patients about their conditions there are many applications (apps) to download to your digital devices. For these apps to qualify as a medical product they have to be certified with a CE-mark. There is many apps to help individuals with weight-loss, diet, insulindosage, diary for glucosevalues, medicationreminders and so on. Apps could of value to patients with diabetes since they have to manage their condition themselves and it can also save money since diabetes and complications from diabetes cost the society a lot of money. Although the amount of apps on the market and increasing, not a lot of studies have evaluated their effects. But the research is ongoing and it is very interesting to see what can happen with apps and digital support to help patients in our digital world that is always heading forward. In this report it will be investigated if apps can be effective and of help to diabetespatients for treatment, support, information and to prevent diabetes type 2. In the studies evaluated it has been shown that apps have had positive effects and has been of support and help for patients. It has improved glucosevalues and given a lot of important information to diabetespatients, about the usage of insulin among other things. The apps have been effective to motivate weight-loss and motivate patients to live healthier. Apps have been a good complement to the usual therapy, but should not replace it. To combine treatment with support from apps seems to be a valuable thing for information, help and to prevent individuals to get diabetes type 2.

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  • 26.
    Nilsson, Erica
    Linnaeus University, Faculty of Technology, Department of Media Technology.
    Gränssnittsdesign för videocentrerad online-rådgivning: Utformad efter frågeställarens och rådgivarens olika användarroller2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The following essay is a design study which has developed a design proposal for a online-counseling service by information from literature, earlier analysis, interviews and personas which is suited for the user roles, questioner and advisor by their subject skills and by knowledge of the web service. The aim with the study was to investigate who the interfaces would be designed to accomplish the goals that the respective user role have when using the service. The design proposal is a part of a larger project where patients, diagnosed with cancer have had the opportunity to borrow an iPad which will work as a source of communication when there are no ordinary visits. The part where this work is involved in is a web service where patients have the opportunity to watch pre-recorded videos about the medication and may discuss potential questions with a nurse. The users have the opportunity to use a videotool as a mean of communication, which has been in the center of the design because it can be used to ease the communication between users. The video information which is attached from the existing videos can clarify the users messages. The advisor is in need for an interface with a sufficient amount of functions to clarify the information who is sent to the questioner. In the design proposal it has been made by a larger number of steps for the video function. The design proposal for the questioner's interface has been tested individually with five different participants through a prototype implemented with HTML5, Css and Javascript. The users integrated with the prototype and later answered some questions through an interview. The result showed that it is important to avoid a complicated interface with a large number of functions for the questioner. Furthermore, a simple interface design with clear descriptions and visualization for the clickable element is necessary. If the questioner is irritated and spend a lot of time on learning how the service works he or she may choose not to use the web service.

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  • 27.
    Nilsson, Lovisa
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Vilka informationskällor för läkemedel används mest frekvent av apotekskunder?: En intervjustudie utförd på apotek2021Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The fact that medication is taken as prescribed by the doctor is a basic precondition for a treatment to give the desired effect, but this is not the case with half of all prescriptions. An important prerequisite for the patient to be able to carry out their drug treatment according to the prescription is that they know which drugs to use and how to use them. In order for them to be able to do that, patients need to receive information from somewhere.

    Purpose: The purpose of the study was to investigate how patients know which drugs and which dosage to use. More specifically, the survey will answer the following two questions:

    1. What drug lists have patients received in the past year?
    2. What sources of information do patients primarily use to know which drugs to use and what dosage?

    Method: This project consisted of data collection at pharmacies and analysis of the results. The data collection was carried out by four pharmacy students from Linnaeus University at seven different pharmacies. Pharmacy students used a structured interview guide with patients who agreed to participate in the study. The answers from patients were collected and analysed in Excel.

    Results: A total of 400 individuals who met the inclusion criteria to participate in the study were asked and 215 individuals, 135 women and 80 men, agreed to participate. The response rate was 54%. Together, the individuals had 1717 prescriptions. The study showed that the most frequently used / obtained source of information was a print-out from the national prescription repository called “My saved prescriptions in pharmacies”. The primary source of information for knowing which drugs to use was the response option “other source of information” (such as asking the doctor) and that the source most frequently used to keep track of dosage was the dosage label.

    Discussion: The study indicated that of the oldest individuals who participated in the study, just a few used the digital sources of information. In general, it was common to ask the doctor to keep track of current medications and dosage. The most common reason for declining to participate in the study was a lack of time. The study was performed at pharmacies in various Swedish cities, which increase the generalizability of the results.

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  • 28.
    Olsson, Margaretha
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Apotekskunders kännedom om deras läkemedel och syn på farmaceuters användning av EES och jämförelse mellan män och kvinnor2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Dagligen expedieras en stor mängd recept där läkaren och farmaceuten har en viktig roll i läkemedelsexpeditionen. Många människor drabbas av läkemedelsrelaterade problem till följd av felaktig användning, biverkningar och interaktioner. Det medför en stor kostnad för samhället. Många hamnar på sjukhus och även dödsfall inträffar på grund av läkemedelsrelaterade orsaker. På apoteken finns ett beslutstöd EES (Elektroniskt Expertstöd) till hjälp för farmaceuten som varnar för olämpliga och felaktiga läkemedelskombinationer. Kommunikationen mellan kund och farmaceut är en viktig del i rådgivningen av läkemedel så att kunden är trygg i sin behandling. Syftet med detta arbete var att undersöka apotekskunders syn och kännedom om sina läkemedel och farmaceutens användning av EES. Studien genomfördes genom enkäter till apotekskunder på flera olika apotek. Olika inriktningar gjordes i analysen och denna rapport baseras på eventuella skillnader mellan män och kvinnor i kännedom om deras läkemedelsanvändning och beslutstödet EES.

    Majoriteten av apotekskunderna är trygga i sin läkemedelsanvändning och tycker att de får den information som krävs av läkaren och farmaceuten. Kännedom om EES är mycket begränsad hos kunderna och de vet inte om och när farmaceuten använder beslutstödet. Inga större skillnader i svar mellan män och kvinnor förutom att de har olika informationskällor. Kvinnor läser i större utsträckning bipacksedeln och söker information på nätet och fass.se mer än männen.

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  • 29.
    Persson, Ellen
    et al.
    Linnaeus University, Faculty of Technology, Department of Informatics.
    Johannesson, Ebba
    Linnaeus University, Faculty of Technology, Department of Informatics.
    Förberedelserna inför GDPR: En studie om implementeringen av GDPR på två företag - en jämförelse mellan empiri och teori.2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The purpose of the study is to investigate the approaches chosen by two different companies to implement GDPR in their business. In the report it examined what worked well and less well during the project until they reached today. The collected empirical data is then compared with theory, to investigate how they adapted to existing theory or not.

    A framework has been created to facilitate the understanding of empiric that emerged. Each framework is divided into each main area, which is preliminary study, implementation and follow-up. This division then follows the entire report.

    A qualitative method has been used to get a depth in the survey. Two companies were interviewed based on an interview guide. A semistructured interview strategy was used in order to be able to distance the interview guide, ask additional questions, control questions and to reduce the risk of missing important information that may be of importance. Frameworks were then created for both empirical and theory, to make a comparison easily.

    The result of the study shows that both companies have used already known methods and adapted them according to their own business. Company A customized method after business, while company B took advantage of a purchased package, thus modifying a suitable method. Both companies have chosen to spend a lot of time studying, which is also recommended by different theories. Implementation among the two companies has some similarities in spreading the message in the organization, but differences regarding the layout of project groups. In category follow-up, companies are required to describe what they consider to be good and less good, as well as giving tips to other companies. The conclusion from both a theoretical and an empirical perspective is a combination of methods, to implement a change. The study provides guidance and knowledge contributions to other companies that will implement GDPR or a similar implementation of change in their organization. Proposals for further research are to carry out a quantitative study. Instead of interviewing two companies regarding the implementation phase of GDPR, making a questionnaire and collecting data from several companies.

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  • 30.
    Persson, Mari
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Farmaceuters användning av beslutsstöd för läkemedel och vilka effekter det har för patienter2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: Research and development of medication and techniques is always ongoing and because of that more diseases can be cured. When people get older the use of medication increases. Many of the elderly people have about 10 different medications on the prescription and the risk for drug-related problems increases with the amount of medications. To decrease the risk of drug-related problems different decision-support systems have been developed which can help both doctors and pharmacists to make decisions about the use of drugs for patients. These decision-support systems are built to discover and give warnings if there are any drug-related problems, for example interactions between two medications, wrong dosage of medication and usage of two medications for the same purpose. Aim: The aim of this study is to evaluate the effects and potential of pharmacists’ usage of decision support systems to detect or prevent drug-related problems. Method: This work is an explorative literature-study where scientific articles have been found in the Pubmed database. Six articles where selected for evaluation. Results: Four of the articles evaluated drug-related problems which were detected by the pharmacist compared with a decision-support system. In three of the studies the decision-support system identified more problems than the pharmacist made. In one of the studies they compared six different decision-support systems, the results from that study showed that none of the systems where fully optimal and not completely correct giving warnings. In one of the articles they evaluated if the pharmacists answers to drug-related interactions where affected by the use of decision-support and it showed that it did not affect the pharmacists answer. Discussion and conclusion: The development of decision-support is heading forward. None of the decision-support systems that was evaluated in these studies were completely optimal. It would have been interesting to evaluate how the electronic expert support system (EES), a decision-support system that is used by pharmacists in Sweden, affect the safety of the patients. Since this literature-study is relatively small with only six articles, it is hard to draw an absolute conclusion. The results are a bit unclear but points that the use of a well-designed decision-support system could potentially help pharmacists in the pharmacological control, to identify drug-related problems that will have a positive effect for the patients and the safe usage of medications by patients.

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  • 31.
    Persson, Oliver
    et al.
    Linnaeus University, Faculty of Technology, Department of Informatics.
    Sugareski, Filip
    Linnaeus University, Faculty of Technology, Department of Informatics.
    Global kommunikation i tjänstesektor: Kommunikation och Informationsspridning ur ett globalt perspektiv2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Det underliggande problemet som undersökningen ville besvara var hur organisationer kommunicerar internt och externt samt hur de sprider information ur ett globalt perspektiv mellan olika geografiska platser. Undersökningen har använt sig av tidigare forskning, teorier och tre intervjuer på organisationer inom tjänstesektorn för att undersöka hur dessa organisationer hanterar sin globala kommunikation samt vilka risker och möjligheter de själva har identifierat. Svaren utifrån intervjuerna har jämförts gentemot tidigare forskning och teori för att skapa struktur. Undersökningen har kommit fram till hur dessa tre organisationer har planerat och hur de använder sig av global kommunikation. Samt vilka risker och möjligheter de har identifierat under arbetetsgång. Undersökningen visar också att en medveten kommunikationsstrategi hjälper organisationen att arbeta på ett enhetligt och standardiserat sätt vilket ger ett bättre helhetsintryck av organisationen. Studiens resultat visar på en uppsjö av kommunikationskanaler, där den bästa kanalen bestäms utifrån organisationens behov samt kapacitet men gemensamt är att IT står för merparten utav dagens föredragna kommunikationskanaler.

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    Global kommunikation
  • 32.
    Rudenfors, Elin
    et al.
    Linnaeus University, Faculty of Technology, Department of Informatics.
    Lundgren, Elin
    Linnaeus University, Faculty of Technology, Department of Informatics.
    Intern kommunikation balansen mellan struktur och flexibilitet2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The report's study will treat the subject of internal communication in an organization at the forefront of technology. In today's organizations, communication and information management are A and O. Because the individual has different knowledge and experiences, they will also interpret and apply information differently. Therefore, employee application and understanding is an important factor in ensuring that the right information is handled through appropriate communication channels and tools for getting the right information to the right person and at the right time.

    The study has been carried out at the company OBOS Sverige AB in the Sales Support department. A qualitative study has been applied to a department where the purpose is to investigate how different metaphorical perspectives can be used to analyze empiric. The study is limited to analyzing the employees' own interpretation and application. Gareth Morgan's machine metaphor and organometrics have been used to describe and analyze employee flexibility and adaptation to new communication tools to analyze the work structure and routine work in the sales support department. The analysis is aimed at information management and the individual's choice of communication tools.

    The qualitative survey showed that the application of oral communication face to face was the primary communication channel used to ensure that the message was received and interpreted according to the sender's purpose. E-mail was used to preserve the information documented for future events. There was a risk that the recipient misinterprets the message as the information can be interpreted differently between individuals. This is based on the information and communication shortcomings that existed within the department's work structure and routine work. The application of the metaphors describes in a fundamental way how and why individuals work as they do.

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  • 33.
    Wesén, Linda
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Ger digitala översikter översikt?: – Vårdpersonalens användning och behov av verktyg för att skapa helhetsperspektiv på patientrelaterade arbetsuppgifter inom psykiatrin.2021Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: idag finns många digitala verktyg för att visualisera data i översikter men i vårdens ordinarie system lyser dessa med sin frånvaro. Istället använder dagens vårdpersonal ofta papper för att förmedla information och data precis som omvårdnadsvetenskapens pionjär Florence Nightingale gjorde när hon tidigt påvisade att visualisering av vårddata kan hjälpa till att påvisa och förklara komplexa samband inom vården.

    Syfte: undersöka användning och behov av översikter av patientspecifika vårddata samt patientrelaterade arbetsuppgifter hos vårdpersonal inom psykiatrin.Material och metod: studien har en explorativ ansats och utgår från intervjuer av sjuksköterskor och undersköterskor inom psykiatrin. Materialet har analyserats med hjälp av innehållsanalys.

    Resultat: journalens brist på processtöd, mobilitet samt instrument för visualisering kompenseras av muntlig information samt egengjorda pappers- och digitala lösningar. Många informanter önskar bättre sökfunktioner och visualiseringar av komplexa sammanhang samt ökad mobil tillgång till information och data. För översikt förlitar öppenvården sig mer på egna lösningar i pappersform än digitala översikter, slutenvården använder digitala översikter men även mycket papperslösningar. Vårdpersonalen tar olika vägar till översikt men baserar kunskapen på samma information. Stora skillnader finns mellan den information slutenvård och öppenvård behöver. Pappersjournalen minns som lättillgänglig, framförallt genom dess mobila egenskaper samt att den inte omgavs av inloggningsförfaranden. 

    Slutsats: digitala översikter skapade i samarbete med tekniker kan vara en framgångsfaktor men öppenvård och slutenvård kan inte förväntas ha samma översikt eftersom de har olika behov. Eventuellt kan även individer ha behov av att skräddarsy sin egen digitala översikt. Framförallt slutenvården behöver ett processtödsverktyg, i avsaknad av det skapas egna system som ofta är i pappersformeftersom det har de egenskaper vad det gäller mobilitet samt möjlighet att fritt disponera anteckningar som personalen efterfrågar

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