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  • 51.
    Petersson, Göran
    University of Kalmar, eHealth Institute, School of Human Sciences, University of Kalmar,.
    Förutsättningar och utmaningar för Bayern i Distansutbildning i Schweiz och Bayern – rapport från studieresa oktober 20042005Report (Other academic)
  • 52.
    Petersson, Göran
    University of Kalmar, eHealth Institute, School of Human Sciences, University of Kalmar,.
    Regionalt perspektiv på e-lärande i Distansutbildning i Frankrike - rapport från studieresa oktober 20052005Report (Other academic)
  • 53.
    Petersson, Göran
    University of Kalmar, School of Human Sciences. University of Kalmar, eHealth Institute, School of Human Sciences, University of Kalmar,.
    Språkets roll inom vården, i Medicinens språk (The Language of Medicin)(in Swedish)2006Book (Other academic)
  • 54.
    Petersson, Göran
    et al.
    University of Kalmar, eHealth Institute, School of Human Sciences, University of Kalmar,. Hälsouniversitet, Linköping ; Myndigheten för Sveriges nätuniversitet, Härnösand.
    Ahlin, K-Å
    Attström, R
    Boberg, J
    Fors, U
    Hulting, A-L
    Lundquist, P-G
    Mohlin, M
    Rydmark, M
    Södersten, K
    Förnyelse av medicinska grundutbildningar genom teknik- och mediastöd2004Report (Other academic)
  • 55.
    Petersson, Göran
    et al.
    University of Kalmar, School of Human Sciences. University of Kalmar, eHealth Institute, School of Human Sciences, University of Kalmar,.
    Algers, A
    Fransson, T
    Lagergren, F
    Nilsson, A
    Tågerud, Yael
    Westman, P
    Lundquist, J
    Impact of outreach in e-learning: role of an international committee of an national agency2008Conference paper (Refereed)
  • 56.
    Petersson, Göran
    et al.
    University of Kalmar, eHealth Institute, School of Human Sciences, University of Kalmar,.
    Cordewener, B
    Whistlecroft, L
    From the first to the second decade of EKMA: reflections and recommendations2004In: Evaluation in e-learning: the European Academic Software Award / [ed] Panckhurst R, David S, Whistlecroft L, Université Montpellier III , 2004, p. 89-96Chapter in book (Other academic)
  • 57. Sandholm, A
    et al.
    Fritzson, P
    Arora, V
    Delp, S
    Petersson, Göran
    University of Kalmar, School of Human Sciences. University of Kalmar, eHealth Institute, School of Human Sciences, University of Kalmar,.
    The Gait E-Book – Development of Effective Participatory Learning using Simulation and Active Electronic Books2007Conference paper (Refereed)
  • 58. Sandholm, A
    et al.
    Fritzson, P
    Arora, V
    Delp, S
    Petersson, Göran
    University of Kalmar, School of Human Sciences. University of Kalmar, eHealth Institute, School of Human Sciences, University of Kalmar,.
    Rose, R
    11th Mediterranean Conference on Medical and Biomedical Engineering and Computing 20072007In: IFMBE Proceedings, 11th Mediterranean Conference on Medical and Biomedical Engineering and Computing 16, 2007Conference paper (Refereed)
  • 59. Sandholm, A
    et al.
    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,.
    Fritzson, P
    Towards a flexible general training simulator platform based on Modelica2006In: 7th Conference on Simulation and Modelling of the Scandinavian Simulation Society SIMS2006, 2006Conference paper (Refereed)
  • 60.
    Savolainen, Liina
    et al.
    Chalmers University of Technology, Göteborg.
    Hanson, Elizabeth
    University of Kalmar, eHealth Institute, School of Human Sciences, University of Kalmar,.
    Magnusson, Lennart
    University of Kalmar, eHealth Institute, School of Human Sciences, University of Kalmar,.
    Gustavsson, Tomas
    Chalmers University of Technology, Göteborg.
    An Internet-based videoconferencing system for supporting frail elderly people and their carers2008In: Journal of Telemedicine and Telecare, ISSN 1357-633X, E-ISSN 1758-1109, Vol. 14, p. 79-82Article in journal (Refereed)
    Abstract [en]

    The ACTION project uses information and communication technologyto support frail elderly people and their family carers. Theaims are to enhance their quality of life, independence andpreparedness and to break social isolation. A videoconferencingsystem, connecting homes and a call centre, was used in a pilotstudy in 1997–2002. A re-designed system was brought intouse in late 2004 and over 60 new units were introduced duringthe first six months. The new system was evaluated with an interviewstudy and by data logging. Eight family users and four professionalcarers were interviewed. The family users had used the videophoneat least six times and they had had the equipment at home forat least two months. The average number of initiated calls peruser was 5.7 per month and the average call time per user was40 min per month. Seven of the users (88%) reported that thesystem very much reduced their sense of loneliness and isolation.The results of the evaluation were encouraging. There were severalfrequent users of videoconferencing. System quality was acceptablealthough a shorter audio delay would be desirable. The systemwas used regularly by the participants and it fulfilled itspurpose.

  • 61.
    Steinschaden, Thomas
    et al.
    University of Kalmar, eHealth Institute, School of Human Sciences, University of Kalmar,.
    Petersson, Göran
    University of Kalmar, School of Human Sciences. University of Kalmar, eHealth Institute, School of Human Sciences, University of Kalmar,.
    Åstrand, Bengt
    University of Kalmar, School of Pure and Applied Natural Sciences.
    Physicians’ attitudes towards ePrescribing: A comparative web survey in Austria and Sweden2009In: Informatics in Primary Care, ISSN 1476-0320, E-ISSN 1475-9985, Vol. 17, no 4, p. 241-248Article in journal (Refereed)
    Abstract [en]

    Background: The eHealth Action Plan required the member states of the European Union (EU) to provide online services such as eprescribing of pharmaceuticals by the end of 2008. So far, implementation activities and efforts of the member states have been uneven. While in Austria pilot projects and feasibility studies have been conducted, Sweden has always been one of the leading countries in the field of eprescribing.Objective: To identify potential success factors for the implementation of eprescribing in Sweden, by comparing the attitudes of Austrian and Swedish physicians.Method: In a web survey, we asked 1824 Austrian and 427 Swedish physicians within primary care and other disciplines to declare to what extent they agreed with ten statements regarding their attitudes towards eprescribing. We deployed the chi-square test for testing the relationship between the country of residence of physicians and their attitudes towards eprescribing.Results: We demonstrated a relationship between the country of residence of physicians and their attitudes towards eprescribing (P<0.001) for all the responses. Of the Swedish physicians, 92% regarded eprescribing as time-saving, 88.1% as being safer and 96.0% as providing a better service for patients. Although less strongly supportive, the attitudes of the Austrian physicians were mainly positive.Conclusion: We found that the major potential success factors for the implementation of eprescribing in Sweden were saving of time for the physician, improved safety and better service for patients. The mainly positive attitudes of the Austrian physicians may enable implementation of eprescribing in due course.

  • 62.
    Torp, Steffen
    et al.
    Vestfold University College, Tønsberg, Norway.
    Hanson, Elizabeth
    University of Kalmar, eHealth Institute, School of Human Sciences, University of Kalmar,.
    Hauge, Solveig
    Vestfold University College, Tønsberg, Norway.
    Ulstein, Ingun
    Norwegian Centre for Dementia Research, Ullevaal University Hospital, Oslo, Norway.
    Magnusson, Lennart
    University of Kalmar, eHealth Institute, School of Human Sciences, University of Kalmar,.
    A pilot study of how information and communication technology may contribute to health promotion among elderly spousal carers in Norway2008In: Health & Social Care in the Community, ISSN 0966-0410, E-ISSN 1365-2524, Vol. 16, no 1, p. 75-85Article in journal (Refereed)
    Abstract [en]

    The objective of this pilot Norwegian intervention study was to explore whether use of information and communication technology (ICT) by informal carers of frail elderly people living at home would enable them to gain more knowledge about chronic illness, caring and coping, establish an informal support network and reduce stress and related mental health problems. Potential participants were close relatives of an elderly person with a diagnosis of a chronic illness dwelling in the same household who wished to continue caring for their relative at home, were 60 years of age or older, had been caring for less than 2 years, were a computer novice and had Norwegian as their first language. Nineteen elderly spousal carers participated in the study from two municipalities in eastern Norway. The project commenced in January 2004 and consisted of a multimethod evaluation model. Outcomes measured included carers' social contacts (measured by the Family and Friendship Contacts scale); burden of care (measured by the Relative Stress scale); and knowledge about chronic disease and caring, stress and mental health and use of ICT (examined via a composite carer questionnaire). These quantitative data were collected immediately prior to the study and at 12 months. Qualitative data were also collected via focus group interviews with participant carers at 7 months. At follow-up, quantitative measures did not reveal any reduction in carer stress or mental health problems. However, carers reported extensive use of the ICT service, more social contacts and increased support and less need for information about chronic illness and caring. Contact with and support from other carers with similar experiences was particularly valued by participants. The intervention also enhanced contacts with family and friends outside the carer network. Thus, it can be seen that ICT has the potential to contribute to health promotion among elderly spousal carers.

  • 63. Umefjord, G
    et al.
    Hamberg, K
    Malker, H
    Petersson, Göran
    University of Kalmar, School of Human Sciences. University of Kalmar, eHealth Institute, School of Human Sciences, University of Kalmar,.
    The use of an Internet-based Ask the Doctor Service involving family physicians: evaluation by a web survey2006In: Family practice, Vol. 23 (2), p. 159-166Article in journal (Refereed)
  • 64. Umefjord, G
    et al.
    Malker, H
    Olofsson, N
    Hensjö, L-O
    Petersson, Göran
    University of Kalmar, eHealth Institute, School of Human Sciences, University of Kalmar,. Linköping University.
    Primary care physicians’ experiences of carrying out consultations on the internet2004In: Informatics in Primary Care, ISSN 1476-0320, E-ISSN 1475-9985, Vol. 12, no 2, p. 85-90Article in journal (Refereed)
    Abstract [en]

    Background The internet is increasingly used for health matters, including consulting a doctor. Primary care physicians (general practitioners) will probably be involved in performing text-based consultations on the internet as a complement to physical meetings. In the present study, we explored the experiences of GPs already performing consultations on the internet: the challenges, worries and educational demands of the task. Materials and methods A questionnaire was given to 21 GPs performing consultations on the internet for a public, non-commercial ‘ask the doctor’ service. The questionnaire was carried out at a meeting or sent by mail. The doctors answered a total of 28 questions, 12 of which included graded alternatives. Results The participating GPs were stimulated and challenged by performing consultations on the internet with previously unknown enquirers, in spite of limitations caused by the lack of personal meetings and physical examinations. The participants experienced a high educational value as a result of the problem-based learning situation induced by unfamiliar questions. The asynchronous feature was appreciated as it allowed time to reflect and perform relevant information searches before replying. Prior training and long-term experience as a family doctor were recommended before embarking on this method of consultation. Conclusions We conclude that the GPs studied experienced their new role as internet doctors mainly in a positive way, with some limitations. With the increase in consultations on the internet, training in this technique should be integrated into the curricula of medical schools and of continuous professional development (CPD).

  • 65. Umefjord, G
    et al.
    Sandström, H
    Malker, H
    Petersson, Göran
    University of Kalmar, School of Human Sciences. University of Kalmar, eHealth Institute, School of Human Sciences, University of Kalmar,.
    Medical text-based consultations on the Internet: a 4-year study2008In: International Journal of Medical Informatics, ISSN 1386-5056, E-ISSN 1872-8243, Vol. 77, p. 114-121Article in journal (Refereed)
  • 66.
    Wærn, Karolina
    et al.
    University of Kalmar, eHealth Institute, School of Human Sciences, University of Kalmar,.
    Hellström, Lina
    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,.
    Förskrivares uppfattningar om e-recept: och möjliga orsaker till avvikelser vid e-receptförskrivning2008Report (Other academic)
    Abstract [sv]

    Avsikten med e-recept är att öka säkerheten och kvaliteten vid recepthanteringen. I december 2007 utgjorde e-recept 68% av alla nyutskrivna recept. I samband med att antalet e-recept har ökat har en ny typ av avvikelser uppmärksammats: läkemedel till fel patient, fel läkemedel utskrivet, ofullständiga/felaktiga doseringar samt receptdubletter. För att kunna minska antalet avvikelser som uppstår vid e-receptförskrivning behövs kunskap om vilka brister i journalsystemen som kan orsaka dessa avvikelser. Apoteket AB och Sveriges Kommuner och Landsting gav i början av 2007 eHälsoinstitutet i uppdrag att utifrån ett förskrivarperspektiv identifiera och belysa möjliga orsaker till avvikelser vid e-receptförskrivning med fokus på funktionalitet och utformning av användargränssnittet. Avsikten med studien har varit att identifiera trender.

    Studien har omfattat sex journalsystem: Cosmic, Journal III, Melior, SYSteam Cross, Take Care och VAS. Två enkätundersökningar har genomförts, en till förskrivare och en till respektive journalleverantör. Svarsfrekvensen på webbenkäten till förskrivarna uppgick till 46%. Fem av sex journalleverantörer besvarade enkäten. Take Care valde att inte besvara enkäten.

    Förskrivarna var i stort sett nöjda med att förskriva läkemedel som e-recept, men i studien identifierades en rad brister i de använda journalsystemen. Inget journalsystem var fritt från brister, utan samtliga journalsystem hade både styrkor och svagheter. De brister i journalsystemens e-receptfunktion som förskrivarna angav och som kan orsaka att förskrivare åstadkommer fel är: brister i användargränssnittets utformning, brister i funktioner och avsaknad av funktioner. Vi anser att det bland annat krävs ett tydligare användargränssnitt avseende hur information om läkemedlens olika förpackningar visas, att aktuell patients namn och personnummer visas tydligare samt att möjligheten för att kunna hantera mer än en patient i taget elimineras. Avseende funktioner efterfrågar vi kontrollfunktioner, till exempel att förskrivaren före sändning av ett e-recept måste godkänna hela e-receptet visat i klartext för förskrivaren – en form av sista kontroll. Att en sista kontroll ska vara möjlig ställer krav på journalleverantörer och att rutinen införs i verksamheten. En samverkan mellan verksamhet, individ och IT-stöd i högre grad än idag är nödvändig för en bättre patientsäkerhet.

    Några av de identifierade bristerna i journalsystemens e-receptfunktion uppges ska åtgärdas i kommande versioner, godkända enligt Nationellt e-recept format. Exempelvis kommer samtliga journalsystem att stödja funktionen att hantera kvittenser om mottagna recept från apoteket.

    För en ökad patientsäkerhet avseende e-recept är vår rekommendation att journalleverantörerna åtgärdar påvisade brister i e-receptfunktionernas användargränssnitt och funktioner samt att beställaren, det vill säga landstingen, framöver ställer tydligare krav. Vi rekommenderar vidare att förskrivare involveras i utvecklingen av e-receptfunktionen, att verksamhetens rutiner i förskrivningsprocessen tydliggörs samt att inblandade parter samlas kring ett regelverk och minimikrav avseende e-receptförskrivning.

  • 67.
    Åstrand, Bengt
    et al.
    University of Kalmar, School of Pure and Applied Natural Sciences.
    Hovstadius, Bo
    Antonov, Karolina
    Petersson, Göran
    University of Kalmar, eHealth Institute, School of Human Sciences, University of Kalmar,.
    The Swedish National Pharmacy Register2007In: MEDINFO 2007: Proceedings of the 12th World Congress on Health (Medical) Informatics – Building Sustainable Health Systems, 2007, Vol. 12, no 1, p. 345-349Conference paper (Refereed)
  • 68.
    Åstrand, Bengt
    et al.
    University of Kalmar, School of Pure and Applied Natural Sciences.
    Montelius, Emelie
    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,.
    Ekedahl, Anders
    University of Kalmar, School of Pure and Applied Natural Sciences.
    Assessment of ePrescription quality: an observational study at three mail-order pharmacies2009In: BMC Medical Informatics and Decision Making, ISSN 1472-6947, E-ISSN 1472-6947, Vol. 9, no 1, p. Article number: 8-Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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  • 69.
    Åstrand, Bengt
    et al.
    University of Kalmar, School of Pure and Applied Natural Sciences.
    Åstrand, Emelie
    Uppsala universitet.
    Antonov, Karolina
    Apoteket AB, Stockholm.
    Petersson, Göran
    University of Kalmar, School of Human Sciences. University of Kalmar, eHealth Institute, School of Human Sciences, University of Kalmar,.
    Detection of potential drug interactions: a model for a national pharmacy register2006In: European Journal of Clinical Pharmacology, ISSN 0031-6970, E-ISSN 1432-1041, Vol. 62, no 9, p. 749-756Article in journal (Refereed)
    Abstract [en]

    Objective  The widespread use of pharmaceuticals prescribed by different physicians has caused the Swedish government to propose a new legislation with registration of all prescriptions dispensed at the Swedish pharmacies. In the present study, we wanted to examine the frequency, distribution and determinants of potential drug interactions.Methods  The prescriptions from all individuals (n=8,214) with two or more prescriptions during October 2003 to December 2004 were collected from the ongoing Jämtland cohort study of a total of about 11,000 individuals. Potential drug–drug interactions were detected with a computerized interaction detection system and classified according to clinical relevance (types A–D).Results  On average each individual filled 14.6 (men 14.3, women 14.8) prescriptions during the study period. 3.6% of the individuals used more than 15 different drugs. The number of detected potential drug interactions type A–D was 4,941 (men 1,949, women 2,992). The risk of receiving a potential interaction type A–D was estimated as the cumulative incidence 0.26 (2,116/8,214) overall, 0.22 (748/3,467) for men and 0.29 (1,368/4,747) for women during the 15-month study period. The age adjusted risk, RRadj, for women was estimated as 1.30. Excluding sex hormones and modulators of the genital system, the RRadj was 0.96, with no elevated risk for women. For potential interactions type D, that might have serious clinical consequences, 167 (cumulative incidence 0.0203) individuals (72 men, cumulative incidence 0.0208, 95 women cumulative incidence 0.0200) were detected. The risk of receiving a combination of potentially interacting drugs was positively correlated to age and polypharmacy. The cumulative incidence for elderly was estimated as 0.36 (65–84 years) and 0.39 (85 years and above). The relative risk for individuals with 15 drugs or more was estimated as 3.67 (95% CI 3.46–3.90).Conclusion  In a general population there were relatively few severe potential drug interactions. The new Swedish national pharmacy register will provide health care professionals with a powerful tool to systematically review all prescriptions. An alert system should focus on the more potential drug interactions, type C–D, with close monitoring of elderly and patients with polypharmacy.

  • 70.
    Åstrand, Emelie
    et al.
    University of Kalmar.
    Åstrand, Bengt
    University of Kalmar, School of Pure and Applied Natural Sciences.
    Antonov, Karolina
    The Association of Pharmaceutical Industry, Stockholm.
    Petersson, Göran
    University of Kalmar, School of Human Sciences. University of Kalmar, eHealth Institute, School of Human Sciences, University of Kalmar,.
    Erratum: Potential drug interactions during a three-decade study2007In: European Journal of Clinical Pharmacology, ISSN 0031-6970, E-ISSN 1432-1041, Vol. 63, no 11, p. 1095-Article in journal (Refereed)
  • 71.
    Åstrand, Emelie
    et al.
    University of Kalmar, School of Pure and Applied Natural Sciences. University of Kalmar, eHealth Institute, School of Human Sciences, University of Kalmar,.
    Åstrand, Bengt
    University of Kalmar, School of Pure and Applied Natural Sciences. Apoteket AB.
    Antonov, Karolina
    The Association of Pharmaceutical IndustryStockholm.
    Petersson, Göran
    University of Kalmar, School of Human Sciences. University of Kalmar, eHealth Institute, School of Human Sciences, University of Kalmar,.
    Potential drug interactions during a three-decade study period: a cross-sectional study of a prescription register2007In: European Journal of Clinical Pharmacology, ISSN 0031-6970, E-ISSN 1432-1041, Vol. 63, no 9, p. 851-859Article in journal (Refereed)
    Abstract [en]

    Objectives  The increased risk of adverse events in patients receiving potentially interacting drugs has long been recognized. The purpose of the present study was to evaluate the change in the risk of receiving potentially interacting drugs during a period covering three decades and to examine the relative risk of actual drug combinations. Methods  The prescriptions from all individuals (about 8,000) with two or more prescriptions during three periods of 15 months, October to December 1983–1984, 1993–1994 and 2003–2004, were collected from an ongoing cohort study in the county of Jämtland, Sweden. The potential interactions were detected by a computerized system. Results  The relative risk (RR) of receiving potentially interacting drugs increased for type C interactions [RR: 1.177, 95% confidence interval (CI): 1.104–1.256] and decreased for type D interactions (RR: 0.714, 95% CI: 0.587–0.868) from the period 1983–1984 to 2003–2004. Polypharmacy for the participants increased by 61%, from 9.05 filled prescriptions per subject in 1983–1984 to 10.6 in 1993–1994 and 14.6 in 2003–2004. The RR was positively correlated to the pronounced increase in polypharmacy; in addition, an exponential relationship was found for the more severe type D interactions. Few interacting drug combinations were responsible for a large proportion of the risk. Conclusion  We conclude that the risk of receiving potentially interacting drugs was strongly correlated to the concomitant use of multiple drugs. The pronounced increase in polypharmacy over time implies a growing reason for prescribers and pharmacists to be aware of drug interactions. Recently established national prescription registers should be evaluated for drug interaction vigilance, both clinically and epidemiologically.

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