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Direct mail improves knowledge of basic life support guidelines in general practice: a randomised study.

https://arctichealth.org/en/permalink/ahliterature119889
Source
Scand J Trauma Resusc Emerg Med. 2012;20:72
Publication Type
Article
Date
2012
Author
Niels Secher
Mette Marie Mikkelsen
Kasper Adelborg
Ronni Mikkelsen
Erik Lerkevang Grove
Jens Mørch Rubak
Peter Vedsted
Bo Løfgren
Author Affiliation
Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark.
Source
Scand J Trauma Resusc Emerg Med. 2012;20:72
Date
2012
Language
English
Publication Type
Article
Keywords
Cardiopulmonary Resuscitation - standards
Clinical Competence - standards
Denmark
Female
General Practice - education
Heart Arrest - therapy
Humans
Male
Middle Aged
Postal Service
Practice Guidelines as Topic
Questionnaires
Abstract
Implementation of new guidelines into clinical practice is often incomplete. Direct mail is a simple way of providing information to physicians and may improve implementation of new guidelines on basic life support (BLS). The aim of this study was to describe knowledge of the most recent European Resuscitation Council (ERC) Guidelines for BLS among general practitioners (GPs) and investigate whether direct mail improves theoretical knowledge of these guidelines.
All general practice clinics (n=351) in Central Denmark Region were randomised to receive either direct mail (intervention) or no direct mail (control). The direct mail consisted of the official ERC BLS/AED poster and a cover letter outlining changes in compression depth and frequency in the new guidelines. In general practice clinics randomised to intervention, every GP received a direct mail addressed personally to him/her. Two weeks later, a multiple-choice questionnaire on demographics and BLS guidelines were mailed to GPs in both groups.
In total, 830 GPs were included in this study (direct mail, n=408; control, n=422). The response rate was 58%. The majority (91%) of GPs receiving direct mail were familiar with BLS Guidelines 2010 compared to 72% in the control group (P
Notes
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PubMed ID
23062629 View in PubMed
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Heart failure and risk of dementia: a Danish nationwide population-based cohort study.

https://arctichealth.org/en/permalink/ahliterature287047
Source
Eur J Heart Fail. 2017 Feb;19(2):253-260
Publication Type
Article
Date
Feb-2017
Author
Kasper Adelborg
Erzsébet Horváth-Puhó
Anne Ording
Lars Pedersen
Henrik Toft Sørensen
Victor W Henderson
Source
Eur J Heart Fail. 2017 Feb;19(2):253-260
Date
Feb-2017
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aged, 80 and over
Alzheimer Disease - epidemiology
Cohort Studies
Dementia - epidemiology
Dementia, Vascular - epidemiology
Denmark - epidemiology
Female
Heart Failure - epidemiology
Hospitalization
Humans
Male
Middle Aged
Proportional Hazards Models
Registries
Risk
Risk factors
Sex Factors
Abstract
The association between heart failure and dementia remains unclear. We assessed the risk of dementia among patients with heart failure and members of a general population comparison cohort.
Individual-level data from Danish medical registries were linked in this nationwide population-based cohort study comparing patients with a first-time hospitalization for heart failure between 1980 and 2012 and a year of birth-, sex-, and calendar year-matched comparison cohort from the general population. Stratified Cox regression analysis was used to compute 1-35-year hazard ratios (HRs) for the risk of all-cause dementia and, secondarily, Alzheimer's disease, vascular dementia, and other dementias. Analyses included 324 418 heart failure patients and 1 622 079 individuals from the general population (median age 77?years, 52% male). Compared with the general population cohort, risk of all-cause dementia was increased among heart failure patients [adjusted HR 1.21, 95% confidence interval (CI) 1.18-1.24]. The associations were stronger in men and in heart failure patients under age 70. Heart failure patients had higher risks of vascular dementia (adjusted HR 1.49, 95% CI 1.40-1.59) and other dementias (adjusted HR 1.30, 95% CI 1.26-1.34) than members of the general population cohort. Heart failure was not associated with Alzheimer's disease (adjusted HR 1.00, 95% CI 0.96-1.04).
Heart failure was associated with an increased risk of all-cause dementia. Heart failure may represent a risk factor for dementia, but not necessarily for Alzheimer's disease.
Notes
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PubMed ID
27612177 View in PubMed
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Organisation of in-hospital cardiac arrest teams - a nationwide study.

https://arctichealth.org/en/permalink/ahliterature270274
Source
Resuscitation. 2015 Apr;89:123-8
Publication Type
Article
Date
Apr-2015
Author
Kasper Glerup Lauridsen
Anders Sjørslev Schmidt
Kasper Adelborg
Bo Løfgren
Source
Resuscitation. 2015 Apr;89:123-8
Date
Apr-2015
Language
English
Publication Type
Article
Keywords
Cardiopulmonary Resuscitation
Clinical Protocols
Cross-Sectional Studies
Denmark
Heart Arrest - therapy
Hospital Rapid Response Team - organization & administration
Humans
Abstract
In-hospital cardiac arrests are treated by a team of health care providers. Improving team performance may increase survival. Currently, no international standards for cardiac arrest teams exist in terms of member composition and allocation of tasks.
To describe the composition of in-hospital cardiac arrest teams and review pre-arrest allocation of tasks.
A nationwide cross-sectional study was performed. Data on cardiac arrest teams and pre-arrest allocation of tasks were collected from protocols on resuscitation required for hospital accreditation in Denmark. Additional data were collected through telephone interviews and email correspondence. Psychiatric hospitals and hospitals serving outpatients only were excluded.
Data on the cardiac arrest team were available from 44 of 47 hospitals. The median team size was 5 (25th percentile; 75th percentile: 4; 6) members. Teams included a nurse anaesthetist (100%), a medical house officer (82%), an orderly (73%), an anaesthesiology house officer (64%) and a medical assistant (20%). Less likely to participate was a cardiology house officer (23%) or a cardiology specialist registrar (5%). Overall, a specialist registrar was represented on 20% of teams and 20% of cardiac arrest teams had a different team composition during nights and weekends. In total, 41% of teams did not define a team leader pre-arrest, and the majority of the teams did not define the tasks of the remaining team members.
In Denmark, there are major differences among cardiac arrest teams. This includes team size, profession of team members, medical specialty and seniority of the physicians. Nearly half of the hospitals do not define a cardiac arrest team leader and the majority do not define the tasks of the remaining team members.
PubMed ID
25617486 View in PubMed
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Positive predictive value of cardiovascular diagnoses in the Danish National Patient Registry: a validation study.

https://arctichealth.org/en/permalink/ahliterature287307
Source
BMJ Open. 2016 11 18;6(11):e012832
Publication Type
Article
Date
11-18-2016
Author
Jens Sundbøll
Kasper Adelborg
Troels Munch
Trine Frøslev
Henrik Toft Sørensen
Hans Erik Bøtker
Morten Schmidt
Source
BMJ Open. 2016 11 18;6(11):e012832
Date
11-18-2016
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Cardiovascular Diseases - classification - diagnosis - epidemiology
Denmark - epidemiology
Female
Humans
International Classification of Diseases
Male
Medical Records - statistics & numerical data
Middle Aged
Predictive value of tests
Registries
Abstract
The majority of cardiovascular diagnoses in the Danish National Patient Registry (DNPR) remain to be validated despite extensive use in epidemiological research. We therefore examined the positive predictive value (PPV) of cardiovascular diagnoses in the DNPR.
Population-based validation study.
1 university hospital and 2 regional hospitals in the Central Denmark Region, 2010-2012.
For each cardiovascular diagnosis, up to 100 patients from participating hospitals were randomly sampled during the study period using the DNPR.
Using medical record review as the reference standard, we examined the PPV for cardiovascular diagnoses in the DNPR, coded according to the International Classification of Diseases, 10th Revision.
A total of 2153 medical records (97% of the total sample) were available for review. The PPVs ranged from 64% to 100%, with a mean PPV of 88%. The PPVs were =90% for first-time myocardial infarction, stent thrombosis, stable angina pectoris, hypertrophic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, takotsubo cardiomyopathy, arterial hypertension, atrial fibrillation or flutter, cardiac arrest, mitral valve regurgitation or stenosis, aortic valve regurgitation or stenosis, pericarditis, hypercholesterolaemia, aortic dissection, aortic aneurysm/dilation and arterial claudication. The PPVs were between 80% and 90% for recurrent myocardial infarction, first-time unstable angina pectoris, pulmonary hypertension, bradycardia, ventricular tachycardia/fibrillation, endocarditis, cardiac tumours, first-time venous thromboembolism and between 70% and 80% for first-time and recurrent admission due to heart failure, first-time dilated cardiomyopathy, restrictive cardiomyopathy and recurrent venous thromboembolism. The PPV for first-time myocarditis was 64%. The PPVs were consistent within age, sex, calendar year and hospital categories.
The validity of cardiovascular diagnoses in the DNPR is overall high and sufficient for use in research since 2010.
Notes
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PubMed ID
27864249 View in PubMed
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Sixteen-year nationwide trends in antithrombotic drug use in Denmark and its correlation with landmark studies.

https://arctichealth.org/en/permalink/ahliterature284191
Source
Heart. 2016 Dec 01;102(23):1883-1889
Publication Type
Article
Date
Dec-01-2016
Author
Kasper Adelborg
Erik Lerkevang Grove
Jens Sundbøll
Maja Laursen
Morten Schmidt
Source
Heart. 2016 Dec 01;102(23):1883-1889
Date
Dec-01-2016
Language
English
Publication Type
Article
Keywords
Administration, Oral
Adult
Aged
Aged, 80 and over
Anticoagulants - administration & dosage - therapeutic use
Denmark
Drug Prescriptions
Drug Utilization Review
Female
Fibrinolytic Agents - therapeutic use
Heparin - therapeutic use
Humans
Male
Middle Aged
Platelet Aggregation Inhibitors - therapeutic use
Polysaccharides - therapeutic use
Practice Patterns, Physicians' - trends
Primary Health Care - trends
Registries
Time Factors
Young Adult
Abstract
Antithrombotic drugs are widely used in the prevention and treatment of cardiovascular diseases; yet, nationwide long-term usage trends remain unexplored. We examined long-term trends in the use of antithrombotic drugs in Denmark.
Using nationwide prescription data, we obtained information on primary care use of antiplatelet drugs, vitamin K antagonists (VKA), non-vitamin K antagonist oral anticoagulants (NOAC), heparins and fondaparinux during 1999-2014.
During the 16-year period, the use of antithrombotic drugs per 1000 inhabitants/day increased from 64 to 96 defined daily doses (DDD), and the prevalence proportion of users doubled from 5.1% to 9.6% of the Danish population. From 1999 to 2014, there was an increased use of both antiplatelet drugs (from 60 to 79 DDD per 1000 inhabitants/day) and VKA (from 4 to 9 DDD per 1000 inhabitants/day). NOAC was marketed in 2008 and had an abrupt rise in use to 8 DDD per 1000 inhabitants/day in 2014. The use of heparins and fondaparinux increased slightly during the study period (from 0 to 0.6 DDD per 1000 inhabitants/day). Hospital use of antithrombotic drugs also increased during the study period, but constituted a minor part of the total use (4 DDD per 1000 inhabitants/day in 2014).
Considerable changes have occurred in the use of antithrombotic drugs during the past 16 years, including the introduction of several new and increasingly used treatment modalities such as NOAC. The trends in use of individual drugs correlate well with the publication of landmark studies.
PubMed ID
27406838 View in PubMed
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