Skip header and navigation

Refine By

61 records – page 1 of 7.

A 10 year asthma programme in Finland: major change for the better.

https://arctichealth.org/en/permalink/ahliterature168103
Source
Thorax. 2006 Aug;61(8):663-70
Publication Type
Article
Date
Aug-2006
Author
T. Haahtela
L E Tuomisto
A. Pietinalho
T. Klaukka
M. Erhola
M. Kaila
M M Nieminen
E. Kontula
L A Laitinen
Author Affiliation
Skin and Allergy Hospital, Helsinki University Central Hospital, P O Box 160, FIN-00029 HUS, Finland. tari.haahtela@hus.fi
Source
Thorax. 2006 Aug;61(8):663-70
Date
Aug-2006
Language
English
Publication Type
Article
Keywords
Adult
Anti-Asthmatic Agents - therapeutic use
Asthma - economics - epidemiology - therapy
Child
Communication
Cost of Illness
Disabled Persons
Emergency Treatment - statistics & numerical data
Finland - epidemiology
Health Promotion - economics - organization & administration - trends
Hospitalization - statistics & numerical data
Humans
Incidence
Insurance, Disability - economics
Interprofessional Relations
National Health Programs - economics - trends
Pharmaceutical Services - standards
Primary Health Care
Program Evaluation
Smoking - epidemiology
Abstract
A National Asthma Programme was undertaken in Finland from 1994 to 2004 to improve asthma care and prevent an increase in costs. The main goal was to lessen the burden of asthma to individuals and society.
The action programme focused on implementation of new knowledge, especially for primary care. The main premise underpinning the campaign was that asthma is an inflammatory disease and requires anti-inflammatory treatment from the outset. The key for implementation was an effective network of asthma-responsible professionals and development of a post hoc evaluation strategy. In 1997 Finnish pharmacies were included in the Pharmacy Programme and in 2002 a Childhood Asthma mini-Programme was launched.
The incidence of asthma is still increasing, but the burden of asthma has decreased considerably. The number of hospital days has fallen by 54% from 110 000 in 1993 to 51 000 in 2003, 69% in relation to the number of asthmatics (n = 135 363 and 207 757, respectively), with the trend still downwards. In 1993, 7212 patients of working age (9% of 80 133 asthmatics) received a disability pension from the Social Insurance Institution compared with 1741 in 2003 (1.5% of 116 067 asthmatics). The absolute decrease was 76%, and 83% in relation to the number of asthmatics. The increase in the cost of asthma (compensation for disability, drugs, hospital care, and outpatient doctor visits) ended: in 1993 the costs were 218 million euro which had fallen to 213.5 million euro in 2003. Costs per patient per year have decreased 36% (from 1611 euro to 1031 euro).
It is possible to reduce the morbidity of asthma and its impact on individuals as well as on society. Improvements would have taken place without the programme, but not of this magnitude.
Notes
Cites: Eur Respir J. 1999 Aug;14(2):288-9410515403
Cites: BMJ. 1996 Mar 23;312(7033):762-68605467
Cites: Allergy. 2005 Mar;60(3):283-9215679712
Cites: N Engl J Med. 2005 Apr 14;352(15):1519-2815829533
Cites: BMJ. 2005 May 21;330(7501):1186-715849204
Cites: Thorax. 2005 Jul;60(7):545-815994260
Cites: Eur Respir J. 2000 Feb;15(2):235-710706483
Cites: Respir Med. 2000 Apr;94(4):299-32710845429
Cites: CMAJ. 1999 Nov 30;161(11 Suppl):S1-6110906907
Cites: Pediatr Allergy Immunol. 2000 Nov;11(4):236-4011110578
Cites: Eur Respir J. 2000 Nov;16(5):802-711153575
Cites: Am J Respir Crit Care Med. 2001 Aug 15;164(4):565-811520716
Cites: Thorax. 2001 Oct;56(10):806-1411562522
Cites: J Allergy Clin Immunol. 2001 Nov;108(5 Suppl):S147-33411707753
Cites: Eur Respir J. 2002 Aug;20(2):397-40212212973
Cites: Thorax. 2003 Feb;58 Suppl 1:i1-9412653493
Cites: Int J Tuberc Lung Dis. 2003 Jun;7(6):592-812797704
Cites: J Allergy Clin Immunol. 2004 Jul;114(1):40-715241342
Cites: Scand J Public Health. 2004;32(4):310-615370772
Cites: Am Rev Respir Dis. 1985 Apr;131(4):599-6063994155
Cites: N Engl J Med. 1991 Aug 8;325(6):388-922062329
Cites: N Engl J Med. 1994 Sep 15;331(11):700-58058076
Cites: Qual Health Care. 1994 Mar;3(1):45-5210136260
Cites: BMJ. 1996 Mar 23;312(7033):748-528605463
Cites: Eur Respir J. 2004 Nov;24(5):734-915516665
PubMed ID
16877690 View in PubMed
Less detail

[About the hazards concerning over the counter prescription drugs].

https://arctichealth.org/en/permalink/ahliterature212980
Source
Duodecim. 1996;112(9):775-80
Publication Type
Article
Date
1996

Acute childhood asthma in Finland: a retrospective review of hospital admissions from 1976 to 1995.

https://arctichealth.org/en/permalink/ahliterature196376
Source
Pediatr Allergy Immunol. 2000 Nov;11(4):236-40
Publication Type
Article
Date
Nov-2000
Author
K. Malmström
K. Korhonen
M. Kaila
T. Dunder
M. Nermes
T. Klaukka
S. Sarna
K. Juntunen-Backman
Author Affiliation
Hospital for Children and Adolescents, Helsinki University Central Hospital, Finland. kristiina.malmstrom@pp.fimnet.fi
Source
Pediatr Allergy Immunol. 2000 Nov;11(4):236-40
Date
Nov-2000
Language
English
Publication Type
Article
Keywords
Acute Disease
Adolescent
Adult
Asthma - drug therapy - epidemiology - etiology
Child
Child, Preschool
Female
Finland - epidemiology
Hospitalization
Humans
Infant
Infant, Newborn
Male
Retrospective Studies
Time Factors
Abstract
The prevalence of childhood asthma has increased markedly in many Western societies during recent decades. We wanted to study whether the incidence and severity of childhood asthma in Finland had changed during the time-period 1976-95. Hospital admission rates from 1976 to 1995 were obtained from the National Hospital Discharge Register and the individual intensive care unit (ICU) registers of the five university hospitals in Finland. The number and length of treatment periods for childhood asthma in all Finnish hospitals and at the ICUs of the five university hospitals were analyzed. The number of children receiving special reimbursement for asthma medication costs was obtained from the central register of the Social Insurance Institution. The data showed that during the time-period investigated, hospital admissions as a result of asthma had increased by 2.8-fold, but the mean length of hospital stay had more than halved (from 7.3 to 2.6 days). The increase in hospital admissions showed greatest significance in the 0-4-year age-group among both sexes (p
Notes
Comment In: Pediatr Allergy Immunol. 2001 Jun;12(3):173-411473683
PubMed ID
11110578 View in PubMed
Less detail

Adoption of celecoxib and rofecoxib: a nationwide database study.

https://arctichealth.org/en/permalink/ahliterature175412
Source
J Clin Pharm Ther. 2005 Apr;30(2):145-52
Publication Type
Article
Date
Apr-2005
Author
A. Helin-Salmivaara
R. Huupponen
A. Virtanen
T. Klaukka
Author Affiliation
Centre for Pharmacotherapy Development, Helsinki, Finland. arja.helin-salmivaara@rohto.fi
Source
J Clin Pharm Ther. 2005 Apr;30(2):145-52
Date
Apr-2005
Language
English
Publication Type
Article
Keywords
Age Factors
Anti-Inflammatory Agents, Non-Steroidal - therapeutic use
Child
Databases, Factual - statistics & numerical data - trends
Drug Utilization Review - methods
Finland - epidemiology
Humans
Insurance, Pharmaceutical Services - trends - utilization
Lactones - therapeutic use
Medicine - statistics & numerical data
Physician's Practice Patterns - statistics & numerical data - trends
Product Surveillance, Postmarketing - economics - methods
Pyrazoles - therapeutic use
Retrospective Studies
Sex Factors
Specialization
Sulfonamides - therapeutic use
Sulfones - therapeutic use
Time Factors
Abstract
Cyclooxygenase 2-selective non-steroidal anti-inflammatory drugs (NSAIDs, coxibs) are recommended primarily for patients at high risk of gastrointestinal bleeding, most of them being elderly. Our objective was to describe and analyse patient- and physician-related factors affecting the adoption of celecoxib and rofecoxib 2 years after their launch in Finland.
Retrospective analysis of the nationwide Prescription Register. Physicians who had issued at least 200 reimbursed prescriptions in 2002 (n = 12 033, 80% of working-age Finnish physicians) were involved in the analysis.
Excluding patients with rheumatoid arthritis (RA), almost one-fifth (18%) of NSAIDs prescriptions were for coxibs. In patients with RA the share was 25%. The share of coxib prescriptions of all NSAIDs increased with age of the patient. Over one half (58%) of coxib prescriptions were issued for patients under 65 years of age. Specialists in physical and rehabilitation medicine were the fastest adopters of coxibs: one-third of their NSAID prescriptions in 2002 were for coxibs. Primary care physicians were the most conservative both in adopting and favouring coxibs.
Coxibs have gained the status of standard prescription NSAIDs within a few years. Their use should be restricted to patients who could benefit most from the use. Routine prescribing of expensive new drugs increases the drug bill without additional health gain.
PubMed ID
15811167 View in PubMed
Less detail

Antibiotic use by indication: a basis for active antibiotic policy in the community.

https://arctichealth.org/en/permalink/ahliterature191275
Source
Scand J Infect Dis. 2001;33(12):920-6
Publication Type
Article
Date
2001
Author
U M Rautakorpi
T. Klaukka
P. Honkanen
M. Mäkelä
T. Nikkarinen
E. Palva
R. Roine
H. Sarkkinen
P. Huovinen
Author Affiliation
Pirkkala Health Centre, Finland.
Source
Scand J Infect Dis. 2001;33(12):920-6
Date
2001
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Distribution
Aged
Anti-Bacterial Agents - therapeutic use
Child
Child, Preschool
Community-Acquired Infections - drug therapy - epidemiology
Female
Finland - epidemiology
Health Policy
Humans
Infant
Infant, Newborn
Male
Middle Aged
Physician's Practice Patterns - statistics & numerical data
Primary Health Care - statistics & numerical data
Abstract
The aim of this study was to survey current treatment practices for common infections in primary care as a basis for implementation of recently released evidence-based guidelines for community-acquired infections. A point-prevalence survey was conducted in 30 health centres in the Finnish primary care system with a population base of 819,777. All patients consulting the health centres for an infection during a 1-week period were included in the study. The main outcome measures were the prevalence of antibiotic prescription and the selection of drugs by infection diagnosis. Of the 7777 recorded consultations, 85% were with a physician and the rest with a nurse. The most common cause for a visit was respiratory tract infections (74%), followed by skin/wound infections and urinary tract infections (both 6%). The infection panorama varied markedly according to age: in the youngest children ( 65 y was 50%; the proportions of visits for urinary tract infections in these age groups were 7% and 26%, respectively. Of the patients with acute bronchitis, 70% were treated with antimicrobial agents, mostly macrolides (39%) and doxycycline (36%). Of the otitis media patients, 53% were treated with amoxicillin, 16% with macrolides and 16% with sulphatrimethoprim. Macrolides were mostly used to treat otitis media (31%), acute bronchitis (26%) and sinusitis (20%). In conclusion, antimicrobial agents are still used excessively in Finland, particularly for the treatment of acute bronchitis. Moreover, the selection of drugs for treating sinusitis and otitis media is non-optimal; macrolides and cephalosporins are frequently chosen unnecessarily. Knowledge of the indication-based prescription practices for antimicrobial agents is essential in order to improve the treatment habits of primary care physicians. The data obtained in this study provide a unique tool for the active and targeted implementation of evidence-based guidelines for primary care physicians.
PubMed ID
11868766 View in PubMed
Less detail
Source
BMJ. 1994 Jun 11;308(6943):1573
Publication Type
Article
Date
Jun-11-1994
Author
E. Vuori
J. Lönnqvist
T. Klaukka
Source
BMJ. 1994 Jun 11;308(6943):1573
Date
Jun-11-1994
Language
English
Publication Type
Article
Keywords
Antidepressive Agents - therapeutic use
Finland
Humans
Suicide - prevention & control
Sweden
Notes
Comment On: BMJ. 1994 Feb 19;308(6927):506-98136668
PubMed ID
8019337 View in PubMed
Less detail

Antidepressants and suicide mortality.

https://arctichealth.org/en/permalink/ahliterature203602
Source
J Affect Disord. 1998 Sep;50(2-3):225-33
Publication Type
Article
Date
Sep-1998
Author
A. Ohberg
E. Vuori
T. Klaukka
J. Lonnqvist
Author Affiliation
Department of Forensic Medicine, University of Helsinki, Finland. annakatri.ohberg@helsinki.fi
Source
J Affect Disord. 1998 Sep;50(2-3):225-33
Date
Sep-1998
Language
English
Publication Type
Article
Keywords
Antidepressive Agents, Tricyclic - poisoning
Depressive Disorder - drug therapy
Finland - epidemiology
Humans
Mortality - trends
Risk factors
Serotonin Uptake Inhibitors - poisoning
Suicide - statistics & numerical data
Abstract
This paper presents a nationwide analysis of suicide mortality in Finland from 1990 to 1995, when the total use of antidepressants, especially that by selective serotonin reuptake inhibitors (SSRIs) expanded in the country.
Suicide rate was analysed by various methods including that by intake of antidepressants. Various antidepressants were compared by calculating fatal toxicity indices (FTI) by relating number of fatal poisonings by a drug to its consumption.
The expanded use of antidepressants coincided with an increased number of deaths caused by these drugs. The proportion of suicides committed by use of antidepressants among all suicides increased from 5.6% to 8.4%. The total suicide rate, however, declined significantly. This was mainly accounted for by the reduced suicide rates by hanging and carbomonoxide poisoning, which outnumbered the increased figures of suicides by poisoning. On the whole, 82% of suicides by antidepressants were committed by use of tricyclics. Use of doxepin and amitriptyline remained steady, and their FTIs were constantly high. The lowest FTIs were associated with fluoxetine, citalopram, mianserin and moclobemide.
The method ignores causality between the increased use of SSRIs and suicide mortality. Various factors affecting risk of suicide or choice of a method remain outside the scope of the data.
The increased use of SSRIs coincided with a significant decline in suicide mortality. However, suicides by use of antidepressants showed an upward trend. Therefore, in suicide prevention, risks and benefits of antidepressants should be considered in choosing treatment for depressive patients.
PubMed ID
9858081 View in PubMed
Less detail

Application of the O.E.C.D. disability questions in Finland.

https://arctichealth.org/en/permalink/ahliterature244857
Source
Rev Epidemiol Sante Publique. 1981;29(4):431-9
Publication Type
Article
Date
1981
Author
T. Klaukka
Source
Rev Epidemiol Sante Publique. 1981;29(4):431-9
Date
1981
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Adult
Age Factors
Aged
Disability Evaluation
Finland
Health Status Indicators
Health Surveys
Humans
Interviews as Topic
Middle Aged
Physical Examination
Sampling Studies
Abstract
A draft series of OECD-disability questions were included into the Mini-Finland Health Survey. Preliminary results of a sub-sample reveal that the series is quite feasible and acceptable to a big health survey. However, the questions apply best to an elderly population. Questions measuring the level of health above the normal should also be developed in order to categorize younger and middle-age people. The combination of answers to a single index of disability cannot yet be recommended because of the technical difficulties and of the fear of losing information. The study contains information on impairments, functional disability and the person'medical conditions. The interrelationships between these will be studied later.
PubMed ID
7339718 View in PubMed
Less detail

The association between team climate at work and mental health in the Finnish Health 2000 Study.

https://arctichealth.org/en/permalink/ahliterature151591
Source
Occup Environ Med. 2009 Aug;66(8):523-8
Publication Type
Article
Date
Aug-2009
Author
M. Sinokki
K. Hinkka
K. Ahola
S. Koskinen
T. Klaukka
M. Kivimäki
P. Puukka
J. Lönnqvist
M. Virtanen
Author Affiliation
Finnish Institute of Occupational Health, Lemminkäisenkatu 14-18 B, FI-20520 Turku, Finland. marjo.sinokki@utu.fi
Source
Occup Environ Med. 2009 Aug;66(8):523-8
Date
Aug-2009
Language
English
Publication Type
Article
Keywords
Adaptation, Psychological
Adult
Alcohol-Related Disorders - epidemiology - psychology
Antidepressive Agents - therapeutic use
Anxiety Disorders - drug therapy - epidemiology
Cooperative Behavior
Depressive Disorder - drug therapy - epidemiology
Female
Finland - epidemiology
Health Surveys
Humans
Interpersonal Relations
Job Satisfaction
Male
Middle Aged
Social Support
Workplace - psychology
Abstract
Depression, anxiety and alcohol use disorders are common mental health problems in the working population. However, the team climate at work related to these disorders has not been studied using standardised interview methods and it is not known whether poor team climate predicts antidepressant use. This study investigated whether team climate at work was associated with DSM-IV depressive, anxiety and alcohol use disorders and subsequent antidepressant medication in a random sample of Finnish employees.
The nationally representative sample comprised 3347 employees aged 30-64 years. Team climate was measured with a self-assessment scale. Diagnoses of depressive, anxiety and alcohol use disorders were based on the Composite International Diagnostic Interview. Data on the purchase of antidepressant medication in a 3-year follow-up period were collected from a nationwide pharmaceutical register of the Social Insurance Institution.
In the risk factor adjusted models, poor team climate at work was significantly associated with depressive disorders (OR 1.61, 95% CI 1.10 to 2.36) but not with alcohol use disorders. The significance of the association between team climate and anxiety disorders disappeared when the model was adjusted for job control and job demands. Poor team climate also predicted antidepressant medication (OR 1.53, 95% CI 1.02 to 2.30).
A poor team climate at work is associated with depressive disorders and subsequent antidepressant use.
PubMed ID
19359286 View in PubMed
Less detail

61 records – page 1 of 7.