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ABS52: Organisation of asthma and COPD care in primary health care in Mid-Sweden.

https://arctichealth.org/en/permalink/ahliterature76340
Source
Prim Care Respir J. 2006 May 20;
Publication Type
Article
Date
May-20-2006
Author
Karin Lisspers
Bjorn Stallberg
Kristina Broms
Mikael Hasselgren
Gunnar Johansson
Peter Odeback
Mats Arne
Christer Janson
Kurt Svardsudd
Author Affiliation
Department of Public Health and Caring Sciences, Uppsala University, Uppsala Science Park, Uppsala, SE 751 85, Sweden.
Source
Prim Care Respir J. 2006 May 20;
Date
May-20-2006
Language
English
Publication Type
Article
PubMed ID
16716736 View in PubMed
Less detail

ABS77: Organisation of asthma and COPD care in secondary care in Mid-Sweden.

https://arctichealth.org/en/permalink/ahliterature76341
Source
Prim Care Respir J. 2006 May 20;
Publication Type
Article
Date
May-20-2006
Author
Bjorn Stallberg
Karin Lisspers
Christer Janson
Author Affiliation
Department of Public Health and Caring Sciences, Uppsala University, Uppsala Science Park, Uppsala, 751 85, Sweden.
Source
Prim Care Respir J. 2006 May 20;
Date
May-20-2006
Language
English
Publication Type
Article
PubMed ID
16716671 View in PubMed
Less detail

Change in health status in COPD: a seven-year follow-up cohort study.

https://arctichealth.org/en/permalink/ahliterature288171
Source
NPJ Prim Care Respir Med. 2016 10 20;26:16073
Publication Type
Article
Date
10-20-2016
Author
Josefin Sundh
Scott Montgomery
Mikael Hasselgren
Mary Kämpe
Christer Janson
Björn Ställberg
Karin Lisspers
Source
NPJ Prim Care Respir Med. 2016 10 20;26:16073
Date
10-20-2016
Language
English
Publication Type
Article
Keywords
Aged
Body mass index
Cohort Studies
Depression - epidemiology
Diabetes Mellitus - epidemiology
Disease Progression
Dyspnea - epidemiology - etiology - physiopathology
Female
Follow-Up Studies
Health status
Heart Diseases - epidemiology
Humans
Male
Middle Aged
Pulmonary Disease, Chronic Obstructive - complications - epidemiology - physiopathology
Surveys and Questionnaires
Sweden - epidemiology
Thinness - epidemiology
Abstract
Health status is a prognostic factor included in the assessment of chronic obstructive pulmonary disease (COPD). The aim of our study was to examine the associations of clinical factors with change in health status over a 7-year follow-up period. In 2005, 970 randomly selected primary and secondary care patients with a COPD diagnosis completed questionnaires including the Clinical COPD Questionnaire (CCQ); and in 2012, 413 completed the CCQ questionnaire again. Linear regression used difference in mean total CCQ score between 2005 and 2012 as the dependent variable. Independent variables were CCQ score at baseline 2005, sex, age, educational level, body mass index (BMI), smoking status, heart disease, diabetes, depression, number of exacerbations in the previous 6 months, dyspnoea (modified Medical Research Council (mMRC)). Health status worsened from mean total CCQ (s.d.) 2.03 (1.26) in 2005 to 2.16 (1.37) in 2012 (P=0.011). In linear regression with adjustment for baseline CCQ; older age, lower education, higher mMRC and BMI below 25?kg/m2 at baseline were associated with worsened health status in 2012. When sex, age and all statistically significant measures were included simultaneously in the analysis of the main study group, higher mMRC and BMI below 25?kg/m2 were were associated with deteriorated health status (P
Notes
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Cites: Respir Res. 2006 Aug 16;7:10916914029
PubMed ID
27763623 View in PubMed
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Clinical COPD Questionnaire score (CCQ) and mortality.

https://arctichealth.org/en/permalink/ahliterature117645
Source
Int J Chron Obstruct Pulmon Dis. 2012;7:833-42
Publication Type
Article
Date
2012
Author
Josefin Sundh
Christer Janson
Karin Lisspers
Scott Montgomery
Björn Ställberg
Author Affiliation
Department of Respiratory Medicine, Örebro University Hospital, Örebro, Sweden. josefin.sundh@orebroll.se
Source
Int J Chron Obstruct Pulmon Dis. 2012;7:833-42
Date
2012
Language
English
Publication Type
Article
Keywords
Aged
Comorbidity
Female
Health status
Humans
Kaplan-Meier Estimate
Lung - physiopathology
Male
Middle Aged
Multivariate Analysis
Predictive value of tests
Primary Health Care
Prognosis
Proportional Hazards Models
Pulmonary Disease, Chronic Obstructive - diagnosis - mortality - physiopathology - psychology
Quality of Life
Questionnaires
Risk assessment
Risk factors
Secondary Care
Spirometry
Sweden - epidemiology
Time Factors
Abstract
The Clinical COPD Questionnaire (CCQ) measures health status and can be used to assess health-related quality of life (HRQL). We investigated whether CCQ is also associated with mortality.
Some 1111 Swedish primary and secondary care chronic obstructive pulmonary disease (COPD) patients were randomly selected. Information from questionnaires and medical record review were obtained in 970 patients. The Swedish Board of Health and Welfare provided mortality data. Cox regression estimated survival, with adjustment for age, sex, heart disease, and lung function (for a subset with spirometry data, n = 530). Age and sex-standardized mortality ratios were calculated.
Over 5 years, 220 patients (22.7%) died. Mortality risk was higher for mean CCQ = 3 (37.8% died) compared with mean CCQ
Notes
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PubMed ID
23277739 View in PubMed
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Co-morbidity, body mass index and quality of life in COPD using the Clinical COPD Questionnaire.

https://arctichealth.org/en/permalink/ahliterature135048
Source
COPD. 2011 Jun;8(3):173-81
Publication Type
Article
Date
Jun-2011
Author
Josefin Sundh
Björn Ställberg
Karin Lisspers
Scott M Montgomery
Christer Janson
Author Affiliation
Department of Respiratory Medicine, Örebro University Hospital, 701 85 Örebro, Sweden. josefin.sundh@orebroll.se
Source
COPD. 2011 Jun;8(3):173-81
Date
Jun-2011
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Body mass index
Comorbidity
Depression - epidemiology
Female
Health Status Indicators
Heart Diseases - epidemiology
Humans
Male
Middle Aged
Obesity - epidemiology
Pulmonary Disease, Chronic Obstructive - epidemiology
Quality of Life
Questionnaires
Sex Distribution
Spirometry
Sweden - epidemiology
Thinness - epidemiology
Abstract
Quality of life is an important patient-oriented measure in COPD. The Clinical COPD Questionnaire (CCQ) is a validated instrument for estimating quality of life. The impact of different factors on the CCQ-score remains an understudied area. The aim of this study was to investigate the association of co-morbidity and body mass index with quality of life measured by CCQ.
A patient questionnaire including the CCQ and a review of records were used. A total of 1548 COPD patients in central Sweden were randomly selected. Complete data were collected for 919 patients, 639 from primary health care and 280 from hospital clinics. Multiple linear regression with adjustment for sex, age, level of education, smoking habits and level of care was performed. Subanalyses included additional adjustment for lung function in the subgroup (n = 475) where spirometry data were available.
Higher mean CCQ score indicating lower quality of life was statistically significant and independently associated with heart disease (adjusted regression coefficient (95%CI) 0.26; 0.06 to 0.47), depression (0.50; 0.23 to 0.76) and underweight (0.58; 0.29 to 0.87). Depression and underweight were associated with higher scores in all CCQ subdomains. Further adjustment for lung function in the subgroup with this measure resulted in statistically significant and independent associations with CCQ for heart disease, depression, obesity and underweight.
The CCQ identified that heart disease, depression and underweight are independently associated with lower health-related quality of life in COPD.
PubMed ID
21513436 View in PubMed
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Comorbidity, disease burden and mortality across age groups in a Swedish primary care asthma population: An epidemiological register study (PACEHR).

https://arctichealth.org/en/permalink/ahliterature296644
Source
Respir Med. 2018 03; 136:15-20
Publication Type
Journal Article
Observational Study
Date
03-2018
Author
Karin Lisspers
Christer Janson
Kjell Larsson
Gunnar Johansson
Gunilla Telg
Marcus Thuresson
Björn Ställberg
Author Affiliation
Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine, Uppsala University, Uppsala, Sweden. Electronic address: karin.lisspers@ltdalarna.se.
Source
Respir Med. 2018 03; 136:15-20
Date
03-2018
Language
English
Publication Type
Journal Article
Observational Study
Keywords
Acute Disease
Adolescent
Adult
Age Distribution
Aged
Asthma - mortality - physiopathology
Child
Cohort Studies
Comorbidity
Female
Forced Expiratory Volume - physiology
Hospitalization - statistics & numerical data
Humans
Male
Middle Aged
Patient Acceptance of Health Care - statistics & numerical data
Prognosis
Registries
Risk factors
Sweden - epidemiology
Young Adult
Abstract
Asthma is often associated with other diseases. To identify and manage comorbidities is important, as these conditions may increase the disease burden.
To describe the prevalence of comorbidities, disease burden and mortality across age groups in a large Swedish primary care real-life asthma population.
Observational cohort study of asthma patients, all ages, identified from electronic medical records by ICD-10-CM code, data from 36 primary care centers. Data were linked to national mandatory Swedish health registers. Comorbidities were identified by ICD-10-CM codes and collected from electronic medical records and the National Patient Registers, mortality data from the Cause of Death Register. Exacerbations were defined as hospitalizations due to asthma, and/or emergency visits at hospital and/or prescription claims of oral steroids.
In total 33,468 patients (58% women) were included. The most prevalent comorbidities were acute upper respiratory tract infection (53%), rhinitis (25%), acute lower respiratory tract infection (25%), hypertension (21%), anxiety and depression (20%). The comorbidities associated with highest risk for an exacerbation were COPD OR 1.98 (95%CI: 1.80-2.19), nasal polyps OR 1.75 (95%CI: 1.49-2.05) and rhinitis OR 1.52 (95%CI: 1.41-1.63). All-cause mortality was similar to the Swedish population, 1011 deaths per 100,000 person/year compared with 1058 deaths (standardized risk?=?0.99 [95%CI:0.95-1.04]). The pulmonary related death rate was greater in the study population versus the Swedish population (122 versus 72 per 100,000person/year).
Comorbid disease was frequent in this large real-life asthma population with an impact on exacerbations. To identify and treat comorbidities with impact on asthma outcomes are essential to improve asthma care.
PubMed ID
29501242 View in PubMed
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A complex intervention of self-management for patients with COPD or CHF in primary care improved performance and satisfaction with regard to own selected activities; A longitudinal follow-up.

https://arctichealth.org/en/permalink/ahliterature299854
Source
J Adv Nurs. 2019 Jan; 75(1):175-186
Publication Type
Journal Article
Date
Jan-2019
Author
Ann-Britt Zakrisson
Mats Arne
Mikael Hasselgren
Karin Lisspers
Björn Ställberg
Kersti Theander
Author Affiliation
Department of University Healthcare Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Source
J Adv Nurs. 2019 Jan; 75(1):175-186
Date
Jan-2019
Language
English
Publication Type
Journal Article
Keywords
Aged
Aged, 80 and over
Chronic Disease - nursing
Female
Heart Failure - nursing
Humans
Longitudinal Studies
Male
Patient Education as Topic
Personal Satisfaction
Primary Health Care - methods
Pulmonary Disease, Chronic Obstructive - nursing
Quality of Life
Self Care - methods
Sweden
Abstract
To test a self-management intervention in primary health care (PHC) for patients with chronic obstructive pulmonary disease (COPD) or chronic heart failure (CHF) on self-efficacy, symptoms, functioning, and health.
Patients with COPD or CHF experience often the same symptoms such as shortness of breath, cough, lack of energy, dry mouth, numbness or tingling in hands and feet, pain and sleeping problems.
A multicentre randomized control trial.
The trial was conducted with one intervention group (N = 73) and one control group (N = 77). The trial was performed from September 2013-September 2015 at nine PHC centres in three county councils in Sweden. At baseline patients with COPD and CHF experienced any symptom. Follow-ups were performed after 3 months and 1 year. The intervention was structured on Bandura's theory of self-efficacy in six meetings and individual action plans based on personal problems were performed and discussed.
At baseline, there were no differences between the groups except for SF-36 social function. After 3 months, the intervention group improved performance and satisfaction with regard to own selected activities, otherwise no differences were found.
When designing a program, the patient's own difficulties must be taken into consideration if person-centred care is to be established. It is feasible to include both patients with COPD and CHF in the same group in PHC. Healthcare professionals need supervision in pedagogics during intervention in self-management.
PubMed ID
30375028 View in PubMed
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A Cross-Sectional Study Assessing Appropriateness Of Inhaled Corticosteroid Treatment In Primary And Secondary Care Patients With COPD In Sweden.

https://arctichealth.org/en/permalink/ahliterature307847
Source
Int J Chron Obstruct Pulmon Dis. 2019; 14:2451-2460
Publication Type
Journal Article
Multicenter Study
Observational Study
Date
2019
Author
Johanna Sulku
Christer Janson
Håkan Melhus
Andrei Malinovschi
Björn Ställberg
Kristina Bröms
Marieann Högman
Karin Lisspers
Margareta Hammarlund-Udenaes
Elisabet I Nielsen
Author Affiliation
Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden.
Source
Int J Chron Obstruct Pulmon Dis. 2019; 14:2451-2460
Date
2019
Language
English
Publication Type
Journal Article
Multicenter Study
Observational Study
Keywords
Administration, Inhalation
Adrenal Cortex Hormones - administration & dosage - adverse effects
Aged
Cross-Sectional Studies
Drug Therapy, Combination
Drug Utilization
Female
Guideline Adherence
Humans
Lung - drug effects - physiopathology
Male
Middle Aged
Practice Guidelines as Topic
Practice Patterns, Physicians'
Primary Health Care
Pulmonary Disease, Chronic Obstructive - diagnosis - drug therapy - physiopathology
Secondary Care
Sweden
Treatment Outcome
Abstract
Inhaled corticosteroids (ICS) are often more widely prescribed in the treatment of chronic obstructive pulmonary disease (COPD) than what is recommended in the guidelines. The aim of this study was to evaluate the appropriateness of ICS treatment in COPD patients using the algorithm proposed by the International Primary Care Respiratory Group (IPCRG) and to identify factors associated with ICS treatment.
Appropriateness of ICS therapy was studied with respect to concomitant asthma, history of exacerbations and blood eosinophils (B-Eos) in a Swedish cohort of primary and secondary care patients with COPD. Factors associated with ICS were investigated using multivariable logistic regression.
Triple treatment was found to be the most common treatment combination, used by 46% of the 561 included patients, and in total 63% were using ICS. When applying the IPCRG algorithm, there was a possible indication for discontinuation of ICS in 55% of the patients with ICS treatment. Of the patients not using ICS, 18% had an indication for starting such treatment. The strongest factors associated with ICS therapy were frequent exacerbations (aOR 8.61, 95% CI 4.06, 20.67), secondary care contacts (aOR 6.99, 95% CI 2.48, 25.28) and very severe airflow limitation (aOR 5.91, 95% CI 1.53, 26.58).
More than half of the COPD patients on ICS met the criteria where withdrawal of the treatment could be tried. There was, however, also a subgroup of patients not using ICS for whom there was an indication for starting ICS treatment. Patients using ICS were characterized by more frequent exacerbations and lower lung function.
PubMed ID
31806954 View in PubMed
Less detail

Data-driven questionnaire-based cluster analysis of asthma in Swedish adults.

https://arctichealth.org/en/permalink/ahliterature311028
Source
NPJ Prim Care Respir Med. 2020 04 06; 30(1):14
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
04-06-2020
Author
Marta A Kisiel
Xingwu Zhou
Josefin Sundh
Björn Ställberg
Karin Lisspers
Andrei Malinovschi
Hanna Sandelowsky
Scott Montgomery
Anna Nager
Christer Janson
Author Affiliation
Department of Medical Sciences: Environmental and Occupational Medicine, Uppsala University, Uppsala, Sweden. marta.kisiel@medsci.uu.se.
Source
NPJ Prim Care Respir Med. 2020 04 06; 30(1):14
Date
04-06-2020
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Administration, Inhalation
Adult
Age of Onset
Aged
Asthma - classification - drug therapy - epidemiology - physiopathology
Body mass index
Cardiovascular Diseases - epidemiology
Cluster analysis
Comorbidity
Cost of Illness
Diabetes Mellitus - epidemiology
Disease Progression
Female
Glucocorticoids - therapeutic use
Humans
Male
Middle Aged
Phenotype
Primary Health Care
Quality of Life
Reproducibility of Results
Rhinitis - epidemiology
Rhinitis, Allergic, Seasonal - epidemiology
Severity of Illness Index
Sex Factors
Sinusitis - epidemiology
Sleep Apnea Syndromes - epidemiology
Smoking - epidemiology
Surveys and Questionnaires
Sweden - epidemiology
Abstract
The aim of this study was to identify asthma phenotypes through cluster analysis. Cluster analysis was performed using self-reported characteristics from a cohort of 1291 Swedish asthma patients. Disease burden was measured using the Asthma Control Test (ACT), the mini Asthma Quality of Life Questionnaire (mini-AQLQ), exacerbation frequency and asthma severity. Validation was performed in 748 individuals from the same geographical region. Three clusters; early onset predominantly female, adult onset predominantly female and adult onset predominantly male, were identified. Early onset predominantly female asthma had a higher burden of disease, the highest exacerbation frequency and use of inhaled corticosteroids. Adult onset predominantly male asthma had the highest mean score of ACT and mini-AQLQ, the lowest exacerbation frequency and higher proportion of subjects with mild asthma. These clusters, based on information from clinical questionnaire data, might be useful in primary care settings where the access to spirometry and biomarkers is limited.
Notes
CommentIn: NPJ Prim Care Respir Med. 2020 Apr 6;30(1):13 PMID 32249774
PubMed ID
32249767 View in PubMed
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Economic burden of COPD in a Swedish cohort: the ARCTIC study.

https://arctichealth.org/en/permalink/ahliterature289388
Source
Int J Chron Obstruct Pulmon Dis. 2018; 13:275-285
Publication Type
Journal Article
Date
2018
Author
Karin Lisspers
Kjell Larsson
Gunnar Johansson
Christer Janson
Madlaina Costa-Scharplatz
Jean-Bernard Gruenberger
Milica Uhde
Leif Jorgensen
Florian S Gutzwiller
Björn Ställberg
Author Affiliation
Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine, Uppsala University, Uppsala.
Source
Int J Chron Obstruct Pulmon Dis. 2018; 13:275-285
Date
2018
Language
English
Publication Type
Journal Article
Abstract
We assessed direct and indirect costs associated with COPD in Sweden and examined how these costs vary across time, age, and disease stage in a cohort of patients with COPD and matched controls in a real-world, primary care (PC) setting.
Data from electronic medical records linked to the mandatory national health registers were collected for COPD patients and a matched reference population in 52 PC centers from 2000 to 2014. Direct health care costs (drug, outpatient or inpatient, PC, both COPD related and not COPD related) and indirect health care costs (loss of income, absenteeism, loss of productivity) were assessed.
A total of 17,479 patients with COPD and 84,514 reference controls were analyzed. During 2013, direct costs were considerably higher among the COPD patient population (€13,179) versus the reference population (€2,716), largely due to hospital nights unrelated to COPD. Direct costs increased with increasing disease severity and increasing age and were driven by higher respiratory drug costs and non-COPD-related hospital nights. Indirect costs (~€28,000 per patient) were the largest economic burden in COPD patients of working age during 2013.
As non-COPD-related hospital nights represent the largest direct cost, management of comorbidities in COPD would offer clinical benefits and relieve the financial burden of disease.
Notes
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PubMed ID
29391785 View in PubMed
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33 records – page 1 of 4.