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Change in psychotropic drug use in Norwegian nursing homes between 2004 and 2011.

https://arctichealth.org/en/permalink/ahliterature297761
Source
Int Psychogeriatr. 2018 03; 30(3):385-394
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
03-2018
Author
G Selbæk
S I M Janus
S Bergh
K Engedal
S Ruths
A S Helvik
J Šaltyte Benth
S U Zuidema
Author Affiliation
Norwegian National Advisory Unit on Ageing and Health,Vestfold Hospital Trust,Tønsberg,Norway.
Source
Int Psychogeriatr. 2018 03; 30(3):385-394
Date
03-2018
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Aged
Aged, 80 and over
Antipsychotic Agents - therapeutic use
Behavioral Symptoms - drug therapy - psychology
Cognition Disorders - drug therapy - psychology
Cohort Studies
Dementia - drug therapy - psychology
Drug Utilization - statistics & numerical data
Female
Homes for the Aged
Humans
Length of Stay - statistics & numerical data
Male
Norway - epidemiology
Nursing Homes - statistics & numerical data
Psychotic Disorders - drug therapy - epidemiology
Psychotropic Drugs - administration & dosage - therapeutic use
Abstract
ABSTRACTBackground:We aimed to assess whether there were any changes in the use of psychotropic drugs in Norwegian nursing homes between 2004 and 2011. Also, we investigated whether the predictors of use of specific psychotropic drug groups have changed.
We conducted a secondary analysis of two cohort studies of two Norwegian nursing home samples (2004/05 and 2010/11). Multivariate models were applied.
We found a significant decrease in the prescription of antipsychotic drugs between 2004 and 2011 (0.63 OR, 95%CI = 0.49-0.82, p
PubMed ID
28988552 View in PubMed
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Drug treatment of heart failure--do nursing-home residents deserve better?

https://arctichealth.org/en/permalink/ahliterature53975
Source
Scand J Prim Health Care. 2000 Dec;18(4):226-31
Publication Type
Article
Date
Dec-2000
Author
S. Ruths
J. Straand
H A Nygaard
F. Hodneland
Author Affiliation
Department of Public Health and Primary Health Care, University of Bergen, Norway. sabine.ruths@isf.uib.no
Source
Scand J Prim Health Care. 2000 Dec;18(4):226-31
Date
Dec-2000
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Angiotensin-Converting Enzyme Inhibitors - therapeutic use
Cross-Sectional Studies
Diuretics - therapeutic use
Female
Heart Failure, Congestive - complications - drug therapy
Homes for the Aged - standards
Humans
Male
Middle Aged
Norway
Nursing Homes - standards
Quality of Health Care
Research Support, Non-U.S. Gov't
Abstract
OBJECTIVE: To describe and assess drug treatment of heart failure (HF) in nursing-home residents. DESIGN: Descriptive cross-sectional study. Individual patient information was obtained from the medical records and drug-dispensing cards. SETTING: Nursing homes in Bergen, Norway. MAIN OUTCOME MEASURES: Demographic data, diagnostic data (main diagnoses, diagnostic indications for the drugs used), medications (drugs, dosage and duration of use). RESULTS: Data were gathered from 23 of 27 obtainable institutions representing 1552 residents (86% of the Bergen nursing-home population); 469 (30%) of the residents used drugs for HF, the majority of whom (293 patients) were treated with furosemide only. Supplementary angiotensin-converting enzyme (ACE) inhibitors (predominantly in sub-target doses) were provided to 17% of the HF patients. About one out of four used drug combinations which we considered to be potentially harmful for HF patients. CONCLUSIONS: ACE inhibitors are probably under-utilised for HF in nursing-home residents. Potentially harmful drug combinations commonly occur. Both diagnosis and drug treatment for HF should be challenged in the nursing-home setting.
PubMed ID
11205091 View in PubMed
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Initial prescription of antipsychotics and antidepressants in general practice and specialist care in Norway.

https://arctichealth.org/en/permalink/ahliterature136202
Source
Acta Psychiatr Scand. 2011 Jun;123(6):459-65
Publication Type
Article
Date
Jun-2011
Author
S R Kjosavik
S. Hunskaar
D. Aarsland
S. Ruths
Author Affiliation
Research Group for General Practice, Department of Public Health and Primary Health Care, University of Bergen, Norway. svein.kjosavik@isf.uib.no
Source
Acta Psychiatr Scand. 2011 Jun;123(6):459-65
Date
Jun-2011
Language
English
Publication Type
Article
Keywords
Adult
Age Distribution
Aged
Aged, 80 and over
Antidepressive Agents - therapeutic use
Antipsychotic Agents - therapeutic use
Cross-Sectional Studies
Drug Utilization
Female
General Practice - statistics & numerical data
Humans
Male
Mental Disorders - drug therapy
Middle Aged
Norway
Psychiatry - statistics & numerical data
Sex Distribution
Young Adult
Abstract
To examine the incidence rates of antipsychotic (AP) and antidepressant (AD) drug treatment in Norway and the proportions initiated in general practice and specialist care respectively.
Data on all prescriptions of APs and ADs dispensed to the general population in Norway from 1 January 2004 until 31 August 2009 were extracted from the Norwegian Prescription Database. This information was merged with data about general practitioners (GPs) from the Norwegian Regular General Practitioner Scheme.
One-year incidence rates per 1000 inhabitants were 3.4 for APs and 8.6 for ADs. GPs initiated 58% of APs and 73% of ADs, while psychiatrists initiated 15% and 6% respectively. Psychiatrists initiated treatment more often among younger patients, and they prescribed relatively newer drugs more commonly than GPs. A large share of incident users did not refill their prescriptions for APs (57%) or ADs (33%).
GPs have a key role as regards initiating treatment with APs and ADs in Norway, while psychiatrists' influence seems limited, particularly among older patients. Efforts for quality improvement of mental health care need to involve primary health care. In addition, an increased focus from psychiatrists towards the increasingly ageing part of the population seems requisite.
PubMed ID
21401533 View in PubMed
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[Mental impairment in nursing home residents]

https://arctichealth.org/en/permalink/ahliterature72048
Source
Tidsskr Nor Laegeforen. 2000 Oct 30;120(26):3113-6
Publication Type
Article
Date
Oct-30-2000
Author
H A Nygaard
M. Naik
S. Ruths
Author Affiliation
Seksjon for geriatri Institutt for samfunnsmedisinske fag, Bergen. harald.nygaard@isf.uib.no
Source
Tidsskr Nor Laegeforen. 2000 Oct 30;120(26):3113-6
Date
Oct-30-2000
Language
Norwegian
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Aged, 80 and over
Cross-Sectional Studies
Dementia - diagnosis - epidemiology
English Abstract
Female
Geriatric Assessment - statistics & numerical data
Geriatric Psychiatry - statistics & numerical data
Humans
Male
Mental Disorders - diagnosis - epidemiology
Mental health
Mental Status Schedule
Mentally Disabled Persons - statistics & numerical data
Norway - epidemiology
Nursing Assessment - statistics & numerical data
Nursing Homes - statistics & numerical data
Abstract
BACKGROUND: Nursing homes are the corner stones in long-term institutional care for frail elderly people. Expansion and strengthening of community-based services during the last decade has enabled frail elderly who earlier would have moved into a nursing home to stay in their own home or in service apartments. MATERIAL AND METHODS: In a cross-sectional, anonymised study, changes in nursing homes in the city of Bergen between 1985 and 1996/97 were analysed with regard to prevalence of mentally impaired residents. The following items were assessed by nurses who were in daily contact with the residents: mental capacity by means of Clinical Dementia Rating (CDR), activities of daily living (ADL), and behaviour. The study population consisted of 1,296 residents from 21 institutions in 1985 and 1,141 residents from 16 institutions i 1996/97. RESULTS: The percentage of mentally impaired residents increased significantly, from 75 to 82, and the percentage of residents who were in need of extended nursing care rose from 87 to 91. The median duration of stay did not change significantly, but was reduced for residents with slight mental impairments (CDR 1), from 871 to 721 days. INTERPRETATION: Today, predominately mentally impaired and physically disabled elderly are cared for in general nursing homes. These are patients in need of continuous medical care and supervision, and do not fit into an ideology which "demedicalizes" severe medical conditions in old people. Both nursing homes and sheltered livings are needed.
PubMed ID
11109355 View in PubMed
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Multidisciplinary medication review in nursing home residents: what are the most significant drug-related problems? The Bergen District Nursing Home (BEDNURS) study.

https://arctichealth.org/en/permalink/ahliterature71328
Source
Qual Saf Health Care. 2003 Jun;12(3):176-80
Publication Type
Article
Date
Jun-2003
Author
S. Ruths
J. Straand
H A Nygaard
Author Affiliation
Section for Geriatric Medicine, Department of Public Health and Primary Health Care, University of Bergen, Norway. sabine.ruths@isf.uib.no
Source
Qual Saf Health Care. 2003 Jun;12(3):176-80
Date
Jun-2003
Language
English
Publication Type
Article
Keywords
Aged
Cross-Sectional Studies
Drug Therapy - adverse effects - utilization
Drug Utilization Review
Female
Health Services Misuse
Health Services Research
Humans
Male
Medication Errors
Norway
Nursing Homes - organization & administration
Psychotropic Drugs - therapeutic use
Research Support, Non-U.S. Gov't
Abstract
AIM: Based on a multidisciplinary review of drug use in nursing home residents, this study aimed to identify the most frequent clinically relevant medication problems and to analyse them according to the drugs involved and types of problems. METHODS: Cross sectional study auditing drug use by 1354 residents in 23 nursing homes in Bergen, Norway. Data were collected in 1997. A physician/pharmacist panel performed a comprehensive medication review with regard to indications for drug use and active medical conditions. The drug related problems were subsequently classified according to the drugs involved and types of problems (indication, effectiveness, and safety issues). RESULTS: 2445 potential medication problems were identified in 1036 (76%) residents. Psychoactive drugs accounted for 38% of all problems; antipsychotics were the class most often involved. Multiple psychoactive drug use was considered particularly problematic. Potential medication problems were most frequently classified as risk of adverse drug reactions (26%), inappropriate drug choice for indication (20%), and underuse of beneficial treatment (13%). CONCLUSIONS: Three of four nursing home residents had clinically relevant medication problems, most of which were accounted for by psychoactive drugs. The most frequent concerns were related to adverse drug reactions, drug choice, and probable undertreatment.
PubMed ID
12792006 View in PubMed
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Psychotropic drug use in nursing homes--diagnostic indications and variations between institutions.

https://arctichealth.org/en/permalink/ahliterature46066
Source
Eur J Clin Pharmacol. 2001 Sep;57(6-7):523-8
Publication Type
Article
Date
Sep-2001
Author
S. Ruths
J. Straand
H A Nygaard
Author Affiliation
Department of Public Health and Primary Health Care, University of Bergen, Norway. sabine.ruths@isf.uib.no
Source
Eur J Clin Pharmacol. 2001 Sep;57(6-7):523-8
Date
Sep-2001
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Anxiety - diagnosis - drug therapy
Cross-Sectional Studies
Data Collection - statistics & numerical data
Depression - diagnosis - drug therapy
Female
Homes for the Aged - statistics & numerical data
Humans
Male
Mental Disorders - diagnosis - drug therapy
Norway
Nursing Homes - statistics & numerical data
Prescriptions, Drug - statistics & numerical data
Psychomotor Agitation - diagnosis - drug therapy
Psychotropic Drugs - therapeutic use
Research Support, Non-U.S. Gov't
Sleep Disorders - diagnosis - drug therapy
Abstract
OBJECTIVE: Psychotropic drug use among nursing home residents with regard to diagnostic indications and patient- and institution characteristics was analysed. METHODS: A cross-sectional study of medication data from 1552 residents at 23 nursing homes in Bergen, Norway, was performed. Psychotropic drug use (neuroleptics, anxiolytics, hypnotics, antidepressants, and two sedative antihistamines) was analysed with regard to prevalence, diagnostic indications, duration of use, and general patient- and institution characteristics. RESULTS: Psychotropic drugs were taken on a daily schedule by 59% of all residents, most commonly as long-term treatment. Antidepressants (in 70% selective serotonin re-uptake inhibitors) were used by 31%, neuroleptics by 23%, and benzodiazepines by 22% of all the residents. Neuroleptics were given for non-psychotic behavioural and psychological symptoms in 66% of the cases. Sleeping disorders were most commonly treated with long-acting benzodiazepine hypnotics. Psychotropic drug use decreased with increasing patient age. Drug use patterns varied greatly between the different nursing homes: the prevalence of neuroleptic use varied from 0 to 61% of the residents, and antidepressant use varied from 10 to 63%. In nursing homes providing relatively more physician staff time, the residents were more likely to use antidepressants. CONCLUSIONS: Psychotropic drugs are used by a majority of nursing home residents as long-term symptomatic treatment. The great variations between the institutions can only to a small extent be explained by quantitative differences between the institutions.
PubMed ID
11699620 View in PubMed
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Use of hormonal contraceptives among immigrant and native women in Norway: data from the Norwegian Prescription Database.

https://arctichealth.org/en/permalink/ahliterature260813
Source
BJOG. 2014 Sep;121(10):1221-8
Publication Type
Article
Date
Sep-2014
Author
G. Omland
S. Ruths
E. Diaz
Source
BJOG. 2014 Sep;121(10):1221-8
Date
Sep-2014
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Africa - ethnology
Americas - ethnology
Asia - ethnology
Australasia - ethnology
Contraceptive Agents - administration & dosage
Contraceptive Devices, Female - utilization
Cross-Sectional Studies
Drug Prescriptions - statistics & numerical data
Emigrants and Immigrants - statistics & numerical data
Europe - ethnology
Female
Humans
Middle Aged
Norway - epidemiology
Population Groups - statistics & numerical data
Scandinavian and Nordic Countries - ethnology
Socioeconomic Factors
Young Adult
Abstract
To examine the use of hormonal contraceptives among immigrant and native women in Norway.
Nationwide registry-based study based on merged data from the Norwegian Prescription Database, the Norwegian Population Registry, the Regular General Practitioner Database and the Medical Birth Registry.
Norway.
All women born abroad to two foreign-born parents (immigrants), or born in Norway to two Norwegian-born parents (natives) aged 16-45 years, who lived in Norway in 2008.
Data on all collected supplies of hormonal contraceptives in 2008 were merged with demographic, socio-economic and immigration data, information on any delivery and women's general practitioners.
User rates of hormonal contraception and predictors of contraceptive use.
A total of 893,073 women were included, of whom 130,080 were immigrants. More native women (38%) used hormonal contraceptives compared with all immigrant groups (15-24%). The odds ratios for any use of hormonal contraceptives for immigrants compared with Norwegian-born women were; Nordic countries 0.53, South and Central America 0.53, Western countries 0.39, Asia 0.30, Eastern Europe 0.29, Africa 0.29. Work, education, long stay in Norway and young age of immigration predicted the use of hormonal contraceptives among immigrants.
The use of hormonal contraceptives varies between natives and immigrant groups. Further work is needed to ascertain whether these differences can be explained by higher desires for fertility, preferential use of non-hormonal contraceptives or other reasons identified through qualitative research.
Notes
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PubMed ID
24931487 View in PubMed
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7 records – page 1 of 1.