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5-FU split dose; a phase I/II and pharmacokinetic study of a different schedule of the Nordic regimen in advanced colorectal carcinoma.

https://arctichealth.org/en/permalink/ahliterature18358
Source
Anticancer Res. 2003 Mar-Apr;23(2C):1789-94
Publication Type
Article
Author
Ake Berglund
G�¶ran Carlsson
Bengt Gustavsson
Jan-Erik Fr�¶din
Peter Ragnhammar
Bengt Glimelius
Author Affiliation
Department of Oncology, Radiology and Clinical Immunology, University of Uppsala, Akademiska Sjukhuset, Uppsala, Sweden. ake.berglund@onkologi.uu.se
Source
Anticancer Res. 2003 Mar-Apr;23(2C):1789-94
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Antimetabolites, Antineoplastic - administration & dosage - adverse effects - blood - pharmacokinetics
Colorectal Neoplasms - blood - drug therapy
Dose-Response Relationship, Drug
Drug Administration Schedule
Female
Fluorouracil - administration & dosage - adverse effects - blood - pharmacokinetics
Humans
Male
Middle Aged
Abstract
PURPOSE: Despite more than four decades of fluoro-pyrimidine treatment in different cancers, the optimal schedule is still not known. The plasma half-life of 5-fluorouracil (5-FU) is extremely short and continuous infusion has gained popularity. In this study we explored whether repeated bolus 5-FU injections could improve the results. PATIENTS AND METHODS: Forty-three patients with advanced gastrointestinal carcinoma, where no standard treatment was available, were included in the phase I study. The initial dose of 5-FU was 250 mg/m2 with 30 mg/m2 leucovorin, repeated three hours later. Treatments were repeated every week. Twenty-six patients were recruited in the following phase II after maximal-tolerated dose (MTD) was reached. Plasma was collected for 5-FU pharmacokinetics. RESULTS: Diarrhoea was the dose-limiting toxicity (DLT), and was reached at 450 mg/m2. One complete and three partial responses (24%) were seen in the phase II study at 400 mg/m2. In addition, several patients had lasting subjective improvements. The treatments were well-tolerated but accumulated toxicity was seen after several months. Dose intensity was 89% after four months of treatment. A great interpatient variability was seen in 5-FU pharmacokinetics. The plasma AUC correlated with the 5-FU dose and toxicity, but not with the tumour response. CONCLUSION: A split of the 5-FU push bolus injection is possible with maintained treatment activity and surprisingly high doses can be tolerated; a weekly dose intensity of 800 mg/m2 could be reached compared with 500 mg/m2 in the standard Nordic FLv schedule.
PubMed ID
12820460 View in PubMed
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A 26-week, prospective, open-label, uncontrolled, multicenter study to evaluate the effect of an escalating-dose regimen of trandolapril on change in blood pressure in treatment-naive and concurrently treated adult hypertensive subjects (TRAIL).

https://arctichealth.org/en/permalink/ahliterature163832
Source
Clin Ther. 2007 Feb;29(2):305-15
Publication Type
Article
Date
Feb-2007
Author
Richard H Tytus
Ellen D Burgess
Linda Assouline
Anita Vanjaka
Author Affiliation
Hamilton Health Sciences, Hamilton, Ontario, Canada.
Source
Clin Ther. 2007 Feb;29(2):305-15
Date
Feb-2007
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Angiotensin-Converting Enzyme Inhibitors - administration & dosage - adverse effects - therapeutic use
Antihypertensive Agents - administration & dosage - adverse effects
Blood Pressure - drug effects
Calcium Channel Blockers - therapeutic use
Canada
Diuretics - therapeutic use
Dose-Response Relationship, Drug
Drug Administration Schedule
Drug Therapy, Combination
Female
Humans
Hypertension - drug therapy
Indoles - administration & dosage - adverse effects
Male
Middle Aged
Primary Health Care
Prospective Studies
Verapamil - therapeutic use
Abstract
This study evaluated the effectiveness of an escalating-dose regimen of trandolapril in subjects with stage 1 or stage 2 hypertension.
This was a 26-week, prospective, open-label,multicenter study in Canadian primary care centers. Subjects with hypertension who were treatment naive or whose disease was uncontrolled on current first-line antihypertensive monotherapy were treated with trandolapril for 26 weeks alone or in addition to their current treatment. Uncontrolled hypertension was defined as systolic/diastolic blood pressure (SBP/DBP) >or=140/90 mm Hg in subjects with no other risk factors or >or=130/80 mm Hg in subjects with diabetes or kidney disease. Trandolapril therapy was initiated at 1 mg/d and was titrated as required to 2 or 4 mg at 4 and 9 weeks after initiation of treatment, respectively, in those not achieving BP targets. At 14 weeks after treatment initiation, subjects not achieving BP targets could receive a combination of trandolapril 4 mg plus a calcium channel blocker (verapamil 240 mg) with or without a diuretic. Primary outcome was the percentage of patients reaching target BP after 14 weeks.
A total of 1683 subjects from 192 general practice clinics across Canada completed the 14-week trandolapril dose-optimization phase, and 1650 completed the full 26-week follow-up. Mean (SD) age was 56.6 (12.6) years, and 49.2% of the subjects were men. At baseline, 82.4% (1359/1650) of subjects were antihypertensive-treatment naive. At the trial end, 73.4% (95% CI, 70.9-75.9) of subjects achieved a target level of SBP/DBP
PubMed ID
17472822 View in PubMed
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The 2004 Canadian recommendations for the management of hypertension: Part II--Therapy.

https://arctichealth.org/en/permalink/ahliterature181498
Source
Can J Cardiol. 2004 Jan;20(1):41-54
Publication Type
Article
Date
Jan-2004
Author
Nadia A Khan
Finlay A McAlister
Norman R C Campbell
Ross D Feldman
Simon Rabkin
Jeff Mahon
Richard Lewanczuk
Kelly B Zarnke
Brenda Hemmelgarn
Marcel Lebel
Mitchell Levine
Carol Herbert
Author Affiliation
Division of General Internal Medicine, University of British Columbia, Vancouver, Canada.
Source
Can J Cardiol. 2004 Jan;20(1):41-54
Date
Jan-2004
Language
English
Publication Type
Article
Keywords
Adult
Aged
Antihypertensive Agents - administration & dosage
Blood Pressure Determination - standards
Canada - epidemiology
Cardiovascular Diseases - prevention & control
Dose-Response Relationship, Drug
Drug Administration Schedule
Drug Therapy, Combination
Evidence-Based Medicine - standards
Female
Humans
Hypertension - diagnosis - drug therapy - epidemiology
Male
Middle Aged
Prognosis
Risk assessment
Severity of Illness Index
Societies, Medical
Treatment Outcome
Abstract
To provide updated, evidence-based recommendations for the management of hypertension in adults.
For patients who require pharmacological therapy for hypertension, a number of antihypertensive agents may be used. Randomized trials evaluating first-line therapy with diuretics, beta-blockers, angiotensin-converting enzyme (ACE) inhibitors, calcium channel blockers (CCBs), alpha-blockers, centrally acting agents or angiotensin receptor antagonists were reviewed. Also, randomized trials evaluating other agents, such as statins or acetylsalicylic acid, in patients with hypertension were reviewed. Changes in cardiovascular morbidity and mortality were the primary outcomes of interest. In addition, other relevant outcomes such as development of end-stage renal disease or changes in blood pressure were examined where appropriate.
MEDLINE searches were conducted from November 2001 to October 2003 to update the 2001 Recommendations for the management of hypertension. Reference lists were scanned, experts were contacted, and the personal files of the subgroup members and authors were used to identify additional published studies. All relevant articles were reviewed and appraised independently, using prespecified levels of evidence by content and methodology experts.
This document contains detailed recommendations and supporting evidence on treatment thresholds, target blood pressures and choice of agents for hypertensive patients with or without comorbidities. Lifestyle modifications are a key component of any antiatherosclerotic management strategy and detailed recommendations are contained in a separate document. Key recommendations for pharmacotherapy include the following: treatment thresholds and targets should take into account each individual's global atherosclerotic risk, target organ damage and comorbidities, with particular attention to systolic blood pressure; blood pressure should be lowered to 140/90 mmHg or less in all patients, and 130/80 mmHg or less in those with diabetes mellitus or renal disease (125/75 mmHg or less in those with nondiabetic renal disease and more than 1 g of proteinuria per day); most adults with hypertension require more than one agent to achieve target blood pressures; for adults without compelling indications for other agents, initial therapy should include thiazide diuretics; other agents appropriate for first-line therapy for diastolic hypertension with or without systolic hypertension include beta-blockers (in those younger than 60 years), ACE inhibitors (in non-Blacks), long-acting dihydropyridine CCBs or angiotensin receptor antagonists; other agents appropriate for first-line therapy for isolated systolic hypertension include long-acting dihydropyridine CCBs or angiotensin receptor antagonists; certain comorbidities provide compelling indications for first-line use of other agents: in patients with angina, recent myocardial infarction or heart failure, beta-blockers and ACE inhibitors are recommended as first-line therapy; in patients with diabetes mellitus, ACE inhibitors or angiotensin receptor antagonists (or thiazides in patients with diabetes mellitus without albuminuria) are appropriate first-line therapies; and in patients with mild to moderate nondiabetic renal disease, ACE inhibitors are recommended; all hypertensive patients should have their fasting lipids screened and those with dyslipidemia should be treated using the thresholds, targets and agents as per the Recommendations for the management of dyslipidemia and the prevention of cardiovascular disease; and selected patients with hypertension should also receive statin and/or acetylsalicylic acid therapy.
All recommendations were graded according to the strength of the evidence and voted on by the Canadian Hypertension Education Program Evidence-Based Recommendations Task Force. Individuals with irreconcilable competing interests (declared by all members, compiled and circulated before the meeting) relative to any specific recommendation were excluded from voting on that recommendation. Only recommendations achieving at least 70% consensus are reported here. These guidelines will continue to be updated annually.
PubMed ID
14968142 View in PubMed
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Abstinence-orientated buprenorphine replacement therapy for young adults in out-patient counselling.

https://arctichealth.org/en/permalink/ahliterature82423
Source
Drug Alcohol Rev. 2006 Mar;25(2):123-30
Publication Type
Article
Date
Mar-2006
Author
Kornør Hege
Waal Helge
Ali Robert L
Author Affiliation
Unit for Addiction Medicine, University of Oslo, Norway. hege.kornor@kunnskapssenteret.no
Source
Drug Alcohol Rev. 2006 Mar;25(2):123-30
Date
Mar-2006
Language
English
Publication Type
Article
Keywords
Adult
Ambulatory Care Facilities
Buprenorphine - administration & dosage
Counseling
Drug Administration Schedule
Female
Humans
Male
Narcotic Antagonists - administration & dosage
Norway
Opioid-Related Disorders - drug therapy
Outpatients
Patient compliance
Risk factors
Stress, Psychological
Substance Withdrawal Syndrome
Treatment Outcome
Abstract
This study assessed treatment retention, compliance and completion of a 9-month buprenorphine replacement programme. In addition, changes in drug use and other relevant variables, as well as predictors of completion, were examined. Seventy-five opioid-dependent out-patients (mean age 26 years; 33% females) who aimed for opioid abstinence were enrolled into the study. Assessments were undertaken prior to buprenorphine induction and again at 3, 6 and 9 months. Forty patients (53%) completed the buprenorphine programme. At 9 months, 67 patients (87%) were still in counselling. Mean attendance rates for buprenorphine dosing and counselling sessions were 0.91 and 0.74, respectively. There were significant and persistent reductions in drug use during treatment with, however, a reversed tendency in the 9th month. Psychiatric problems escalated at 9 months, and three patients died during the detoxification phase. Completion was predicted by fewer previous treatment episodes. Detoxification from buprenorphine is associated with substantial psychological distress and an increased death risk. Buprenorphine replacement therapy should be continued until the patient chooses to leave, and close monitoring during the detoxification phase is essential.
PubMed ID
16627301 View in PubMed
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Aclarubicin plus cytosine arabinoside versus daunorubicin plus cytosine arabinoside in previously untreated patients with acute myeloid leukemia: a Danish national phase III trial. The Danish Society of Hematology Study Group on AML, Denmark.

https://arctichealth.org/en/permalink/ahliterature24824
Source
Leukemia. 1991 Jun;5(6):510-6
Publication Type
Article
Date
Jun-1991
Author
O P Hansen
J. Pedersen-Bjergaard
J. Ellegaard
H. Brincker
A M Boesen
B E Christensen
A. Drivsholm
E. Hippe
H. Jans
K B Jensen
Author Affiliation
Finsen Institute-Rigshospitalet, Department of Hematology L, Copenhagen, Denmark.
Source
Leukemia. 1991 Jun;5(6):510-6
Date
Jun-1991
Language
English
Publication Type
Article
Keywords
Aclarubicin - administration & dosage
Adolescent
Adult
Aged
Amsacrine - administration & dosage
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Chi-Square Distribution
Comparative Study
Cytarabine - administration & dosage
Daunorubicin - administration & dosage
Denmark
Drug Administration Schedule
Etoposide - administration & dosage
Humans
Leukemia, Myelocytic, Acute - drug therapy - mortality
Middle Aged
Regression Analysis
Remission Induction
Survival Rate
Abstract
A regimen of aclarubicin (ACR) of 75 mg/m2 daily for 3 days plus a continuous intravenous infusion of cytosine arabinoside (ara-C) of 100 mg/m2 per day for 7 days was compared with daunorubicin (DNR) 45 mg/m2/day for 3 days plus ara-C for 7 days as first-line chemotherapy of de novo acute myeloid leukemia (AML) in a randomized, nationwide Danish study. A total of 180 patients aged between 17 and 65 years were entered onto the protocol. Patients who achieved complete remission (CR) were given five courses of intensive consolidation therapy consisting of two courses of high dose ara-C, two courses of amsacrine plus etoposide, and one course of DNR plus ara-C. Of 174 evaluable patients, 99 achieved CR. The rate of CR was significantly higher on ACR plus ara-C than on DNR plus ara-C [66% versus 50% (p = 0.043)] and decreased significantly with increasing age. The hematological toxicity was identical for the two regimens. A total of 83 patients entered consolidation therapy. At 4 years, 37% of patients with CR following ACR were still in remission compared with 33% following DNR (p = 0.48), and the total survival at 4 years was 29% versus 20% (p = 0.26). The duration of remission and total survival both decreased with increasing age. ACR plus ara-C seem at least as good or better than DNR plus ara-C as first-line chemotherapy of AML.
PubMed ID
2056774 View in PubMed
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Acute conjunctivitis. A comparison of fusidic acid viscous eye drops and chloramphenicol.

https://arctichealth.org/en/permalink/ahliterature11748
Source
Acta Ophthalmol (Copenh). 1993 Apr;71(2):165-8
Publication Type
Article
Date
Apr-1993
Author
I. Hørven
Author Affiliation
Department of Ophthalmology, Oslo University, National Hospital, Rikshospitalet, Norway.
Source
Acta Ophthalmol (Copenh). 1993 Apr;71(2):165-8
Date
Apr-1993
Language
English
Publication Type
Article
Keywords
Acute Disease
Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Chloramphenicol - administration & dosage - therapeutic use
Comparative Study
Conjunctivitis - drug therapy - microbiology
Double-Blind Method
Drug Administration Schedule
Eye Infections, Bacterial - drug therapy
Female
Fusidic Acid - administration & dosage - therapeutic use
Humans
Infant
Infant, Newborn
Male
Middle Aged
Ophthalmic Solutions
Abstract
Fucidic acid viscous eye drops 1% given twice daily was compared with chloramphenicol eye drops 0.5% given 6 times daily in patients with acute conjunctivitis. Patients were recruited from 38 general practitioners in Norway. The mean duration of treatment was 6.6 days for Fucidic acid, 6.2 days for chloramphenicol. There was no major differences between the two groups in the bacteriological findings, and there was no significant difference in response to treatment. The use of fusidic acid in a carbomer vehicle as in Fucithalmic, has proved to give a long-lasting antibiotic concentration in the tear fluid, which allows the preferable twice daily application.
PubMed ID
8333258 View in PubMed
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Acute myeloid leukemia in Manitoba. The consequences of standard "7 + 3" remission-induction therapy followed by high dose cytarabine postremission consolidation for myelosuppression, infectious morbidity, and outcome.

https://arctichealth.org/en/permalink/ahliterature217808
Source
Cancer. 1994 Jul 1;74(1):52-60
Publication Type
Article
Date
Jul-1-1994
Author
E J Bow
M G Kilpatrick
B A Scott
J J Clinch
M S Cheang
Author Affiliation
Department of Medicine, University of Manitoba, Winnipeg, Canada.
Source
Cancer. 1994 Jul 1;74(1):52-60
Date
Jul-1-1994
Language
English
Publication Type
Article
Keywords
Adult
Aged
Antineoplastic Combined Chemotherapy Protocols - adverse effects - therapeutic use
Bone Marrow - drug effects
Cytarabine - administration & dosage - adverse effects
Daunorubicin - administration & dosage - adverse effects
Drug Administration Schedule
Female
Humans
Infection - complications - epidemiology
Leukemia, Myeloid, Acute - complications - drug therapy - mortality
Male
Manitoba
Middle Aged
Multivariate Analysis
Neutropenia - chemically induced - complications
Prognosis
Remission Induction
Retrospective Studies
Survival Rate
Treatment Outcome
Abstract
To the authors' knowledge, the natural history of myelosuppression and infectious complications associated with the use of standard cytarabine (ARA-C) plus daunorubicin ("7 + 3") remission-induction therapy for adult acute myeloid leukemia (AML) and high dose ARA-C (HDARA-C) consolidation has not been described completely.
A retrospective study of untreated adult AML patients receiving standard 7 + 3 induction followed by "5 + 2" and HDARA-C consolidation was undertaken to describe the relationship of the myelosuppression profiles, blood product use, and infectious morbidity, and to correlate this finding with the outcome of antileukemic therapy. Multivariate techniques were used to evaluate variables of prognostic importance.
Fifty-nine percent of the patients achieved remission after a median of 35 days; almost half (48%) of these patients required more than one 7 + 3 induction course. For one, two, and three induction courses, the mean number of days the patients experienced severe neutropenia (
PubMed ID
8004583 View in PubMed
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Addition of sunitinib to cetuximab and irinotecan in patients with heavily pre-treated advanced colorectal cancer.

https://arctichealth.org/en/permalink/ahliterature142304
Source
Acta Oncol. 2010 Aug;49(6):833-6
Publication Type
Article
Date
Aug-2010
Author
Camilla Qvortrup
Benny Vittrup Jensen
Trine Lembrecht Jorgensen
Dorte Nielsen
Jon Kroll Bjerregaard
Per Pfeiffer
Author Affiliation
Department of Oncology, Odense University Hospital, Odense, Denmark. Camilla.qvortrup@ouh.regionsyddanmark.dk
Source
Acta Oncol. 2010 Aug;49(6):833-6
Date
Aug-2010
Language
English
Publication Type
Article
Keywords
Administration, Oral
Adult
Aged
Antibodies, Monoclonal - administration & dosage
Antibodies, Monoclonal, Humanized
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Camptothecin - administration & dosage - analogs & derivatives
Colorectal Neoplasms - drug therapy - pathology
Compassionate Use Trials
Denmark
Drug Administration Schedule
Female
Humans
Indoles - administration & dosage
Kaplan-Meier Estimate
Male
Middle Aged
Organoplatinum Compounds - administration & dosage
Pyrroles - administration & dosage
Receptor Protein-Tyrosine Kinases - antagonists & inhibitors
Retrospective Studies
Treatment Outcome
Abstract
Results of continuous sunitinib, in combination with cetuximab and irinotecan every other week (SIC) for compassionate use in heavily pre-treated patients with mCRC are presented.
Patients with mCRC resistant to oxaliplatin, irinotecan, 5-FU and cetuximab received SIC at two Danish oncologic departments. The regimen consisted of sunitinib given as a continuous-dosing in combination with cetuximab and irinotecan every other week (CetIri). The first six patients started with a daily oral dose of sunitinib of 12.5 mg. Subsequent patients started at a daily dose of 25 mg with the possibility to escalate to 37.5 mg.
Twenty-nine patients received SIC. No patient had an objective response, but 13 patients had subjective relief and 42% had stable disease. The median time to progression was 3.2 months and median overall survival was 7.4 months. Fatigue and leukopenia were the most frequently reported severe adverse event (18% grade 3 and 18% grade 3/4, respectively).
Sunitinib continuous-dosing with 25 mg/day can safely be combined with CetIri administered every other week.
PubMed ID
20615171 View in PubMed
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Adherence of Renal Transplant Recipients to Once-daily, Prolonged-Release and Twice-daily, Immediate-release Tacrolimus-based Regimens in a Real-life Setting in Sweden.

https://arctichealth.org/en/permalink/ahliterature298202
Source
Transplant Proc. 2018 Dec; 50(10):3275-3282
Publication Type
Journal Article
Date
Dec-2018
Author
B Fellström
J Holmdahl
N Sundvall
E Cockburn
S Kilany
L Wennberg
Author Affiliation
Department of Medical Sciences, Uppsala University, Uppsala, Sweden. Electronic address: bengt.fellstrom@medsci.uu.se.
Source
Transplant Proc. 2018 Dec; 50(10):3275-3282
Date
Dec-2018
Language
English
Publication Type
Journal Article
Keywords
Adult
Aged
Delayed-Action Preparations
Drug Administration Schedule
Female
Graft Rejection - prevention & control
Humans
Immunosuppressive Agents - administration & dosage
Kidney Transplantation
Male
Medication Adherence
Middle Aged
Sweden
Tacrolimus - administration & dosage
Transplant Recipients
Abstract
In this study we investigated medication adherence of kidney transplant patients (KTPs) to an immediate-release tacrolimus (IR-T) regimen and, after conversion, to a prolonged-release tacrolimus (PR-T) regimen in routine clinical practice.
This was a non-interventional, observational, multicenter Swedish study. We included adult KTPs with stable graft function, remaining on IR-T or converting from IR-T to PR-T. Data were collected at baseline, and months 3, 6, and 12 post-baseline. The primary endpoint was adherence using the Basel Assessment of Adherence to Immunosuppressive Medication Scale (BAASIS©). Secondary assessments included tacrolimus dose and trough levels, clinical laboratory parameters (eg, estimated glomerular filtration rate), and adverse drug reactions (ADRs).
Overall, data from 233 KTPs were analyzed (PR-T, n = 175; IR-T, n = 58). Mean change in PR-T dose from baseline (4.8 mg/d) to month 12 was -0.2 mg/d, and for IR-T (4.2 mg/d) was -0.4 mg/d; tacrolimus trough levels remained similar. Overall adherence was similar between baseline and month 12 in both groups (PR-T: 54.4% vs 57.0%, respectively; IR-T: 65.5% vs 69.4%); timing adherence followed a similar pattern. The probability of taking adherence improved between baseline and month 12 (odds ratio, 1.97; P = .0092) in the PR-T group only. Mean BAASIS visual analog scale score at baseline was 94.3 ± 11.1% (PR-T) and 95.3 ± 7.6% (IR-T), and >95% at subsequent visits. Laboratory parameters remained stable. Eight (4.6%) patients receiving PR-T (none receiving IR-T) had ADRs considered probably/possibly treatment-related.
Disparity existed between high, patient-perceived and low, actual adherence. Overall adherence to the immunosuppressive regimen (measured by BAASIS) did not improve significantly over 12 months in stable KTPs converting to PR-T or remaining on IR-T; renal function remained stable.
PubMed ID
30577197 View in PubMed
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Adherence to national guidelines for initiation of antiretroviral regimens in HIV patients: a Danish nationwide study.

https://arctichealth.org/en/permalink/ahliterature137186
Source
Br J Clin Pharmacol. 2011 Jul;72(1):116-24
Publication Type
Article
Date
Jul-2011
Author
Tonny S Petersen
Stig E Andersen
January Gerstoft
Kristina Thorsteinsson
Carsten S Larsen
Gitte Pedersen
Court Pedersen
Niels Obel
Author Affiliation
Department of Clinical Pharmacology, Copenhagen University Hospital, Bispebjerg Hospital, Bispebjerg Bakke 23, 2400 Copenhagen, Denmark. tsp@person.dk
Source
Br J Clin Pharmacol. 2011 Jul;72(1):116-24
Date
Jul-2011
Language
English
Publication Type
Article
Keywords
Adult
Anti-HIV Agents - administration & dosage
Antiretroviral Therapy, Highly Active - methods - standards
Cohort Studies
Denmark
Drug Administration Schedule
Female
Guideline Adherence
HIV Infections - drug therapy
Humans
Male
Patient compliance
Practice Guidelines as Topic
Regression Analysis
State Medicine
Treatment Outcome
Abstract
To determine the adherence to the national guidelines for start of highly active antiretroviral treatment (HAART) in HIV infected patients.
We used a Danish nationwide cohort of HIV infected patients to calculate the fraction of patients who in the period 1997-2006 started HAART according to the guidelines from The Danish Society of Infectious Diseases. We used Kaplan-Meier tables to estimate time from fulfilling the criteria for start of HAART to initiation of the treatment. Cox regression and logistic regression was used to identify risk factors for delayed initiation of treatment and chance of being included in clinical trials.
The study included 3223 patients, 74% of whom initiated HAART in the study period. Ninety-four% fulfilled the criteria for start of HAART, with minor differences over calendar periods. Ninety-four% initiated a recommended regimen or were included in a clinical trial. Intravenous drug use predicted initiation of a non-recommended regimen and delay in start of HAART, while non-Caucasians were less likely to be included in clinical trials.
In a Western world setting, the adherence to national guidelines for start of HAART can be high. We suggest that simplicity of the guidelines, centralization of treatment and involvement of local clinicians in the development of guidelines are of major importance for high adherence to treatment guidelines.
Notes
Cites: Stud Health Technol Inform. 2008;136:339-4418487754
Cites: Scand J Infect Dis. 2010 Dec;42(11-12):917-2320840000
Cites: Nature. 2009 Sep 17;461(7262):336-919759594
Cites: Antivir Ther. 2009;14(7):995-100019918103
Cites: Health Serv Res. 2000 Mar;34(7):1429-4810737446
Cites: Br J Clin Pharmacol. 2001 Mar;51(3):213-711298066
Cites: J Gen Intern Med. 2001 Sep;16(9):625-3311556944
Cites: Clin Infect Dis. 2003 Mar 15;36(6):803-1112627367
Cites: Med Care. 1994 Mar;32(3):202-138145598
Cites: N Engl J Med. 1994 Nov 17;331(20):1350-37935706
Cites: BMJ. 1998 Sep 26;317(7162):858-619748183
Cites: JAMA. 1999 Jun 23-30;281(24):2305-1510386555
Cites: HIV Med. 2004 Nov;5(6):415-2015544693
Cites: AIDS. 2005 May 20;19(8):815-2215867496
Cites: Scand J Infect Dis. 2005;37(5):338-4316051569
Cites: Cochrane Database Syst Rev. 2006;(2):CD00025916625533
Cites: J Acquir Immune Defic Syndr. 2007 Jan 1;44(1):20-917091020
Cites: Ann Intern Med. 2007 Jan 16;146(2):87-9517227932
Cites: Br J Clin Pharmacol. 2007 Dec;64(6):722-517953721
Cites: HIV Med. 2008 Jan;9(1):47-5618199172
Cites: Ugeskr Laeger. 2008 Feb 25;170(9):740-418307962
Cites: J Acquir Immune Defic Syndr. 2008 Mar 1;47(3):377-8318176324
Cites: JAMA. 2008 Aug 6;300(5):555-7018677028
PubMed ID
21306418 View in PubMed
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410 records – page 1 of 41.