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Different patterns in use of antibiotics for lower urinary tract infection in institutionalized and home-dwelling elderly: a register-based study.

https://arctichealth.org/en/permalink/ahliterature121293
Source
Eur J Clin Pharmacol. 2013 Mar;69(3):665-71
Publication Type
Article
Date
Mar-2013
Author
Ylva Haasum
Johan Fastbom
Kristina Johnell
Author Affiliation
Aging Research Center, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet and Stockholm University, Gävlegatan 16, 113 30 Stockholm, Sweden. Ylva.Haasum@ki.se
Source
Eur J Clin Pharmacol. 2013 Mar;69(3):665-71
Date
Mar-2013
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Anti-Bacterial Agents - adverse effects - therapeutic use
Drug Prescriptions
Drug Utilization - trends
Drug Utilization Review
Female
Guideline Adherence
Homes for the Aged
Humans
Independent living
Institutionalization
Logistic Models
Lower Urinary Tract Symptoms - diagnosis - drug therapy - microbiology
Male
Multivariate Analysis
Odds Ratio
Physician's Practice Patterns - trends
Polypharmacy
Practice Guidelines as Topic
Registries
Sex Factors
Sweden
Urinary Tract Infections - diagnosis - drug therapy - microbiology
Abstract
We compared the quality and pattern of use of antibiotics to treat urinary tract infection (UTI) between institutionalized and home-dwelling elderly.
We analyzed the quality of use of UTI antibiotics in Swedish people aged = 65 years at 30 September 2008 (1,260,843 home-dwelling and 86,721 institutionalized elderly). Data regarding drug use, age and sex were retrieved from the Swedish Prescribed Drug Register and information about type of housing from the Social Services Register. In women, we assessed: (1) the proportion who use quinolones (should be as low as possible); (2) the proportion treated with the recommended drugs (pivmecillinam, nitrofurantoin, or trimethoprim) (proportions should be about 40 %, 40 % and 15-20 %, respectively); In men, we assessed: (1) the proportion who used quinolones or trimethoprim (should be as high as possible).
The 1-day point prevalence for antibiotic use for UTI was 1.6 % among institutionalized and 0.9 % among home-dwelling elderly. Of these, about 15 % of institutionalized and 19 % of home-dwelling women used quinolones. The proportion of women treated with the recommended drugs pivmecillinam, nitrofurantoin or trimethoprim was 29 %, 27 % and 45 % in institutions and 40 %, 28 % and 34 % for home-dwellers. In men treated with antibiotics for UTI, quinolones or trimethoprim were used by about 76 % in institutions and 85 % in home-dwellers.
Our results indicate that recommendations for UTI treatment with antibiotics are not adequately followed. The high use of trimethoprim amongst institutionalized women and the low use of quinolones or trimethoprim among institutionalized men need further investigation.
PubMed ID
22922683 View in PubMed
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Drug use in centenarians compared with nonagenarians and octogenarians in Sweden: a nationwide register-based study.

https://arctichealth.org/en/permalink/ahliterature129199
Source
Age Ageing. 2012 Mar;41(2):218-24
Publication Type
Article
Date
Mar-2012
Author
Jonas W Wastesson
Marti G Parker
Johan Fastbom
Mats Thorslund
Kristina Johnell
Author Affiliation
Aging Research Center, Karolinska Institutet and Stockholm University, Gävlegatan 16, SE-113 30 Stockholm, Sweden. jonas.wastesson@ki.se
Source
Age Ageing. 2012 Mar;41(2):218-24
Date
Mar-2012
Language
English
Publication Type
Article
Keywords
Age Factors
Aged, 80 and over
Drug Prescriptions - statistics & numerical data
Drug Utilization - statistics & numerical data
Drug Utilization Review
Female
Guideline Adherence
Health Care Surveys
Humans
Independent living
Institutionalization
Logistic Models
Male
Multivariate Analysis
Odds Ratio
Palliative Care
Physician's Practice Patterns - statistics & numerical data
Practice Guidelines as Topic
Prescription Drugs - therapeutic use
Registries
Sweden
Abstract
the number of centenarians increases rapidly. Yet, little is known about their health and use of medications.
to investigate pharmacological drug use in community-dwelling and institutionalised centenarians compared with nonagenarians and octogenarians.
we analysed data on dispensed drugs for centenarians (n = 1,672), nonagenarians (n = 76,584) and octogenarians (n = 383,878) from the Swedish Prescribed Drug Register, record-linked to the Swedish Social Services Register. Multivariate logistic regression analysis was used to analyse whether age was associated with use of drugs, after adjustment for sex, living situation and co-morbidity.
in the adjusted analysis, centenarians were more likely to use analgesics, hypnotics/sedatives and anxiolytics, but less likely to use antidepressants than nonagenarians and octogenarians. Moreover, centenarians were more likely to use high-ceiling diuretics, but less likely to use beta-blockers and ACE-inhibitors.
centenarians high use of analgesics, hypnotics/sedatives and anxiolytics either reflects a palliative approach to drug treatment in centenarians or that pain and mental health problems increase into extreme old age. Also, centenarians do not seem to be prescribed cardiovascular drug therapy according to guidelines to the same extent as nonagenarians and octogenarians. Whether this reflects an age or cohort effect should be evaluated in longitudinal studies.
PubMed ID
22130561 View in PubMed
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Living Alone with Alzheimer's Disease: Data from SveDem, the Swedish Dementia Registry.

https://arctichealth.org/en/permalink/ahliterature292004
Source
J Alzheimers Dis. 2017; 58(4):1265-1272
Publication Type
Journal Article
Date
2017
Author
Pavla Cermakova
Maja Nelson
Juraj Secnik
Sara Garcia-Ptacek
Kristina Johnell
Johan Fastbom
Lena Kilander
Bengt Winblad
Maria Eriksdotter
Dorota Religa
Author Affiliation
Department of Neurobiology, Care Sciences andSociety, Division of Neurogeriatrics, Karolinska Institutet, Huddinge, Stockholm, Sweden.
Source
J Alzheimers Dis. 2017; 58(4):1265-1272
Date
2017
Language
English
Publication Type
Journal Article
Keywords
Aged
Aged, 80 and over
Alzheimer Disease - drug therapy - epidemiology - psychology
Antidepressive Agents
Antipsychotic Agents - therapeutic use
Cohort Studies
Comorbidity
Dementia - epidemiology - psychology
Female
Humans
Independent living
Magnetic Resonance Imaging
Male
Registries
Social Conditions
Sweden - epidemiology
Abstract
Many people with Alzheimer's disease (AD) live alone in their own homes. There is a lack of knowledge about whether these individuals receive the same quality of diagnostics and treatment for AD as patients who are cohabiting.
To investigate the diagnostic work-up and treatment of community-dwelling AD patients who live alone.
We performed a cross-sectional cohort study based on data from the Swedish Dementia Registry (SveDem). We studied patients diagnosed with AD between 2007 and 2015 (n?=?26,163). Information about drugs and comorbidities was acquired from the Swedish Prescribed Drug Register and the Swedish Patient Register.
11,878 (46%) patients lived alone, primarily older women. After adjusting for confounders, living alone was inversely associated with receiving computed tomography (OR 0.90; 95% CI 0.82-0.99), magnetic resonance imaging (OR 0.91; 95% CI 0.83-0.99), and lumbar puncture (OR 0.86; 95% CI 0.80-0.92). Living alone was also negatively associated with the use of cholinesterase inhibitors (OR 0.81; 95% CI 0.76; 0.87), memantine (OR 0.77; 95% CI 0.72; 0.83), and cardiovascular medication (OR 0.92; 0.86; 0.99). On the other hand, living alone was positively associated with the use of antidepressants (OR 1.15; 95% CI 1.08; 1.22), antipsychotics (OR 1.41; 95% CI 1.25; 1.58), and hypnotics and sedatives (OR 1.09; 95% CI 1.02; 1.17).
Solitary living AD patients do not receive the same extent of care as those who are cohabiting.
Notes
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PubMed ID
28550260 View in PubMed
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