Skip header and navigation

Refine By

12 records – page 1 of 2.

[Adherence to international recommendations in the fight against antimicrobial resistance - Substantial difference between outpatient consumption in Spain and Denmark].

https://arctichealth.org/en/permalink/ahliterature278374
Source
Rev Esp Quimioter. 2016 Feb;29(1):40-3
Publication Type
Article
Date
Feb-2016
Author
Sara Malo
María José Rabanaque
Lars Bjerrum
Source
Rev Esp Quimioter. 2016 Feb;29(1):40-3
Date
Feb-2016
Language
Spanish
Publication Type
Article
Keywords
Anti-Bacterial Agents - therapeutic use
Bacterial Infections - drug therapy - epidemiology - microbiology
Cephalosporins
Databases, Factual
Denmark - epidemiology
Drug Resistance, Bacterial
Drug Utilization
Fluoroquinolones
Guideline Adherence - statistics & numerical data
Guidelines as Topic
Humans
Macrolides
Outpatients
Spain - epidemiology
Abstract
Increasing antibiotic resistance represents a major public health threat that jeopardises the future treatment of bacterial infections. This study aims to describe the adherence to recommendations proposed by the World Health Organization (WHO) Advisory Group on Integrated Surveillance of Antimicrobial Resistance (AGISAR), in Spain and Denmark, and to analyse the relation between the outpatient use of Critically Important Antimicrobials (CIA) and the bacterial resistance rates to these agents.
The Antimicrobial consumption interactive database (ESAC-Net) and Antimicrobial resistance interactive database (EARS-Net) provided data on outpatient use (2010-2013) of CIA (fluoroquinolones, macrolides, and 3rd and 4th generation cephalosporins) and the percentages of isolates of the main pathogens causing serious infections, resistant to these agents.
The use of cephalosporins and fluoroquinolones, as well as the percentage of bacteria resistant, is higher in Spain than in Denmark. Although consumption of macrolides in both countries is similar, the proportion of Streptococcus pneumoniae resistant to macrolides is significantly higher in Spain.
The high outpatient consumption of CIA agents in Spain deviates substantially from the WHO recommendations. Moreover, it has the effect of elevated rates of antimicrobial resistance, that are lower in Denmark.
PubMed ID
26809795 View in PubMed
Less detail

Cross-cultural differences in the reporting of global functional capacity: an example in cataract patients.

https://arctichealth.org/en/permalink/ahliterature50985
Source
Med Care. 1998 Jun;36(6):868-78
Publication Type
Article
Date
Jun-1998
Author
J. Alonso
C. Black
J C Norregaard
E. Dunn
T F Andersen
M. Espallargues
P. Bernth-Petersen
G F Anderson
Author Affiliation
Health Services Research Unit, Institut Municipal d'Investigació Mèdica, Barcelona, Spain.
Source
Med Care. 1998 Jun;36(6):868-78
Date
Jun-1998
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Bias (epidemiology)
Cataract - ethnology - physiopathology
Comparative Study
Cross-Cultural Comparison
Cultural Characteristics
Denmark
Female
Health Status Indicators
Humans
Logistic Models
Male
Manitoba
Multivariate Analysis
Outcome Assessment (Health Care) - methods - standards
Questionnaires - standards
Reproducibility of Results
Research Support, Non-U.S. Gov't
Sensitivity and specificity
Spain
United States
Visual acuity
Abstract
OBJECTIVES: Patient-based health status measures have an important role to play in the assessment of health care outcomes. Among these measures, global assessments increasingly have been used, although the understanding of the performance of these indicators and the determinants of patients responses is underdeveloped. In this study, the performance of a single-item global indicator of visual function in cataract patients of four international settings was compared. METHODS: Visual acuity and ocular comorbidity was assessed by patients' ophthalmologist using Snellen-type charts in patients referred for a first cataract surgery in the United States, Manitoba (Canada), Denmark, and Barcelona (Spain). Patients also were interviewed by telephone and asked to report overall trouble with vision on a single-item indicator ("great deal," "moderate," "a little," "none") and to complete the Visual Functioning Index (VF-14), a scale of visual function ranging from 0 (worst function) to 100 (best level of function), along with other questions including the degree the patient was bothered by symptoms as measured by the Cataract Symptom Score (CSS). A total of 1,407 patients completed the clinical examination and the preoperative interview. RESULTS: Distribution of overall trouble with vision varied across the sites, with the proportion of patients reporting a great deal of trouble ranging from 21.7% to 37.9%. In all sites, patients reporting more trouble with vision tended to show a poorer age-adjusted and sex-adjusted visual acuity. The proportion of patients reporting great deal of trouble with vision was higher in the groups with worse visual acuity (P
PubMed ID
9630128 View in PubMed
Less detail

Differences in outpatient antibiotic use between a Spanish region and a Nordic country.

https://arctichealth.org/en/permalink/ahliterature274523
Source
Enferm Infecc Microbiol Clin. 2014 Aug-Sep;32(7):412-7
Publication Type
Article
Author
Sara Malo-Fumanal
María José Rabanaque-Hernández
Cristina Feja-Solana
María Jesús Lallana-Alvarez
Javier Armesto-Gómez
Lars Bjerrum
Source
Enferm Infecc Microbiol Clin. 2014 Aug-Sep;32(7):412-7
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Anti-Bacterial Agents - therapeutic use
Child
Child, Preschool
Denmark
Drug Prescriptions - statistics & numerical data
Drug Utilization - statistics & numerical data
Female
Humans
Infant
Male
Middle Aged
Spain
Young Adult
Abstract
Antibiotic use and misuse are linked to pathogen resistance and, as such, both constitute a public health issue with local, national, and global dimensions. Early studies have shown striking variations in the use of these drugs between Nordic and Mediterranean countries. The aim of the present study was to describe and compare antibiotic prescribing in Primary Care in Denmark and Aragón (a North-eastern Spanish region).
Outpatient antibiotic prescription data (2010) were obtained from the National Institute for Health Data and Disease Control (Denmark), and the Information System on Medication Consumption in Aragón. The consumption of antibiotics (ATC J01) was analyzed from the prescription rates and the number of defined daily dose (DDD) per 1000 inhabitants/day (DID).
The rate of antibiotic prescription in 2010 in Aragón was greater than in Denmark (407 compared to 315 exposed individuals/1000 inhabitants). There were significant differences as regards overall consumption of antibiotics (23.2 DID in Aragón and 17.0 DID in Denmark), as well as the therapeutic group selection. There was an elevated use of broad spectrum penicillins, quinolones and cephalosporins in the Spanish region while, in Denmark, the most-consumed antibiotic was narrow spectrum penicillin.
The use of antibiotics in the Spanish region is very high, and there are marked differences in the choice of drug between this region and Denmark. Interventions are needed that promote the rational use of these drugs to reduce potential bacterial resistance, and to avoid unnecessary risks to patients.
PubMed ID
24262316 View in PubMed
Less detail

Inappropriate antibiotic prescribing and demand for antibiotics in patients with upper respiratory tract infections is hardly different in female versus male patients as seen in primary care.

https://arctichealth.org/en/permalink/ahliterature270514
Source
Eur J Gen Pract. 2015 Jun;21(2):118-23
Publication Type
Article
Date
Jun-2015
Author
Kathrine Bagger
Anni B Sternhagen Nielsen
Volkert Siersma
Lars Bjerrum
Source
Eur J Gen Pract. 2015 Jun;21(2):118-23
Date
Jun-2015
Language
English
Publication Type
Article
Keywords
Anti-Bacterial Agents - therapeutic use
Argentina
Cross-Sectional Studies
Denmark
Female
Humans
Inappropriate Prescribing - statistics & numerical data
Lithuania
Male
Otitis Media - drug therapy
Patient Acceptance of Health Care - statistics & numerical data
Pharyngitis - drug therapy
Primary Health Care - statistics & numerical data
Respiratory Tract Infections - drug therapy
Russia
Sex Factors
Spain
Sweden
Tonsillitis - drug therapy
Abstract
Unnecessary prescribing of antibiotics is a major public health concern. General practitioners (GPs) prescribe most antibiotics, often for upper respiratory tract infections (URTIs), and have in general been shown to prescribe antibiotics more often to women. No studies have examined the influence of patient gender on unnecessary antibiotic prescribing.
To study a possible gender difference in unnecessary antibiotic prescriptions for URTIs in general practice; to assess whether a possible difference is explained by patient demand for antibiotics.
Post-hoc analysis of a cross-sectional study including 15,022 patients with URTI (acute rhinitis, acute otitis media, acute sinusitis, acute pharyngotonsillitis) from Argentina, Denmark, Lithuania, Russia, Spain and Sweden (HAPPY AUDIT Project). The association between gender and unnecessary antibiotic prescriptions, unadjusted and adjusted for treatment demand, was analysed using logistic regression models.
A total of 25% of patients with URTI received antibiotics; in 45% of the cases, antibiotics were unnecessary. Overall, no gender difference for unnecessary prescribing of antibiotics for URTIs was found. Women with acute otitis media received an unnecessary antibiotic twice as often as men (14.4% versus 7.1%). In Danish patients with acute pharyngotonsillitis, there was a gender difference in unnecessary prescriptions for antibiotics (women 29.1% versus men 48.6%). Some 14% of patients receiving unnecessary antibiotics demonstrated a demand for antibiotics, but no gender difference was found in this group.
This study indicated a high rate of unnecessary antibiotic prescribing for URTIs in general practice, but overall found no gender differences in receiving unnecessary antibiotic prescriptions.
PubMed ID
25712495 View in PubMed
Less detail

International variation in anesthesia care during cataract surgery: results from the International Cataract Surgery Outcomes Study.

https://arctichealth.org/en/permalink/ahliterature207513
Source
Arch Ophthalmol. 1997 Oct;115(10):1304-8
Publication Type
Article
Date
Oct-1997
Author
J C Nørregaard
O D Schein
L. Bellan
C. Black
J. Alonso
P. Bernth-Petersen
E. Dunn
T F Andersen
M. Espallargues
G F Anderson
Author Affiliation
Institute of Public Health, Faculty of Health Sciences, University of Copenhagen, Denmark.
Source
Arch Ophthalmol. 1997 Oct;115(10):1304-8
Date
Oct-1997
Language
English
Publication Type
Article
Keywords
Anesthesia - economics - methods - standards
Canada
Cataract Extraction
Cost-Benefit Analysis
Denmark
Humans
Interprofessional Relations
Monitoring, Intraoperative - methods - standards
Physician's Practice Patterns
Questionnaires
Random Allocation
Retrospective Studies
Spain
Treatment Outcome
United States
Abstract
To describe international variation in anesthesia care and monitoring during cataract surgery and to discuss its implications for cost and safety.
A standardized questionnaire was sent to random samples of ophthalmologists in the United States, Canada, and Barcelona, Spain, and to all ophthalmologists in Denmark. The survey was conducted in 1993 and 1994. Certified ophthalmologists who had performed 1 or more cataract extractions in the previous year were eligible for enrollment.
The response rates were 62% in the United States (n=148), 67% in Canada (n=276), 70% in Barcelona (n=89), and 80% in Denmark (n=82). The anesthetic technique for cataract surgery varied significantly between sites (P
PubMed ID
9338678 View in PubMed
Less detail

International variation in ophthalmologic management of patients with cataracts. Results from the International Cataract Surgery Outcomes Study.

https://arctichealth.org/en/permalink/ahliterature72764
Source
Arch Ophthalmol. 1997 Mar;115(3):399-403
Publication Type
Article
Date
Mar-1997
Author
J C Norregaard
O D Schein
G F Anderson
J. Alonso
E. Dunn
C. Black
T F Andersen
P. Bernth-Petersen
L. Bellan
M. Espallargues
Author Affiliation
Department of Social Medicine, Faculty of Health Sciences, University of Copenhagen, Denmark.
Source
Arch Ophthalmol. 1997 Mar;115(3):399-403
Date
Mar-1997
Language
English
Publication Type
Article
Keywords
Adult
Canada
Cataract - complications - therapy
Cataract Extraction - methods - statistics & numerical data
Comparative Study
Denmark
Female
Humans
Male
Middle Aged
Ophthalmology - statistics & numerical data - trends
Physician's Practice Patterns - statistics & numerical data - trends
Questionnaires
Random Allocation
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
Spain
Treatment Outcome
United States
World Health
Abstract
OBJECTIVES: To describe international variation in the management of patients with cataacts in 4 health care systems and to discuss the potential implications for cost and utilization of services. DESIGN: To characterize current clinical practice on patients with no coexisting medical or ocular conditions, a standardized questionnaire was sent to random samples of ophthalmologists in the United States (response rate, 82.5%), Canada (66.9%), and Barcelona, Spain (70.4%), and to all ophthalmologists in Denmark (80.1%). From the United States, 526 ophthalmologists who performed cataract surgery participated in the study; there were 276 from Canada, 89 from Barcelona, and 82 from Denmark. RESULTS: Although in all 4 sites most surgeons reported that they performed A-scanning, fundus examination, and refraction routinely before surgery, significant crossnational variation was observed in preoperative ophthalmic and medical testing. While preoperative medical tests were virtually unused in Denmark, they were widely used in the other sites. A significantly higher proportion of the surgeons in the United States and Barcelona reported that they performed less than 100 extractions per year compared with surgeons in Canada and Denmark (P
PubMed ID
9076214 View in PubMed
Less detail

Marked differences in GPs' diagnosis of pneumonia between Denmark and Spain: a cross-sectional study.

https://arctichealth.org/en/permalink/ahliterature106085
Source
Prim Care Respir J. 2013 Dec;22(4):454-8
Publication Type
Article
Date
Dec-2013
Author
Sarah Friis Christensen
Lars Christian Jørgensen
Gloria Cordoba
Carl Llor
Volkert Siersma
Lars Bjerrum
Author Affiliation
Section of General Practice and Research Unit for General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
Source
Prim Care Respir J. 2013 Dec;22(4):454-8
Date
Dec-2013
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Anti-Bacterial Agents - therapeutic use
Bronchitis - diagnosis - drug therapy - epidemiology
C-Reactive Protein - analysis
Cross-Sectional Studies
Denmark - epidemiology
Diagnosis, Differential
Dyspnea - epidemiology
Female
Fever - epidemiology
General practice
Humans
Lung - radiography
Male
Middle Aged
Physician's Practice Patterns - statistics & numerical data
Pneumonia - diagnosis - drug therapy - epidemiology
Prevalence
Respiratory Tract Infections - diagnosis - drug therapy - epidemiology
Spain - epidemiology
Young Adult
Abstract
In patients with lower respiratory tract infections (LRTIs) it is a challenge to identify who should be treated with antibiotics. According to international guidelines, antibiotics should be prescribed to patients with suspected pneumonia while acute bronchitis is considered a viral infection and should, generally, not be treated with antibiotics. Overdiagnosis of pneumonia in patients with LRTIs may lead to antibiotic overprescribing.
To investigate the prevalence of presumed pneumonia in patients with LRTI in two countries with different antibiotic prescribing rates (Denmark and Spain) and to compare which symptoms and clinical tests are of most importance for the GP when choosing a diagnosis of pneumonia rather than acute bronchitis.
A cross-sectional study including GPs from Denmark and Spain was conducted as part of the EU-funded project HAPPY AUDIT. A total of 2,698 patients with LRTI were included.
In Denmark, 47% of the patients with LRTI were classified with a diagnosis of pneumonia compared with 11% in Spain. In Spain, fever and a positive x-ray weighted significantly more in the diagnosis of pneumonia than in Denmark. Danish GPs, however, attached more importance to dyspnoea/polypnoea and C-reactive protein levels >50mg/L. None of the other typical symptoms of pneumonia had a significant influence.
Our results indicate that GPs' diagnostic criteria for pneumonia differ substantially between Denmark and Spain. The high prevalence of pneumonia among Danish patients with LRTI may indicate overdiagnosis of pneumonia which, in turn, may lead to antibiotic overprescribing.
Notes
Comment In: Prim Care Respir J. 2013 Dec;22(4):387-824301858
Comment In: Prim Care Respir J. 2013 Dec;22(4):383-524270365
PubMed ID
24248329 View in PubMed
Less detail

Patients' acceptance of waiting for cataract surgery: what makes a wait too long?

https://arctichealth.org/en/permalink/ahliterature51028
Source
Soc Sci Med. 1997 Jun;44(11):1603-10
Publication Type
Article
Date
Jun-1997
Author
E. Dunn
C. Black
J. Alonso
J C Norregaard
G F Anderson
Author Affiliation
Health Sciences Clinical Research Centre, Faculty of Medicine, University of Manitoba, Winnipeg, Canada.
Source
Soc Sci Med. 1997 Jun;44(11):1603-10
Date
Jun-1997
Language
English
Publication Type
Article
Keywords
Aged
Cataract Extraction - psychology
Comparative Study
Denmark
Female
Humans
Logistic Models
Male
Manitoba
National Health Programs
Patient Acceptance of Health Care
Predictive value of tests
Prospective Studies
Questionnaires
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
Spain
Time Factors
Visual acuity
Waiting Lists
Abstract
The patient's perspective about waiting for elective surgery is an important consideration in the management of waiting lists, yet it has received little attention to date. This study was undertaken to assess the acceptability of personal waiting times from the perspective of patients, and to examine waiting time and patient characteristics associated with the perception that a wait for cataract surgery is too long. The international prospective study was conducted in three sites with explicit waiting systems: Manitoba, Canada; Denmark; and Barcelona, Spain. Patients over the age of 50 years were recruited consecutively from ophthalmologists' practices at the time of their enlistment for first-eye cataract surgery. Anticipated waiting time, opinions about personal waiting time, and patients' visual and health characteristics were identified by means of telephone interviews. The 550 patients interviewed at the time of enlistment for surgery anticipated waits varying from
PubMed ID
9178406 View in PubMed
Less detail

The quality of outpatient antimicrobial prescribing: a comparison between two areas of northern and southern Europe.

https://arctichealth.org/en/permalink/ahliterature257135
Source
Eur J Clin Pharmacol. 2014 Mar;70(3):347-53
Publication Type
Article
Date
Mar-2014
Author
Sara Malo
Lars Bjerrum
Cristina Feja
María Jesús Lallana
José María Abad
María José Rabanaque-Hernández
Author Affiliation
Departamento de Medicina Preventiva y Salud Pública, Universidad de Zaragoza, Domingo Miral s/n, 50009, Zaragoza, Spain.
Source
Eur J Clin Pharmacol. 2014 Mar;70(3):347-53
Date
Mar-2014
Language
English
Publication Type
Article
Keywords
Ambulatory Care - standards
Anti-Bacterial Agents - therapeutic use
Denmark
Guideline Adherence
Humans
Inappropriate Prescribing - statistics & numerical data
Outpatients
Penicillins - therapeutic use
Physician's Practice Patterns - standards
Practice Guidelines as Topic
Quality Indicators, Health Care
Seasons
Spain
Abstract
The aim of the study was to analyse and compare the quality of outpatient antimicrobial prescribing in Denmark and Aragón (in northeastern Spain), with the objective of assessing inappropriate prescribing.
Outpatient antimicrobial prescription data were obtained from the National Institute for Health Data and Disease Control in Denmark, and from the Aragón Information System of Drug Consumption. The number of Defined Daily Doses (DDD) of the different substances were calculated, and the quality of the antimicrobial prescription was analysed using the 'Drug Utilization 90 %' method and the European Surveillance of Antimicrobial Consumption (ESAC) quality indicators for outpatient antimicrobial use.
The majority of the prescriptions (90 % of total DDD) were comprised of 14 (of 39) different antimicrobials in Denmark, based mainly on narrow spectrum penicillin, and 11 (of 59) antimicrobials in Aragón, principally broad spectrum penicillins. The quality indicators described an elevated consumption of antimicrobials and an important seasonal variation in Aragón. In Denmark, the values obtained reflected a more moderate use with minor seasonal variation.
The results showed important differences between the two study areas in relation to quantity and quality of outpatient antimicrobial prescription. The data indicate an overuse (and/or misuse) of antimicrobials in the Spanish region, despite national and local guidelines. The pattern of prescription in Denmark reflects a better adherence to recommendations.
PubMed ID
24322966 View in PubMed
Less detail

Respiratory tract infections in general practice: considerable differences in prescribing habits between general practitioners in Denmark and Spain.

https://arctichealth.org/en/permalink/ahliterature182290
Source
Eur J Clin Pharmacol. 2004 Mar;60(1):23-8
Publication Type
Article
Date
Mar-2004
Author
Lars Bjerrum
Albert Boada
Josep M Cots
Carlos Llor
Dolors Forés Garcia
Bente Gahrn-Hansen
Anders Munck
Author Affiliation
Research Unit of General Practice, University of Southern Denmark, Winsløwsparken 19, 3rd floor, 5000 Odense C, Denmark. lbjerrum@health.sdu.dk
Source
Eur J Clin Pharmacol. 2004 Mar;60(1):23-8
Date
Mar-2004
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Anti-Bacterial Agents - adverse effects - therapeutic use
Denmark
Drug Prescriptions - statistics & numerical data
Drug Resistance, Microbial
Drug Utilization - trends
Family Practice - trends
Female
Humans
Male
Middle Aged
Pharmacoepidemiology - methods - statistics & numerical data
Physician's Practice Patterns - trends
Respiratory Tract Infections - diagnosis - drug therapy - epidemiology
Spain
Time Factors
Abstract
The prevalence of antibiotic resistance in a country reflects the local consumption of antibiotics. The majority of antibiotics are prescribed in general practice and most prescriptions are attributable to treatment of respiratory tract infections (RTIs). The aim of this study was to compare general practitioners' (GPs') prescribing of antibiotics for respiratory tract infections in a country with a high prevalence of antibiotic resistance (Spain) with a country with a low prevalence of antibiotic resistance (Denmark).
A group of GPs in Copenhagen and Barcelona registered all contacts ( n=2833) with patients with RTIs during a 3-week period between 1 November 2001 and 31 January 2002.
Overall, Spanish GPs treated a higher proportion of patients than Danish GPs. After adjusting for unequal distribution of age and sex, we found that Spanish GPs prescribed significantly more antibiotics to patients with focus of infection in tonsils and bronchi/lungs. Narrow-spectrum penicillin was the most used antibiotic in Denmark, representing 58% of all prescriptions issued, followed by macrolide and broad-spectrum penicillin. In Spain, prescriptions were distributed among a great number of compounds, with broad-spectrum penicillins and combinations of amoxicillin plus beta-lactamase inhibitors most frequently used.
The substantial difference in the way GPs manage respiratory tract infections in Denmark and Spain cannot be explained by different patterns of RTIs in general practice. The discrepancies indicate variations in national recommendations, different treatment traditions or different impact of pharmaceutical marketing.
PubMed ID
14689127 View in PubMed
Less detail

12 records – page 1 of 2.