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Holmberg, H., Glader, E.-L., Näslund, U., Carlberg, B., Sönnerstam, E., Norberg, M. & Själander, A. (2024). Improved adherence to statin treatment and differences in results between men and women after pictorial risk communication: a sub-study of the VIPVIZA RCT. European Journal of Clinical Pharmacology, 80(8), 1209-1218
Open this publication in new window or tab >>Improved adherence to statin treatment and differences in results between men and women after pictorial risk communication: a sub-study of the VIPVIZA RCT
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2024 (English)In: European Journal of Clinical Pharmacology, ISSN 0031-6970, E-ISSN 1432-1041, Vol. 80, no 8, p. 1209-1218Article in journal (Refereed) Published
Abstract [en]

Background: People with intermediate CVD risk constitute most of the population. Within this group, the proportion of events is lower compared to the high-risk group, but they contribute with the largest absolute number of events. Atherosclerosis is a dynamic process and progression can be slowed or even reversed with medication and lifestyle changes, but adherence to prescribed treatment is crucial.

Aim: To investigate the long-term effects of interventions with pictorial risk communication of cardiovascular (CVD) risk on average adherence in a group of statin users. Compare response in adherence over time between men and women after intervention.

Methods: Participants on active statin treatment were followed up to 5 years after being randomly assigned to an intervention program aimed at raising CVD risk awareness among participants and their physicians. Merging prescribed medication databases with VIPVIZA study to study adherence over time. A moving average adherence was used to compare groups.

Results: Generally, the average adherence to statins among the 512 participants was high. Men had a higher average adherence over time, while women had a sharper increase in adherence in conjuncture with the intervention program.

Conclusions: Both men and women were receptive to pictorial information regarding CVD risk, but the intervention effect was more pronounced in women. Sex differences are important when considering risk communication strategies. Periodically repeating the intervention was beneficial for maintaining the intervention effect over time.

Place, publisher, year, edition, pages
Springer, 2024
Keywords
Atherosclerosis, Cardiovascular disease prevention, Cardiovascular risk, Pictorial information, Statin initiation, Statins
National Category
Public Health, Global Health and Social Medicine Cardiology and Cardiovascular Disease
Identifiers
urn:nbn:se:umu:diva-224129 (URN)10.1007/s00228-024-03694-6 (DOI)001209527900001 ()38684558 (PubMedID)2-s2.0-85191700644 (Scopus ID)
Funder
Region Västerbotten, ALFVLL-298001Region Västerbotten, ALFVLL-643391Swedish Research Council, 521-2013-2708Swedish Research Council, 2016-01891Swedish Heart Lung Foundation, 20150369Swedish Heart Lung Foundation, 20170481Swedish Society of MedicineNorrländska HjärtfondenThe Swedish Stroke AssociationSwedish Social Insurance AgencyVisare NorrThe Swedish Heart and Lung Association
Available from: 2024-05-14 Created: 2024-05-14 Last updated: 2025-02-20Bibliographically approved
Krachler, B., Söderholm, A., Ekman, F., Lindberg, F., Lindbäck, J., Nilsson Sommar, J., . . . Lindahl, B. (2024). Intensive lifestyle intervention for cardiometabolic prevention implemented in healthcare: higher risk predicts premature dropout. American Journal of Lifestyle Medicine
Open this publication in new window or tab >>Intensive lifestyle intervention for cardiometabolic prevention implemented in healthcare: higher risk predicts premature dropout
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2024 (English)In: American Journal of Lifestyle Medicine, ISSN 1559-8276, E-ISSN 1559-8284Article in journal (Refereed) Epub ahead of print
Abstract [en]

Aims: Patient characteristics and treatment setting are potential predictors of premature dropout from lifestyle interventions, but their relative importance is unknown.

Methods: From the quality registry of the unit for behavioral medicine, Umeå University hospital, we identified 2589 patients who had been enrolled in a multimodal lifestyle intervention for cardiometabolic risk reduction between 2006 and 2015. Baseline characteristics predicting dropout before 1-year follow-up were selected by a stepwise logistic regression algorithm.

Results: Better physical health and older age predicted full participation, with odds ratios for premature dropout (ORs) of.44 (95% confidence interval (CI).31-.63), and.47 (95% CI.34-.65) in the highest compared to the lowest quartile, respectively. Odds of premature dropout were also lower among female participants,.71 (95% CI.58-.89). Premature dropout was predicted by higher BMI, snuffing tobacco, and smoking, with ORs of 1.53 (95% CI 1.13-2.08) in the highest compared to the lowest quartile of BMI, 1.37 (95% CI 1.03-1.81) comparing snuff user with non-users and 2.53 (95% CI 1.79-3.61) comparing smokers with non-smokers. Odds ratio for premature dropout among inpatients compared with outpatients was.84 (95% CI.68-1.04).

Conclusion: Higher risk at baseline predicts premature dropout.

Place, publisher, year, edition, pages
Sage Publications, 2024
Keywords
early medical intervention, health behavior, lifestyle risk reduction, preventive health programs, primary prevention, treatment adherence
National Category
General Practice
Identifiers
urn:nbn:se:umu:diva-227327 (URN)10.1177/15598276241259961 (DOI)001281773600001 ()2-s2.0-85196478353 (Scopus ID)
Funder
Umeå University
Available from: 2024-07-02 Created: 2024-07-02 Last updated: 2025-04-24
Sjölander, M., Gustafsson, M., Holmberg, H. & Glader, E.-L. (2024). Longitudinal changes in self-reported medication adherence and beliefs about post-stroke medicines in Sweden: a repeated cross-sectional study. BMJ Open, 14(10), Article ID e084680.
Open this publication in new window or tab >>Longitudinal changes in self-reported medication adherence and beliefs about post-stroke medicines in Sweden: a repeated cross-sectional study
2024 (English)In: BMJ Open, E-ISSN 2044-6055, Vol. 14, no 10, article id e084680Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: To explore changes in beliefs about medicines and self-reported medication non-adherence between 3 and 24 months after stroke and to investigate associations between beliefs about medicines and non-adherence at 24 months after stroke. DESIGN: Longitudinal questionnaire survey. SETTING: Patients treated for acute stroke in 25 Swedish hospitals. PARTICIPANTS: Only patients living at home were included. Of the 594 individuals who answered the 3 month questionnaire, 401 were included at 24 months; among the remainder, 34 (5.7%) had died, 149 (25,1%) did not respond or had incomplete information on adherence and 10 (1.7%) were not living at home. MEASURES: The primary outcome was self-reported medication adherence as measured with the Medication Adherence Report Scale (MARS). The Beliefs about Medicines Questionnaires (BMQ) was used to assess personal beliefs about medicines. Background and clinical data were included from the Swedish national stroke register. RESULTS: According to dichotomised MARS sum scores, more individuals were classified as non-adherent at 24 months after stroke (n=63, 15.7%) than at 3 months after stroke (n=45, 11.2%) (p=0.030). For BMQ, the only difference over time was an increase in the Necessity subscale (p=0.007). At 24 months, in comparison to adherent patients, non-adherent patients scored statistically significant higher on negative beliefs about medicines, such as Concern (OR 1.17, 95% CI: 1.09 to 1.25), Overuse (OR: 1.37, 95% CI: 1.21 to 1.54) and Harm (OR: 1.24, 95% CI: 1.11 to 1.39), and lower on positive beliefs about medicines, namely, Necessity (OR: 0.88, 95% CI: 0.80 to 0.96) and Benefit (OR: 0.85, 95% CI: 0.74 to 0.98). CONCLUSIONS: Stroke patients' beliefs about medicines were associated with adherence, and over time beliefs remained stable across all domains, except for an increased perception of medications as being necessary. Despite this, more patients became non-adherent over time. To counteract non-adherence, interventions targeted to improve intentional adherence as well as non-intentional adherence should be investigated and implemented.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2024
Keywords
Behavior, CLINICAL PHARMACOLOGY, PREVENTIVE MEDICINE, Stroke medicine
National Category
Social and Clinical Pharmacy
Identifiers
urn:nbn:se:umu:diva-232398 (URN)10.1136/bmjopen-2024-084680 (DOI)001337368000001 ()39424386 (PubMedID)2-s2.0-85206833066 (Scopus ID)
Funder
Västerbotten County Council
Available from: 2024-11-28 Created: 2024-11-28 Last updated: 2024-11-28Bibliographically approved
Lindmark, A., von Euler, M., Glader, E.-L., Sunnerhagen, K. S. & Eriksson, M. (2024). Socioeconomic differences in patient reported outcome measures 3 months after stroke: a nationwide Swedish register-based study. Stroke, 55(8), 2055-2065
Open this publication in new window or tab >>Socioeconomic differences in patient reported outcome measures 3 months after stroke: a nationwide Swedish register-based study
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2024 (English)In: Stroke, ISSN 0039-2499, E-ISSN 1524-4628, Vol. 55, no 8, p. 2055-2065Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: There is a well-known association between low socioeconomic status (SES), poor survival, and clinician-reported outcomes after stroke. We aimed to assess socioeconomic differences in Patient Reported Outcome Measures 3 months after stroke.

METHODS: This nationwide cohort study included patients registered with acute stroke in the Swedish Stroke Register 2015-2017. Patient Reported Outcome Measures included activities of daily living (mobility, toileting, and dressing), and poststroke symptoms (low mood, fatigue, pain, and poor general health). Information on SES prestroke was retrieved from Statistics Sweden and defined by a composite measure based on education and income tertiles. Associations between SES and Patient Reported Outcome Measures were analyzed using logistic regression adjusting for confounders (sex and age) and additionally for potential mediators (stroke type, severity, cardiovascular disease risk factors, and living alone). Subgroup analyses were performed for stroke type, men and women, and younger and older patients.

RESULTS: The study included 44 511 patients. Of these, 31.1% required assistance with mobility, 18% with toileting, and 22.2% with dressing 3 months after stroke. For poststroke symptoms, 12.3% reported low mood, 39.1% fatigue, and 22.7% pain often/constantly, while 21.4% rated their general health as poor/very poor. Adjusted for confounders, the odds of needing assistance with activities of daily living were highest for patients with low income and primary school education, for example, for mobility, odds ratio was 2.06 (95% CI, 1.89-2.24) compared with patients with high income and university education. For poststroke symptoms, odds of poor outcome were highest for patients with low income and university education (eg, odds ratio, 1.79 [95% CI, 1.49-2.15] for low mood). Adjustments for potential mediators attenuated but did not remove associations. The associations were similar in ischemic and hemorrhagic strokes and more pronounced in men and patients <65 years old.

CONCLUSIONS: There are substantial SES-related differences in Patient Reported Outcome Measures poststroke. The more severe outcome associated with low SES is more pronounced in men and in patients of working age.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2024
Keywords
Patient Reported Outcome Measures, activities of daily living, health status, low socioeconomic status, stroke
National Category
Public Health, Global Health and Social Medicine Neurology
Identifiers
urn:nbn:se:umu:diva-227614 (URN)10.1161/STROKEAHA.124.047172 (DOI)001272487000011 ()38946533 (PubMedID)2-s2.0-85199283597 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2018-00852Swedish Research Council, 2018-02670
Available from: 2024-07-01 Created: 2024-07-01 Last updated: 2025-04-24Bibliographically approved
Lillqvist, J., Nilsson Sommar, J., Gustafsson, P. E., Glader, E.-L., Hamberg, K. & Rolandsson, O. (2023). Are doctors using more preventive medication for cardiovascular disease?: A Swedish cross-sectional study. Scandinavian Journal of Primary Health Care, 41(3), 297-305
Open this publication in new window or tab >>Are doctors using more preventive medication for cardiovascular disease?: A Swedish cross-sectional study
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2023 (English)In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 41, no 3, p. 297-305Article in journal (Refereed) Published
Abstract [en]

Background: Despite decreasing mortality from cardiovascular disease (CVD), there are persistent inequities in mortality between socioeconomic groups. Primary preventative medications reduce mortality in CVD; thus, inequitable treatments will contribute to unequal outcomes. Physicians might contribute to inequality by prescribing preventative medication for CVD to themselves in a biased manner.

Aim: To determine whether primary medications for preventing CVD were prescribed inequitably between physicians and non-physicians.

Design and setting: This retrospective study retrieved registry data on prescribed medications for all physicians in Sweden aged 45–74 years, during 2013, and for reference non-physician individuals, matched by sex, age, residence, and level of education. The outcome was any medication for preventing CVD, received at least once during 2013.

Method: Age and the sex-specific prevalence of myocardial infarction (MI) among physicians and non-physicians were used as a proxy for the need for medication. Thereafter, to limit the analysis to preventative medication, we excluded individuals that were diagnosed with CVD or diabetes. To analyse differences in medication usage between physicians and matched non-physicians, we estimated odds ratios (ORs) with conditional logistic regression and adjusted for need and household income.

Results: MI prevalences were 5.7% for men and 2.3% for women, among physicians, and 5.4% for men and 1.8% for women, among non-physicians. We included 25,105 physicians and 44,366 non-physicians. The OR for physicians receiving any CVD preventative medication, compared to non-physicians, was 1.65 (95% confidence interval 1.59–1.72).

Conclusion: We found an inequity in prescribed preventative CVD medications, which favoured physicians over non-physicians.

Place, publisher, year, edition, pages
Taylor & Francis, 2023
Keywords
cardiovascular disease, epidemiology, Healthcare inequities, pharmacoepidemiology, prevention
National Category
Public Health, Global Health and Social Medicine
Identifiers
urn:nbn:se:umu:diva-212491 (URN)10.1080/02813432.2023.2234439 (DOI)001029892800001 ()37467115 (PubMedID)2-s2.0-85165481697 (Scopus ID)
Funder
Västerbotten County Council
Available from: 2023-08-01 Created: 2023-08-01 Last updated: 2025-02-20Bibliographically approved
Kindstedt, J., Andersson, P., Westberg, A., Glader, E.-L., Lövheim, H. & Gustafsson, M. (2023). Exploring medication-related hospital admissions and their association with cognitive impairment among acutely admitted older people. Research in Social and Administrative Pharmacy, 19(7), 1048-1053
Open this publication in new window or tab >>Exploring medication-related hospital admissions and their association with cognitive impairment among acutely admitted older people
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2023 (English)In: Research in Social and Administrative Pharmacy, ISSN 1551-7411, E-ISSN 1934-8150, Vol. 19, no 7, p. 1048-1053Article in journal (Refereed) Published
Abstract [en]

Introduction: Medication-related hospital admissions (MRAs) are common among older people. Persons with cognitive impairment are especially vulnerable to adverse drug effects. At the same time, increased home health care and social support could theoretically prevent medication-related problems. This study aims to estimate the proportion of MRAs and explore their relationship with cognitive impairment in a population of acutely admitted older people.

Methods: This cross-sectional study comprised 300 individuals aged 75 years or older admitted to an acute medical ward. Two assessors identified possibly MRAs using the Assessment Tool for Hospital Admissions Related to Medications 10 (AT-HARM10). Screening for cognitive impairment was performed during ward stay using a 4-item test related to time orientation. Prevalence odds ratios between cognitive test scores and MRAs were analysed through logistic regression.

Results: Using AT-HARM10, 108 out of 300 admissions (36%) were classified as possibly MRAs by both assessors. Moreover, MRAs were least common among patients with the lowest cognitive test scores. There was an association regarding MRAs when the lowest test score was treated as a cut-off and compared against a reference category comprising all other scores (OR, 0.31 [95% CI 0.10–0.93]; p = 0.037) in a logistic regression model adjusted for cohabitation and home health care.

Conclusion: Approximately one-third of the hospital admissions among acutely admitted older people were considered at least possibly medication-related. Hence, there is still a great need to manage medication-related problems and reduce MRAs in this vulnerable population. Using a 4-item instrument to screen for cognitive impairment, there was a negative association between MRA and lowest cognitive test score. Further exploration of the relationship between MRAs and cognitive impairment may indicate appropriate components and target populations for interventions that aims to reduce the risk of MRA.

Place, publisher, year, edition, pages
Elsevier, 2023
Keywords
Cognitive impairment, Hospital admissions, Medication-related problems, Older people
National Category
Public Health, Global Health and Social Medicine Geriatrics
Identifiers
urn:nbn:se:umu:diva-207881 (URN)10.1016/j.sapharm.2023.04.117 (DOI)001001988900001 ()37105774 (PubMedID)2-s2.0-85153801441 (Scopus ID)
Funder
Swedish Research Council, 2019-01078Forte, Swedish Research Council for Health, Working Life and Welfare, 2017-01438Region Västerbotten
Available from: 2023-05-09 Created: 2023-05-09 Last updated: 2025-02-20Bibliographically approved
Kindstedt, J., Glader, E.-L., Lövheim, H., Lindkvist, M. & Gustafsson, M. (2023). The impact of nursing home residency on psychotropic drug use in major neurocognitive disorder: a nationwide comparison. International Journal of Geriatric Psychiatry, 38(11), Article ID e6018.
Open this publication in new window or tab >>The impact of nursing home residency on psychotropic drug use in major neurocognitive disorder: a nationwide comparison
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2023 (English)In: International Journal of Geriatric Psychiatry, ISSN 0885-6230, E-ISSN 1099-1166, Vol. 38, no 11, article id e6018Article in journal (Refereed) Published
Abstract [en]

Introduction: Psychotropic drugs are utilized against neuropsychiatric symptoms among people with major neurocognitive disorder (NCD) despite well-documented risks, and older people in nursing homes are expected to be more frequently exposed to those medicines. This study compared psychotropic drug use and associated factors between older people with major NCD and matched references.

Methods: This cross-sectional study included individuals from three national registries in Sweden. References were randomly matched 1:1 by age and sex from the Swedish Total Population Register. Drug use was defined as at least one prescription fill from 1 July to 31 December 2019 and presented as proportion of drug users. In addition, ORs regarding psychotropic drug use and associated factors use were analysed using generalized estimating equations.

Results: There were 102,419 complete matching pairs alive on 31 December 2019. The proportions of psychotropic drug users were 59% in the population of people with major NCD and 28% in the reference group. Moreover, there was a substantial number of individuals in nursing homes who had been treated with antipsychotics but who, for unknown reasons, had not been diagnosed with major NCD. Psychotropic drug use was positively associated with both major NCD and nursing home residency. The difference in drug use in relation to major NCD was more pronounced among people living in ordinary homes.

Conclusion: Despite well-documented risks in people with cognitive impairment, psychotropic drug use was overall high and positively associated with both major NCD and nursing home residency. Taken together, interventions to better target neuropsychiatric symptoms in older people are warranted. Hypnotic drug use among older people in general as well as antipsychotic drug exposure among older people in nursing homes appear to be two important focus areas.

Place, publisher, year, edition, pages
John Wiley & Sons, 2023
Keywords
major neurocognitive disorder, nursing home, older people, psychotropic drugs
National Category
Public Health, Global Health and Social Medicine
Identifiers
urn:nbn:se:umu:diva-216677 (URN)10.1002/gps.6018 (DOI)001094169200001 ()37909144 (PubMedID)2-s2.0-85175678118 (Scopus ID)
Available from: 2023-11-22 Created: 2023-11-22 Last updated: 2025-04-24Bibliographically approved
Westberg, A., Sjölander, M., Glader, E.-L. & Gustafsson, M. (2022). Primary Non-Adherence to Preventive Drugs and Associations with Beliefs About Medicines in Stroke Survivors. Patient Preference and Adherence, 16, 343-352
Open this publication in new window or tab >>Primary Non-Adherence to Preventive Drugs and Associations with Beliefs About Medicines in Stroke Survivors
2022 (English)In: Patient Preference and Adherence, E-ISSN 1177-889X, Vol. 16, p. 343-352Article in journal (Refereed) Published
Abstract [en]

Background: Medication non-adherence is a common problem in clinical practice. Little is known about stroke survivors’ primary non-adherence to preventive drugs, and we hypothesised that their beliefs about medicines are associated with primary non-adherence. The objective was to describe primary non-adherence among stroke survivors and to assess associations between primary non-adherence to preventive drugs and beliefs about medicines.

Methods: Questionnaires were sent to 797 individuals 3 months after stroke to assess beliefs about medicines through the Beliefs about Medicines Questionnaire (BMQ). All participants were registered in the Swedish Stroke Register (Riksstroke), and prescriptions for new preventive drugs during the hospital stay were identified through data from Riksstroke. Primary non-adherers were those who failed to fill one or more new prescriptions within 1 month of hospital discharge based on data from the Swedish Prescribed Drug Register. Differences between primary non-adherers and adherers were assessed by X2 tests and associations between the BMQ subscales and primary non-adherence were analysed using independent two-sample t-tests and multivariable logistic regression models.

Results: A total of 594 individuals responded to the survey, of which 452 received new prescriptions of preventive drugs. Overall, 53 (12%) participants were classified as primary non-adherent. Primary non-adherers were more often dependent on help or support from next of kin (p=0.032) and had difficulties with memory more often (p=0.002) than the primary adherent individuals. No statistically significant differences in BMQ subscale-scores were found between the two groups (p>0.05).

Conclusion: Primary non-adherence to preventive drugs was low, and no associations were found between primary non-adherence and beliefs about medicines. Associations with cognitive impairments such as difficulties with memory and need for help from next of kin suggest that more effort is needed to help stroke survivors to start important preventive drug treatments after discharge from hospital.

Place, publisher, year, edition, pages
Dove Medical Press, 2022
Keywords
beliefs about medicines, preventive drugs, primary non-adherence, stroke
National Category
Health Care Service and Management, Health Policy and Services and Health Economy Social and Clinical Pharmacy
Identifiers
urn:nbn:se:umu:diva-196170 (URN)10.2147/PPA.S351001 (DOI)000754223000004 ()35177898 (PubMedID)2-s2.0-85130860393 (Scopus ID)
Funder
Region Västerbotten
Available from: 2022-06-14 Created: 2022-06-14 Last updated: 2024-01-17Bibliographically approved
Norberg, H., Sjölander, M., Glader, E.-L. & Gustafsson, M. (2022). Self-reported medication adherence and pharmacy refill adherence among persons with ischemic stroke: a cross-sectional study. European Journal of Clinical Pharmacology, 78, 869-877
Open this publication in new window or tab >>Self-reported medication adherence and pharmacy refill adherence among persons with ischemic stroke: a cross-sectional study
2022 (English)In: European Journal of Clinical Pharmacology, ISSN 0031-6970, E-ISSN 1432-1041, Vol. 78, p. 869-877Article in journal (Refereed) Published
Abstract [en]

Purpose: To describe and compare self-reported medication adherence assessed with the 5-item version of Medication Adherence Report Scale (MARS-5) and pharmacy refill adherence based on data from the Swedish Prescribed Drug Register (SPDR) among persons with ischemic stroke, and to investigate independent predictors associated with respective assessments.

Methods: A study questionnaire was sent to persons with ischemic stroke registered in the Swedish Stroke Register between Dec 2011 and March 2012, and who lived at home 3 months after discharge. The primary outcome was dichotomized to adherent/non-adherent based on MARS-5 and SPDR and analyzed with multivariable logistic regression. Adherence according to MARS-5 was defined as score 23 or higher (out of 25). Adherence according to SPDR was defined as at least one filled statin prescription recorded in SPDR in each 6-month interval during 2 years of follow-up.

Results: Of 420 participants, 367 (87%) and 329 (78%) were adherent according to MARS-5 and SPDR, respectively, and 294 (70%) participants were adherent according to both assessments. A significant association was shown between medication adherence according to the two assessments (p = 0.020). Independent predictors associated with medication adherence according to MARS-5 were female sex, while factors associated with SPDR were male sex and being younger.

Conclusions: The majority of participants were classified as adherent, 87% according to MARS-5 and 78% based on data from SPDR. However, only 70% were adherent according to both MARS-5 and SPDR, and different predictors were associated with the different measurements, suggesting that these assessments are measuring different aspects of adherence.

Place, publisher, year, edition, pages
Springer Science+Business Media B.V., 2022
Keywords
Ischemic stroke, MARS-5, Medication adherence, Pharmacy refill adherence, Self-reported adherence, The Swedish Prescribed Drug Register
National Category
Social and Clinical Pharmacy
Identifiers
urn:nbn:se:umu:diva-192741 (URN)10.1007/s00228-022-03284-4 (DOI)000756114700002 ()35156130 (PubMedID)2-s2.0-85124771172 (Scopus ID)
Funder
Västerbotten County Council
Available from: 2022-02-24 Created: 2022-02-24 Last updated: 2023-09-05Bibliographically approved
Holmberg, H., Sjölander, M., Glader, E.-L., Näslund, U., Carlberg, B., Norberg, M. & Själander, A. (2022). Time to initiation of lipid-lowering drugs for subclinical atherosclerosis: sub-study of VIPVIZA randomized controlled trial, with single-arm cross-over. European Heart Journal Open, 2(1), Article ID oeac003.
Open this publication in new window or tab >>Time to initiation of lipid-lowering drugs for subclinical atherosclerosis: sub-study of VIPVIZA randomized controlled trial, with single-arm cross-over
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2022 (English)In: European Heart Journal Open, E-ISSN 2752-4191, Vol. 2, no 1, article id oeac003Article in journal (Refereed) Published
Abstract [en]

AIMS: Visual information about subclinical atherosclerosis was provided to physicians and participants in the VIPVIZA trial, inclusion 2013-16 in northern Sweden, aiming to improve adherence to cardiovascular disease (CVD) prevention guidelines. Pictorial risk information may be more actionable. The aim of this study was to investigate the effect of intervention with pictorial risk information on time to first dispensing of statins.

METHODS AND RESULTS: Asymptomatic atherosclerotic disease was screened for by carotid ultrasound examination in 3532 participants enrolled in VIPVIZA, of those 3000 met the criteria for this study. Participants were randomly assigned to receive pictorial risk information consisting of graphical representation of atherosclerosis as compared to a control group without intervention. Time to initiation of statins was assessed during 5 years of follow-up through the National prescribed drug register. After 3 years, both groups were re-examined and received the intervention information. In the intervention group, initiation of statins increased considerably for the first 3 years and a smaller increase was also seen after re-intervention. After the cross-over, the control group showed a sharp increase in initiation of statins, almost reaching the same proportion treated at 5 years. The propensity to initiate statin treatment increased over the study period and there was no difference between men and women.

CONCLUSIONS: The pictorial information had an effect on time to initiation of statins, both as original and repeated intervention and also in the control group after single-arm cross-over. The current study supports pictorial information as a tool to shorten time to initiation of statins for CVD prevention.

Place, publisher, year, edition, pages
Oxford University Press, 2022
Keywords
Atherosclerosis, Cardiovascular disease prevention, Cardiovascular risk, Statin initiation, Statins
National Category
Cardiology and Cardiovascular Disease
Research subject
cardiovascular disease
Identifiers
urn:nbn:se:umu:diva-201549 (URN)10.1093/ehjopen/oeac003 (DOI)35919662 (PubMedID)2-s2.0-85147266606 (Scopus ID)
Funder
Region Västerbotten, ALFVLL-298001Region Västerbotten, ALFVLL-643391Swedish Research Council, 521-2013-2708Swedish Research Council, 2016-01891Swedish Research Council, 2017-02246Swedish Heart Lung Foundation, 20150369Swedish Heart Lung Foundation, 20170481Visare Norr
Available from: 2022-12-07 Created: 2022-12-07 Last updated: 2025-02-10Bibliographically approved
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Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0003-4095-6501

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