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  • 1. Andersen, Toril
    et al.
    Bleher, Stefan
    Flaten, Goril Eide
    Tho, Ingunn
    Mattsson, Sofia
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Pharmacology.
    Skalko-Basnet, Natasa
    Chitosan in Mucoadhesive Drug Delivery: Focus on Local Vaginal Therapy2015In: Marine Drugs, ISSN 1660-3397, E-ISSN 1660-3397, Vol. 13, no 1, p. 222-236Article in journal (Refereed)
    Abstract [en]

    Mucoadhesive drug therapy destined for localized drug treatment is gaining increasing importance in today's drug development. Chitosan, due to its known biodegradability, bioadhesiveness and excellent safety profile offers means to improve mucosal drug therapy. We have used chitosan as mucoadhesive polymer to develop liposomes able to ensure prolonged residence time at vaginal site. Two types of mucoadhesive liposomes, namely the chitosan-coated liposomes and chitosan-containing liposomes, where chitosan is both embedded and surface-available, were made of soy phosphatidylcholine with entrapped fluorescence markers of two molecular weights, FITC-dextran 4000 and 20,000, respectively. Both liposomal types were characterized for their size distribution, zeta potential, entrapment efficiency and the in vitro release profile, and compared to plain liposomes. The proof of chitosan being both surface-available as well as embedded into the liposomes in the chitosan-containing liposomes was found. The capability of the surface-available chitosan to interact with the model porcine mucin was confirmed for both chitosan-containing and chitosan-coated liposomes implying potential mucoadhesive behavior. Chitosan-containing liposomes were shown to be superior in respect to the simplicity of preparation, FITC-dextran load, mucoadhesiveness and in vitro release and are expected to ensure prolonged residence time on the vaginal mucosa providing localized sustained release of entrapped model substances.

  • 2. Andersen, Toril
    et al.
    Mishchenko, Ekaterina
    Flaten, Gøril Eide
    Ericson Sollid, Johanna U.
    Mattsson, Sofia
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Pharmacology.
    Tho, Ingunn
    Škalko-Basnet, Nataša
    Chitosan-Based Nanomedicine to Fight Genital Candida Infections: Chitosomes2017In: Marine Drugs, ISSN 1660-3397, E-ISSN 1660-3397, Vol. 15, no 3, article id 64Article in journal (Refereed)
    Abstract [en]

    Vaginal infections are associated with high recurrence, which is often due to a lack of efficient treatment of complex vaginal infections comprised of several types of pathogens, especially fungi and bacteria. Chitosan, a mucoadhesive polymer with known antifungal effect, could offer a great improvement in vaginal therapy; the chitosan-based nanosystem could both provide antifungal effects and simultaneously deliver antibacterial drugs. We prepared chitosan-containing liposomes, chitosomes, where chitosan is both embedded in liposomes and surface-available as a coating layer. For antimicrobial activity, we entrapped metronidazole as a model drug. To prove that mucoadhesivness alone is not sufficient for successful delivery, we used Carbopol-containing liposomes as a control. All vesicles were characterized for their size, zeta potential, entrapment efficiency, and in vitro drug release. Chitosan-containing liposomes were able to assure the prolonged release of metronidazole. Their antifungal activity was evaluated in a C. albicans model; chitosan-containing liposomes exhibited a potent ability to inhibit the growth of C. albicans. The presence of chitosan was crucial for the system's antifungal activity. The antifungal efficacy of chitosomes combined with antibacterial potential of the entrapped metronidazole could offer improved efficacy in the treatment of mixed/complex vaginal infections.

  • 3. Andersen, Toril
    et al.
    Vanić, Zeljka
    Flaten, Gøril Eide
    Mattsson, Sofia
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Pharmacology.
    Tho, Ingunn
    Skalko-Basnet, Nataša
    Pectosomes and chitosomes as delivery systems for metronidazole: the one-pot preparation method2013In: Pharmaceutics, ISSN 1999-4923, E-ISSN 1999-4923, Vol. 5, no 3, p. 445-456Article in journal (Refereed)
    Abstract [en]

    Mucoadhesive liposomes offer a potential for improved residence time of liposomal systems targeting contact with mucosal tissues, such as in buccal, oral, colon, and vaginal drug delivery. Most of the currently available methods rely on the coating of preformed liposomes by various mucoadhesive polymers. The aim of this study was to develop novel mucoadhesive system by the one-pot preparation method. The pectin- and chitosan-containing liposomes, namely pectosomes and chitosomes, were prepared by the modified solvent injection method. In order to optimize this novel delivery system, we used pectins and chitosans of both high and low degree of esterification/deacetylation (DE/DD), respectively. Sonication was applied to reduce the original vesicle size. All vesicles were characterized for their size, zeta potential, metronidazole entrapment, and stability. Both pectosomes and chitosomes were found to entrap more metronidazole than conventional plain liposomes. Preliminary data indicate that the polymer is present on the liposomal surface, embedded within inner liposomal bilayers, and entrapped inside the aqueous compartment. The next step in the evaluation of this system is the testing of its mucoadhesiveness.

  • 4.
    Bredenberg, Susanne
    et al.
    Orexo AB, SE-75105 Uppsala, Sweden.
    Dahlgren, Anna
    Orexo AB, SE-75105 Uppsala, Sweden.
    Mattsson, Sofia
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Pharmacology.
    Evaluation of a sieve classification method for characterization of low-dose interactive mixtures2013In: Pharmaceutical development and technology (Print), ISSN 1083-7450, E-ISSN 1097-9867, Vol. 18, no 6, p. 1366-1371Article in journal (Refereed)
    Abstract [en]

    This study investigated a sieve classification method for evaluating carrier materials and particle size fractions, which could be a valuable tool in the early development of pharmaceutical dosage forms containing low-dose interactive mixtures. When developing new products based on interactive mixtures, it is essential to ensure that the drug particles are successfully deagglomerated and have adhered to the carrier particles. In this study, the effect on the demixing potential (DP) of low-dose interactive mixtures was assessed for various carrier particle sizes and surface textures. The model drug used was sodium salicylate and the tested carriers were lactose, mannitol, and isomalt. The results showed that the lowest DPs, i.e. the most mechanically stable mixtures, were obtained with lactose. Furthermore, for interactive mixtures, small carrier particles and/or a narrow carrier particle size range are essential for obtaining a low DP and high homogeneity. Calculation of the DP provided a reliable estimate of the quality of the low-dose interactive mixtures used in this study.

  • 5.
    Gabrielsson, Linda
    et al.
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Pharmacology.
    Mattsson, Sofia
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Pharmacology.
    Fowler, Christopher J.
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Pharmacology.
    Palmitoylethanolamide for the treatment of pain: pharmacokinetics, safety and efficacy2016In: British Journal of Clinical Pharmacology, ISSN 0306-5251, E-ISSN 1365-2125, Vol. 82, no 4, p. 932-942Article, review/survey (Refereed)
    Abstract [en]

    Palmitoylethanolamide (PEA) has been suggested to have useful analgesic properties and to be devoid of unwanted effects. Here, we have examined critically this contention, and discussed available data concerning the pharmacokinetics of PEA and its formulation. Sixteen clinical trials, six case reports/pilot studies and a meta-analysis of PEA as an analgesic have been published in the literature. For treatment times up to 49days, the current clinical data argue against serious adverse drug reactions (ADRs) at an incidence of 1/200 or greater. For treatment lasting more than 60days, the number of patients is insufficient to rule out a frequency of ADRs of less than 1/100. The six published randomized clinical trials are of variable quality. Presentation of data without information on data spread and nonreporting of data at times other than the final measurement were among issues that were identified. Further, there are no head-to-head clinical comparisons of unmicronized vs. micronized formulations of PEA, and so evidence for superiority of one formulation over the other is currently lacking. Nevertheless, the available clinical data support the contention that PEA has analgesic actions and motivate further study of this compound, particularly with respect to head-to-head comparisons of unmicronized vs. micronized formulations of PEA and comparisons with currently recommended treatments.

  • 6.
    Gustafsson, Maria
    et al.
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Pharmacology.
    Mattsson, Sofia
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Pharmacology.
    Gallego, Gisselle
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Pharmacology.
    Students' satisfaction with a web-based pharmacy program in a re-regulated pharmacy market2017In: Pharmacy, ISSN 2226-4787, E-ISSN 1913-4711, Vol. 5, no 3, article id E47Article in journal (Refereed)
    Abstract [en]

    In response to the shortage of pharmacists in Northern Sweden, a web-based Bachelor of Science in Pharmacy program was established at Umeå University in 2003. In 2009, the Swedish pharmacy market was re-regulated from a state monopoly to an open market, but it is unknown what impact this has had on education satisfaction. The objectives of this study were to examine the level of satisfaction among graduates from a web-based pharmacy program and to describe what subjects and skills students would have liked more or less of in their education. A secondary objective was to compare the level of satisfaction before and after the Swedish pharmacy market was re-regulated. A cross-sectional survey was conducted in 2015 with all alumni who had graduated from the pharmacy program between 2006 and 2014 (n = 511), and responses to questions about graduates' satisfaction with the program were analyzed (n = 200). Most graduates (88%) agreed or strongly agreed that the knowledge and skills acquired during their education were useful in their current job. The graduates stated that they would have wanted more applied pharmacy practice and self-care counselling, and fewer social pharmacy and histology courses. Further, 82% stated that they would start the same degree program if they were to choose again today, and 92% agreed or strongly agreed that they would recommend the program to a prospective student. Graduates were more likely to recommend the program after the re-regulation (p = 0.007). In conclusion, pharmacy graduates were very satisfied with their education, and no negative effects of the re-regulation could be observed on program satisfaction.

  • 7.
    Gustafsson, Maria
    et al.
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Pharmacology.
    Mattsson, Sofia
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Pharmacology.
    Wallman, Andy
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Pharmacology.
    Gallego, Gisselle
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Pharmacology. School of Medicine, The University of Notre Dame Australia, NSW, Australia.
    Pharmacists' satisfaction with their work: Analysis of an alumni survey2018In: Research in Social and Administrative Pharmacy, ISSN 1551-7411, E-ISSN 1934-8150, Vol. 14, no 7, p. 700-704Article in journal (Refereed)
    Abstract [en]

    Background: The level of job satisfaction among practicing pharmacists is important because it has been found to affect job performance and employee turnover. The Swedish pharmacy market has undergone major changes in recent years, and little is known about pharmacists' job satisfaction.

    Objectives: The objective of this study was to investigate the level of job satisfaction and associated factors among graduates from the web-based pharmacy programs at Umea University.

    Methods: Job satisfaction of pharmacists was measured as part of an alumni survey conducted with those who graduated from the pharmacy programmes between 2006 and 2014. Data analysis included descriptive statistics, and logistic regression was used to explore factors affecting job satisfaction.

    Results: The total number of graduates who completed the survey was 222 (response rate 43%.) The majority of respondents were female (95%), and most were employed at a community pharmacy (85%). The mean age was 39.7 years. The majority of graduates (91%) were satisfied with their job "most of the time" or "all of the time", and 87% of the respondents would "definitely" or "maybe" choose the same career again. The multivariate analysis showed that increasing years in the current position (OR: 0.672 (0.519-0.871)) was associated with lower job satisfaction. Older age (OR: 1.123 (1.022-1.234)), the perception that the knowledge and skills acquired during university education is useful in the current job (OR: 4.643 (1.255-17.182)) and access to continuing professional development (OR: 9.472 (1.965 -45.662)) were associated with higher job satisfaction.

    Conclusion: Most graduates from the web-based pharmacy programmes were satisfied with their current job. Access to continuing professional development seems to be important for the level of job satisfaction among pharmacists.

  • 8. Hagen, Eirik
    et al.
    Sandberg Loding, Fredrik
    Mattsson, Sofia
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Pharmacology.
    Tho, Ingunn
    Use of interactive mixtures to obtain mini-tablets with high dose homogeneity for paediatric drug delivery2016In: Journal of Drug Delivery Science and Technology, ISSN 1773-2247, Vol. 34, p. 51-59Article in journal (Refereed)
    Abstract [en]

    Mini-tablets are suitable for children since they are easy to swallow and offer dose flexibility by adjustment of the number of units. The main objective was to investigate the use of interactive mixtures as a means to obtain high dose homogeneity in mini-tablets. The effect of carrier particle properties, mixing time, mixing equipment and sample size on homogeneity was evaluated. Micronized sodium salicylate (1% w/w) was mixed with different size fractions of spray-dried and granulated mannitol. The degree of homogeneity was expressed as the relative standard deviation (RSD). Mini-tablets were prepared from the interactive mixtures and characterized with respect to uniformity of mass and content, dose homogeneity, tablet strength, wetting time and disintegration time. Generally, RSD decreased with increasing mixing times, and levelled out around 3-4%. The lowest RSD was achieved with carrier particles of intermediate sizes; 125-180 mu m, 180-250 mu m and 250-355 mu m. The tumbling mixer was considered to be more suitable than the planetary mixer and longer mixing times were required to reach high degree of homogeneity in the smaller sample size. Mini-tablets showed high dose homogeneity as well as appropriate tensile strength and disintegration time to be suitable as orally disintegrating mini-tablets for children.

  • 9.
    Mattsson, Sofia
    et al.
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience.
    Gustafsson, Maria
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience.
    Svahn, Sofia
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience.
    Norberg, Helena
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Gallego, Gisselle
    Who enrols and graduates from web-based pharmacy education: experiences from Northern Sweden2018In: Currents in pharmacy teaching and learning, ISSN 1877-1297, Vol. 10, no 8, p. 1004-1012Article in journal (Refereed)
    Abstract [en]

    Introduction: As a response to the shortage of prescriptionists in Northern Sweden, a web-based Bachelor of Science in Pharmacy program was introduced at Umea. University in 2003. This study explored who is likely to enrol and graduate from the web-based bachelor program and whether the program has addressed the shortage of prescriptionists in rural Northern Sweden.

    Methods: Data from three different sources were included in this study; the initial cohort including students admitted to the program in 2003 (survey), the entire cohort including all people admitted to the program between 2003 and 2014 (university's admissions data) and the alumni cohort including graduates who participated in an alumni survey in 2015.

    Results: A typical student of the web-based pharmacy program is female, over 30 years of age, married or in a de-facto relationship and has children. Furthermore, the students graduating before 2009 were more likely to live in Northern Sweden compared to those graduating later.

    Discussion and conclusion: The results indicate that the introduction of a web-based bachelor of pharmacy program at Umea. University was to some extent able to address the shortage of prescriptionists in Northern Sweden. Web-based education may potentially help address the maldistribution of health professionals by providing flexible education opportunities.

  • 10.
    Mattsson, Sofia
    et al.
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Pharmacology.
    Sjöström, Hans-Erik
    Umeå University, Umeå University Library, Centre for teaching and learning (UPL).
    Englund, Claire
    Umeå University, Umeå University Library, Centre for teaching and learning (UPL).
    Using a Virtual Tablet Machine to Improve Student Understanding of the Complex Processes Involved in Tablet Manufacturing2016In: American Journal of Pharmaceutical Education, ISSN 0002-9459, E-ISSN 1553-6467, Vol. 80, no 5, article id 87Article in journal (Refereed)
    Abstract [en]

    Objective. To develop and implement a virtual tablet machine simulation to aid distance students' understanding of the processes involved in tablet production.

    Design. A tablet simulation was created enabling students to study the effects different parameters have on the properties of the tablet. Once results were generated, students interpreted and explained them on the basis of current theory.

    Assessment. The simulation was evaluated using written questionnaires and focus group interviews. Students appreciated the exercise and considered it to be motivational. Students commented that they found the simulation, together with the online seminar and the writing of the report, was beneficial for their learning process.

    Conclusion. According to students' perceptions, the use of the tablet simulation contributed to their understanding of the compaction process.

  • 11.
    Mattsson, Sofia
    et al.
    Umeå University, Faculty of Arts, Centre for Teaching and Learning (UPC). Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience.
    Sjöström, Hans-Erik
    Umeå University, Faculty of Arts, Centre for Teaching and Learning (UPC).
    Lampe Persson, Jonas
    Umeå University, Faculty of Arts, Centre for Teaching and Learning (UPC).
    Englund, Claire
    Umeå University, Faculty of Arts, Centre for Teaching and Learning (UPC).
    Use of a virtual tablet machine in pharmaceutical education2012In: NGL 2012 Next Generation Learning Conference Falun: Book of Abstracts, 2012Conference paper (Refereed)
    Abstract [en]

    One of the pedagogical problems frequently faced by distance students, particularly on web-based vocational programmes, is the lack of opportunity to train practical elements in the course. This presentation describes a project to provide a technological solution to this problem and also to enhance distance students’ understanding of the processes involved in tablet production by means of a virtual tablet machine. The web-based Master of Science in Pharmacy Programme at Umeå University includes the course Drug Formulation. One of the expected learning outcomes of the course is to understand and explain relationships between composition, compaction process and properties of tablets. In order to facilitate this, a tablet simulation (virtual tablet machine) was created. Simulations can be successfully used in education to illustrate rather complex relationships during a limited time frame and they are also ideal in distance education since they do not require access to expensive laboratory facilities and can be carried out by the student at any time and place. A web-based tablet simulation was created enabling the students to choose different compositions, compaction pressures and compaction speeds in order to observe which effect these parameters have on the properties of the tablet produced. The simulation is performed and the results are displayed in the form of graphs. Once the results have been generated the students then interpret and explain the results on the basis of current theory using a Wiki. During the course the students also manufacture tablets in real life; the tablet simulation therefore also serves as preparation for these practical experiments. After the simulation had been carried out it was evaluated by the students in the form of a written questionnaire and a focus group interview. The students found the tablet simulation easy to use, motivational and considered the simulation to have contributed to their understanding of the compaction process. The students also considered the simulation to be a good theoretical preparation for the practical experiments. Some operational problems were reported, for example difficulties in changing the compaction pressure and the presentation of the results may also be improved. In conclusion, we found that the use of the tablet simulation, in combination with practical experiments and assignments, improved the student’s understanding of the compaction process and provided a suitable technological solution to a pedagogical problem in a web-based Pharmaceutical Science Programme. The project would like to thank “Flexible education at Umeå University” for financial support.

  • 12.
    Vinterflod, Charlotta
    et al.
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience.
    Gustafsson, Maria
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience.
    Mattsson, Sofia
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience.
    Gallego, Gisselle
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience. School of Medicine, The University of Notre Dame Australia, Darlinghurst, Australia.
    Physicians' perspectives on clinical pharmacy services in Northern Sweden: a qualitative study2018In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 18, article id 35Article in journal (Refereed)
    Abstract [en]

    Background: In many countries, clinical pharmacists are part of health care teams that work to optimize drug therapy and ensure patient safety. However, in Sweden, clinical pharmacy services (CPSs) in hospital settings have not been widely implemented and regional differences exist in the uptake of these services. Physicians' attitudes toward CPSs and collaborating with clinical pharmacists may facilitate or hinder the implementation and expansion of the CPSs and the role of the clinical pharmacist in hospital wards. The aim of this study was to explore physicians' perceptions regarding CPSs performed at hospital wards in Northern Sweden.

    Methods: Face-to-face semi-structured interviews were conducted with a purposive sample of nine physicians who had previously worked with clinical pharmacists between November 2014 and January 2015. Interviews were digitally recorded, transcribed and analysed using a constant comparison method.

    Results: Different themes emerged regarding physicians' views of clinical pharmacy; two main interlinked themes were service factors and pharmacist factors. The service was valued and described in a positive way by all physicians. It was seen as an opportunity for them to learn more about pharmacological treatment and also an opportunity to discuss patient medication treatment in detail. Physicians considered that CPSs could improve patient outcomes and they valued continuity and the ability to build a trusting relationship with the pharmacists over time. However, there was a lack of awareness of the CPSs. All physicians knew that one of the pharmacist's roles is to conduct medication reviews, but most of them were only able to describe a few elements of what this service encompasses. Pharmacists were described as "drug experts" and their recommendations were perceived as clinically relevant. Physicians wanted CPSs to continue and to be implemented in other wards.

    Conclusions: All physicians were positive regarding CPSs and were satisfied with the collaboration with the clinical pharmacists. These findings are important for further implementation and expansion of CPSs, particularly in Northern Sweden.

  • 13.
    Wamil, Natacha
    et al.
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience.
    Mattsson, Sofia
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience.
    Gustafsson, Maria
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience.
    Assessment of potentially inappropriate medications using the EU (7)-PIM list and the Swedish quality indicators2019In: International Journal of Clinical Pharmacy, ISSN 2210-7703, E-ISSN 2210-7711, Vol. 41, no 4, p. 903-912Article in journal (Refereed)
    Abstract [en]

    Background: Several tools to evaluate the appropriateness of prescriptions have been developed over the years.

    Objective: To compare the prevalence of potentially inappropriate medication (PIM) among elderly, using the European Union (EU) (7)-PIM list and the Swedish quality indicators. Secondary objectives were to investigate factors associated with the use of PIMs using the two tools.

    Setting: Medical ward in a hospital in Northern Sweden.

    Methods: Medical records for patients aged >= 65 years admitted to the medical ward were reviewed by clinical pharmacists from September to November 2015 and from February to April 2016. PIMs were identified through the abovementioned identification tools.

    Main outcome measure: Prevalence of PIMs.

    Results: Of 93 patients, 18.3% had one PIM according to the Swedish quality indicators. The most common PIM class was non-steroidal anti-inflammatory drugs and diclofenac was one of the most commonly prescribed PIMs. According to the EU (7)-PIM list, 45.2% of the study population was prescribed one or more PIMs. The most common PIM class was hypnotic and sedative drugs, and the most frequently prescribed PIM was apixaban. No significant associations between PIMs and different factors were found using either identification tool.

    Conclusion: The prevalence of PIMs was relatively low in the study sample according to the Swedish guidelines but high according to the EU (7)-PIM list. Different evaluation tools might give inconclusive results, but it is still important to continuously evaluate the need for PIMs in older patients in order to improve drug treatment and to decrease the risk of adverse drug reactions.

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