Biomedical subjects

Ebba Holme Hansen

Publications and source records attributed to Ebba Holme Hansen.

11 recordsLinked to original sources

PubMed2004

Patterns of psychotropic medicine use and related diseases across educational groups: national cross-sectional survey.

OBJECTIVE: To analyse whether the use of different groups of psychotropic medicines among educational groups in a general population was congruent with the occurrence of related diseases. METHODS: Data from The Danish Health and Morbidity Survey 2000 were analysed. The survey was conducted by face-to-face interviews with a representative sample of the Danish population aged 16 years and above ( n=16,690). The prevalence of four different types of psychotropic medicine use and related diseases in educational groups was analysed by indirect standardisation. Age and gender standardised prevalence ratios (SPRs) and 95% confidence intervals were calculated based on the total study population. RESULTS: In general, respondents in the two least-educated groups used psychotropic medicines more often and had a higher proportion reporting the related disease than could be expected according to indirect standardisation. The opposite picture appeared for respondents in the two highest educated groups (SPR<100). The overall patterns were similar for all four groups of psychotropic medicine users, although some of the SPRs were not significant. CONCLUSIONS: The results documented an uneven distribution of health problems in the general population. Psychotropic medicine use was congruent with the distribution of related health problems, which means that the least-educated groups in most need of treatment also had the most-frequent medicine use. Expenses incurred by the individual user did not seem to be a barrier to access to medicines, not even for specific groups of medicine ineligible for reimbursement in Denmark.

Adult↗

PubMed2004

The threatened self: general practitioners' self-perception in relation to prescribing medicine.

Insufficient understanding of the variation in GP's medicine prescribing behaviour and ineffective interventions call for an investigation of the GPs' own perspective. This article describes the GP's self-perception as it emerged in 20 semi-structured interviews that explored the GP's perspective on their own prescribing. Data collection and analysis was largely inspired by grounded theory. The GPs described a constantly active process in which they prescribed, experienced an emotional reaction to their prescribing, evaluated themselves, redefined themselves for the better or worse, defined the new prescribing situation, prescribed and so forth. The GPs felt disappointed with themselves when their prescribing conflicted with their human or scientific ideals, and when they did not live up to their image of themselves, as GPs and as persons. They experienced discomfort when they were exposed to pressure as well as when they gave in to it. These negative emotions demanded a redefinition of the GPs' selves. The GPs applied both preventive and coping strategies to protect themselves from redefining themselves negatively. They strived to live up to their ideals, lowered their ideals, convinced themselves of the appropriateness of their prescribing and sought inspiration and self-development. This study demonstrates that self-perception is fundamental to how GPs prescribe medicines. Future interventions in quality development that aim to improve GPs' prescribing practices should therefore include considerations of the GPs' self-perception and facilitate autonomous self-development.

Data Collection↗

PubMed2004

Social class variation in medicine use among adolescents.

BACKGROUND: Little is known about social determinants of adolescents' medicine use. The objective was to analyse the association between the family's social class and adolescents' use of medicine for headache, stomachache, difficulties in getting to sleep, and nervousness. METHODS: Cross-sectional study of 11-, 13- and 15-year-olds, a Danish contribution to the WHO international collaborative study Health Behaviour in School-aged Children (HBSC) 1998. The study population comprised students from a national random sample of schools who answered a standardized questionnaire in the classroom, participation rate 88%, n=5,205. RESULTS: Logistic regression analyses showed that medicine use for all four symptoms increased by decreasing social class, controlled for age and prevalence of the specific symptom for which the medicine was taken. Adjusted OR (95% CI) for medicine use among students from lower social classes were: medicine for headache 1.35 (1.11-1.65), medicine for stomachache 1.41 (1.08-1.84), medicine for difficulties in getting to sleep 2.00 (1.30-3.08), and medicine for nervousness 3.22 (1.87-5.56). CONCLUSION: Symptom-adjusted medicine use in a representative sample of Danish adolescents showed a clear and graded increase with decreasing social class. Policies to reduce social inequality in health should address medicine use as well.

Abdominal Pain↗

PubMed2003

Prescription and non-prescription medicine use in Denmark: association with socio-economic position.

OBJECTIVE: To analyse the association among different types of medicine use and different measures of socio-economic position (SEP) in one and the same general population. METHODS: Data from The Danish Health and Morbidity Survey 2000 were analysed. The survey was conducted by face-to-face interviews with a representative sample of the adult Danish population (n=16,690). The associations between prescription and over-the-counter (OTC) medicine use and education, occupation and income were assessed by logistic regression analyses. All analyses were adjusted for age, gender and two measures of health status. RESULTS: This cross-sectional analysis of medicine use in a large representative sample of the Danish population found greater use of prescription medicines among disability pensioners and "others" than in salaried employees. Disability pensioners and self-employed individuals used less OTC medicine than salaried employees. Individuals with low income used more prescription medicines but not more OTC medicines, than those with high income. No major differences were found in prescription medicine use with respect to education, but men within the two middle educational groups tended to use prescription medicine less frequently than both lower and higher educated men. A similar trend was not found for women. OTC medicine use was not associated with education for either gender. CONCLUSIONS: The prevalence of prescription medicine use increases with declining SEP, after adjusting for health status. Such an association does not exist for OTC medicine use. The results show that the least affluent have access to prescription medicine. The difference between prescription and OTC medicine use may be explained by a compensation mechanism.

Adolescent↗

PubMed2003

Utilisation of antibiotics in young children: opposite relationships to adult educational levels in Danish and Swedish counties.

BACKGROUND: Antibiotic utilisation varies profoundly among and within countries, and the extent of antibiotic utilisation correlates with the frequency of bacterial resistance, particularly among children. Hence, it is important to assess which factors may influence prescribing. In addition to variations in morbidity, health-care organisation, drug regulatory and supply systems, prescriber's attitudes, parents' behaviour, attitudes and socio-economic positions seem important. We compared socio-economic position (educational level of adults) and antibiotic utilisation in children in the municipalities within a Danish and a Swedish county which are geographically close, have similar social and economic development, and similar drug regulatory and supply systems. METHODS: Data on antibiotic utilisation (1998), expressed in defined daily doses per 1000 inhabitants per day (DDD/TID), were obtained from the Copenhagen County Health Insurance register and from the National Corporation of Swedish Pharmacies. Data on municipal educational levels were obtained from Statistics Denmark and Statistics Sweden. RESULTS: The utilisation of antibiotics in 0- to 6-year-old children was higher in the Swedish than in the Danish county but varied between the municipalities within both the Swedish (9.6-17.7 DDD/TID) and the Danish (8.0-12.9 DDD/TID) counties. Most notably, utilisation rates correlated negatively with the education levels in the Danish (r=-0.539, P=0.021) but positively in the Swedish (r=+0.390, P=0.025) municipalities. CONCLUSION: The observed variations in antibiotic prescribing may reflect different parental and/or prescriber attitudes towards use of antibiotics and they emphasise that antibiotic prescribing is influenced by factors other than the prevalence of bacterial infections. Relationships between socio-economic position (educational level) and drug utilisation should not be generalised from one area to another.

Anti-Bacterial Agents↗

PubMed2003

Community participation as an interactive learning process: experiences from a schistosomiasis control project in Zimbabwe.

A schistosomiasis control project was undertaken from 1994 to 1998 in Guruve District, Zimbabwe, based on the active involvement of local communities in the growing and application of the molluscicidal plant Phytolacca dodecandra as a supplement to other control measures such as chemotherapy and health education. The berries of P. dodecandra are highly molluscicidal to the intermediate host snails of schistosomiasis and is rapidly degradable in water. It was observed that plant care fluctuated during the study period. Only a few households participated in snail control activities, although 97% of respondents in a baseline survey had stated a willingness to take part. This invoked an investigation to explore the reality from a user perspective. Focus group discussions, semi-structured interviews and observations were used to solicit information. In spite of a cultural inclination for collective work, many reasons for low-level involvement emerged, inter alia the low perceived value of the project, demands for tangible benefits, inaccessible fields and weak leadership. This study shows that community participation is a complex process upon which a multiplicity of social and cultural determinants have an impact. If community participation is to become successful in development programmes it ought to be viewed as a mutual learning process where obstacles are identified and discussed and solutions shared among community members and project staff.

Animals↗

PubMed2003

Pharmaceutical care in Denmark: perceived importance of medicine-related problems and participation in postgraduate training.

OBJECTIVE: To investigate the readiness of Danish community pharmacists to provide pharmaceutical care. Special focus was on information provided to patients on medicine-related problems and participation in postgraduate training. METHOD: National cross-sectional survey distributed to all Danish community pharmacies (N = 288). Response rate 75.7%; non-responders were interviewed by telephone to establish their reasons for not participating. MAIN OUTCOME MEASURES: Prioritization of information to patients regarding medicine-related problems. Postgraduate courses selected by pharmacists during the past three years. RESULTS: In accordance with the profile of Danish community pharmacists, respondents were primarily female and half were below 45 years of age. The main reason given for not responding was lack of time. The prioritization of information to patients regarding medicine-related problems resulted in three clusters of answers. The overall topics of the clusters were: information related to the technical-practical use of medicines; information related to pharmacotherapeutic aspects of medicine use; and information related to the function of the medicine. The clusters accounted for 61.9% of the total variance. The most frequently attended postgraduate courses were on quality assurance and specific diseases. CONCLUSION: The patient information prioritized by Danish community pharmacists is primarily of a technical-practical nature. The postgraduate training pursued is primarily technical without much focus on the philosophy of pharmaceutical care. These factors contribute to the lack of proper readiness of pharmacists to practice pharmaceutical care.

Adult↗

PubMed2003

Leading ordinary lives: a qualitative study of younger women's perceived functions of antidepressants.

BACKGROUND: While the overall consumption of psychotropic medicines such as tranquillisers and hypnotics has declined, the consumption of the newer antidepressants--selective serotonin reuptake inhibitors (SSRIs) has increased drastically since their introduction. In order to understand the mechanisms underlying the use, it is important to gain insight into the users' perceptions about their medicine and use. OBJECTIVE: To analyse younger women's perceived functions of SSRIs in their everyday lives. METHODS: 12 in-depth interviews and 6 re-interviews were conducted with a community-based sample of 21- to 34-year-old women taking SSRIs. The women were recruited through Danish pharmacies. RESULTS: Prior to taking SSRIs the women struggled with their emotional problems, often in great frustration and distress. While taking SSRIs the women experienced that the medicine functioned both at a psychological and a social level. They believed that the medicine gave them resources to behave actively in a way that was not previously possible. They felt that the medicine use enabled them to concentrate on daily life activities other than dealing solely with their emotional problems. The women found that the medicine gave them back a sense of 'normality'. CONCLUSION: The main finding in this paper is that the perceived functions of SSRIs were related to social meanings and goals in everyday life.

Adult↗

PubMed2003

Self-reported medicine use among 11- to 15-year-old girls and boys in Denmark 1988-1998.

AIMS: To describe the self-reported medicine use for common health complaints among 11-15-year-olds in Denmark during a ten year period, 1988-1998. The paper focuses on medicine for headache, stomach ache, cough, cold, nervousness, and difficulties in getting to sleep. METHODS: Four cross-sectional surveys of 11-15-year-old students in random samples of schools in Denmark, conducted in 1988 (n=1671), 1991 (n=1860), 1994 (n=4046) and 1998 (n=5205). The surveys were similar with regard to sampling and data collection. Data were collected by self-administered questionnaires in the classroom. RESULTS: A large proportion of 11-15-year-olds reported medicine use during the past month. It was most common to take medicines for headache (used by 55% of 15-year-old girls and 36% of 15-year-old boys in 1998) and stomach ache (33% among 15-year-old girls in 1998). Pain reliever use was higher among girls than boys and this sex difference increased with age. There was an upward trend in reported medicine use from 1988 to 1998, in particular regarding medicine for stomach-ache among 13- and 15-year-old girls. A large proportion of girls were frequent users of medicine for headache, stomach-ache, and sleeping difficulties. CONCLUSION: A high proportion of 11-15-year-old girls and boys reported medicine use in relation to common health complaints. The proportion of users increased during the past decade. It is suggested that more information about medicine be built into health education programs in the future.

Adolescent↗

PubMed2002

Prescription habits of dispensing and non-dispensing doctors in Zimbabwe.

The number of dispensing doctors has increased in the last decade, but the implication of this trend on the quality of health care and drug use is unknown. We present a comparative drug utilization study of 29 dispensing doctors and 28 non-dispensing doctors in Zimbabwe based on standard indicators developed by the World Health Organization. Dispensing doctors prescribed significantly more drugs per patient than non-dispensing doctors (2.3 versus 1.7), injected more patients (28.4% versus 9.5%), and prescribed more antibiotics (0.72 versus 0.54) and mixtures (0.43 versus 0.25) per encounter. Dispensing doctors also spent significantly less time on each encounter (8.7 min versus 13.0 min) than their non-dispensing colleagues. The use of generic name, brand name and essential drugs did not differ significantly between the two groups of practitioners. Multivariate analyses controlling for gender, race, place of education, location of practice and patients seen per day showed that dispensing by doctors was associated with less clinically and economically appropriate prescribing. These findings suggest that the quality of health care--as related to drug use, patient safety and treatment cost--is lower with dispensing doctors than with non-dispensing doctors.

Cohort Studies↗

PubMed2002

Changes in self-concept while using SSRI antidepressants.

In this study, the authors analyze how younger women see themselves within the context of using the antidepressants selective serotonin re-uptake inhibitors (SSRIs). Twelve in-depth interviews and 6 reinterviews were conducted with a community-based sample of women who had been taking SSRIs between 1 and 4 years. The empirical analysis revealed that SSRI users passed through stages in their careers as medicine users, these stages corresponding to how the users thought and felt about themselves. Four major changes in self-concept emerged: distressed and needing help, conflicts about taking the medicine, improvements in condition, and problems discontinuing the medicine. Users evaluated themselves from what they believed was the perspective of society, and the way they saw themselves was closely related to how they felt they functioned in everyday life.

Adult↗