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J Kragstrup

Publications and source records attributed to J Kragstrup.

At least 37 records · Page 2Linked to original sources
PubMed1998

[Antabus treatment in general practice. A pharmaco-epidemiological study of prescription patterns based on a prescription database].

Denmark has a long tradition for the use of alcohol-aversive drugs in the treatment of alcoholism, most commonly disulfiram (Antabuse). The purpose of this study was to examine the prescription patterns for disulfiram in Danish general practice on an individual level. By means of a prescription database we analysed 150,787 prescriptions on reimbursed medicine to persons who had redeemed prescriptions for alcohol-aversive drugs during the period 1.1.1993 to 31.12.1995 in the County of Funen. Prevalence of disulfiram treatment was 12 per 10,000 inhabitants, three-year prevalence 75 per 10,000 inhabitants and incidence 21 per 10,000 inhabitants per year. Eighty-seven percent of treatments were stopped at (or before) the expiration of one prescription, and relapse was frequent (46%).

Adult↗
PubMed1998

[Role of Danish general practitioners in the prevention of AIDS].

The study describes Danish general practitioners' perception of their own role and their actual behaviour in the prevention of HIV/AIDS. Data collection was carried out by questionnaire and prospective registration of consultations dealing with HIV/AIDS during a two-week period. The results showed that most of the GPs (94%) were of the opinion that GPs should play a central part in the prevention of HIV, and 90% thought that the GP should take the initiative to talk about HIV. The median number of consultations dealing with HIV was two during ten working days (range 0-18), and more than half the GPs (56%) had not themselves initiated a conversation concerning the problem. The conclusion of the study is that there was discrepancy between the GPs' vision of their role in HIV prevention and activities in practice. It is recommended that initiatives are taken to strengthen the GPs' role in AIDS prevention.

Acquired Immunodeficiency Syndrome↗
PubMed1998

Polypharmacy: correlations with sex, age and drug regimen. A prescription database study.

OBJECTIVE: To analyse the occurrence of multiple drug use (polypharmacy, PP) in the population and to identify individuals particularly prone to PP. METHODS: Data were derived from the Odense Pharmacoepidemiological Database (OPED) and covered all subsidised prescriptions during 1994 presented by inhabitants in the county of Funen (n = 466567). The number of individuals concurrently using two to four drugs (minor PP) and five or more drugs (major PP) was calculated on a random day in 1994. Drugs were classified according to the Anatomical Therapeutical Chemical (ATC) classification index. The main therapeutic class (second level of the ATC code) was used as an indicator for the type of health problem. A stepwise backwards logistic regression was used to identify predictors of major PP. Odds ratios were calculated for different drug classes, and the age and sex of all drug users. RESULTS: On a random day, 8.3% of the population were exposed to minor PP and 1.2% to major PP. The prevalence of PP increased with age, and from the age of 70 years, two thirds of all drug users were PP users. Drug use was 50% more prevalent among women than men, but over the age of 70, the sexes did not differ in the prevalence of major PP. Many different drug combinations were found, and among major PP users (n = 5443), two thirds had their own unique drug regimen, different from all other drug users. Cardiovascular drugs and analgesics were often involved in PP among the elderly, while asthma drugs, psychotropic drugs and anti-ulcer drugs were predominant among young individuals exposed to PP. The odds ratio (OR) for major PP was substantially increased for individuals treated for cardiovascular diseases (OR, 4.5), anaemia (OR, 4.1) and respiratory diseases (OR, 3.6). CONCLUSIONS: PP is widespread in the population. Clinicians and organisers who are responsible for quality assurance programmes should intensify their surveillance of the groups most prone to PP (the elderly and those using analgesics or drugs for cardiovascular disease, anaemia, asthma and diabetes).

Adolescent↗
PubMed1997

[Age at menarche and first sexual intercourse. A cross-sectional study of 17-year old Danish women].

The age at menarche and first intercourse was analyzed from data obtained from a questionnaire sent to 1500 17 year-old randomly selected Danish women (76% responded). The average age at menarche was 13.37 years (SD: 1.24). The median age at the time of the first intercourse was 16.6 years. Late sexual debut was observed for girls who were relatively old at menarche and for those with a higher level of education. Apparently the age at menarche and at first sexual intercourse has not changed significantly in recent years.

Adolescent↗
PubMed1997

[The impact of postal invitations and user fee on influenza vaccination among the elderly. A randomized controlled trial in general practice].

Influenza epidemics are accompanied by considerable excess morbidity and mortality especially among the elderly and the chronically ill. In the influenza season 1995 a controlled, randomized trial was carried out to examine the impact of postal invitations and user fee on influenza vaccination rates. Five hundred and eighty-five patients aged 65 years or older participated. They were all recognized by their general practitioner (GP) to be in the risk group to whom influenza vaccination is recommended. One third were invited to free influenza vaccination. Another third received postal invitations to influenza vaccination paying the usual fee ($40-$60 US). The last third served as a control group, being vaccinated on their own request and paying the usual fee. In the control group 25% (19-31%, 95% confidence interval) of the patients were vaccinated, compared to 49% (42-56%) in the group which received a postal reminder and paid the usual fee, and 72% (65-78%) in the group invited to be vaccinated free of charge.

Aged↗
PubMed1997

[General practitioners' choice of treatment for young women with metrorrhagia as evaluated by vignettes].

A consensus conference on menstrual disorders concluded that a discrepancy exists between the large number of curettages performed annually on fertile women and the actual findings of cancer of the endometrium in this group of patients. Based on three written simulated consultations (vignettes) with 42-year-old women with metrorrhagia but without increased risk of cancer a decision analysis was performed among 695 general practitioners in Denmark and the Faroe Islands. The first choice of treatment was curettage in 43% of the responders. It was found that a large proportion of doctors decided on curettage when the patient had developed anaemia. The choice of curettage was associated with the doctors' assessment of need to exclude cancer of the endometrium, while doctors who gave high priority to non-invasive treatment and cessation of bleeding were less likely to refer for curettage. A larger proportion of male than female doctors chose curettage as primary treatment.

Adult↗
PubMed1997

Methods for estimating the occurrence of polypharmacy by means of a prescription database.

OBJECTIVE: Concurrent use of multiple drugs (polypharmacy, PP) may cause health risks such as adverse drug reactions, medication errors and poor compliance. The objective of this study, based on data from a prescription database, was to evaluate estimators of PP in the general population. METHODS: Data were retrieved from Odense Pharmaco-epidemiological Database (OPED) and consisted of all prescriptions in 1994 from a 10% random sample of drug users (n = 26,977) in the county of Funen, Denmark. For each prescription, the period of consumption was calculated by setting the duration of treatment to equal the amount of drug purchased, as measured in defined daily doses (DDD), thereby assuming a daily intake of one DDD. PP was defined as overlapping periods of consumption for different drugs. A Venn diagram was used to illustrate and compare this estimator of PP with two other indicators of multiple-drug use: the number of drugs purchased in 3 months and the mean number of drugs used in 1 year. A receiver operating curve (ROC) was used to evaluate the possibility of predicting episodes of PP from the number of drugs purchased in 3 months. RESULTS: The proposed estimator of PP was robust towards changes in DDD. On an average day in 1994, the prevalence of PP was 9.9% and the standard deviation (SD) between days was 0.3%. Two to four drugs (minor PP) were used by 8.7% of the population (SD, 0.2%) and five or more drugs (major PP) by 1.2% (SD, 0.1%). The number of individuals displaying PP for the first time in 1994 stabilised after approximately 6 months, resulting in an incidence of major PP of 0.2% and of minor PP of 1.2% per month. For individuals exposed to PP, the median number of days of exposure was 61 and 10.5% were exposed for more than 350 days of the year. Purchase of five or more drugs in the first 3 months of 1994 predicted episodes of major PP in the same year with a positive predictive value of 80%. CONCLUSION: Epidemiological measures of multiple drug use can be estimated from data in a prescription database. From a conceptual point of view, an estimator based on the number of simultaneously used drugs (calculated from the date of purchase and the number of DDD) is preferable, but the number of drugs purchased in a 3-month period may also be a useful estimator.

Databases, Factual↗
PubMed1997

Impact of postal invitations and user fee on influenza vaccination rates among the elderly. A randomized controlled trial in general practice.

OBJECTIVE: To examine the impact of postal invitations and user fee on influenza vaccination rates. DESIGN: A controlled randomized trial in 13 general practices. One third of the participating patients received postal invitations to influenza vaccination free of charge. Another third received postal invitations to influenza vaccination on paying the usual fee (US$ 40-60). The last third served as a control group, being vaccinated at their own request and paying the usual fee. SETTING: General practice in the Counties of Funen and Vejle, Denmark. PATIENTS: Five hundred and eighty-five patients aged 65 years or older, recognized by their general practitioner (GP) as being in the risk group for whom influenza vaccination is recommended. MAIN OUTCOME MEASURES: Influenza vaccination rates. RESULTS: In the control group 25% (19-31%, 95% confidence interval) of the patients were vaccinated, compared with 49% (42-56%) in the group who received a postal reminder and paid the usual fee, and 72% (65-78%) in the group invited to be vaccinated free of charge. CONCLUSION: It is suggested that GPs send postal invitations to their elderly patients in the risk groups urgently recommending influenza vaccination. Attention should also be given to offering free influenza vaccination to elderly patients who have recognized indications for vaccination.

Aged↗
PubMed1995

[The first gynecologic examination. Indications, age and place].

The purpose was to investigate age, place, and indication for 17 year-old women's first pelvic examination. A postal questionnaire was sent to 1500 randomly selected 17 years-old Danish women. The response rate was 76%. The median age at which such examinations first took place was 17 years and 10 months. The majority (86%) of examinations were performed by general practitioners and 72% were performed in relation to prescription of oral contraceptives. This indication has previously been a recommendation of the Danish National Board of Health, but changes have been announced, and indications for pelvic examinations of teenagers should be discussed.

Adolescent↗
PubMed1995

Experiences of the first pelvic examination in a random samples of Danish teenagers.

OBJECTIVE: To describe Danish teenagers' experiences and preferences concerning the first pelvic examination. METHODS: Cross-sectional postal questionnaire study. A total of 1500 women, aged 17 years, were selected at random among all Danish women of that age. The response rate was 76%, and 551 had experienced their first examination. RESULTS: Thirty-two percent gave a negative general evaluation of the examination, and 13% found the examination very painful. The negative evaluation was strongly associated with the experience of pain, embarrassment, perceived impossibility of interrupting the examination, not knowing what the doctor was doing, learning nothing during the examination, indications other than oral contraception, and feeling of insufficient knowledge when arriving for the first examination. CONCLUSION: It is recommended that teenagers are given more information and realistic expectations prior to the first pelvic examination.

Adolescent↗
PubMed1995

Expectations and knowledge of pelvic examinations in a random sample of Danish teenagers.

The purpose of the study was to describe teenagers' expectations and knowledge of the pelvic examination (PE). The study was carried out as a cross-sectional postal questionnaire study. A total of 1500 women, aged 17 years, were selected at random from all Danish women of that age. The response rate was 76%, and 551 of these 1112 teenagers had experienced their first PE. Among the teenagers who had not had a PE, 48% thought the examination would be painful, 29% feared that the doctor would discover abnormal anatomy, 67% felt they would be embarrassed by exposing their genitals and 23% expected to be indisposed for the rest of the examination day. Among the teenagers who had not experienced a PE, only 17% felt that they had sufficient knowledge of the examination, compared to 68% in the group who had already experienced an examination. In the group who had not experienced a PE 33% knew what the doctor was able to inspect during the instrumental part of the examination, compared to 55% in the other group with experience. It is concluded that a considerable proportion of teenagers have negative expectations of the PE, and increased effort to improve teenagers' expectations and knowledge of the PE may be recommended.

Adolescent↗
PubMed1995

Role of Danish general practitioners in AIDS prevention.

OBJECTIVE: To describe Danish general practitioners' perception of their own role and to register their actual behaviour in the prevention of HIV/AIDS. DESIGN: Data collection was carried out by a) questionnaire and b) prospective registration of consultations dealing with HIV/AIDS in a two-week period in September 1992. SETTING: General practice, Denmark. SUBJECTS: One thousand general practitioners (GPs), selected at random, were asked to participate. The study population comprised 352 GPs who returned the questionnaire and participated in the prospective registration. RESULTS: Most of the GPs (94%) were of the opinion that GPs should play a central part in the prevention of HIV; 96% found that their knowledge was sufficient to advise on the prevention of HIV, and 90% thought that the GP should take the initiative to talk about HIV. The median number of consultations dealing with HIV was two during ten working days (range 0-18), and more than half the GPs (56%) had not themselves initiated a conversation concerning the problem. CONCLUSION: There was discrepancy between the GPs' vision of their role in HIV prevention and the activities in practice. It is recommended that initiatives are taken to strengthen the GPs' role in AIDS prevention.

Acquired Immunodeficiency Syndrome↗
PubMed1993

[General practitioners are carrying a heavy load of work, but they are satisfied with their choice of profession].

Seven hundred and seventy-six general practitioners (GPs) sampled randomly from the list of GPs in Denmark were asked about job satisfaction and professional attitudes by questionnaire. The majority (four-fifth) felt that they would decide to become GPs if they were to choose again. On the other hand, two-thirds complained about a workload which had negative effects on their family life. Low job satisfaction was associated with a preference for public employment instead of the current system of private practice. Dissatisfied GPs tended to believe that patients have too great expectations and present problems that they ought to solve themselves. They, also, felt that daily work didn't leave time for preventive medicine and they felt anxiety because of the risk of overlooking serious diseases.

Attitude of Health Personnel↗
PubMed1993

[Computer simulation of a patient with gastrointestinal symptoms used for evaluation of clinical decision among general practitioners].

This study used a computer-based simulation of a patient with gastrointestinal symptoms for an investigation of decision-making amongst 122 general practitioners participating in the 6th Nordic Congress of General Practice. The simulation model, developed in the computer software COMCATS, makes use of an IBM-compatible personal computer attached to an automated slide-projector. All participants were given a short introduction to the patient and his symptoms, but all further information was optimal and selected by the doctor. Large variations were found between the participants with respect to clinical patterns: for example, expenses for further examinations ranged from 0 to 2,400 Danish crowns. For research into clinical decision-making the great advantages of the computer-model are that it allows for a standardisation of the clinical situation, gives the doctor an opportunity to select between optional information and permits an automatic gathering of huge amounts of information about the decision-making process.

Adult↗
PubMed1993

Computer-based simulation model for evaluation of variations in practice patterns of general practitioners: a feasibility study.

Our study aimed at developing a computer-based simulation model for the consultation process in general practice. The model was developed in the computer language COM-CATS and makes use of an IBM-compatible personal computer with an automated diasprojector attached. A feasibility study comprised 122 general practitioners (108 male and 14 female), participating in the 6th Nordic Congress of General Practice (Aarhus, Denmark, 1989). All participants were given a short introduction to the patient and his symptoms, but all further information was optimal and selected by the doctor. There was a large variation in practice patterns of the general practitioners. Their actions were, however, performed selectively, i.e. a few tests were requested by most doctors and none of the doctors performed large numbers of tests. The great advantage of the computer-model in research into clinical decision-making is that it allows for a standardization of the clinical situation, gives the doctor an opportunity to select between optional information, and permits an automatic gathering of huge amounts of information about the decision-making process.

Computer Simulation↗
PubMed1991

[Laser treatment of sinusitis in general practice assessed by a double-blind controlled study].

The effect of Low Level Laser therapy (Galium-Aluminium-Arsenide laser, 30 mW/830 nm, Unilaser 2000 3B) on sinuitis was evaluated in a double-blind randomised clinical study comprising 60 patients from general practice. All patients received three treatments (90 seconds radiation on each sinus) with one to three days interval. No statistically significant differences in pain relief, well-being or duration of illness were observed between patients treated with laser and a placebo.

Adolescent↗