Prolonged opioid use after distal radius fracture.

Background: Prolonged opioid use (more than 90 days) after injury puts the patient at risk for adverse effects. We investigated the patterns of opioid prescription after distal radius fracture and the effect of pre- and post-fracture factors on the risk for prolonged use.

Methods: This register-based cohort study uses routinely collected health care data, including purchases of prescription opioids, in the county of Skåne, Sweden.

Mortality over 14 years in MTX-refractory patients randomized to a strategy of addition of infliximab or sulfasalazine and hydroxychloroquine.

Objective: To compare mortality risk over up to 14 years of follow-up in methotrexate-refractory patients with early RA randomized to a strategy starting with addition of infliximab vs addition of SSZ and HCQ.

Methods: Data was from the two-arm, parallel, randomized, active-controlled, open-label Swefot trial in which patients with early RA (symptom duration <1 y) were recruited from 15 rheumatology clinics in Sweden (2002-2005). Patients who did not achieve low disease activity after 3-4 months of MTX were randomized to addition of infliximab (n = 128) or SSZ and HCQ (n = 130).

The nature stroke study; NASTRU: A randomized controlled trial of nature-based post-stroke fatigue rehabilitation.

Objective: To determine whether nature-based rehabilitation, as an add-on to standard care, has a long-term influence on post-stroke fatigue, perceived value of everyday occupations, disability, health-related quality of life, anxiety, and depression at follow-up 8 and 14 months after randomization.

Design: Single-blinded, 2-armed, randomized controlled trial.

Methods: Stroke survivors, identified through routine 3-month follow-up visit (sub-acute) or medical records (chronic stroke > 1 year previously), were randomized to standard care + nature-based rehabilitation (intervention group) or standard care alone (control group).

Long-term effects on function, health-related quality of life and work ability after structured physiotherapy including a workplace intervention. A secondary analysis of a randomised controlled trial (WorkUp) in primary care for patients with neck and/or back pain.

To study the long-term effects of a workplace intervention in addition to structured physiotherapy regarding self-reported measures in patients with acute/subacute neck and/or back pain. WorkUp - a cluster-randomised controlled trial in 32 primary care centers in Sweden, from January 2013 through December 2014 (ClinicalTrials.gov ID: NCT02609750).

Evaluation of a multimodal pain rehabilitation programme in primary care based on clinical register data: a feasibility study.

Aim: Investigate the feasibility of identifying a well-defined treatment group and a comparable reference group in clinical register data.

Background: There is insufficient knowledge on how to avert neck/back pain from turning chronic or to impair work ability. The Swedish Government implemented a national multimodal rehabilitation (MMR) programme in primary care intending to promote work ability, reduce sick leave and increase return to work.

Patients with rheumatoid arthritis facing sick leave or work disability meet varying regulations: a study among rheumatologists and patients from 44 European countries.

Objectives: To describe and explore differences in formal regulations around sick leave and work disability (WD) for patients with rheumatoid arthritis (RA), as well as perceptions by rheumatologists and patients on the system's performance, across European countries.

Methods: We conducted three cross-sectional surveys in 50 European countries: one on work (re-)integration and social security (SS) system arrangements in case of sick leave and long-term WD due to RA (one rheumatologist per country), and two among approximately 15 rheumatologists and 15 patients per country on perceptions regarding SS arrangements on work participation. Differences in regulations and perceptions were compared across categories defined by gross domestic product (GDP), type of social welfare regime, European Union (EU) membership and country RA WD rates.

Educational inequalities in mortality associated with rheumatoid arthritis and other musculoskeletal disorders in Sweden.

Background: Musculoskeletal (MSK) disorders are less likely to be reported as an underlying cause of death (UCD) and since cause of death studies are generally limited to the UCD, little is known about socioeconomic inequalities in MSK disorders as cause of death in the general population. Using multiple-cause-of-death data, we aimed to quantify and compare educational inequalities in musculoskeletal (MSK) disorders- with non-MSK disorders-related mortality.

Methods: All residents aged 30-99 years in the Skåne region, Sweden, during 1998-2013 (n = 999,148) were followed until their 100th birthday, death, relocation outside Skåne, or end of 2014.

Can the STarT Back Tool predict health-related quality of life and work ability after an acute/subacute episode with back or neck pain? A psychometric validation study in primary care.

Objectives: The predictive ability of the STarT Back Tool (SBT) has not yet been examined among acute/subacute back and/or neck pain in a primary care setting in respect to health-related quality of life (HRQoL) and work ability outcomes. The aim of this study was to evaluate the SBT's predictive validity for HRQoL and work ability outcomes at long-term follow-up in a population with acute/subacute back and/or neck pain.

Setting: Prospective data from 35 primary care centres in south Sweden during 2013.

Protocol for evaluating and implementing a pragmatic value-based healthcare management model for patients with inflammatory arthritis: a Danish population-based regional cohort and qualitative implementation study.

Introduction: The provision of healthcare for patients with inflammatory arthritis occurs in the context of somewhat conflicting targets, values and drivers. Therefore, there is a need for introducing 'value-based healthcare' defined as the value of patient relevant health outcomes in relation to costs. This term is a central part of tomorrow's healthcare sector, especially for rheumatic diseases, yet the transition is a huge challenge, as it will impact the development, delivery and assessment of healthcare.

Secular trends in work disability and its relationship to musculoskeletal pain and mental health: a time-trend analysis using five cross-sectional surveys (2002-2010) in the general population.

Objectives: International evidence suggests that rates of inability to work because of illness can change over time. We hypothesised that one reason for this is that the link between inability to work and common illnesses, such as musculoskeletal pain and mental illness, may also change over time. We have investigated this in a study based in one UK district.

Cost-effectiveness of internet-based cognitive-behavioural therapy and physical exercise for depression.

Background: Both internet-based cognitive-behavioural therapy (ICBT) and physical exercise are alternatives to treatment as usual (TAU) in managing mild to moderate depression in primary care.

Aims: To determine the cost-effectiveness of ICBT and physical exercise compared with TAU in primary care.

Method: Economic evaluation of a randomised controlled trial ( = 945) in Sweden.

Temporal trend and regional disparity in osteoarthritis hospitalisations in Sweden 1998-2015.

Aim: This study investigated time trend and regional disparities in hospitalisations due to osteoarthritis (OA) among people aged ≥20 years in Sweden from 1998 through 2015.

Methods: National and regional data on hospital admissions with a primary diagnosis of OA were collected from the National Patient Register. The absolute and relative regional disparities were assessed using the absolute weighted mean difference from overall mean and the index of disparity.

Early workplace dialogue in physiotherapy practice improved work ability at 1-year follow-up-WorkUp, a randomised controlled trial in primary care.

Workplace involvement in rehabilitation for patients with musculoskeletal pain may improve work ability. Convergence Dialogue Meeting (CDM) is a model aimed at helping the patient, the care giver, and the employer to support work ability and return-to-work. Our aim was to study the effect on work ability when adding a workplace dialogue according to CDM in physiotherapy practice for patients with pain in ordinary primary care.

High and rising burden of hip and knee osteoarthritis in the Nordic region, 1990-2015.

Background and purpose - Osteoarthritis (OA) imposes a substantial burden on individuals and societies. We report on the burden of knee and hip OA in the Nordic region. Patients and methods - We used the findings from the 2015 Global Burden of Diseases Study to explore prevalence, years lived with disability (YLDs), and disability-adjusted life-years (DALYs) of OA in the 6 Nordic countries during 1990-2015 (population of about 27 million in 2015).

The revised Bristol Rheumatoid Arthritis Fatigue measures and the Rheumatoid Arthritis Impact of Disease scale: validation in six countries.

Objective: To evaluate the Bristol Rheumatoid Arthritis Fatigue Multidimensional Questionnaire (BRAF-MDQ), the revised Bristol Rheumatoid Arthritis Numerical Rating Scales (BRAF-NRS V2) and the Rheumatoid Arthritis Impact of Disease (RAID) scale in six countries.

Methods: We surveyed RA patients in France, Germany, The Netherlands, Spain, Sweden and the UK, including the HAQ, 36-item Short Form Health Survey (SF-36) and potential revisions of the BRAF-NRS coping and Spanish RAID coping items. Factor structure and internal consistency were examined by factor analysis and Cronbach's α and construct validity by Spearman's correlation.

Secular trends in sickness absence among Swedish patients with ankylosing spondylitis and psoriatic arthritis.

The aim was to investigate whether secular trends in sickness absence (SA) were present in patients with ankylosing spondylitis (AS) and psoriatic arthritis (PsA) receiving their diagnosis between 2002 and 2011. A repeated cross-sectional study design was used. Patients were identified in the Skåne Healthcare Register (SHR).

Income disparities in healthcare use remain after controlling for healthcare need: evidence from Swedish register data on psoriasis and psoriatic arthritis.

We used a southern Swedish cohort of psoriasis (PSO) and psoriatic arthritis (PsA) patients and population-based referents (N = 57,800) to investigate the influence of socioeconomic and demographic factors on the probability of healthcare use and on healthcare costs when controlling for need as measured by PSO/PsA and common additional morbidities such as diabetes, depression and myocardial infarction. People with PSO/PsA were identified by ICD-10 codes in the Skåne Healthcare Register 1998-2007. Resource use and costs for years 2008-2011 were retrieved from the Skåne Healthcare Register and the Swedish Prescribed Drug Register, and socioeconomic data were retrieved from Statistics Sweden.

Severe Extraarticular Manifestations in a Community-based Cohort of Patients with Rheumatoid Arthritis: Risk Factors and Incidence in Relation to Treatment with Tumor Necrosis Factor Inhibitors.

Objective: The aims of this study were to evaluate whether treatment with tumor necrosis factor (TNF) inhibitors in patients with rheumatoid arthritis (RA) affects the risk of developing severe extraarticular rheumatoid arthritis (ExRA) manifestations and to investigate potential predictors for developing ExRA.

Methods: A dynamic community-based cohort of patients with RA was studied (n = 1977). Clinical records were reviewed and cases of severe ExRA were identified.

Comparison of the Swedish STarT Back Screening Tool and the Short Form of the Örebro Musculoskeletal Pain Screening Questionnaire in patients with acute or subacute back and neck pain.

Background: Patients with back and neck pain are often seen in primary care and it is important to provide them with tailored interventions based on risk stratification/triage. The STarT Back Screening Tool (SBT) is a widely used screening questionnaire which has not yet been validated for a population with back and/or neck pain with short duration. Our aim was to compare the concurrent validity of the SBT and the short form of the ÖMPSQ including psychometric properties and clinical utility in a primary care setting.

Referring to multimodal rehabilitation for patients with musculoskeletal disorders - a register study in primary health care.

Background: In 2008, the Swedish government introduced a National Rehabilitation Program, in which the government financially reimburses the county councils for evidence-based multimodal rehabilitation (MMR) interventions. The target group is patients of working age with musculoskeletal disorders (MSD), expected to return to work or remain at work after rehabilitation. Much attention in the evaluations has been on patient outcomes and on processes.

Sick leave in Sweden before and after total joint replacement in hip and knee osteoarthritis patients.

Background and purpose - Little is know about patterns of sick leave in connection with total hip and knee joint replacement (THR and TKR) in patients with osteoarthritis (OA). Patients and methods - Using registers from southern Sweden, we identified hip and knee OA patients aged 40-59 years who had a THR or TKR in the period 2004-2012. Patients who died or started on disability pension were excluded.

A Multi-Biomarker Disease Activity Score and the Choice of Second-Line Therapy in Early Rheumatoid Arthritis After Methotrexate Failure.

Objective: To investigate whether the Multi-Biomarker Disease Activity (MBDA) score predicts optimal add-on treatment in patients with early rheumatoid arthritis (RA) who were inadequate responders to MTX (MTX-IRs).

Methods: We analyzed data from 157 MTX-IRs (with a Disease Activity Score using the erythrocyte sedimentation rate [DAS28-ESR] >3.2) from the Swedish Pharmacotherapy (SWEFOT) trial who were randomized to receive triple therapy (MTX plus sulfasalazine plus hydroxychloroquine) versus MTX plus infliximab.

Understanding Occupation, Sick Leave, and Disability Pension Due to Knee and Hip Osteoarthritis From a Sex Perspective.

Objective: To investigate the association between occupation and risk for sick leave or disability pension due to knee or hip osteoarthritis (OA) from a sex perspective.

Methods: We conducted a population-based study including residents ages 40-70 years in the Skåne region, Sweden (2007) and working in the included job sectors (n = 165,179). We retrieved data on cause-specific sick leave and disability pension (2007-2012) and linked to individual information on occupation and education (2007).