Comparing the long-term outcomes in chronic coronary syndrome patients with prior ST-segment and non-ST-segment elevation myocardial infarction: findings from the TIGRIS registry.

Objectives: Compared with ST-segment elevation myocardial infarction (STEMI) patients, non-STEMI (NSTEMI) patients have more comorbidities and extensive coronary artery disease. Contemporary comparative data on the long-term prognosis of stable post-myocardial infarction subtypes are needed.

Design: Long-Term rIsk, clinical manaGement and healthcare Resource utilisation of stable coronary artery dISease (TIGRIS) was a multinational, observational and longitudinal cohort study.

Mind the gap: analysis of two pilot projects of a home telehealth service for persons with complex conditions in a Swedish hospital.

Background: Developing and implementing home telehealth (HTH) services for patients with chronic conditions is a challenge. HTH services provide continuous and integrated care to patients, but very often pilot projects face non-adoption and abandonment issues. Change processes in healthcare are often complex and require learning to adapt to non-linear and unpredictable events.

Comparison of Characteristics and Outcomes of Patients With Heart Failure With Preserved Ejection Fraction With Versus Without Hyperuricemia or Gout.

Hyperuricemia and gout are common in patients with heart failure (HF) and are associated with poor outcomes. Data describing hyperuricemia and gout in patients with HF with preserved ejection fraction (HFpEF) are limited. We used data from the Duke University Health System to describe characteristics of patients with HFpEF and hyperuricemia (serum uric acid >6 mg/dl) or gout (gout diagnosis or gout medication within the previous year) and to explore associations with 5-year outcomes (death and hospitalization).

Risk Analysis of Nonunion After First Metatarsophalangeal Joint Arthrodesis.

The standard therapy for a symptomatic hallux rigidus is still the arthrodesis of the first metatarsophalangeal (MTP) joint. A nonunion of the arthrodesis is a possible postoperative complication. This study aimed to evaluate the incidence of nonunion associated with first MTP joint arthrodesis and identify risk factors influencing this.

The significance of walking from the perspective of people with Parkinson's disease.

Background: Parkinson's disease (PD) is associated with progressive mobility and walking difficulties. Although these aspects have been found to be central from a patient perspective, the perceived significance of walking is less well understood.

Objective: To explore the significance of walking as perceived and experienced by individuals with PD.

Reducing dispensing errors in Swedish pharmacies: the impact of a barrier in the computer system.

Background: Since 2004, a web-based reporting system enables monitoring of dispensing errors in all Swedish pharmacies. The adoption of this system was followed by an overall increase in reports, mainly explained by the dispensing of medicines of improper strength. In 2006 an intervention was implemented, aimed at reducing these errors.

Socioeconomic determinants of psychotropic drug utilisation among elderly: a national population-based cross-sectional study.

Background: Psychotropic drugs are commonly utilised among the elderly. This study aimed to analyse whether two socioeconomic determinants - income and marital status - are associated with differences in utilisation of psychotropic drugs and potentially inappropriate psychotropic drugs among elderly in Sweden.

Methods: All individuals aged 75 years and older who had purchased a psychotropic drug in Sweden during 2006 were included (68.

A comparative analysis of remuneration models for pharmaceutical professional services.

Objectives: Pharmacists provide a wide range of professional services to support the appropriate use of medicines by patients. This study aims to conduct an international, comparative analysis of remuneration models for pharmaceutical professional services.

Methods: Information about remuneration models was derived from a literature review and a semi-structured questionnaire completed by experts.

Multifaceted national and regional drug reforms and initiatives in ambulatory care in Sweden: global relevance.

It is a continual challenge trying to improve the quality of prescribing while concurrently trying to address increasing pharmaceutical development, utilization and expenditure. National and regional reforms and initiatives in Sweden have moderated growth in ambulatory drug expenditure to 2.7% per annum in recent years despite increasing volumes.

Prescribing behaviour after the introduction of decentralized drug budgets: is there an association with employer and type of care facility?

Objective: To analyse whether prescribing patterns changed after introduction of drug budgets and whether there is an association between drug prescribing patterns and the type of employer and care facility.

Methods: Data analysed encompassed information on dispensed medicines, by workplaces, prescribed in the Region Vastra Gotaland, Sweden, for the years 2003 and 2006. Workplaces (n = 969) were categorized according to type of employer and type of care facility.

To what extent does the indicator "concurrent use of three or more psychotropic drugs" capture use of potentially inappropriate psychotropics among the elderly?

Purpose: The indicator "concurrent use of three or more psychotropic drugs" has been used as a measure of quality in drug use among the elderly. The aim of our study was to assess to what extent the indicator captures the use of specific psychotropics associated with an increased risk of adverse events among the elderly, i.e.

Recent national and regional drug reforms in Sweden: implications for pharmaceutical companies in Europe.

With an aging population and increased prevalence of chronic diseases, such as obesity and diabetes mellitus, drug reforms are needed across Europe to ensure the continued provision of comprehensive healthcare. It is also a challenge, with the limited resources available, to fund new innovative drugs that significantly improve patient health. Recent national and regional reforms in Sweden have moderated the rate of increase in drug expenditure, despite increased volumes of drug use and the launch of new, expensive drugs.

Influence of mandatory generic substitution on pharmaceutical sales patterns: a national study over five years.

Background: Mandatory generic substitution was introduced in Sweden in October 2002 in order to try to curb escalating pharmaceutical expenditure. The aim of this study was to investigate how sales patterns for substitutable and non-substitutable pharmaceuticals have developed since the introduction of mandatory generic substitution; furthermore, to compare sales patterns in different groups of the population, based on patients' age and gender.

Methods: Five therapeutic groups comprising both substitutable and non-substitutable pharmaceuticals were included.

Physicians' opinions and experiences of the Pharmaceutical Benefits Reform.

Aim: To investigate opinions on and experiences of the new Pharmaceutical Benefits Reform (PBR) among physicians working in the Swedish county council of Region Västra Götaland.

Methods: Questionnaires were sent to all private practitioners who had contracts with the county council of Region Västra Götaland (n = 320) and a random sample of 25% of the doctors employed by the same county council (n = 1,068). The questionnaire comprised questions on how the physicians had received information on the PBR and sought opinions on the introduction of generic substitution in pharmacies, workplace codes, individual prescriber codes, and the Pharmaceutical Benefits Board.

Impact of a generic substitution reform on patients' and society's expenditure for pharmaceuticals.

Sweden's pharmaceutical expenditure has increased during the last decades. On 1 October 2002 mandatory generic substitution was introduced in Sweden with the purpose to reduce the growth in pharmaceutical expenditure. The aim of the present study was to investigate if the implementation of generic substitution was associated with changes in patients' expenses and reimbursed cost for prescribed pharmaceuticals included in the Swedish Pharmaceutical Benefits Scheme (PBS).

Beliefs about medicines among Swedish pharmacy employees.

Objective: The aim of this study was to describe the beliefs about medicines among pharmacy employees. A further aim was to analyse whether these beliefs were associated with any background characteristics, such as age, professional category or medication use.

Method: The study subjects were pharmacy employees at 24 community pharmacies in Göteborg, Sweden.

Do policy changes in the pharmaceutical reimbursement schedule affect drug expenditures? Interrupted time series analysis of cost, volume and cost per volume trends in Sweden 1986-2002.

The last decades increasing pharmaceutical expenditures in Sweden and other western countries have created a need for reforms to reduce the trend. The aim was to analyse if reforms concerning the pharmaceutical reimbursement scheme in Sweden during the years 1986-2002 were associated with changes in cost, volume and cost per volume of pharmaceuticals. Effects of changes in the reimbursement schedule during the study period were evaluated for all registered pharmaceuticals in Sweden and for five indicator drug groups.

Posttranscriptional regulation of TNFalpha expression via eukaryotic initiation factor 4E (eIF4E) phosphorylation in mouse macrophages.

Resident mouse macrophages secrete Tumor necrosis factor alpha (TNFalpha) upon challenge with LPS. The production of TNFalpha is controlled not only at the transcription of the gene, but also by strong posttranscriptional regulation. When macrophages are stimulated with LPS different signal transduction pathways become activated.

What are the obstacles to generic substitution? An assessment of the behaviour of prescribers, patients and pharmacies during the first year of generic substitution in Sweden.

Purpose: The aim of the present study was to investigate obstacles to generic substitution and savings achieved during the first year after Sweden introduced generic substitution in October 2002.

Methods: Normal prescriptions encompassed by generic substitution were included. Data on dispensed prescriptions in the Vastra Gotaland region was obtained from the National Corporation of Swedish Pharmacies.

Signal sequence deletion and fusion to tetanus toxoid epitope augment antitumor immune responses to a human carcinoembryonic antigen (CEA) plasmid DNA vaccine in a murine test system.

Carcinoembryonic antigen (CEA, CEACAM5) is expressed on several human carcinomas including colon cancer. CEA contains signal peptides that target the protein through the endoplasmic reticulum and to the cell membrane. We constructed a plasmid DNA vaccine encoding a truncated CEA (deltaCEA), devoid of its signal peptides, and demonstrated that it was retained inside the cell, while full-length CEA (wtCEA) was expressed on the membrane.