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Wallander, Mari-Ann
Publications (10 of 122) Show all publications
Bardel, A., Wallander, M.-A., Wallman, T., Rosengren, A., Johansson, S., Eriksson, H. & Svärdsudd, K. (2019). Age and sex related self-reported symptoms in a general population across 30 years: Patterns of reporting and secular trend. PLoS ONE, 14(2), Article ID e0211532.
Open this publication in new window or tab >>Age and sex related self-reported symptoms in a general population across 30 years: Patterns of reporting and secular trend
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2019 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 14, no 2, article id e0211532Article in journal (Refereed) Published
Abstract [en]

Objective To study age and sex specific prevalence of 30 symptoms in random samples from the general population and to analyze possible secular trends across time. Study population The study was based on data from eight on-going Swedish cohort studies, with baseline investigations performed between 1973 and 2003. Samples were drawn from the general population of the cities of Gothenburg and Eskilstuna, and of Uppsala County. Overall, 20,160 subjects were sampled, 14,470 (71.8%) responded, of whom 12.000 were unique subjects, and 2548 were part of more than one sample. Methods The Complaint score sub-scale of the Gothenburg Quality of Life instrument, listing 30 general symptoms was used. Responders were asked to indicate which symptoms they had experienced during the last three months. Results Women reported on average 7.8 symptoms, and men 5.3 (p<0.0001). Women reported higher prevalence than men for 24 of the 30 symptoms. In multivariate analyses four patterns of prevalence across age were identified in both men and women; increasing prevalence, decreasing, stable and biphasic prevalence. The symptoms in the various pattern groups differed somewhat between men and women. However, symptoms related to strain were prominent among symptoms decreasing with age. Moreover, there were secular trends. Across all symptoms reporting prevalence increased over time in men (p<0.001) as well as in women (p<0.0001). Conclusions Women reported higher total symptom prevalence than men. Symptoms related to health generally increased with age, while symptoms related to stress decreased markedly. Significant secular trends across time regarding symptom prevalence were found.

Place, publisher, year, edition, pages
PUBLIC LIBRARY SCIENCE, 2019
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-377595 (URN)10.1371/journal.pone.0211532 (DOI)000457744200030 ()30716129 (PubMedID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare
Available from: 2019-03-01 Created: 2019-03-01 Last updated: 2019-03-07Bibliographically approved
Cea-Soriano, L., Wallander, M.-A. & Garcia Rodriguez, L. A. (2016). Prescribing patterns of combined hormonal products containing cyproterone acetate, levonorgestrel and drospirenone in the UK. Journal of family planning and reproductive health care, 42(4), 247-+
Open this publication in new window or tab >>Prescribing patterns of combined hormonal products containing cyproterone acetate, levonorgestrel and drospirenone in the UK
2016 (English)In: Journal of family planning and reproductive health care, ISSN 1471-1893, E-ISSN 2045-2098, Vol. 42, no 4, p. 247-+Article in journal (Refereed) Published
Abstract [en]

Background There are limited data to show the levels of prescribing of combined oral contraceptives (COCs) and other hormonal products containing estrogen/progestogen combinations that may be outside the product licence. Aims To determine the diagnosis/indication recorded at the time of prescription of cyproterone acetate/ethinylestradiol (CPA/EE) and two COCs, levonorgestrel/EE (LNG/EE) and drospirenone/EE (DRSP/EE). Design and setting Retrospective study using a primary care database, The Health Improvement Network (THIN). Methods Women in THIN aged 12-49 years prescribed CPA/EE, LNG/EE or DRSP/EE in 2002-2010 were identified. Overall use of each product and proportion of new users each year were determined. Among new users, database codes were analysed to infer the reason for prescription. Results The proportion of new users of each product in 2002 and 2010, respectively, were: LNG/EE, 2.03% and 2.40%; CPA/EE, 0.45% and 0.27%; and DRSP/EE, 0.27% and 0.56%. Most new users prescribed CPA/EE had a record of acne (51.0% and 79.2% in 2002 and 2010, respectively) or hirsutism (3.0% and 5.0% in 2002 and 2010, respectively); the proportion of new users with a record only for contraception decreased from 32.9% in 2002 to 8.6% in 2010. Among new users prescribed DRSP/EE or LNG/EE in 2010, 43.2% and 30.8% of women, respectively, did not have a record indicating use for contraception. Conclusions Adherence to prescribing guidelines for CPA/EE has improved over time. A substantial proportion of women using DRSP/EE or LNG/EE had records for hormone-responsive conditions only, suggesting that many women were prescribed these therapies for non-contraceptive use.

National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:uu:diva-308933 (URN)10.1136/jfprhc-2015-101202 (DOI)000386461700004 ()27098200 (PubMedID)
Available from: 2016-12-01 Created: 2016-12-01 Last updated: 2017-11-29Bibliographically approved
Jick, S. S., Li, L., Falcone, G. J., Vassilev, Z. P. & Wallander, M.-A. (2015). Epidemiology of multiple sclerosis: results from a large observational study in the UK. Journal of Neurology, 262(9), 2033-2041
Open this publication in new window or tab >>Epidemiology of multiple sclerosis: results from a large observational study in the UK
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2015 (English)In: Journal of Neurology, ISSN 0340-5354, E-ISSN 1432-1459, Vol. 262, no 9, p. 2033-2041Article in journal (Refereed) Published
Abstract [en]

Multiple sclerosis (MS) progression to mortality may not be solely determined by the underlying autoimmune process. We conducted a study in a large cohort of MS patients with the aim of describing characteristics of MS patients and identification of predictors for all-cause mortality in this patient group. We performed a retrospective analysis of primary care data from the UK Clinical Practice Research Datalink. Incident MS cases diagnosed between 1993 and 2006 were identified and validated using electronic and original medical records. Patients were followed to identify deaths; hazard ratios (HRs) and 95 % confidence intervals (CIs) were estimated using Cox proportional regression with age as time-scale. In total, 1713 incident MS cases were identified. Following MS diagnosis, frequent comorbidities were infections (80 %), and depression (46 %). Adjusted HRs (95 % CIs) for all-cause mortality were: 2.0 (1.2-3.4) for current smoking; 7.6 (3.2-17.7) for alcohol abuse; 2.7 (1.6-4.5) for pneumonia and influenza; 4.1 (2.7-6.3) for urinary tract infections; 2.2 (1.2-4.2) for heart disease and 4.9 (2.9-8.0) for cancer. Our results suggest that MS survival is influenced not only by the underlying autoimmune process, but also by patient comorbidities and lifestyle factors.

Keywords
Multiple sclerosis, Epidemiology, Cohort Analysis, Mortality
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-267345 (URN)10.1007/s00415-015-7796-2 (DOI)000363035400004 ()26067217 (PubMedID)
Available from: 2015-11-24 Created: 2015-11-20 Last updated: 2017-12-01Bibliographically approved
Bardel, A., Wallander, M.-A. & Svärdsudd, K. (2015). Factors associated with adherence to drug therapy. In: Mehmet Ungen & Carl Steylaerts (Ed.), The world book of family medicine: European edition published on the ocction of the 20th Anniversary of WONCA Europe, Istanbul, October 2015 (pp. 100-102). Ljubljana: Narodna in univerzitetna
Open this publication in new window or tab >>Factors associated with adherence to drug therapy
2015 (English)In: The world book of family medicine: European edition published on the ocction of the 20th Anniversary of WONCA Europe, Istanbul, October 2015 / [ed] Mehmet Ungen & Carl Steylaerts, Ljubljana: Narodna in univerzitetna , 2015, p. 100-102Chapter in book (Other academic)
Place, publisher, year, edition, pages
Ljubljana: Narodna in univerzitetna, 2015
National Category
General Practice
Identifiers
urn:nbn:se:uu:diva-280548 (URN)978-961-281-983-5 (ISBN)
Available from: 2016-03-11 Created: 2016-03-11 Last updated: 2018-01-10Bibliographically approved
Cea Soriano, L., Wallander, M.-A., Andersson, S., Filonenko, A. & García Rodríguez, L. A. (2015). The continuation rates of long-acting reversible contraceptives in UK general practice using data from The Health Improvement Network. Pharmacoepidemiology and Drug Safety, 24(1), 52-58
Open this publication in new window or tab >>The continuation rates of long-acting reversible contraceptives in UK general practice using data from The Health Improvement Network
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2015 (English)In: Pharmacoepidemiology and Drug Safety, ISSN 1053-8569, E-ISSN 1099-1557, Vol. 24, no 1, p. 52-58Article in journal (Refereed) Published
Abstract [en]

PURPOSE: The purpose of this study was to determine the continuation rates of new users of long-acting reversible contraceptive (LARC) methods in the UK, using data from general practice.

METHODS: We conducted an observational study using a general practitioner (GP) database, The Health Improvement Network (THIN). The methods studied were copper intrauterine devices (Cu-IUDs), levonorgestrel-releasing intrauterine system (LNG-IUS), progestogen-only implants and progestogen-only injections. The study population comprised women in THIN aged 18-44 years during the period 2004-2009 who had been registered with their GP for at least 5 years, with a computerized prescription history of at least 1 year. Using computer algorithms, the database was searched for the Read and Multilex codes for each LARC method. New LARC users were identified and followed until there was a record indicating termination of use or the study period ended.

RESULTS: The proportion of women who discontinued use during the same year of administration was 7.5% for Cu-IUDs, 10.6% for LNG-IUS, 13.2% for progestogen-only implants and 54.4% for progestogen-only injections. By the end of the study, a higher proportion of Cu-IUD and LNG-IUS users (21.1 and 18.6%, respectively) undertook consecutive use of the same method than progestogen-only implant users (10.7%). Manual review of computerized profiles demonstrated the validity of this approach.

CONCLUSIONS: In the UK, the continuation rates of LARCs are high, and approximately one fifth of women chose to have a second intrauterine device fitted after expiry of the first device. A validation step demonstrated the reliability of the methodology and computer algorithms used.

National Category
General Practice
Identifiers
urn:nbn:se:uu:diva-237021 (URN)10.1002/pds.3710 (DOI)000347710100008 ()25250863 (PubMedID)
Available from: 2014-11-26 Created: 2014-11-26 Last updated: 2018-01-11Bibliographically approved
Martín-Merino, E., García Rodríguez, L. A., Wallander, M.-A., Andersson, S. & Soriano-Gabarró, M. (2015). The incidence of hysterectomy, uterus-preserving procedures and recurrent treatment in the management of uterine fibroids. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 194, 147-152
Open this publication in new window or tab >>The incidence of hysterectomy, uterus-preserving procedures and recurrent treatment in the management of uterine fibroids
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2015 (English)In: European Journal of Obstetrics, Gynecology, and Reproductive Biology, ISSN 0301-2115, E-ISSN 1872-7654, Vol. 194, p. 147-152Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To determine the incidence of hysterectomy and uterus-preserving procedures (UPPs) among women with uterine fibroids (UFs) and the incidence of further procedures after a UPP.

STUDY DESIGN: This was an observational study using a primary care database, The Health Improvement Network (THIN). Women in THIN with UFs aged 15-54 years between January 2000 and December 2009 were eligible for study. The UPPs examined were myomectomy, endometrial ablation (EA) and uterine artery embolization (UAE). Using Read codes, women were followed up until one of the following was met: there was a record of hysterectomy or UPPs, they died or the study ended (end of 2010).

RESULTS: The cumulative incidence of hysterectomy or UPPs was 23.6% at 1 year, and 40.9% after the follow-up period (median 3.6 years). At the end of the follow-up period, the cumulative incidences of hysterectomy, myomectomy, EA and UAE were 33.0%, 3.9%, 6.4% and 1.9%, respectively. For women initially treated with a UPP, the cumulative incidence of second procedures was 11.5% at 1 year. At the end of the follow-up period (median 2.7 years), the cumulative incidence of further procedures was 26.1%, and the cumulative incidences of women undergoing hysterectomy, myomectomy, EA and UAE were 19.0%, 4.3%, 3.4% and 1.4%, respectively.

CONCLUSIONS: Women considering UPPs for the management of UFs should be made aware that the incidence of further treatments is high, with hysterectomy being the most frequent procedure undergone.

Keywords
RTW, long-term sick leave, sickness benefit, cognitive intervention approach, co-operation
National Category
Public Health, Global Health, Social Medicine and Epidemiology Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:uu:diva-270497 (URN)10.1016/j.ejogrb.2015.08.034 (DOI)000365057800029 ()26407334 (PubMedID)
Available from: 2015-12-29 Created: 2015-12-29 Last updated: 2017-12-01Bibliographically approved
Brobert, G., Garcia Rodriguez, L. A., Garbe, E., Bezemer, I. D., Layton, D., Friberg, L., . . . Wallander, M.-A. (2014). Development of a Collaborative European Pharmacoepidemiologic Post-Authorization Safety Study (PASS) Programme Examining Rivaroxaban Use in Routine Clinical Practice. Paper presented at ISPOR 17th Annual European Congress, nov 8-12, 2014, Amsterdam, The Netherlands. Value in Health, 17(7), A473-A474, Article ID PCV6.
Open this publication in new window or tab >>Development of a Collaborative European Pharmacoepidemiologic Post-Authorization Safety Study (PASS) Programme Examining Rivaroxaban Use in Routine Clinical Practice
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2014 (English)In: Value in Health, ISSN 1098-3015, E-ISSN 1524-4733, Vol. 17, no 7, p. A473-A474, article id PCV6Article in journal, Meeting abstract (Other academic) Published
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:uu:diva-247623 (URN)000346917301099 ()
Conference
ISPOR 17th Annual European Congress, nov 8-12, 2014, Amsterdam, The Netherlands
Available from: 2015-03-23 Created: 2015-03-22 Last updated: 2017-12-04Bibliographically approved
Garcia Rodriguez, L., Garbe, E., Bezemer, I., Layton, D., Suzart-Woischnik, K., Brobert, G., . . . Wallander, M.-A. (2014). Development of a Collaborative European Post-Authorization Safety Study (PASS) Program Examining Rivaroxaban Use in Routine Clinical Practice. Paper presented at 30th International Conference on Pharmacoepidemiology and Therapeutic Risk Management, October 24–27, 2014, Taipei, Taiwan. Pharmacoepidemiology and Drug Safety, 23(S1), 459-460
Open this publication in new window or tab >>Development of a Collaborative European Post-Authorization Safety Study (PASS) Program Examining Rivaroxaban Use in Routine Clinical Practice
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2014 (English)In: Pharmacoepidemiology and Drug Safety, ISSN 1053-8569, E-ISSN 1099-1557, Vol. 23, no S1, p. 459-460Article in journal, Meeting abstract (Other academic) Published
National Category
Pharmacology and Toxicology
Identifiers
urn:nbn:se:uu:diva-236261 (URN)000342763600847 ()
Conference
30th International Conference on Pharmacoepidemiology and Therapeutic Risk Management, October 24–27, 2014, Taipei, Taiwan
Available from: 2014-11-18 Created: 2014-11-17 Last updated: 2018-01-11Bibliographically approved
Jick, S. S., Li, L., Falcone, G. J., Vassilev, Z. P. & Wallander, M.-A. (2014). Mortality of patients with multiple sclerosis: a cohort study in UK primary care. Journal of Neurology, 261(8), 1508-1517
Open this publication in new window or tab >>Mortality of patients with multiple sclerosis: a cohort study in UK primary care
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2014 (English)In: Journal of Neurology, ISSN 0340-5354, E-ISSN 1432-1459, Vol. 261, no 8, p. 1508-1517Article in journal (Refereed) Published
Abstract [en]

We aimed to estimate rates, causes and risk factors of all-cause mortality in a large population-based cohort of multiple sclerosis (MS) patients compared with patients without MS. Using data from the UK General Practice Research Database, we identified MS cases diagnosed during 2001-2006 and validated using patients' original records where possible. We also included MS cases during 1993-2000 identified and validated in an earlier study. Cases were matched to up to ten referents without MS by age, sex, index date (date of first MS diagnosis for cases and equivalent reference date for controls), general practice and length of medical history before first MS diagnosis. Patients were followed up to identify deaths; hazard ratios (HRs) and 95 % confidence intervals (CIs) were estimated using Cox-proportional regression. MS patients (N = 1,822) had a significantly increased risk of all-cause mortality compared with referents (N = 18,211); adjusted HR 1.7 (95 % CI 1.4-2.1). Compared with referents, female MS patients had a higher but not significantly different HR for death than males; adjusted HR 1.86 (95 % CI 1.46-2.38) vs. HR 1.31 (95 % CI 0.93-1.84), respectively. The most commonly recorded cause of death in MS patients was 'MS' (41 %), with a higher proportion recorded among younger patients. A significantly higher proportion of referents than MS patients had cancer recorded as cause of death (40 vs. 19 %). Patients with MS have a significant 1.7-fold increased risk of all-cause mortality compared with the general population. MS is the most commonly recorded cause of death among MS patients.

Keywords
Multiple sclerosis, Epidemiology, Cause of death, Cohort analysis, Mortality
National Category
Neurology
Identifiers
urn:nbn:se:uu:diva-231240 (URN)10.1007/s00415-014-7370-3 (DOI)000340052000008 ()
Note

Erratum in Journal of Neurology, 2014:261, issue 8, pp 1518-1521, doi: 10.1007/s00415-014-7421-9

Available from: 2014-09-08 Created: 2014-09-05 Last updated: 2017-12-05Bibliographically approved
Kaye, J. A., Castellsague, J., Bui, C. L., Calingaert, B., McQuay, L. J., Riera-Guardia, N., . . . Perez-Gutthann, S. (2014). Risk of acute liver injury associated with the use of moxifloxacin and other oral antimicrobials: a retrospective, population-based cohort study. Pharmacotherapy, 34(4), 336-349
Open this publication in new window or tab >>Risk of acute liver injury associated with the use of moxifloxacin and other oral antimicrobials: a retrospective, population-based cohort study
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2014 (English)In: Pharmacotherapy, ISSN 0277-0008, E-ISSN 1875-9114, Vol. 34, no 4, p. 336-349Article in journal (Refereed) Published
Abstract [en]

STUDY OBJECTIVE: To estimate the incidence and relative risk of a hospitalization or emergency visit for noninfectious liver injury in users of eight oral antimicrobials-amoxicillin, amoxicillin-clavulanic acid, clarithromycin, cefuroxime, doxycycline, levofloxacin, moxifloxacin, telithromycin-compared with nonusers of these antimicrobials.

DESIGN: Retrospective, observational cohort study with a nested case-control analysis.

DATA SOURCE: HealthCore Integrated Research Database.

PATIENTS: Adults with continuous health plan enrollment for at least 6 months before study entry who had a new dispensing of a study antimicrobial between July 1, 2001, and March 31, 2009. Cases had diagnoses indicating noninfectious liver injury during follow-up. To control for potentially confounding risk factors, 10 controls at risk for liver injury during follow-up were matched to each case by age, sex, and event date (liver injury date of the case), and analyses were adjusted for medical history, concomitant drugs, and health care service use.

MEASUREMENTS AND MAIN RESULTS: Two physician reviewers (blind to exposure) validated the cases. Among 1.3 million antimicrobial users, we identified 607 cases of liver injury, including 82 cases of severe hepatocellular injury and 11 cases of liver failure. Liver injury incidence in nonusers of study antimicrobials was 35/100,000 person-years (95% confidence interval [CI] 29-42/100,000 person-years). For valid cases, the adjusted relative risk among current users of multiple antimicrobials was 3.2 (95% CI 1.6-6.7). Levofloxacin had the highest relative risk for current single use (3.2, 95% CI 1.8-5.8). Relative risks were also elevated for amoxicillin-clavulanic acid (2.5, 95% CI 1.3-5.0), doxycycline (2.5, 95% CI 1.2-5.2), moxifloxacin (2.3, 95% CI 1.1-4.7), and amoxicillin (2.3, 95% CI 1.1-4.7).

CONCLUSION: The results support a comparatively high adjusted relative risk of liver injury among patients exposed concurrently to multiple antimicrobials and modest elevations in the risk for several antimicrobials used alone; however, we found little evidence of any strong effect of commonly used antimicrobials on the risk of liver injury.

National Category
General Practice
Identifiers
urn:nbn:se:uu:diva-237037 (URN)10.1002/phar.1367 (DOI)24865821 (PubMedID)
Available from: 2014-11-26 Created: 2014-11-26 Last updated: 2018-01-11Bibliographically approved
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