uu.seUppsala University Publications
Change search
Link to record
Permanent link

Direct link
BETA
Stålhammar, Jan
Alternative names
Publications (10 of 46) Show all publications
Husdal, R., Thors Adolfsson, E., Leksell, J., Eliasson, B., Jansson, S., Jerdén, L., . . . Rosenblad, A. (2019). Associations between quality of work features in primary health care and glycaemic control in people with Type 2 diabetes mellitus: A nationwide survey.. Primary Care Diabetes, 13(2), 176-186, Article ID S1751-9918(18)30277-8.
Open this publication in new window or tab >>Associations between quality of work features in primary health care and glycaemic control in people with Type 2 diabetes mellitus: A nationwide survey.
Show others...
2019 (English)In: Primary Care Diabetes, ISSN 1751-9918, E-ISSN 1878-0210, Vol. 13, no 2, p. 176-186, article id S1751-9918(18)30277-8Article in journal (Refereed) Published
Abstract [en]

Aims: To describe and analyse the associations between primary health care centres’ (PHCCs’) quality of work (QOW) and individual HbA1c levels in people with Type 2 diabetes mellitus (T2DM).

Methods: This cross-sectional study invited all 1152 Swedish PHCCs to answer a questionnaire addressing QOW conditions. Clinical, socio-economic and comorbidity data for 230,958 people with T2DM were linked to data on QOW conditions for 846 (73.4%) PHCCs.

Results: Of the participants, 56% had controlled (≤52 mmol/mol), 31.9% intermediate (53–69 mmol/mol), and 12.1% uncontrolled (≥70 mmol/mol) HbA1c. An explanatory factor analysis identified seven QOW features. The features having a call-recall system, having individualized treatment plans, PHCCs’ results always on the agenda, and having a follow-up strategy combined with taking responsibility of outcomes/results were associated with lower HbA1c levels in the controlled group (all < 0.05). For people with intermediate or uncontrolled HbA1c, having individualized treatment plans was the only QOW feature that was significantly associated with a lower HbA1c level (< 0.05).

Conclusions: This nationwide study adds important knowledge regarding associations between QOW in real life clinical practice and HbA1c levels. PHCCs’ QOW may mainly only benefit people with controlled HbA1c and more effective QOW strategies are needed to support people with uncontrolled HbA1c.

Keywords
Diabetes mellitus, National survey, Primary health care, Quality of health care, Type 2
National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:uu:diva-373949 (URN)10.1016/j.pcd.2018.11.005 (DOI)000462105300010 ()30545793 (PubMedID)
Available from: 2019-01-17 Created: 2019-01-17 Last updated: 2019-04-17Bibliographically approved
Lindmark, K., Boman, K., Olofsson, M., Tornblom, M., Levine, A., Castelo-Branco, A., . . . Wikström, G. (2019). Epidemiology of heart failure and trends in diagnostic work-up: a retrospective, population-based cohort study in Sweden. Clinical Epidemiology, 11, 231-244
Open this publication in new window or tab >>Epidemiology of heart failure and trends in diagnostic work-up: a retrospective, population-based cohort study in Sweden
Show others...
2019 (English)In: Clinical Epidemiology, ISSN 1179-1349, E-ISSN 1179-1349, Vol. 11, p. 231-244Article in journal (Refereed) Published
Abstract [en]

Purpose: The purpose of this study was to examine the trends in heart failure (HF) epidemiology and diagnostic work-up in Sweden.

Methods: Adults with incident HF (>= 2 ICD-10 diagnostic codes) were identified from linked national health registers (cohort 1, 2005-2013) and electronic medical records (cohort 2, 2010-2015; primary/secondary care patients from Uppsala and Vasterbotten). Trends in annual HF incidence rate and prevalence, risk of all-cause and cardiovascular disease (CVD)-related 1-year mortality and use of diagnostic tests 6 months before and after first HF diagnosis (cohort 2) were assessed.

Results: Baseline demographic and clinical characteristics were similar for cohort 1 (N=174,537) and 2 (N=8,702), with mean ages of 77.4 and 76.6 years, respectively; almost 30% of patients were aged >= 85 years. From 2010 to 2014, age-adjusted annual incidence rate of HF/1,000 inhabitants decreased (from 3.20 to 2.91, cohort 1; from 4.34 to 3.33, cohort 2), while age-adjusted prevalence increased (from 1.61% to 1.72% and from 2.15% to 2.18%, respectively). Age-adjusted 1-year all-cause and CVD-related mortality was higher in men than in women among patients in cohort 1 (all-cause mortality hazard ratio [HR] men vs women 1.07 [95% CI 1.06-1.09] and CVD-related mortality subdistribution HR for men vs women 1.04 [95% CI 1.02-1.07], respectively). While 83.5% of patients underwent N-terminal pro-B-type natriuretic peptide testing, only 36.4% of patients had an echocardiogram at the time of diagnosis, although this increased overtime. In the national prevalent HF population (patients with a diagnosis in 1997-2004 who survived into the analysis period; N=273,999), death from ischemic heart disease and myocardial infarction declined between 2005 and 2013, while death from HF and atrial fibrillation/flutter increased (P<0.0001 for trends over time).

Conclusion: The annual incidence rate of HF declined over time, while prevalence of HF has increased, suggesting that patients with HF were surviving longer over time. Our study confirms that previously reported epidemiological trends persist and remain to ensure proper diagnostic evaluation and management of patients with HF.

Keywords
diagnosis, heart failure, incidence rate, mortality, prevalence, real-world
National Category
Cardiac and Cardiovascular Systems Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-382363 (URN)10.2147/CLEP.S170873 (DOI)000464038900001 ()30962724 (PubMedID)
Available from: 2019-04-24 Created: 2019-04-24 Last updated: 2019-04-24Bibliographically approved
Lindmark, K., Boman, K., Olofsson, M., Wirta, S. B., Proenca, C. C., Levine, A., . . . Wikström, G. (2018). Increased all-cause mortality in newly diagnosed patients with heart failure between 2006 and 2012: a retrospective, population-based study in Sweden. European Journal of Heart Failure, 20(S1), 6-6
Open this publication in new window or tab >>Increased all-cause mortality in newly diagnosed patients with heart failure between 2006 and 2012: a retrospective, population-based study in Sweden
Show others...
2018 (English)In: European Journal of Heart Failure, ISSN 1388-9842, E-ISSN 1879-0844, Vol. 20, no S1, p. 6-6Article in journal, Meeting abstract (Other academic) Published
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:uu:diva-365131 (URN)000434123900004 ()
Available from: 2018-11-09 Created: 2018-11-09 Last updated: 2018-11-09Bibliographically approved
Husdal, R., Karlsson, A., Leksell, J., Eliasson, B., Jansson, S., Jerden, L., . . . Thors Adolfsson, E. (2018). Resources and organisation in primary health care are associated with HbA1c level: A nationwide study of 230958 people with Type 2 diabetes mellitus.. Primary Care Diabetes, 12(1), 23-33
Open this publication in new window or tab >>Resources and organisation in primary health care are associated with HbA1c level: A nationwide study of 230958 people with Type 2 diabetes mellitus.
Show others...
2018 (English)In: Primary Care Diabetes, ISSN 1751-9918, E-ISSN 1878-0210, Vol. 12, no 1, p. 23-33Article in journal (Refereed) Published
Abstract [en]

AIMS: To examine the association between personnel resources and organisational features of primary health care centres (PHCCs) and individual HbA1c level in people with Type 2 diabetes mellitus (T2DM).

METHODS: People with T2DM attending 846 PHCCs (n=230958) were included in this cross-sectional study based on PHCC-level data from a questionnaire sent to PHCCs in 2013 and individual-level clinical data from 2013 for people with T2DM reported in the Swedish National Diabetes Register, linked to individual-level data on socio-economic status and comorbidities. Data were analysed using a generalized estimating equations linear regression models.

RESULTS: After adjusting for PHCC- and individual-level confounding factors, personnel resources associated with lower individual HbA1c level were mean credits of diabetes-specific education among registered nurses (RNs) (-0.02mmol/mol for each additional credit; P<0.001) and length of regular visits to RNs (-0.19mmol/mol for each additional 15min; P<0.001). Organisational features associated with HbA1c level were having a diabetes team (-0.18mmol/mol; P<0.01) and providing group education (-0.20mmol/mol; P<0.01).

CONCLUSIONS: In this large sample, PHCC personnel resources and organisational features were associated with lower HbA1c level in people with T2DM.

Keywords
HbA(1c), Organisation, Personnel resources, Primary health care system, Type 2 diabetes mellitus
National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:uu:diva-332689 (URN)10.1016/j.pcd.2017.09.003 (DOI)000423008800003 ()28964673 (PubMedID)
Available from: 2017-10-31 Created: 2017-10-31 Last updated: 2018-12-21Bibliographically approved
Olofsson, M., Boman, K., Lindmark, K., Wikstrom, G., Bergman, G. J., Tornblom, M., . . . Stålhammar, J. (2017). A description of characteristics of very elderly patients newly diagnosed with heart failure: a retrospective population-based cohort study in Sweden. European Journal of Heart Failure, 19, 362-362
Open this publication in new window or tab >>A description of characteristics of very elderly patients newly diagnosed with heart failure: a retrospective population-based cohort study in Sweden
Show others...
2017 (English)In: European Journal of Heart Failure, ISSN 1388-9842, E-ISSN 1879-0844, Vol. 19, p. 362-362Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
WILEY, 2017
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:uu:diva-333647 (URN)000401005301176 ()
Available from: 2017-12-07 Created: 2017-12-07 Last updated: 2017-12-07
Boman, K., Lindmark, K., Stålhammar, J., Wikström, G., Bergman, G. J., Tornblom, M., . . . Olofsson, M. (2017). Costs associated with heart failure with preserved versus reduced ejection fraction: a retrospective population-based cohort study in Sweden. European Journal of Heart Failure, 19, 346-347
Open this publication in new window or tab >>Costs associated with heart failure with preserved versus reduced ejection fraction: a retrospective population-based cohort study in Sweden
Show others...
2017 (English)In: European Journal of Heart Failure, ISSN 1388-9842, E-ISSN 1879-0844, Vol. 19, p. 346-347Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
WILEY, 2017
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:uu:diva-333644 (URN)000401005301142 ()
Available from: 2017-12-07 Created: 2017-12-07 Last updated: 2017-12-07
Wikström, G., Lindmark, K., Olofsson, M., Stålhammar, J., Bergman, G. J., Tornblom, M., . . . Boman, K. (2017). Drug treatment patterns in patients newly diagnosed with heart failure: a retrospective population-based cohort study in Sweden. European Journal of Heart Failure, 19(Suppl. 1), 55-55
Open this publication in new window or tab >>Drug treatment patterns in patients newly diagnosed with heart failure: a retrospective population-based cohort study in Sweden
Show others...
2017 (English)In: European Journal of Heart Failure, ISSN 1388-9842, E-ISSN 1879-0844, Vol. 19, no Suppl. 1, p. 55-55Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
WILEY, 2017
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:uu:diva-333643 (URN)000401005300131 ()
Available from: 2017-12-07 Created: 2017-12-07 Last updated: 2017-12-07Bibliographically approved
Lindmark, K., Boman, K., Olofsson, M., Wikström, G., Bergman, G. J., Tornblom, M., . . . Stålhammar, J. (2017). Epidemiology of heart failure in Sweden: a retrospective population-based cohort study. European Journal of Heart Failure, 19, 364-364
Open this publication in new window or tab >>Epidemiology of heart failure in Sweden: a retrospective population-based cohort study
Show others...
2017 (English)In: European Journal of Heart Failure, ISSN 1388-9842, E-ISSN 1879-0844, Vol. 19, p. 364-364Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
WILEY, 2017
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:uu:diva-333648 (URN)000401005301181 ()
Available from: 2017-12-07 Created: 2017-12-07 Last updated: 2017-12-07Bibliographically approved
Boman, K., Lindmark, K., Olofsson, M., Stålhammar, J., Bergman, G. J., Tornblom, M., . . . Wikström, G. (2017). Healthcare resource utilization associated with heart failure with preserved versus reduced ejection fraction: a retrospective population-based cohort study in Sweden. European Journal of Heart Failure, 19, 346-346
Open this publication in new window or tab >>Healthcare resource utilization associated with heart failure with preserved versus reduced ejection fraction: a retrospective population-based cohort study in Sweden
Show others...
2017 (English)In: European Journal of Heart Failure, ISSN 1388-9842, E-ISSN 1879-0844, Vol. 19, p. 346-346Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
WILEY, 2017
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:uu:diva-333645 (URN)000401005301141 ()
Available from: 2017-12-07 Created: 2017-12-07 Last updated: 2017-12-07
Hellström, P. M., Stålhammar, J., Beydogan, H., Huetson, P., Skup, M. & Agreus, L. (2017). Indirect burden of patients with moderate inflammatory bowel disease in Uppsala County Council, Sweden: a retrospective study using real-world data. Journal of Crohn's & Colitis, 11, S457-S457
Open this publication in new window or tab >>Indirect burden of patients with moderate inflammatory bowel disease in Uppsala County Council, Sweden: a retrospective study using real-world data
Show others...
2017 (English)In: Journal of Crohn's & Colitis, ISSN 1873-9946, E-ISSN 1876-4479, Vol. 11, p. S457-S457Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
OXFORD UNIV PRESS, 2017
National Category
Gastroenterology and Hepatology
Identifiers
urn:nbn:se:uu:diva-328844 (URN)000398606901268 ()
Available from: 2017-09-04 Created: 2017-09-04 Last updated: 2017-09-04Bibliographically approved
Organisations

Search in DiVA

Show all publications