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  • 1. Halling, Anders
    et al.
    Berglund, Johan
    Concordance between elderly patients' understanding of and their primary healthcare physician's diagnosis of heart failure.2006In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 24, no 2, p. 110-104Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The objective was to study primary healthcare patients' understanding of their diagnosis of heart failure (HF), using patients treated for diabetes mellitus (DM) as a comparative group. DESIGN: A cross-sectional community based study. SETTING: Karlskrona community situated on the Swedish south-east coast with 60,600 inhabitants. SUBJECTS: A total of 1402 subjects, aged 60-96 years in 10 age cohorts, selected randomly from the national population registry participating in the Swedish National study on Ageing and Care - Blekinge. MAIN OUTCOME MEASURES: Understanding of diagnosis of HF or DM in primary healthcare. Prevalence of cognitive impairment. RESULTS: In all, 39.8% of patients with a diagnosis of HF treated in primary healthcare and 97.1% of patients with DM had an understanding of their respective diagnosis. Cognitive impairment was significantly more prevalent in the groups of patients treated for HF (OR 1.9, 95% CI 1.2 to 3.0) and DM (OR 1.8, 95% CI 1.1 to 3.1), when compared with those not treated for either HF or DM. The odds ratio for understanding of diagnosis was 0.013 (95% CI 0.003 to 0.052, p < 0.001) in patients treated for HF, compared with patients treated for DM, when adjusted for the subject's age, sex, and cognitive function. CONCLUSION: In this study it was shown that patients' understanding of their diagnosis was highly dependent on diagnosis, independently of age, sex, or cognitive function. The results suggest that there is room for improvement of care in primary healthcare, to increase HF patients' understanding of their diagnosis.

  • 2. Halling, Anders
    et al.
    Berglund, Johan
    Diagnosis and treatment of heart failure in primary health care among elderly patients with non-insulin-dependent diabetes mellitus, with special reference to use of echocardiography2003In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 21, no 2, p. 96-98Article in journal (Refereed)
    Abstract [en]

    Objective-The aim of the present study was to describe how the diagnosis of heart failure (HF) was assessed, aetiology and management in elderly patients with non-insulin-dependent diabetes mellitus (NIDDM) in primary health care, with special reference to use of echocardiography. Design-Descriptive retrospective investigation. Setting-Ronneby and Karlskrona communities, both situated on the Swedish south-east coast, 28,600 and 60,600 inhabitants, respectively. Patients-279 patients with NIDDM, mean age 77 years (range 70-85). Main outcome measures-Prevalence, aetiology, diagnostic procedures and management of HF. Results-The majority of patients were given the diagnosis of HF mainly as a result of clinical examination, ECG and chest X-ray, or of hospitalisation for HF. The diagnosis of HF by the primary care physicians was based on an objective evaluation of cardiac function in 8% of the patients. Hypertension was the predominant associated disease, followed by ischaemic heart disease (IHD). Therapy included diuretics (91%), angiotensin-converting enzyme (ACE) inhibitors (43%) and digoxin (53%). Conclusion-There is still a gap between current management of HF in primary care and guidelines, particularly in the case of diagnosis that is not generally based on an objective evaluation of cardiac function.

  • 3. Stjernberg, Louise
    et al.
    Berglund, Johan
    Halling, Anders
    Age and gender effect on the use of herbal medicine products and food supplements among the elderly2006In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 24, no 1, p. 50-55Article in journal (Refereed)
    Abstract [en]

    Objective. To describe the users of herbal medicine products and food supplements with respect to age and gender specifically among persons aged ≥60 years. Design. A descriptive study with baseline data from a longitudinal study of the elderly, stratified into different age cohorts (60-69, 70-79, 80-89 and ≥90 years). Setting. Blekinge county, situated in the southeastern Sweden. Subjects. Totally 1380 persons aged 60-96 years (median age 78 years). Main outcome measures. Current use of herbal medicine products and the use of food supplements. Results. Of the participants, 264/1380 (19.1%) used at least one herbal medicine product, 184/1380 (13.3%) used at least one food supplement and 382/1380 (27.7%) used herbal medicine products and/or food supplements. In all regression models, women had a higher probability to use herbal medicine and/or food supplements in comparison with men. Focusing on the use of herbal medicine products alone and in the combination of using herbal medicine and/or food supplement, a decreased use was seen with increasing age. However, 27.9% were still users of herbal medicine products and/or food supplements in the age group 80-89 years. In comparison, 14% were users in the age group ≥90 years. Age did not have an impact on the probability of taking food supplements. Conclusion. General practitioners need to consider the high use of herbal medicine product and food supplements among elderly when making decisions about treatment.

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