Search results for "lääkemääräykset"
showing 7 items of 7 documents
Inadequate oral anticoagulation with warfarin in women with cerebrovascular event and history of atrial fibrillation: the FibStroke study
2021
Abstract Background Women with atrial fibrillation (AF) may be treated less actively with oral anticoagulation (OAC) than men. Patients and methods We assessed sex differences in the implementation of stroke risk stratification with CHADS2 and CHA2DS2-VASc scores and reasons not to use OAC in 1747 AF patients suffering their first cerebrovascular event after the AF diagnosis. Results Women were older and had more often a high stroke risk (CHADS2/CHA2DS2-VASc ≥2) than men (p < .001). On admission, 46.4% of women and 48.2% of men were on OAC with no sex difference (p = .437). However, of patients without OAC, 74.4% of women and 49.5% of men should have been on OAC based on CHADS2/CHA2DS2-VASc…
Information Integration, Coordination Failures, and Quality of Prescribing
2022
Poor information flows hamper coordination, potentially leading to suboptimal decisions in health care. We examine the effects of a large-scale policy of health information integration. We use the staggered adoption of a nationwide electronic prescribing system over four years in Finland and prescription-level administrative data. Our results show no discernible effect on the probability of co-prescribing harmful drugs on average, but the heterogeneity analysis reveals that this probability reduces in rural regions, by 35 percent. This substantial reduction is driven by interacting prescriptions from different physicians and generalists. Information integration can therefore improve the coo…
Impact of a physician-targeted letter on opioid prescribing.
2020
We study the effect of a physician-targeted nudge letter on opioid prescribing. In May 2017, the Social Insurance Institution of Finland sent a personal information letter to all physicians who had issued a prescription containing at least 100 tablets of paracetamol-codeine combination to a new patient. The aim of the letter was to draw the physicians’ attention to their prescribing practices and to decrease the size of the first codeine prescription. Using individual level register data and a difference-in-differences strategy, we estimate that the letter decreased the average number of tablets purchased by new patients by 12.5 percent and the probability of a first purchase being at least…
Lääkkeitä määräävien sairaanhoitajien ja lääkäreiden yhteistyö perusterveydenhuollon vastaanottotoiminnassa
2016
TIIVISTELMÄ Sulkakoski, M. 2016. Lääkkeitä määräävien sairaanhoitajien ja lääkäreiden yhteistyö perusterveydenhuollon vastaanottotoiminnassa. Terveystieteiden laitos, Jyväskylän yliopisto, terveyskasvatuksen pro gradu–tutkielma, 84 s., 8 liitettä. Tämän tutkimuksen tarkoituksena oli selvittää lääkkeitä määräävien sairaanhoitajien ja heidän kanssaan yhteistyössä työskentelevien lääkäreiden näkemyksiä ammattiryhmiensä välisestä yhteistyöstä suomalaisessa perusterveydenhuollon vastaanottotoiminnassa. Tutkimuksessa selvitettiin miten lääkeitä määräävät sairaanhoitajat ja lääkärit tekevät yhteistyötä perusterveydenhuollon vastaanotoilla, mitkä tekijät tukevat yhteistyötä ja millaisia haasteita s…
Determinants of Prescription Opioid Use : Population‐Based Evidence from Finland
2021
Background and aims Previous studies have shown that prescription opioid use is more common in the socioeconomically disadvantaged communities in the US. This study examined the area and individual‐level determinants of prescription opioid use in Finland during the period 1995‐2016. Design Logistic regression analysis using nationwide data on filled opioid‐related prescriptions dispensed at Finnish pharmacies and covered by the National Health Insurance. Opioid consumption was linked, using personal identification codes, to population‐based data maintained by Statistics Finland, which records individual background and area‐level characteristics. Setting and participants Working‐age populati…
Information Integration, Coordination Failures, and Quality of Prescribing
2020
Poor information flows hamper coordination, potentially leading to suboptimal decisions in health care. We examine the effects of a nationwide policy of information integration on the quality of prescribing. We use the rollout of an electronic prescribing system in Finland and prescription-level administrative data. We find no effect on the probability of co-prescribing harmful drug combinations in urban regions. In rural regions, this probability reduces substantially, by 35 percent. The effect is driven by prescriptions from unspecialized physicians and from multiple physicians. Improving the local information environment thus enhances coordination and narrows differences in the quality o…
Prescription opioid use and employment : A nationwide Finnish register study
2021
Background: The secular decline in labor market participation and the concurrent increase in opioid use in many developed countries have sparked a policy debate on the possible connection between these two trends. We examined whether the use of prescription opioids was connected to labor market outcomes relating to participation, employment and unemployment among the Finnish population. Methods: The working-age population (aged 19–64 years) living in Finland during the period 1995–2016 was used in the analyses (consisting of 67 903 701 person-year observations). Lagged values of prescription opioid use per capita were used as the exposure. Instrumental variables (IV) estimation method was u…