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Publications (10 of 88) Show all publications
Saers, J., Bryngelsson, I.-L., Sundh, J., Janson, C. & Andersson, L. (2024). Occupational Dust Exposure as a Risk Factor for Developing Lung Function Impairment. Journal of Occupational and Environmental Medicine
Open this publication in new window or tab >>Occupational Dust Exposure as a Risk Factor for Developing Lung Function Impairment
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2024 (English)In: Journal of Occupational and Environmental Medicine, ISSN 1076-2752, E-ISSN 1536-5948Article in journal (Refereed) Epub ahead of print
Abstract [en]

OBJECTIVE: Dust exposure is high in several industries. We investigated associations of exposure in paper mills, wood pellet plants and iron foundries with lung function impairment.

METHODS: Respirable silica, inhalable paper dust or inhalable wood dust were collected in personal samples and spirometry was performed. Multiple linear regression analyzed associations with FEV1%pred and FVC%pred.

RESULTS: Wood pellet workers with high exposure to inhalable dust had lower FEV1%pred (95%CI) (-9.4(-16,-2.6)) and FVC%pred (-9.8(-15,-4.0)) compared with lowest exposure level. Workers at paper mills and foundries had no dose-dependent association but lower FEV1%pred and FVC%pred than in workers at wood pellets plants.

CONCLUSIONS: Increased exposure to inhalable wood dust is associated with decreased lung function. Foundry and paper mill workers have generally lower lung function than wood pellet workers. Spirometry should be considered in workers in industries with airborne particulate matter pollution.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2024
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:oru:diva-111021 (URN)10.1097/JOM.0000000000003036 (DOI)38242136 (PubMedID)
Funder
Region Örebro County, OLL-979989
Available from: 2024-01-30 Created: 2024-01-30 Last updated: 2024-01-30Bibliographically approved
Svensson, M., Ekström, M., Sundh, J., Ljunggren, M., Grote, L. & Palm, A. (2023). Adherence to CPAP therapy in Down syndrome: the population-based DISCOVERY study. Journal of Clinical Sleep Medicine (JCSM), 19(3), 453-458
Open this publication in new window or tab >>Adherence to CPAP therapy in Down syndrome: the population-based DISCOVERY study
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2023 (English)In: Journal of Clinical Sleep Medicine (JCSM), ISSN 1550-9389, E-ISSN 1550-9397, Vol. 19, no 3, p. 453-458Article in journal (Refereed) Published
Abstract [en]

Study Objectives: Persons with Down syndrome (DS) have an increased risk of obstructive sleep apnea (OSA) needing continuous positive airway pressure (CPAP), but data on the therapy and outcomes in this population are scarce. We aimed to compare patient characteristics and outcomes of CPAP treatment for patients with OSA with and without DS.

Methods: This was a population-based, longitudinal study on patients initiating CPAP therapy between July 2010 and March 2018 in Sweden and a population-based sex-and age-matched control group (control:case ratio 5:1), with linked data from the Swedish National Patient Registry and the Prescribed Drug Registry (DISCOVERY study cohort).

Results: Patients with DS (n = 64) had a higher apnea-hypopnea index (51.7 & PLUSMN; 30.3 vs 36.8 & PLUSMN; 29.1 events/h, P < .001), Epworth Sleepiness Scale score (13.7 & PLUSMN; 5.9 vs 11.0 & PLUSMN; 4.9, P = .001), rate of previous surgery of tonsils and/or adenoids (21.9% vs 8.2%, P = .001), and more thyroid replacement hormone therapy (45.3% vs 7.8%, P < .001), but lower use of cardiovascular drugs (7.8% vs 22.3%, P = .003) compared with controls. At follow-up after 1.3 & PLUSMN; 0.9 years, there were no differences in nocturnal CPAP usage time (5.6 & PLUSMN; 2.4 vs 5.5 & PLUSMN; 2.0 hours, P = .77), CPAP adherence & GE; 4 hours/night (62% vs 65%, P = .93), or improvement in Epworth Sleepiness Scale score (-5.4 & PLUSMN; 6.8 vs-5.0 & PLUSMN; 2.0, P = .84) between DS and non-DS patients.

Conclusions: OSA severity was substantially higher in patients with DS despite an increased rate of tonsil surgery. Treatment outcomes in terms of adherence and improved daytime sleepiness were comparable between groups, underlining the importance of both OSA diagnosis and treatment in patients with DS.

Place, publisher, year, edition, pages
American Academy of Sleep Medicine, 2023
Keywords
CPAP, adherence, down syndrome, sleep apnea
National Category
Neurology
Identifiers
urn:nbn:se:oru:diva-102526 (URN)10.5664/jcsm.10364 (DOI)001046632900005 ()36458740 (PubMedID)2-s2.0-85149179127 (Scopus ID)
Available from: 2022-12-05 Created: 2022-12-05 Last updated: 2024-01-02Bibliographically approved
Palm, A., Theorell-Haglöw, J., Isakson, J., Ljunggren, M., Sundh, J., Ekström, M. P. & Grote, L. (2023). Association between obstructive sleep apnoea and cancer: a cross-sectional, population-based study of the DISCOVERY cohort. BMJ Open, 13(3), Article ID e064501.
Open this publication in new window or tab >>Association between obstructive sleep apnoea and cancer: a cross-sectional, population-based study of the DISCOVERY cohort
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2023 (English)In: BMJ Open, E-ISSN 2044-6055, Vol. 13, no 3, article id e064501Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: Nocturnal hypoxia in obstructive sleep apnoea (OSA) is a potential risk factor for cancer. We aimed to investigate the association between OSA measures and cancer prevalence in a large national patient cohort.

DESIGN: Cross-sectional study. SETTINGS: 44 sleep centres in Sweden.

PARTICIPANTS: 62 811 patients from the Swedish registry for positive airway pressure (PAP) treatment in OSA, linked to the national cancer registry and national socioeconomic data (the course of DIsease in patients reported to Swedish CPAP, Oxygen and VEntilator RegistrY cohort).

OUTCOME MEASURES: After propensity score matching for relevant confounders (anthropometric data, comorbidities, socioeconomic status, smoking prevalence), sleep apnoea severity, measured as Apnoea-Hypopnoea Index (AHI) or Oxygen Desaturation Index (ODI), were compared between those with and without cancer diagnosis up to 5 years prior to PAP initiation. Subgroup analysis for cancer subtype was performed.

RESULTS: OSA patients with cancer (n=2093) (29.8% females, age 65.3 (SD 10.1) years, body mass index 30 (IQR 27-34) kg/m2) had higher median AHI (n/hour) (32 (IQR 20-50) vs 30 (IQR 19-45), n/hour, p=0.002) and median ODI (n/hour) (28 (IQR 17-46) vs 26 (IQR 16-41), p<0.001) when compared with matched OSA patients without cancer. In subgroup analysis, ODI was significantly higher in OSA patients with lung cancer (N=57; 38 (21-61) vs 27 (16-43), p=0.012)), prostate cancer (N=617; 28 (17-46) vs 24, (16-39)p=0.005) and malignant melanoma (N=170; 32 (17-46) vs 25 (14-41),p=0.015).

CONCLUSIONS: OSA mediated intermittent hypoxia was independently associated with cancer prevalence in this large, national cohort. Future longitudinal studies are warranted to study the potential protective influence of OSA treatment on cancer incidence.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2023
Keywords
Adult thoracic medicine, ONCOLOGY, SLEEP MEDICINE
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:oru:diva-104683 (URN)10.1136/bmjopen-2022-064501 (DOI)000960988700044 ()36868588 (PubMedID)2-s2.0-85149583682 (Scopus ID)
Funder
Bror Hjerpstedts stiftelseSwedish Heart Lung Foundation, 20190607 20190611 20210529 20180567Swedish Research Council, Dnr 2019-02081
Note

Funding agencies:

Gaevle Cancer Foundation

Swedish Society for Sleep Research and Sleep Medicine

Centre for Research and Development, Uppsala University/Region Gävleborg

Uppsala Heart and Lung Foundation

Regional Research Council in Mid Sweden RFR- 931234

 

Available from: 2023-03-07 Created: 2023-03-07 Last updated: 2023-08-28Bibliographically approved
Ntouniadakis, E., Sundh, J., Magnuson, A. & von Beckerath, M. (2023). Balloon dilatation is superior to CO2 laser excision in the treatment of subglottic stenosis. European Archives of Oto-Rhino-Laryngology, 280(7), 3303-3311
Open this publication in new window or tab >>Balloon dilatation is superior to CO2 laser excision in the treatment of subglottic stenosis
2023 (English)In: European Archives of Oto-Rhino-Laryngology, ISSN 0937-4477, E-ISSN 1434-4726, Vol. 280, no 7, p. 3303-3311Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: Endoscopic treatment of subglottic stenosis (SGS) is regarded as a safe procedure with rare complications and less morbidity than open surgery yet related with a high risk of recurrence. The abundance of techniques and adjuvant therapies complicates a comparison of the different surgical approaches. The primary aim of this study was to investigate disease recurrence after CO2 laser excisions and balloon dilatation in patients with SGS and to identify potential confounding factors.

MATERIALS AND METHODS: In a tertiary referral center, two cohorts of previously undiagnosed patients treated for SGS were retrospectively reviewed and followed for 3 years. The CO2 laser cohort (CLC) was recruited between 2006 and 2011, and the balloon dilatation cohort (BDC) between 2014 and 2019. Kaplan‒Meier and multivariable Cox regression analyzed time to repeated surgery and estimated hazard ratios (HRs) for different variables.

RESULTS: Nineteen patients were included in the CLC, and 31 in the BDC. The 1-year cumulative recurrence risk was 63.2% for the CLC compared with 12.9% for the BDC (HR 33.0, 95% CI 6.57-166, p < 0.001), and the 3-year recurrence risk was 73.7% for the CLC compared with 51.6% for the BDC (HR 8.02, 95% CI 2.39-26.9, p < 0.001). Recurrence was independently associated with overweight (HR 3.45, 95% CI 1.16-10.19, p = 0.025), obesity (HR 7.11, 95% CI 2.19-23.04, p = 0.001), and younger age at diagnosis (HR 8.18, 95% CI 1.43-46.82, p = 0.018).

CONCLUSION: CO2 laser treatment is associated with an elevated risk for recurrence of SGS compared with balloon dilatation. Other risk factors include overweight, obesity, and a younger age at diagnosis.

Place, publisher, year, edition, pages
Springer, 2023
Keywords
Balloon dilatation, CO2 laser, Endoscopic treatment, Subglottic stenosis
National Category
Surgery
Identifiers
urn:nbn:se:oru:diva-105192 (URN)10.1007/s00405-023-07926-w (DOI)000956320500001 ()36964409 (PubMedID)2-s2.0-85150632016 (Scopus ID)
Funder
Örebro UniversityRegion Örebro County
Available from: 2023-03-27 Created: 2023-03-27 Last updated: 2024-01-02Bibliographically approved
Björklund, F., Palm, A., Gorani, J. A., Ahmadi, Z., Sundh, J., Haglöw, J. T., . . . Ekström, M. (2023). Breathlessness and exercise performance to predict mortality in long-term oxygen therapy. Paper presented at ERS International Congress 2023, Milan, Italy, September 9-13, 2023. European Respiratory Journal, 62(Suppl. 67), Article ID PA3762.
Open this publication in new window or tab >>Breathlessness and exercise performance to predict mortality in long-term oxygen therapy
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2023 (English)In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 62, no Suppl. 67, article id PA3762Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Background: Patients with chronic respiratory failure treated with long-term oxygen therapy (LTOT) often have severe breathlessness, impaired exercise performance, and high but variable mortality that is difficult to predict. We aimed to evaluate breathlessness and exercise performance upon starting LTOT as predictors of overall and short-term mortality.

Methods: This was a longitudinal, population-based study of patients who initiated LTOT between 2015-2018 in Sweden. Breathlessness was measured using the Dyspnea Exertion Scale, and exercise performance using the 30s-Sit-To-Stand test. Associations with overall and three-month mortality were analyzed using Cox-regression. Subgroup analyses were performed for patients with COPD and ILD respectively. The predictive capacity of models was assessed using a C-statistic.

Results: A total of 441 patients (57.6% female, aged 75.4±8.3 years) were analyzed. Both breathlessness and exercise performance were independently associated with overall mortality in the crude models, but only exercise performance remained independently associated with overall mortality when models were adjusted for other predictors, when three-month mortality was analyzed, or when breathlessness and exercise capacity were analyzed concurrently. The multivariable model including exercise performance but not breathlessness provided a relatively high predictive capacity for overall mortality, C-statistic 0.756 (95% CI 0.702-0.810). Similar results were seen in the COPD and ILD subgroups.

Conclusion: Exercise performance as measured by the 30s-STS may be useful to identify patients with higher mortality on LTOT for optimized management and follow-up.

Place, publisher, year, edition, pages
European Respiratory Society, 2023
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:oru:diva-110748 (URN)10.1183/13993003.congress-2023.PA3762 (DOI)001109120506313 ()
Conference
ERS International Congress 2023, Milan, Italy, September 9-13, 2023
Available from: 2024-01-19 Created: 2024-01-19 Last updated: 2024-01-19Bibliographically approved
Björklund, F., Palm, A., Gorani, J. A., Ahmadi, Z., Sundh, J., Theorell-Haglöw, J., . . . Ekström, M. (2023). Breathlessness and exercise performance to predict mortality in long-term oxygen therapy: The population-based DISCOVERY study. Respiratory Medicine, 216, Article ID 107306.
Open this publication in new window or tab >>Breathlessness and exercise performance to predict mortality in long-term oxygen therapy: The population-based DISCOVERY study
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2023 (English)In: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 216, article id 107306Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Patients with chronic respiratory failure treated with long-term oxygen therapy (LTOT) often have severe breathlessness, impaired exercise performance, and high but variable mortality that is difficult to predict. We aimed to evaluate breathlessness and exercise performance upon starting LTOT as predictors of overall and short-term mortality.

METHODS: This was a longitudinal, population-based study of patients who initiated LTOT between 2015 and 2018 in Sweden. Breathlessness was measured using the Dyspnea Exertion Scale, and exercise performance using the 30s-Sit-To-Stand test. Associations with overall and three-month mortality were analyzed using Cox-regression. Subgroup analyses were performed for patients with chronic obstructive pulmonary disease (COPD) and interstitial lung disease (ILD) respectively. The predictive capacity of models was assessed using a C-statistic.

RESULTS: A total of 441 patients (57.6% female, aged 75.4 ± 8.3 years) were analyzed, of whom 141 (32%) died during a median follow-up of 260 (IQR 75-460) days. Both breathlessness and exercise performance were independently associated with overall mortality in the crude models, but only exercise performance remained independently associated with overall mortality when models were adjusted for other predictors, when short-term mortality was analyzed, or when breathlessness and exercise capacity were analyzed concurrently. The multivariable model including exercise performance but not breathlessness provided a relatively high predictive capacity for overall mortality, C-statistic 0.756 (95% CI 0.702-0.810). Similar results were seen in the COPD and ILD subgroups.

CONCLUSION: Exercise performance as measured by the 30s-STS may be useful to identify patients with higher mortality on LTOT for optimized management and follow-up.

Place, publisher, year, edition, pages
Elsevier, 2023
Keywords
Breathlessness, Exercise performance, Long-term oxygen therapy
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:oru:diva-106391 (URN)10.1016/j.rmed.2023.107306 (DOI)001022318600001 ()37286141 (PubMedID)2-s2.0-85161342765 (Scopus ID)
Funder
Region BlekingeUppsala UniversitySwedish Heart Lung Foundation, 20200295 20180567 20210529Swedish Research Council, 2019-02081
Note

Funding agencies:

Regional Research Council in Mid Sweden RFR-931234

Agreement concerning research and education of doctors OLL-939092 ALF-979044 ALF-GBG 966 283

Available from: 2023-06-26 Created: 2023-06-26 Last updated: 2024-01-02Bibliographically approved
Eliasson, G., Janson, C., Johansson, G., Larsson, K., Lindén, A., Löfdahl, C.-G., . . . Sundh, J. (2023). Comorbid conditions as predictors of mortality in severe COPD - an eight-year follow-up cohort study. European Clinical Respiratory Journal, 10(1), Article ID 2181291.
Open this publication in new window or tab >>Comorbid conditions as predictors of mortality in severe COPD - an eight-year follow-up cohort study
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2023 (English)In: European Clinical Respiratory Journal, ISSN 2001-8525, Vol. 10, no 1, article id 2181291Article in journal (Refereed) Published
Abstract [en]

Purpose: Co-morbidities are common in chronic obstructive pulmonary disease (COPD) and are associated with increased morbidity and mortality. The aim of the present study was to explore the prevalence of several comorbid conditions in severe COPD, and to investigate and compare their associations with long-term mortality.

Methods: In May 2011 to March 2012, 241 patients with COPD stage 3 or 4 were included in the study. Information was collected on sex, age, smoking history, weight and height, current pharmacological treatment, number of exacerbations the recent year and comorbid conditions. At December 31st, 2019, mortality data (all-cause and cause specific) were collected from the National Cause of Death Register. Data were analyzed using Cox-regression analysis with gender, age, previously established predictors of mortality and comorbid conditions as independent variables, and all-cause mortality and cardiac and respiratory mortality, respectively, as dependent variables.

Results: Out of 241 patients, 155 (64%) were deceased at the end of the study period; 103 patients (66%) died of respiratory disease and 25 (16%) of cardiovascular disease. Impaired kidney function was the only comorbid condition independently associated with increased all-cause mortality (HR (95% CI) 3.41 (1.47-7.93) p=0.004) and respiratory mortality (HR (95%CI) 4.63 (1.61 to 13.4), p = 0.005). In addition, age >= 70, BMI <22 and lower FEV1 expressed as %predicted were significantly associated with increased all-cause and respiratory mortality.

Conclusion: In addition to the risk factors high age, low BMI and poor lung function; impaired kidney function appears to be an important risk factor for mortality in the long term, which should be taken into account in the medical care of patients with severe COPD.

Place, publisher, year, edition, pages
Taylor & Francis, 2023
Keywords
COPD, mortality, predictor, comorbidity, impaired kidney function
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:oru:diva-105078 (URN)10.1080/20018525.2023.2181291 (DOI)000939762500001 ()36861117 (PubMedID)2-s2.0-85149373938 (Scopus ID)
Available from: 2023-03-20 Created: 2023-03-20 Last updated: 2024-01-02Bibliographically approved
Giezeman, M., Sundh, J., Athlin, Å., Lisspers, K., Ställberg, B., Janson, C., . . . Hasselgren, M. (2023). Comorbid Heart Disease in Patients with COPD is Associated with Increased Hospitalization and Mortality: A 15-Year Follow-Up. The International Journal of Chronic Obstructive Pulmonary Disease, 18, 11-21
Open this publication in new window or tab >>Comorbid Heart Disease in Patients with COPD is Associated with Increased Hospitalization and Mortality: A 15-Year Follow-Up
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2023 (English)In: The International Journal of Chronic Obstructive Pulmonary Disease, ISSN 1176-9106, E-ISSN 1178-2005, Vol. 18, p. 11-21Article in journal (Refereed) Published
Abstract [en]

PURPOSE: The aim of this study was to examine the association of comorbid heart disease, defined as chronic heart failure or ischemic heart disease, on all-cause and cause-specific hospitalization and mortality in patients with COPD over a period of nearly 15 years.

MATERIALS AND METHODS: The cohort study included patients with COPD from primary and secondary care in 2005 with data from questionnaires and medical record reviews. The Swedish Board of Health and Welfare provided hospitalization and mortality data from 2005 through 2019. Cox regression analyses, adjusted for sex, age, educational level, smoking status, BMI, exacerbations, dyspnea score and comorbid diabetes or hypertension, assessed the association of comorbid heart disease with all-cause and cause-specific time to first hospitalization and death. Linear regression analyses, adjusted for the same variables, assessed this association with hospitalization days per year for those patients that had been hospitalized.

RESULTS: Of the 1071 patients, 262 (25%) had heart disease at baseline. Cox regression analysis showed a higher risk of hospitalization for patients with heart disease for all-cause (HR (95% CI) 1.55; 1.32-1.82), cardiovascular (2.14; 1.70-2.70) and other causes (1.27; 1.06-1.52). Patients with heart disease also had an increased risk of all-cause (1.77; 1.48-2.12), cardiovascular (3.40; 2.41-4.78) and other (1.50; 1.09-2.06) mortality. Heart disease was significantly associated with more hospitalization days per year of all-cause (regression coefficient 0.37; 95% CI 0.15-0.59), cardiovascular (0.57; 0.27-0.86) and other (0.37; 0.12-0.62) causes. No significant associations were found between heart disease and respiratory causes of hospitalization and death.

CONCLUSION: Comorbid heart disease in patients with COPD is associated with an increased risk for all-cause hospitalization and mortality, mainly due to an increase of hospitalization and death of cardiovascular and other causes, but not because of respiratory disease. This finding advocates the need of a strong clinical focus on primary and secondary prevention of cardiovascular disease in patients with COPD.

Place, publisher, year, edition, pages
Dove Medical Press Ltd., 2023
Keywords
Chronic heart failure, chronic obstructive pulmonary disease, comorbidity, hospitalization, ischemic heart disease, mortality
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:oru:diva-103309 (URN)10.2147/COPD.S378979 (DOI)000994341900001 ()36644219 (PubMedID)2-s2.0-85146313479 (Scopus ID)
Funder
Region VärmlandRegion Örebro CountyBror Hjerpstedts stiftelse
Available from: 2023-01-23 Created: 2023-01-23 Last updated: 2024-01-03Bibliographically approved
Athlin, Å., Lisspers, K., Hasselgren, M., Ställberg, B., Janson, C., Montgomery, S., . . . Sundh, J. (2023). Diagnostic spirometry in COPD is increasing, a comparison of two Swedish cohorts. npj Primary Care Respiratory Medicine, 33(1), Article ID 23.
Open this publication in new window or tab >>Diagnostic spirometry in COPD is increasing, a comparison of two Swedish cohorts
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2023 (English)In: npj Primary Care Respiratory Medicine, E-ISSN 2055-1010, Vol. 33, no 1, article id 23Article in journal (Refereed) Published
Abstract [en]

Spirometry should be used to confirm a diagnosis of chronic obstructive pulmonary disease (COPD). This test is not always performed, leading to possible misdiagnosis. We investigated whether the proportion of patients with diagnostic spirometry has increased over time as well as factors associated with omitted or incorrectly interpreted spirometry. Data from medical reviews and a questionnaire from primary and secondary care patients with a doctors' diagnosis of COPD between 2004 and 2010 were collected. Data were compared with a COPD cohort diagnosed between 2000 and 2003. Among 703 patients with a first diagnosis of COPD between 2004 and 2010, 88% had a diagnostic spirometry, compared with 59% (p < 0.001) in the previous cohort. Factors associated with not having diagnostic spirometry were current smoking (OR 2.21; 95% CI 1.36-3.60), low educational level (OR 1.81; 1.09-3.02) and management in primary care (OR 2.28; 1.02-5.14). The correct interpretation of spirometry results increased (75% vs 82%; p = 0.010). Among patients with a repeated spirometry, 94% had a persistent FEV1/FVC or FEV1/VC ratio <0.70.

Place, publisher, year, edition, pages
Nature Publishing Group, 2023
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:oru:diva-106171 (URN)10.1038/s41533-023-00345-8 (DOI)000999605900001 ()37264017 (PubMedID)2-s2.0-85160925109 (Scopus ID)
Funder
Bror Hjerpstedts stiftelse
Note

Funding agency:

Uppsala County Association Against Heart and Lung Diseases

Available from: 2023-06-02 Created: 2023-06-02 Last updated: 2024-01-03Bibliographically approved
Smith, C., Hasselgren, M., Janson, C., Kisiel, M. A., Lisspers, K., Nager, A., . . . Montgomery, S. (2023). Does multimorbidity result in de-prioritisation of COPD in primary care?. npj Primary Care Respiratory Medicine, 33(1), Article ID 2.
Open this publication in new window or tab >>Does multimorbidity result in de-prioritisation of COPD in primary care?
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2023 (English)In: npj Primary Care Respiratory Medicine, E-ISSN 2055-1010, Vol. 33, no 1, article id 2Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to describe factors associated with having COPD regularly reviewed in primary care by a nurse or physician and assess whether there was de-prioritisation for COPD in multimorbid patients. We defined de-prioritisation as not having at least one check-up by a physician during a two-year period. Among 713 COPD patients in the Swedish PRAXIS study, 473 (66%) had at least one check-up during the study period (ending in 2014). Patients with check-ups were more likely to have three or more comorbid conditions (31.9% vs. 24.6%) and exacerbations (35.1% vs. 21.7%) than those without. Compared with those without comorbidity, those with three or more diagnoses had increased relative risk ratios (and 95% CI) for consultations discussing COPD with only a physician (5.63 (2.68-11.79)), COPD-nurse only (1.67 (0.83-3.37)) or both (2.11 (1.09-4.06)). COPD patients received more frequent check-ups considering COPD if they had comorbidity or a history of exacerbations. We found no evidence of de-prioritisation for COPD in multimorbid patients.

Place, publisher, year, edition, pages
Nature Publishing Group, 2023
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:oru:diva-103178 (URN)10.1038/s41533-023-00326-x (DOI)000913780400001 ()36641480 (PubMedID)2-s2.0-85146266296 (Scopus ID)
Funder
Swedish Heart Lung FoundationSwedish Asthma and Allergy AssociationBror Hjerpstedts stiftelse
Note

Funding agencies:

Regional Research Council, Central Sweden 

Centre for Clinical Research, Dalarna, Sweden 

Centre for Clinical Research, Värmland, Sweden

Available from: 2023-01-23 Created: 2023-01-23 Last updated: 2024-01-03Bibliographically approved
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