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Jansson, Stefan P. O.ORCID iD iconorcid.org/0000-0001-6864-4679
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Publications (10 of 27) Show all publications
Cos, X., Seidu, S., Brunton, S., Harris, S. B., Jansson, S. P. O., Mata-Cases, M., . . . Khunti, K. (2020). Impact on guidelines: the general practitioner point of view. Diabetes Research and Clinical Practice, Article ID 108091.
Open this publication in new window or tab >>Impact on guidelines: the general practitioner point of view
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2020 (English)In: Diabetes Research and Clinical Practice, ISSN 0168-8227, E-ISSN 1872-8227, article id 108091Article in journal (Refereed) Epub ahead of print
Abstract [en]

Primary care physicians are uniquely placed to offer holistic, patient-centred care to patients with T2DM. While the recent FDA-mandated cardiovascular outcome trials offer a wealth of data to inform treatment discussions, they have also contributed to increasing complexity in treatment decisions, and in the guidelines that seek to assist in making these decisions. To assist physicians in avoiding treatment inertia, Primary Care Diabetes Europe has formulated a position statement that summarises our current understanding of the available T2DM treatment options in various patient populations. New data from recent outcomes trials is contextualised and summarised for the primary care physician. This consensus paper also proposes a unique and simple tool to stratify patients into 'very high' and 'high' cardiovascular risk categories and outlines treatment recommendations for patients with atherosclerotic cardiovascular disease, heart failure and chronic kidney disease. Special consideration is given to elderly/frail patients and those with obesity. A visual patient assessment tool is provided, and a comprehensive set of prescribing tips is presented for all available classes of glucose-lowering therapies. This position statement will complement the already available, often specialist-focused, T2DM treatment guidelines and provide greater direction in how the wealth of outcome trial data can be applied to everyday practice.

Place, publisher, year, edition, pages
Elsevier, 2020
Keywords
Type 2 diabetes, cardiovascular disease, cardiovascular risk factors, chronic kidney disease, heart failure, primary care, therapeutic inertia
National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:oru:diva-80494 (URN)10.1016/j.diabres.2020.108091 (DOI)32105769 (PubMedID)
Available from: 2020-03-25 Created: 2020-03-25 Last updated: 2020-03-25Bibliographically approved
Husdal, R., Thors Adolfsson, E., Leksell, J., Eliasson, B., Jansson, S. P. O., 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
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
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2019 (English)In: Primary Care Diabetes, ISSN 1751-9918, E-ISSN 1878-0210, Vol. 13, no 2, p. 176-186Article 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 (≤52mmol/mol), 31.9% intermediate (53-69mmol/mol), and 12.1% uncontrolled (≥70mmol/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 p<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 (p<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.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Diabetes mellitus, National survey, Primary health care, Quality of health care, Type 2
National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:oru:diva-70803 (URN)10.1016/j.pcd.2018.11.005 (DOI)000462105300010 ()30545793 (PubMedID)2-s2.0-85057982729 (Scopus ID)
Note

Funding Agencies:

Uppsala-Örebro Regional Research Council  RFR-480801  RFR-550891  RFR-640711 

Region Västmanland  LTV-398181  LTV-472371  LTV-552001  LTV-644151 

Available from: 2018-12-18 Created: 2018-12-18 Last updated: 2019-06-18Bibliographically approved
Fadl, H., Saeedi, M., Montgomery, S., Magnuson, A., Schwarcz, E., Berntorp, K., . . . Simmons, D. (2019). Changing diagnostic criteria for gestational diabetes in Sweden: a stepped wedge national cluster randomised controlled trial-the CDC4G study protocol. BMC Pregnancy and Childbirth, 19(1), Article ID 398.
Open this publication in new window or tab >>Changing diagnostic criteria for gestational diabetes in Sweden: a stepped wedge national cluster randomised controlled trial-the CDC4G study protocol
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2019 (English)In: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 19, no 1, article id 398Article in journal (Refereed) Published
Abstract [en]

Background: The optimal criteria to diagnose gestational diabetes mellitus (GDM) remain contested. The Swedish National Board of Health introduced the 2013 WHO criteria in 2015 as a recommendation for initiation of treatment for hyperglycaemia during pregnancy. With variation in GDM screening and diagnostic practice across the country, it was agreed that the shift to new guidelines should be in a scientific and structured way. The aim of the Changing Diagnostic Criteria for Gestational Diabetes (CDC4G) in Sweden () is to evaluate the clinical and health economic impacts of changing diagnostic criteria for GDM in Sweden and to create a prospective cohort to compare the many long-term outcomes in mother and baby under the old and new diagnostic approaches.

Methods: This is a stepped wedge cluster randomised controlled trial, comparing pregnancy outcomes before and after the switch in GDM criteria across 11 centres in a randomised manner. The trial includes all pregnant women screened for GDM across the participating centres during January-December 2018, approximately two thirds of all pregnancies in Sweden in a year. Women with pre-existing diabetes will be excluded. Data will be collected through the national Swedish Pregnancy register and for follow up studies other health registers will be included.

Discussion: The stepped wedge RCT was chosen to be the best study design for evaluating the shift from old to new diagnostic criteria of GDM in Sweden. The national quality registers provide data on the whole pregnant population and gives a possibility for follow up studies of both mother and child. The health economic analysis from the study will give a solid evidence base for future changes in order to improve immediate pregnancy, as well as long term, outcomes for mother and child.

Place, publisher, year, edition, pages
BMC, 2019
Keywords
Gestational diabetes mellitus, Pregnancy outcomes, Diagnostic criteria, WHO 2013 criteria, Stepped wedge cluster randomised controlled trial, LGA, Health economics, Obesity
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:oru:diva-77999 (URN)10.1186/s12884-019-2547-5 (DOI)000494447700004 ()31675922 (PubMedID)2-s2.0-85074418210 (Scopus ID)
Funder
Swedish Research Council, 2018-00470
Note

Funding Agencies:

Fru Mary von Sydows, född Wijk, donation fond  1017 4917 2618

Nyckelfonden Region Örebro County  OLL-597601

Region Örebro County Research committee  OLL-693551 OLL-786911

Regional Research committee Uppsala-Örebro  RFR-749241

Available from: 2019-11-22 Created: 2019-11-22 Last updated: 2019-11-22Bibliographically approved
Rask, E., Peters, H. & Jansson, S. P. O. (2019). Hypoglykemi: problematisk komplikation av överviktskirurgi [Hypoglycemia following gastric bypass surgery: A case, causes and coping]. Läkartidningen, 116(8), Article ID 363.
Open this publication in new window or tab >>Hypoglykemi: problematisk komplikation av överviktskirurgi [Hypoglycemia following gastric bypass surgery: A case, causes and coping]
2019 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 116, no 8, article id 363Article in journal (Refereed) Published
Abstract [en]

Bariatric surgery is a well-documented and good alternative for treatment of obesity with and without type 2-diabetes. One of the documented complications is postprandial hypoglycemia, with possibly serious consequences. We present such a case, what is known of underlying mechanisms, and treatment options. © 2019, Swedish Medical Association. All rights reserved.

Place, publisher, year, edition, pages
Läkartidningen Förlag AB, 2019
National Category
Surgery
Identifiers
urn:nbn:se:oru:diva-73731 (URN)2-s2.0-85062846415 (Scopus ID)
Available from: 2019-04-15 Created: 2019-04-15 Last updated: 2019-04-15Bibliographically approved
Göranzon, C., Lidskog, M., Freire, F. & Jansson, S. P. O. (2019). Peer learning: Medical students learn from and with each other in placement training at the primary health center. In: : . Paper presented at AMEE - Association for Medical Education in Europe, Vienna, Austria, 24-28 August, 2019.
Open this publication in new window or tab >>Peer learning: Medical students learn from and with each other in placement training at the primary health center
2019 (English)Conference paper, Poster (with or without abstract) (Other academic)
Abstract [en]

Background: Peer learning is an emerging educational concept in health education in Sweden and in other countries. Students, as peers, learn from and with each other. Studies show that students develop increased self-confidence, increased independence and confidence in their skill to solve problems and improve the ability for clinical reasoning. The aim of this pilot study was to further develop forms for clinical training which stimulate student active learning and to make the best use of available supervisor resources.

Summary of Work: During 2018, a peer learning activity was tested for medical students during their clinical training at a primary health center. Before the placement, students were informed of the peer learning project. Two students worked together. Before the meeting, the supervisor introduced the students to the tasks to be performed. The students prepared the reception together. At the patient meeting, one student took the active part and the other observed. The students took turns so that they were the active part in every two patient meetings. Feedback with supervisor and between students took place continuously after the visits and at the end of the day. The project was evaluated by a questionnaire to students and supervisors, and a student diary.

Summary of Results: Ten students agreed that they were completely instructed for the task, two agreed partly. Ten supervisors felt they gave instructions completely, five agreed partly and one didn’t answer. On a scale of 1 to 5, students agreed on average 4.3 or more for questions regarding preparation, constructive feedback, facilitated learning and time for reflection and feedback. Supervisors agreed on average 4.1 or more for the same questions with focus on student learning.

Discussion and Conclusions: Although this is a pilot study, the results show that arranging a peer reception, both from student and supervisor perspective, has a positive effect. Diary writing in combination with peer reception contributes to the students gaining a deeper insight into their learning process and skills development. Larger studies are needed to confirm this. Take-home Messages: A peer reception can create a deeper understanding of the learning process and its guidance.

National Category
Medical and Health Sciences Didactics
Identifiers
urn:nbn:se:oru:diva-77487 (URN)
Conference
AMEE - Association for Medical Education in Europe, Vienna, Austria, 24-28 August, 2019
Available from: 2019-10-21 Created: 2019-10-21 Last updated: 2019-10-22Bibliographically approved
Högberg, C., Jansson, S. P. O., Thulesius, H., Cronberg, O., Gunnarsson, U. & Lilja, M. (2019). The usefulness of Faecal Immunochemical Tests alone and combined with blood counts in the diagnosis of colorectal cancer in primary care in Sweden. In: : . Paper presented at The Cancer and Primary Care Research International network (Ca-PRI 2019), Toronto, Canada, 21-23 May, 2019.
Open this publication in new window or tab >>The usefulness of Faecal Immunochemical Tests alone and combined with blood counts in the diagnosis of colorectal cancer in primary care in Sweden
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2019 (English)Conference paper, Poster (with or without abstract) (Other academic)
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:oru:diva-77521 (URN)
Conference
The Cancer and Primary Care Research International network (Ca-PRI 2019), Toronto, Canada, 21-23 May, 2019
Available from: 2019-10-22 Created: 2019-10-22 Last updated: 2019-10-22Bibliographically approved
Lilja, M., Hellgren, M. & Jansson, S. P. O. (2018). Diagnos och behandlingsmål vid diabetes typ 2 [Diagnosis and treatment goals in diabetes type 2]. Läkartidningen, 115, Article ID EYWX.
Open this publication in new window or tab >>Diagnos och behandlingsmål vid diabetes typ 2 [Diagnosis and treatment goals in diabetes type 2]
2018 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 115, article id EYWXArticle in journal (Refereed) Published
Abstract [sv]

The article presents diagnostic criteria for diabetes and treatment goals for diabetes type 2.

Place, publisher, year, edition, pages
Stockholm, Sweden: Läkartidningen Förlag AB, 2018
National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:oru:diva-65289 (URN)29461567 (PubMedID)
Available from: 2018-02-27 Created: 2018-02-27 Last updated: 2018-09-06Bibliographically approved
Galavazi, M., Jansson, S. P. O., Jendle, J. & Karlsson, J. (2018). Long-term effects of low energy diet combined with CBT-based group treatment of patients with obesity on weight, quality of life and eating behaviour: a 2-year intervention study. In: : . Paper presented at IOB, Vienna, Austria, 2018.
Open this publication in new window or tab >>Long-term effects of low energy diet combined with CBT-based group treatment of patients with obesity on weight, quality of life and eating behaviour: a 2-year intervention study
2018 (English)Conference paper, Poster (with or without abstract) (Other academic)
National Category
Nutrition and Dietetics
Identifiers
urn:nbn:se:oru:diva-73801 (URN)
Conference
IOB, Vienna, Austria, 2018
Available from: 2019-04-16 Created: 2019-04-16 Last updated: 2019-04-16Bibliographically approved
Husdal, R., Rosenblad, A., Leksell, J., Eliasson, B., Jansson, S. P. O., Jerden, L., . . . Adolfsson, E. T. (2018). Resources and organisation in primary health care are associated with HbA(1c) level: A nationwide study of 230 958 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 HbA(1c) level: A nationwide study of 230 958 people with Type 2 diabetes mellitus
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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 HbAic level in people with Type 2 diabetes mellitus (T2DM).

Methods: People with T2DM attending 846 PHCCs (n =230 958) were included in this crosssectional 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 HbAi, level were mean credits of diabetes specific education among registered nurses (RNs) (-0.02 mmol/mol for each additional credit; P < 0.001) and length of regular visits to RNs (-0.19 mmol/mol for each additional 15 min; P < 0.001). Organisational features associated with HbAie level were having a diabetes team (-0.18 mmol/mol; P <0.01) and providing group education (-0.20 mmol/mol; P < 0.01).

Conclusions: In this large sample, PHCC personnel resources and organisational features were associated with lower HbA(1c), level in people with T2DM.

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
HbA(1c), Organisation, Personnel resources, Primary health care system, Type 2 diabetes mellitus
National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:oru:diva-64822 (URN)10.1016/j.pcd.2017.09.003 (DOI)000423008800003 ()28964673 (PubMedID)2-s2.0-85030148709 (Scopus ID)
Note

Funding Agencies:

Uppsala-Örebro Regional Research Council  

Region Västmanland 

Available from: 2018-02-06 Created: 2018-02-06 Last updated: 2018-02-06Bibliographically approved
Jansson, S. P. O. (2017). Diabetes i Laxå under 30 år: hög prevalens, stabil incidens. Läkartidningen, 104(23), 1778-1778
Open this publication in new window or tab >>Diabetes i Laxå under 30 år: hög prevalens, stabil incidens
2017 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 104, no 23, p. 1778-1778Article in journal (Other academic) Published
Place, publisher, year, edition, pages
Stockholm: Läkartidningen förlag, 2017
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:oru:diva-64492 (URN)
Available from: 2018-01-24 Created: 2018-01-24 Last updated: 2018-01-24Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-6864-4679

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