Goran Petersson

• MD, PhD
• Managing Director at Linnaeus University

Background In the treatment of coronary heart disease, secondary prevention goals are still often unmet and poor adherence to prescribed drugs has been suggested as one of the reasons. We aimed to investigate whether pharmaceutical care by a pharmacist at the cardiology clinic trained in motivational interviewing improves clinical outcomes and pati...

The aim of this study was to explore the effects of web-based education in the field of drug utilization on elderly individuals’ knowledge of, concerns about and self-assessed understanding of drug utilization. The 260 included participants were randomized to a control group or an intervention group. To assess drug utilization literacy, we used a q...

Introduction There is consistent evidence that the workload in general practices is substantially increasing. The digitalisation of healthcare including the use of artificial intelligence has been suggested as a solution to this problem. We wanted to explore the features of intelligent online triage tools in primary care by conducting a literature...

Background: Trials of complex interventions are often criticized for being difficult to interpret because the effects of apparently similar interventions vary across studies dependent on context, targeted groups, and the delivery of the intervention. The Motivational Interviewing and Medication Review in Coronary heart disease (MIMeRiC) trial is a...

Aims and objectives: To investigate reasons for inadequate documentation of vital signs in an electronic health record. Background: Monitoring vital signs is crucial to detecting and responding to patient deterioration. The ways in which vital signs are documented in electronic health records have received limited attention in the research liter...

BACKGROUND Trials of complex interventions are often criticized for being difficult to interpret because the effects of apparently similar interventions vary across studies dependent on context, targeted groups, and the delivery of the intervention. The Motivational Interviewing and Medication Review in Coronary heart disease (MIMeRiC) trial is a r...

This study explores the attitudes of elderly people to the use of electronic educational technology (e-learning) on drug utilization, with particular emphasis on the layout, usability, content, and level of knowledge in the tool. e-Learning modules were evaluated by a group of elderly people (aged ⩾65 years, n = 16) via a questionnaire comprising c...

Objective: To explore the purpose and performance of clinical evaluation of electronic health records (EHRs) among stakeholders in order to identify any need for regulatory actions or guidelines. Methods: This was a qualitative study of information collected in semi-structured interviews (n=28) of representatives of the five largest EHR vendors in...

The ubiquity of sensor, computing, communication, and storage technologies provides us with access to previously unknown amounts of data - Big Data. Big Data has revolutionized research communities and their scientific methodologies. It has, for instance, innovated the approaches to knowledge and theory building, validation, and exploitation taken...

Controversy pervades the definition of adequate and optimal vitamin D status. The Institutes of Medicine have recommended serum 25(OH)D levels above 50 nmol/L based upon evidence related to bone health, but some experts, including the Endocrine Society and International Osteoporosis Foundation, suggest a minimum serum 25(OH)D level of 75 nmol/L to...

Workarounds are commonplace in healthcare settings. An increase in the use of electronic health records has led to an escalation of workarounds as healthcare professionals cope with systems which are inadequate for their needs. Closely related to this, the documentation of vital signs in electronic health records has been problematic. The accuracy...

Background: Drug-related problems cause suffering for patients and substantial costs. Multi-dose drug dispensing is a service in which patients receive their medication packed in bags with one unit for each dose occasion. The electronic expert support system (EES) is a clinical decision support system that provides alerts if potential drug-related...

Background: Preventive treatment goals for blood pressure and cholesterol levels continue to be unmet for many coronary patients. The effect of drug treatment depends on both its appropriateness and the patients' adherence to the treatment regimen. There is a need for adherence interventions that have a measurable effect on clinical outcomes. Obj...

Background: Physicians, patients and others involved need to have accurate information on patients' current drug prescriptions available, and have that information protected from unauthorized access. During the past decade, many counties in Sweden have implemented regionally shared medication lists within health care. Objective: The aim of this...

Advanced mobile devices allow registered nurses and nursing students to keep up-to-date with expanding health-related knowledge but are rarely used in nursing in Sweden. This study aims at describing registered nurses' and nursing students' views regarding the use of advanced mobile devices in nursing practice. A cross-sectional study was completed...

Background When the Swedish pharmacy market was re-regulated in 2009, Sweden moved from one state-owned pharmacy chain to several private pharmacy companies, and four new dispensing systems emerged to replace the one system that had previously been used at all Swedish pharmacies for more than 20 years. Objectives The aim of this case study was to...

Rationale, aim and objective: To achieve the beneficial effect of drug treatment and reduce unnecessary healthcare costs, patients must be involved in shared decision-making. The aim of this study was to describe patient experiences of participation in decision-making when commencing long-term medication.Method: Nine patients at 2 healthcare center...

Background Drug related problems (DRPs) are frequent and cause suffering for patients and substantial costs for society. Multi-dose drug dispensing (MDDD) is a service by which patients receive their medication packed in bags with one unit for each dose occasion. The clinical decision support system (CDSS) electronic expert support (EES) analyses p...

Vital sign documentation is crucial to detecting patient deterioration. Little is known about the documentation of vital signs in electronic health records. This study aimed to examine documentation of vital signs in electronic health records. We examined the vital signs documented in the electronic health records of patients who had suffered an in...

Medication for elderly patients is often complex and problematic. Several criteria for classifying inappropriate prescribing exist. In 2010, the Swedish National Board of Health and Welfare published the document "Indicators of appropriate drug therapy in the elderly" as a guideline for improving prescribing for the elderly. The aim of this study w...

Objectives Clinical outcomes in the secondary prevention of cardiovascular disease depend on the patients’ adherence to prescribed medicines. Motivational interviewing (MI) is a patient-centred approach used to change different health behaviours. The objective of this pilot study was to explore the impact of a clinical pharmacist's consultation on...

A personal digital assistant (PDA) is a multifunctional information and communication tool allowing nursing students to keep up to date with expanding health related knowledge.Objectives This study was aimed at exploring nursing students' experience of using a PDA in clinical practice.Method In this intervention study, nursing students (n = 67) use...

Purpose: Socioeconomic factors have been suggested to influence the prescribing of newer and more expensive drugs. In the present study, individual and health care provider factors were studied in relation to the prevalence of differently priced drugs. Methods: Register data for dispensed drugs were retrieved for 18 486 individuals in a county c...

Purpose Socioeconomic factors have been suggested to influence the prescribing of newer and more expensive drugs. In the present study, individual and health care provider factors were studied in relation to the prevalence of differently priced drugs. Methods Register data for dispensed drugs were retrieved for 18 486 individuals in a county counci...

Det här är en slutrapport på ett forskningsprojekt som eHälsoinstitutet genomfört på uppdrag av Läkemedelsverket. Syftet var att på ett övergripande sätt kartlägga funktion och kvalitetssäkring av receptexpeditionssystem (RES) i Sverige för att underlätta framtida kvalitetsarbete och den fortsatta tillsynen av apoteken. RES avser den programvara so...

Background: In nursing care, the steady increase of health related information implies that there is need for useful tools that easily provide mobile access to accurate information.

Objectives: To analyse the impact of the observed increase in the prevalence in polypharmacy on the development of prescribed drug expenditure (PDE) in a national population during five years. Methods: A register-based study of all prescribed drugs and PDE for the entire Swedish population during a 3-month period in 2005 and 2009, respectively....

The increased application of eServices in health care, in general, and ePrescribing (electronic prescribing) in particular, have brought quality and interoperability to the forefront. The application of standards has been put forward as one important factor in improving interoperability. However, less focus has been placed on other factors, such as...

What is known and objective: Interventions involving medication reconciliation and review by clinical pharmacists can reduce drug-related problems and improve therapeutic outcomes. The objective of this study was to examine the impact of routine admission medication reconciliation and inpatient medication review on emergency department (ED) revisi...

Background The purpose of this study was to investigate awareness among nurses regarding their new role as reporters of adverse drug reactions in Sweden and factors that may influence reporting by nurses. Methods In 2007, all nurses were included in the adverse drug reaction reporting scheme in Sweden. A questionnaire was sent to 753 randomly sele...

The incorrect use of medications may result from improper prescribing. The poor interface and design of computerised physician order entry (CPOE) systems may contribute. To improve the quality of electronic drug prescription, ePrescribing, there is a need for an evaluation model that is able to assess the quality of the CPOE, focusing on usability....

There are numerous risk factors for patients to develop excessive polypharmacy. The most prominent risk factors are associated with sociodemographics and the patients’ conditions. Risk factors associated with patient behavior, such as patient’s self medication with all types of medications, have not been observed to the same extent but might be at...

To estimate non-adherence in relation to the therapeutic intensity (TI) and the number of dispensed drugs per individual and study whether the TI can be used as an estimator of non-adherence with an increasing number of drugs. The study comprised an individual-based register of all dispensed outpatient prescriptions in Sweden in 2006, including 6.2...

Patients' non-adherence to drug therapy is a major problem for society as it is associated with reduced health outcomes. Generally, approximately only 50% of patients with chronic disease in developed countries adhere to prescribed therapy, and the most common non-adherence refers to chronic under-use, i.e. patients use less medication than prescri...

The aim of this study was to describe one nurse's experience of using a personal digital assistant (PDA) in nursing practice. Nurses handle large amounts of information and a PDA may contain valuable information that nurses need in their daily work. In this qualitative single case study, data were collected through an open-ended interview with one...

Medication misuse results in considerable problems for both patient and society. It is a complex problem with many contributing factors, including timely access to product information. To investigate the value of 3-dimensional (3D) visualization paired with video conferencing as a tool for pharmaceutical advice over distance in terms of accessibili...

To analyse the acquisition cost of dispensed prescription drugs for individuals with multiple medications in a national population. We collected and analysed individual based data regarding the acquisition cost of dispensed prescription drugs for all individuals with five or more dispensed drugs (DP≥5) in Sweden 2006 (2.2 million). Individuals with...

Objective To evaluate Swedish patients' attitudes towards e-prescribing, including the transfer of e-prescriptions, electronic storing of prescriptions and mail-order prescriptions. Methods This study was a nationwide survey of attitudes among Swedish patients and was conducted as a postal questionnaire. The questionnaire was developed for the purp...

Objectives To assess the prevalence and the therapeutic intensity of dispensed drug groups for individuals receiving multiple medications. Methods The individual-based data of all dispensed outpatient prescriptions in Sweden in 2006 were analysed. Five or more dispensed drugs (DP ≥ 5) during a 12-month period were applied as an indicator of multipl...

An increase in the use of drugs and polypharmacy have been displayed over time in spite of the fact that polypharmacy represents a well known risk factor as regards patients' health due to the adverse drug reactions, drug-drug interactions, and low adherence to drug therapy arising from polypharmacy. For policymakers, as well as for clinicians, it...

Objective To evaluate Swedish pharmacists' attitudes towards ePrescribing, including the transfer of ePrescriptions, electronic storing of prescriptions and mail-order prescriptions.Method This study was conducted as a web-based survey among 500 randomly selected Swedish community pharmacists. The questionnaire included open-ended questions, multip...

PurposeTo assess polypharmacy in a population with emphasis on regions.Methods We studied the individual-based data of all dispensed prescription drugs (DP) during a 3-month study period in Sweden 2006. As an indicator of polypharmacy, five or more (DP ≥ 5) different drugs (substances) dispensed were applied. For analysis, we used comparisons of pr...

Electronic patient record (EPR) systems have a huge impact on nursing documentation. Although the largest group of end-users of EPRs, nurses have had minimal input in their design. This study aimed to review current research on how nurses experience using the EPR for documentation. A literature search was conducted in Medline and Cinahl of original...

Inappropriate medication among elderly people increases the risk of adverse drug-drug interactions, drug-related falls and hospital admissions. In order to prevent these effects it is necessary to obtain a profile of the patients' medication. A personal digital assistant (PDA) can be used as a medical decision support system (MDSS) to obtain a prof...

The eHealth Action Plan required the member states of the European Union (EU) to provide online services such as eprescribing of pharmaceuticals by the end of 2008. So far, implementation activities and efforts of the member states have been uneven. While in Austria pilot projects and feasibility studies have been conducted, Sweden has always been...

New simulation tools imply new opportunities to teach skills and train health care professionals. The aim of this study was to investigate the learning gained from computer simulation skills training. The study was designed for optimal educational settings, which benefit student-centred learning. Twenty-four second year undergraduate nursing studen...

Background The penetration rate of Electronic Health Record (EHR) systems in health care is increasing. However, many different EHR-systems are used with varying ePrescription designs and functionalities. The aim of the present study was to evaluate experienced ePrescribers' attitudes towards ePrescribing for suggesting improvements. Methods Physi...

Catheterization of the male urethra might cause harm and discomfort for the patient. Computer-based simulator training might improve the skills of students as well as professional nurses. This study aims to study the feasibility of a new portable computer-based male urethral catheterization simulator, Urecath (Melerit Urecath Vision). The simulator...

Multiple medications is a well-known potential risk factor in terms of patient's health. The aim of the present study was to estimate the prevalence of dispensed drugs and multiple medications in an entire national population, by using individual based data on dispensed drugs. Analyses of all dispensed out-patient prescriptions in 2006 from the Swe...

The introduction of electronic transfer of prescriptions (ETP) or ePrescriptions in ambulatory health care has been suggested to have a positive impact on the prescribing and dispensing processes. Thereby, implying that ePrescribing can improve safety, quality, efficiency, and cost-effectiveness. In December 2007, 68% of all new prescriptions were...

Inappropriate use of medicines increases the risk of hospital admissions for the elderly. Not only does this lead to unnecessary suffering for the patients but also incurs a great financial cost to the society. A medicine decision support system in a Personal Digital Assistant (PDA), with a barcode reader, can provide an overview of the patients' c...

Protocol form translated to English

Many patients receive health care in different settings. Thus, a limitation of clinical care may be inaccurate medication lists, since data exchange between settings is often lacking and patients do not regularly self-report on changes in their medication. Health care professionals and patients are both interested in utilizing electronic health inf...

The Internet is increasingly used for health matters including Ask the doctor services. To describe users and usage pattern of text-based medical consultation with family physicians on the Internet. Descriptive analysis of the first 4 years' use of a Swedish Ask the doctor service concerning number of inquiries, age and gender of inquirers. Time of...

Health care personnel need access to updated information anywhere and at any time, and a Personal Digital Assistant (PDA) has the potential to meet these requirements. A PDA is a mobile tool which has been employed widely for various purposes in health care practice, and the level of its use is expected to increase. Loaded with suitable functions a...

The increased risk of adverse events in patients receiving potentially interacting drugs has long been recognized. The purpose of the present study was to evaluate the change in the risk of receiving potentially interacting drugs during a period covering three decades and to examine the relative risk of actual drug combinations. The prescriptions f...

Healthcare organisations are nowadays expecting the support of IT in the daily routines. Personal digital assistants (PDAs) are in use in some healthcare organisations but in an irregular and unplanned way. The aim of the present study was to describe nurses' and nurse students' demands of functions and usability in a PDA. Interviews were made with...

In this paper we outline an interactive electronic book that teaches high school students about human locomotion. Today the most common teaching methods are lectures or reading a static textbook where the student’s participation is passive and they do not engage in the learning process. When learning about human gait, students not only learn anatom...

To achieve a safer future prescribing, the Swedish government has introduced a mandatory registration of all drugs dispensed at pharmacies. The medication history in the register may be accessed online by registered individuals, prescribers and pharmacists. After 15 months of action, the prevalence of individuals with dispensed drugs in the Swedish...

The widespread use of pharmaceuticals prescribed by different physicians has caused the Swedish government to propose a new legislation with registration of all prescriptions dispensed at the Swedish pharmacies. In the present study, we wanted to examine the frequency, distribution and determinants of potential drug interactions. The prescriptions...

Today we demand highly experienced surgeons who are capable of performing any surgical procedure. Unfortunately many patients deny medical students and physicians to perform surgery even under experienced supervision, since they are afraid of mistakes. This paper gives an overview of four difierent medical training simulators which can replace the...

Internet consultation without a previous relationship between the doctor and the enquirer seems to be increasing in popularity. However, little is known about the advantages, disadvantages or other differences compared with regular health care when using this kind of service. To investigate how an Internet-based Ask the Doctor service out with any...

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The internet is increasingly used for health matters, including consulting a doctor. Primary care physicians (general practitioners) will probably be involved in performing text-based consultations on the internet as a complement to physical meetings. In the present study, we explored the experiences of GPs already performing consultations on the i...

In 1998 the Swedish noncommercial public health service Infomedica opened an Ask the Doctor service on its Internet portal. At no charge, anyone with Internet access can use this service to ask questions about personal health-related and disease-related matters. To study why individuals choose to consult previously-unknown doctors on the Internet....

The aim of this study was to investigate the prevalence of allergic rhinitis and atopy in adolescents and whether air pollution in their schools contributed to allergic sensitization. Analyses were performed in 1992-1994 on 511 18-year-old students at four schools and on the indoor air and floor dust of their classrooms. The students underwent skin...

At the recommendation of the Swedish Government, the Council for the Renewal of Undergraduate Education was established in 1990. In 1993 the Council was declared a permanent National Agency by Swedish Parliament and became part of the newly established National Agency for Higher Education in 1995. The purpose of the Council for Renewal of Undergrad...

The nasal mucosa harbors sensory nerves containing neuropeptides such as substance P (SP), which are released by capsaicin. The neuropeptides are degraded by peptidases, e.g., neutral endopeptidase (NEP) that is present in the nasal mucosa. We studied the effect of enzymatically active recombinant NEP (rNEP) on neuropeptide-evoked secretion of nasa...

At the recommendation of the Swedish Government, the Council for the Renewal of Undergraduate Education was established in 1990. In 1993 the Council was declared a permanent National Agency by Swedish Parliament and became part of the newly established National Agency for Higher Education in 1995. The purpose of the Council for Renewal of Undergrad...

Substance P (SP) evokes fluid secretion and plasma extravasation when applied to the nasal mucosa of rats. SP and another tachykinin, neurokinin A (NKA), are degraded in vitro by neutral endopeptidase (NEP) and angiotensin-1-converting enzyme (ACE). In this study, NKA or SP were applied locally to the nasal mucosa of rats. Subsequent fluid secretio...

Allergic conditions in the upper airways, particularly in the nose, are common and should be considered in all patients who visit an otolaryngologist. The increasing number of patients with allergic disorders, as well the multifactorial etiology, creates a need for both medical and otolaryngic allergists. The otolaryngologist treats many disorders...

The concentration of biomarkers from vessels and inflammatory cells in nasal lavage fluid reflects the degree of hyperresponsiveness in patients with allergic rhinitis. The lavage has usually been performed of both nasal cavities together after prewashings and administration of decongestants. To improve the technique, we introduced a modification i...

We studied the effect of the locally administered glucocorticoid budesonide on plasma extravasation induced by capsaicin and by substance P (SP) in the nasal mucosa of pathogen-free rats. Using Evans blue dye as a tracer, we measured plasma extravasation induced by capsaicin (150 micrograms kg-1 i.v.) or SP (0.5 and 2.5 micrograms kg-1 i.v.) in the...

We used Evans blue dye to assess the effects of bradykinin on vascular extravasation in nasal mucosa of pathogen-free F344 rats. There was a dose-dependent increase in Evans blue extravasation when bradykinin was delivered by topical instillation in the nose (doses, 25-100 nmol). Only the highest intravenous doses (2 and 5 mumol/kg) of bradykinin c...

We studied the role of different tachykinin receptors in mediating neurogenic vasodilation in the nasal mucosa of anesthetized pathogen-free rats. Three successive determinations of blood flow were made by injecting radionuclide-labeled microspheres suspended in 70% dextrose into the left ventricle. A selective agonist of the tachykinin NK1 recepto...

The increase in vascular permeability associated with neurogenic inflammation in the nasal mucosa is mediated by neuropeptides such as substance P released from sensory nerves. Substance P is degraded by the peptidases neutral endopeptidase-24.11 (NEP-24.11) and angiotensin converting enzyme (ACE). In the present study, we used capsaicin to produce...

Substance P (SP), calcitonin gene-related peptide (CGRP), albumin, and histamine were measured in nasal secretions after timothy pollen challenge. The study was performed in 16 patients with allergic rhinitis. Standardized timothy antigen preparations were applied to filter papers, which were inserted into one of the nasal cavities; the contralater...

Nasal permeability was studied in anaesthetized rats after topical challenge with methacholine (MC), substance P (SP), or capsaicin. The drugs were applied onto strips of filter paper. After drying, they were inserted into one side of the nasal cavity while the other side received strips without drugs. The filter paper strips were used not only to...

The secretion of nasal fluid was studied in anaesthetized rats after topical application of capsaicin, and of calcitonin gene‐related peptide (CGRP) alone or CGRP in combination with substance P (SP). The flow of nasal fluid was stimulated and the secretions collected by a filter paper technique. The concentrations of SP and CGRP in nasal biopsies...

The effect of substance P (SP) on nasal secretion was studied in dog, rat, and man. Substance P was administered topically by the use of filter papers that had been soaked with an aqueous solution of SP and dried. The SP-containing filter paper strips were applied to the nasal mucosa for five minutes. The secretion was absorbed onto the filter pape...

Histamine (dihydrochloride or free base), mannitol or sodium chloride applied topically to the nasal mucosa of anaesthetized rats stimulated the secretion of fluid in a dose-dependent manner. Compound 48/80 applied in the same way and histamine given s.c. failed to evoke secretion. The secretion evoked by topically applied histamine was resistant t...

The effect of substance P (SP) and methacholine (MC) on nasal fluid secretion was studied in anesthetized rats. Pre-weighed filter papers impregnated with the challenging agent were applied to the nasal mucosa, changed every 5 minutes and reweighed to measure the secretion absorbed. SP evoked a dose-dependent increase in nasal secretion that was no...

The diagnostic efficacy of clinical history (CH), skin prick test (SPT) and RAST was estimated in relation to nasal and conjunctival provocation tests (NPT, CPT) in 69 patients with seasonal rhinoconjunctivitis. The extracts used were freeze-dried, and biologically standardized birch and timothy allergen preparations matched to the extracts on Phad...

The diagnostic efficacy of clinical history (CH), skin prick test (SPT) and RAST was estimated in relation to nasal and conjunctival provocation tests (NPT, CPT) in 69 patients with seasonal rhinoconjunctivitis. The extracts used were freeze-dried, and biologically standardized birch and timothy allergen preparations matched to the extracts on Phad...