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F H Steffensen

Publications and source records attributed to F H Steffensen.

45 records · Page 3Linked to original sources
PubMed1997

High prescribers of antibiotics among general practitioners--relation to prescribing habits of other drugs and use of microbiological diagnostics.

General practitioners' (GPs') prescriptions of antibiotics have shown large variations and may not always be rational. We analysed GPs' prescriptions and use of microbiological diagnostics in Viborg County during a 6-month period in 1992 based on Danish Health Service data. In a logistic regression model we tried to identify potential predictors for a high prescriber of antibiotics, i.e. the GPs with the highest number of prescriptions per patient (upper quartile). Two categories were calculated for the predictor variables, dividing the distribution by the median value. The most liberal GP wrote 15 times as many prescriptions for antibiotics per patient as the most restrictive GP. A strong predictor for high prescribing of antibiotics was the number of prescriptions for other drugs per patient [odds ratio (OR) 12.3, 95% CI: 2.8-54.4] after adjustment for age and sex. High use of throat swabs was a strong negative predictor of high prescribing of antibiotics (OR 0.2, 95% CI: 0.1-0.8) while high use of cultures (OR 2.4, 95% CI: 0.8-6.9) and of urinary susceptibility tests (OR 3.1, 95% CI: 1.1-9.3) were positive predictors. The GP's general attitude to pharmacotherapy seems important for antimicrobial chemotherapy, and if use of antibiotics should be reduced, targeted strategies should be aimed at high prescribers.

Anti-Bacterial Agents↗
PubMed1996

[Implementation of research results. Are physicians interested in reference programs?].

In a questionnaire we investigated whether 315 general practitioners (GPs), 79 heads of departments of medicine and 20 heads of departments of neuromedicine were aware of new national guidelines for oral anticoagulation in atrial fibrillation issued by the Danish Society of Internal Medicine. The guidelines were only known to 22% of the GPs, 6% of the neurological consultants and 64% of the medical consultants, but nevertheless only 4-7% of the doctors did not want distribution of guidelines. Fifty-four percent of the GPs and 12% of the specialists preferred the Danish College of General Practitioners to in some way participate in the development of guidelines. Our study suggests that guidelines are met with a positive response, but to obtain optimal use a powerful implementation effort must be recommended.

Anticoagulants↗
PubMed1996

Use of microbiological diagnostics and antibiotics in Danish general practice.

This article analyzes the use of antibiotics in Danish general practice. We observed considerable variation in the prescription of antibiotics among general practitioners (GPs). Internationally, Denmark has a low consumption of antibiotics. The use of antibiotics was closely associated with GPs' use of drugs, other than antibiotics, and to some extent with use of microbiological diagnostic tests. These findings provide evidence for the assumption that the consumption of antibiotics can be decreased further, which stresses the need for a restrictive policy concerning antibiotics.

Anti-Bacterial Agents↗
PubMed1995

[Registration in medical journals of prescriptions for strong analgesics prescribed by general practitioners].

The use of strong analgesics was continuously registered in 90 patients throughout 12 months via the public health authorities, who are responsible for the control of prescription of strong analgesics. After the 12 months, questionnaires were sent to the prescribing doctors about the treatment during that period. Twenty-five patients were excluded mainly due to incomplete data and non-responding GPs. Analysis of validity of the GPs' registration, with the public health authorities' registration used as the reference standard, showed 90% (95% confidence limits (CL):68-99%) agreement concerning continuing treatment with strong analgesics and 98% (CL:88-100%) regarding GPs' registration of patients not being treated with strong analgesics. In all, misclassification occurred in 5% (CL:1-13%) of the patients. Our study suggests that the GPs' information about prescriptions of strong analgesics is valid, and that it can be used in research.

Analgesics↗
PubMed1995

Implementation of guidelines on stroke prevention.

The aim of the present paper was to study the implementation of new medical knowledge. We investigated whether Danish doctors have implemented new national guidelines for oral anticoagulation of atrial fibrillation. An anonymous questionnaire with six standardized case stories was sent to 315 general practitioners in the county of Viborg and Ringkøbing, 79 heads of departments of medicine and cardiology, and 20 heads of departments of neuromedicine across the country. The answers showed that the Danish doctors recommended anticoagulant therapy only to a low extent for this group of patients despite the guidelines and the scientific evidence. The reasons for not choosing anticoagulant therapy were lack of knowledge concerning risk of stroke associated with the disease, worries about the disadvantages of the treatment, and lack of knowledge of its benefits. It is concluded that despite solid scientific documentation and an intensive implementation process of guidelines, issued by well-known respected colleagues in a small homogeneous country as Denmark (5 million inhabitants), knowledge of new research findings varies greatly and is generally limited. To obtain optimal use of new research findings, a powerful implementation effort must be recommended and the study reveals a need for a closer link between research and post-graduate education.

Aged↗
PubMed1994

Hyperthyroidism associated with metastatic thyroid carcinoma.

We report a patient with unilateral thyroid carcinoma, who developed hyperfunction of the thyroid gland during the metastatic progression of the thyroid carcinoma. Concurrently with this event, TSI increased and it is suggested that the differentiated aggressive metastatic thyroid neoplasm had initiated the autoimmune disorder leading to TSI production and thus to hyperplasia and hyperfunction of the thyroid resulting in hyperthyroidism.

Adenocarcinoma, Follicular↗