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Biomedical subjects

Mette Brekke

Publications and source records attributed to Mette Brekke.

10 recordsLinked to original sources
PubMed2006

Antihypertensive and lipid lowering treatment in 70-74 year old individuals--predictors for treatment and blood-pressure control: a population based survey. The Hordaland Health Study (HUSK).

BACKGROUND: In an elderly, community based population we aimed at investigating antihypertensive and lipid lowering medication use in relation to own and familiar cardiovascular morbidity and diabetes mellitus, as well as to lifestyle factors and general health. We also examined levels of blood pressure in untreated and treated residents, to investigate factors correlating with blood pressure control. METHODS: A health survey carried out in 1997-9 in the county of Hordaland, Norway included a self-administered questionnaire mailed to 4,338 persons born in 1925-7. Drug use the day prior to filling in the questionnaire was reported. A health check-up was carried out, where their systolic and diastolic blood pressure (SBP and DBP), body mass index (BMI), and serum-cholesterol level were recorded. RESULTS: One third of respondents used one or more antihypertensive drugs, while 13% of men and women were treated with a statin. Diabetes mellitus, own or relatives'cardiovascular disease, having quit smoking, physical inactivity, and overweight correlated with antihypertensive treatment. Mean blood pressure was lower in respondents not on treatment. Among those on treatment, 38% of men and 29% of women had reached a target BP-level of lower than 140/90 mm Hg. Own cardiovascular disease and a low BMI correlated with good BP-control. CONCLUSION: One third of 70-74 year old individuals living in the community used one or more antihypertensive drugs. Only around one third of those treated had reached a target BP-level of less than 140/90 mm Hg. Own cardiovascular disease and a low BMI correlated with good BP-control.

Aged↗
PubMed2006

A cluster-randomized educational intervention to reduce inappropriate prescription patterns for elderly patients in general practice--The Prescription Peer Academic Detailing (Rx-PAD) study [NCT00281450].

BACKGROUND: Age-related alterations in metabolism and excretion of medications increase the risk of adverse drug events in the elderly. Inappropriate polypharmacy and prescription practice entails increased burdens of impaired quality of life and drug related morbidity and mortality. The main objective of this trial is to evaluate effects of a tailored educational intervention towards general practitioners (GPs) aimed at supporting the implementation of a safer drug prescribing practice for elderly patients > or = 70 years. METHODS/DESIGN: Approximately 80 peer continuing medical education (CME) groups (about 600 GPs) in southern Norway will be recruited to a cluster randomized trial. Participating groups will be randomized either to an intervention- or a control group. The control group will not receive any intervention towards prescription patterns in elderly, but will be the target of an educational intervention for prescription of antibiotics for respiratory tract infections. A multifaceted intervention has been tailored, where key components are educational outreach visits to the CME-groups, work-shops, audit and feedback. Prescription Peer Academic Detailers (Rx-PADs), who are trained GPs, will conduct the educational outreach visits. During these visits, a set of quality indicators (QIs), i.e. explicit recommendations for safer prescribing for elderly patients, will be presented and discussed. Software will be handed out for installation in participants' practice computers to enable extraction of pre-defined prescription data. These data will subsequently be linked to corresponding data from the Norwegian Prescription Database (NorPD). Individual feedback reports will be sent all participating GPs during and one year after the intervention. Feedback reports will include QI-scores on individual- and group levels, before and after the intervention. The main outcome of this trial is the change in proportions of inappropriate prescriptions (QIs) for elderly patients > or = 70 years following intervention, compared to baseline levels. DISCUSSION: Improvement of prescription patterns in medical practice is a challenging task. Evidence suggests that a thorough evaluation of diagnostic indications for drug treatment in the elderly and/or a reduction of potentially inappropriate drugs may impose significant clinical benefits. Our hypothesis is that an educational intervention program will be effective in improving prescribing patterns for elderly patients in GP settings.

Aged↗
PubMed2006

Self-reported drug utilization, health, and lifestyle factors among 70-74 year old community dwelling individuals in Western Norway. The Hordaland Health Study (HUSK).

BACKGROUND: To examine the level and patterns of self-reported medication use (prescription and non-prescription drugs) among 70-74 year old individuals living in the community, and to explore self-reported indications for use, and factors possibly predictive of drug use. METHODS: A health survey carried out in 1997-99 in the county of Hordaland (Western Norway) in the setting of a population study. A self-administered questionnaire was mailed to 4338 persons born in 1925-27, and a health check-up was offered. Drug use the previous day was reported (point prevalence). 3341 (77.0%) persons who responded, comprise the material for the analyses. RESULTS: Between one third (males) and one quarter (females) did not take any drug the previous day. Mean number of drugs among users was 2.8 (men and women). 32% used three or more drugs and 11.5% five or more. Hypertension and other cardiovascular problems were by far the most common reasons for drug use, followed by respiratory, musculoskeletal and mental health problems. Self-reported poor health, a high Body Mass Index (BMI), and being an ex-smoker (but not currently a smoker) correlated with increasing number of drugs taken. CONCLUSION: Among 70-74-year old individuals living in the community no use of medication was more common than major polypharmacy (5+ drugs). Persons who had fallen ill and were put on regular medication, probably tended to quit smoking, while those who remained healthy, continued to smoke.

Aged↗
PubMed2004

Musculo-skeletal pain among 40- and 45-year olds in Oslo: differences between two socioeconomically contrasting areas, and their possible explanations.

BACKGROUND: The objective of the study was to compare the prevalence and severity of musculo-skeletal pain between two socioeconomically contrasting areas in Oslo, Norway, and to explore possible explanatory factors. METHODS: Questionnaire survey, carried out as part of The Oslo Health Study in 2000-2001. Data from 821 persons (40 and 45 year old) living in a less affluent inner city area (called east) were compared with 854 persons living in an affluent area of the city (called west). Bivariate comparisons (chi square test) and multiple regression analyses were performed to investigate differences between the samples. RESULTS: 61 % in east and 56 % in west (p < 0.05) reported pain/stiffness in muscles/joints during the last four weeks. 30 % in east versus 19 % in west (p < 0.001) reported extensive pain. The between area difference in extensive pain was partially explained by physical inactivity, mental health problems and being of non-Western origin. CONCLUSION: Musculo-skeletal pain is reported by 55-60 % of middle aged persons in Oslo during a four week period, and must be considered a normal phenomenon. Poor social conditions, inactivity, mental health problems and being an immigrant imply increased risk of more severe symptoms with a concomitant demand of health care.

Journal Article↗
PubMed2003

Changes in self-efficacy and health status over 5 years: a longitudinal observational study of 306 patients with rheumatoid arthritis.

OBJECTIVE: To investigate changes in self-efficacy and health status over 5 years in patients with rheumatoid arthritis (RA), the relationships between these changes, and the influence of baseline values on subsequent changes. METHODS: 306 adult patients with RA, born in 1926 or later, were examined by questionnaire in 1994 and again in 1999. We analyzed data regarding pain (visual analogue scale [VAS], Arthritis Impact Measurement Scale [AIMS2] symptom scale, Short Form-36 [SF-36] pain scale), fatigue (VAS, SF-36 vitality scale), mental distress (AIMS2 affect scale, SF-36 mental health scale) and self-efficacy (Arthritis Self-Efficacy Scales for pain and for other symptoms). RESULTS: On group level, all health status measures were numerically somewhat improved, and self-efficacy slightly reduced. Changes in self-efficacy and in corresponding health status measures were significantly correlated. For patients with above average educational level self-efficacy for pain at baseline was positively correlated to improvement in pain measures. Good mental health at baseline was correlated to improvement in self-efficacy for other symptoms, but only for patients with below average educational level. CONCLUSION: Baseline self-efficacy seems to influence future level of perceived pain and baseline mental health status seems to influence future self-efficacy. These associations seem to be affected by level of education.

Adult↗
PubMed2002

Severity of musculoskeletal pain: relations to socioeconomic inequality.

The main aim of the study was to investigate possible associations between severity of non-inflammatory musculoskeletal pain and residential areas of contrasting socioeconomic status. A 4-page questionnaire inquiring about musculoskeletal pain, and also physical disability, mental health, life satisfaction and use of health services was sent to 10,000 randomly selected adults in Oslo, Norway. For the purpose of this study, we analysed data from respondents living in two socioeconomically contrasting areas of the city. Measures of pain (intensity, duration, localisation), physical disability (MHAQ), mental distress (SCL-5, sleep disturbances), life satisfaction and use of health services (general practitioner, rheumatologist, medication, involvement in and satisfaction with own care) were compared between respondents living in the two areas (n = 870 and n = 892 respondents, respectively) of whom 493 in each area reported non-inflammatory musculoskeletal pain. Multiple regression analyses adjusting for age revealed that living in the less affluent area was associated with strong and widespread pain, with high levels of physical disability and mental distress and with low life satisfaction. Living in the less affluent area was also associated with frequent use of analgesics and with low level of involvement in own health care, after adjustment for age, pain intensity and levels of physical disability and mental distress. Non-inflammatory musculoskeletal pain seems to be a more serious condition in a population living in a less affluent residential area compared with a more affluent one, even in an egalitarian society like Norway. Increased disease severity may thus amplify the impact of greater chronic morbidity in the disadvantaged part of the population. This should have implications for health care provision if the goal is treatment according to needs.

Adult↗