Teknologiers mellemkomst i ambulant behandling og egenomsorg: med fokus på gravide kvinder med diabetes

Currently, important tendencies within the Danish healthcare sector are centralisation of treatment and increased self-care. Technology is often believed to be essential to this development although both dystopian and utopian views exist on whether technology alienates or supports the patient. In this article we illustrate how humans interact with technology in self-care and ambulant treatment through the example of pregnant women with diabetes. Two empirical examples, Maja and Ida, illustrate how a number of strategies are put into practice in seeking to integrate the treatment in everyday life and to meet the demands of the treatment programme. Maja establishes a reciprocal, symbiotic relation to the technology and experiences it as a resource and succeeds in integrating the treatment in her everyday life despite costs. Ida, however, does not experience technology as a resource and is not able to integrate her treatment due to social circumstances and the inflexibility of the treatment programme. The article concludes that whether technologies are experienced as a resource depends on the specific relation between humans and technology that might be influenced by individual, non-medical circumstances.Vigtige tendenser i den danske sundhedssektor i disse år er centralisering af behandling og øget egenomsorg. Teknologi ses ofte som en del af denne udvikling omend der eksisterer både dystopiske og utopiske forestillinger om, hvorvidt teknologi fremmedgør eller støtter patien­ten. I denne artikel belyser vi, ud fra behandling af gravide kvinder med diabetes, hvordan mennesker interagerer med teknologi i udførelse af egenomsorg og i forbindelse med et ambu­lant behandlingsforløb. To empiriske eksempler, Maja og Ida viser hvordan der iværksættes en række strategier i forsøget på at integrere behandlingen i hverdagen og for at leve op til behandlingsprogrammets krav. Maja indgår i en reciprok, symbiotisk relation til teknologien og oplever den som en ressource og formår omend med omkostninger at integrere behandlin­gen i sin hverdag. Ida oplever derimod ikke teknologien som en ressource og er på grund af sociale omstændigheder og behandlingsprogrammets ufleksibilitet ikke i stand til at integrere behandlingen i sin hverdag. Artiklen konkluderer, at hvorvidt teknologier fremtræder som en ressource afhænger af den specifikke relation mellem menneske og teknologi. En relation der kan være påvirket af individuelle, ikke-medicinske omstændigheder

Prescribing patterns and safety monitoring of duloxetine using the Danish Register of Medicinal Product Statistics as a source

Background: The safety and pattern of use of a medicinal product cannot be fully studied prior to its marketing. In Denmark, the Danish Health and Medicines Authority (DHMA) monitors marketed drugs. An available source is the Register of Medicinal Product Statistics (RMPS), which can possibly be used for these purposes. Objective: To investigate utilisation and potential safety issues of relatively new antidepressants containing the active ingredient duloxetine (Cymbalta® and Xeristar®) by using dispensing data available in the RMPS. Methods: A retrospective study using dispensing data was designed to estimate the size and composition of the user population and patterns of use of the antidepressants Cymbalta® and Xeristar® (active ingredient: duloxetine) in the period from 1 January 2005 to 31 December 2010. Data were retrieved from Epikur, a register subset of the RMPS. Results: Both women and men in different age groups used duloxetine for depression. Some users switched to another antidepressant. Prescription of the drug for persons below the age of 18 years revealed a potential safety issue. Concomitant treatment with Cymbalta® or Xeristar® and fluvoxamine, isocarboxazid, Yentreve®, or ciprofloxacin also revealed potential safety issues. Conclusions: The present study indicated that the RMPS is applicable in monitoring the pattern of use and potential safety issues related to duloxetine when it is prescribed for depression. Switching to other antidepressants could reflect some potential safety issues. Use of duloxetine for persons below the age of 18 years and its concomitant use with contraindicated drugs also indicated potential safety issues. </jats:p

Participants and Non-participants in the Scand-Ankle study - An alcohol cessation intervention at the time of fracture surgery

Background Clinical experience indicates that patients declining participation in randomised clinical trials (RCTs) at the time of surgery are older, less healthy and of lower social status than patients accepting to participate, compromising the external validity of the RCT and bringing the non-participants in higher risk at surgery. To our knowledge, no studies exist on patients with hazardous alcohol consumption who decline participation in RCTs at the time of surgery. The aim was to compare characteristics of the participants and non-participants in the Scand-Ankle RCT. Method The Scand-Ankle study is a RCT that investigates the effect of a 6-week gold standard alcohol intervention (GSP-A) on postoperative complications in patients drinking >21 units/week and undergoing ankle fracture surgery. This study included eligible patients that declined to participate in the Scand-Ankle RCT but gave informed consent to follow-up in their medical record (N=67). Their perioperative patient characteristics were obtained from their medical record and the characteristics were compared to the patients enrolled in the study so far (N=61). Results The baseline characteristics showed no differences between participants and non-participants, but some tendencies towards the non-participants being older, having severak co-morbidities and higher ASA scores. None of the variables of interest in relation to postoperative complications (age over 70 years, comorbidity, daily smoking, ASA scores, fracture type, BMI, alcohol) were significant predictors for non-participation. Conclusion No differences were found between participants and non-participants and no patient characteristics could significantly predict participation