Decreased prevalence of moderate to severe COPD over 15 years in northern Sweden

Bäckman, Helena; Eriksson, Berne; Rönmark, Eva; Hedman, Linnéa; Stridsman, Caroline; Jansson, Sven-Arne; Lindberg, Anne; Lundbäck, Bo

doi:10.1016/j.rmed.2016.03.013

Cited by 53 publications

(79 citation statements)

References 45 publications

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“…In the subcategory Driving spirit carries COPD care the COPD nurses was described to be main responsible for the spirometry tests, that is required to confirm a COPD diagnosis [1]. However, it is obvious that prevailing routines and time for diagnosing is not enough, which could contribute to the low prevalence for COPD in our study – only one tenth of the estimated national prevalence of 6.3% [4]. For optimal asthma/COPD receptions in primary care 4 h/week per 1000 enrolled citizens is recommended [39], while the COPD nurses in our study worked with COPD and asthma in median 1.4 h/week per 1000 enrolled citizens, which corresponds to an earlier Swedish study [48].…”

Section: Discussionmentioning

confidence: 91%

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Building COPD care on shaky ground: a mixed methods study from Swedish primary care professional perspective

Lundell

Tistad

Rehn

et al. 2017

BMC Health Serv Res

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BackgroundChronic obstructive pulmonary disease (COPD) is a public health problem. Interprofessional collaboration and health promotion interventions such as exercise training, education, and behaviour change are cost effective, have a good effect on health status, and are recommended in COPD treatment guidelines. There is a gap between the guidelines and the healthcare available to people with COPD.The aim of this study was to increase the understanding of what shapes the provision of primary care services to people with COPD and what healthcare is offered to them from the perspective of healthcare professionals and managers.MethodsThe study was conducted in primary care in a Swedish county council during January to June 2015. A qualitatively driven mixed methods design was applied. Qualitative and quantitative findings were merged into a joint analysis. Interviews for the qualitative component were performed with healthcare professionals (n = 14) from two primary care centres and analysed with qualitative content analysis. Two questionnaires were used for the quantitative component; one was answered by senior managers or COPD nurses at primary care centres (n = 26) in the county council and the other was answered by healthcare professionals (n = 18) at two primary care centres. The questionnaire data were analysed with descriptive statistics.ResultsThe analysis gave rise to the overarching theme building COPD care on shaky ground. This represents professionals driven to build a supportive COPD care on ‘shaky’ organisational ground in a fragmented and non-compliant healthcare organisation. The shaky ground is further represented by uninformed patients with a complex disease, which is surrounded with shame. The professionals are autonomous and pragmatic, used to taking responsibility for their work, and with limited involvement of the management. They wish to provide high quality COPD care with interprofessional collaboration, but they lack competence and are hindered by inadequate routines and lack of resources.ConclusionsThere is a gap between COPD treatment guidelines and the healthcare that is provided in primary care. To facilitate implementation of the guidelines several actions are needed, such as further training for professionals, additional resources, and improved organisational structure for interprofessional collaboration and patient education.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-017-2393-y) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 91%

“…About 65 million people worldwide are estimated to have moderate to severe COPD [3], but the disease is largely underdiagnosed, and the prevalence is consequently difficult to estimate [4, 5]. Therefore, provision of diagnostics by the healthcare system is important.…”

Section: Introductionmentioning

confidence: 99%

Building COPD care on shaky ground: a mixed methods study from Swedish primary care professional perspective

Lundell

Tistad

Rehn

et al. 2017

BMC Health Serv Res

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“…The total annual incidence of all tuberculosis and pulmonary tuberculosis was 7.3 and 4.9 in 100 000 individuals in 2016. Data on chronic obstructive pulmonary disease (COPD) were derived from previously published studies from Sweden . The number of patients with COPD in general population of Sweden in 2016 was between 400 000 and 700 000 individuals.…”

Section: Methodsmentioning

confidence: 99%

Estimated burden of fungal infections in Sweden

Özenci

Klingspor

Ullberg

et al. 2019

Mycoses

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Summary The aim of this study was to estimate the annual burden of fungal infections in Sweden using data mainly from 2016. Data on specific populations were obtained from Swedish national data registries. Annual incidence and prevalence of fungal disease was calculated based on epidemiological studies. Data on infections due to Cryptococcus sp., Mucorales, Histoplasma capsulatum, Coccidioides immitis and Pneumocystis jirovecii were retrieved from Karolinska University Laboratory and covers only 25% of Swedish population. In 2016, the population of Sweden was 9 995 153 (49.8% female). The overall burden of fungal infections was 1 713 385 (17 142/100 000). Superficial fungal infections affect 1 429 307 people (1429/100 000) based on Global Burden of Disease 14.3% prevalence. Total serious fungal infection burden was 284 174 (2843/100 000) in 2016. Recurrent Candida vulvovaginitis is common; assuming a 6% prevalence in women. Prevalence of allergic bronchopulmonary aspergillosis and severe asthma with fungal sensitisation were estimated to be 20 095 and 26 387, respectively. Similarly, chronic pulmonary aspergillosis was estimated to affect 490 patients after tuberculosis, sarcoidosis and other conditions. Candidemia incidence was estimated to be 500 in 2016 (4.7/100 000) and invasive aspergillosis 295 (3.0/100 000). In Stockholm area, Mucorales were reported in three patients in 2015, while Cryptococcus spp. were reported in two patients. In 2016, there were 297 patients PCR positive for P jirovecii. The present study shows that the overall burden of fungal infections in Sweden is high and affects 17% of the population. The morbidity, mortality and the healthcare‐related costs due to fungal infections warrant further studies.

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“…The asthma prevalence differs between regions and is high in north‐western Europe including the British Isles and the Nordic countries, estimated at about 10% of the adult population or even more in recent studies . In Sweden, the smoking prevalence has been steadily decreasing by more than half over the last decades, and the prevalence of COPD has decreased . On the other hand, the prevalence of allergic rhinitis, which is associated with asthma, has been increasing .…”

Section: Introductionmentioning

confidence: 99%

Increased prevalence of allergic asthma from 1996 to 2006 and further to 2016—results from three population surveys

Bäckman

Räisänen

Hedman

et al. 2017

Clin Experimental Allergy

Self Cite

201

175

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SummaryBackground: During the latter half of the 20th century, the prevalence of asthma and many other allergic diseases has increased. Information on asthma prevalence trends among adults after 2010, especially regarding studies separating allergic asthma from non-allergic asthma, is lacking.Objective: The aim was to estimate prevalence trends of current asthma among adults, both allergic and non-allergic, from 1996 to 2016. while the prevalence of non-allergic asthma remained stable around 3.4%-3.8%. The increase in current asthma was most pronounced among women and among the middle-aged. Physician-diagnosed asthma, asthma medication use and ARC also increased significantly, while the prevalence of symptoms common in asthma such as wheeze and attacks of shortness of breath decreased slightly or was stable. The prevalence of current smoking decreased from 27.4% in 1996 to 12.3% in 2016. Conclusions and Clinical Relevance:The prevalence of allergic asthma increased from 1996 to 2006 and further to 2016, while the prevalence of non-allergic asthma remained on a stable prevalence level. The prevalence of symptoms common in asthma decreased slightly or was stable despite a substantial decrease in the prevalence of current smoking. Clinicians should be aware that the previously observed increase in prevalence of allergic asthma is still ongoing.

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Decreased prevalence of moderate to severe COPD over 15 years in northern Sweden

Abstract: Changes in both prevalence and risk factor patterns of COPD were observed between surveys. Following a continuing decrease in smoking habits over several decades, a decrease in the prevalence of moderate to severe COPD was observed from 1994 to 2009 in northern Sweden.

Cited by 53 publications

References 45 publications

Building COPD care on shaky ground: a mixed methods study from Swedish primary care professional perspective

Building COPD care on shaky ground: a mixed methods study from Swedish primary care professional perspective

Estimated burden of fungal infections in Sweden

Increased prevalence of allergic asthma from 1996 to 2006 and further to 2016—results from three population surveys

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