Innlandet Hospital Trust

About: Innlandet Hospital Trust is a healthcare organization based out in Brumunddal, Norway. It is known for research contribution in the topics: Population & Dementia. The organization has 387 authors who have published 1302 publications receiving 37753 citations.

Walking the fine line: Self-reported reasons for substance use in persons with severe mental illness

Abstract: Many theoretical models have been proposed to explain the relationship between severe mental illness (SMI) and substance use. Because many of these are contradictory quantitative American studies, a qualitative, exploratory study of a Scandinavian sample may offer a new perspective. The aim of the study is to explore reasons for substance use through analysis of the participants’ experiences. A qualitative study with semistructured interviews was used. Purposeful sampling (N=11) of patients with substance use disorder (SUD) and SMI, who were included in assertive community treatment teams, was completed. Inclusion criteria are increased quality of life or increased general functioning, and decreased substance use, after a minimum of 12 months in treatment. Reasons given for using substances were categorized as (a) controlling the symptoms of mental illness, (b) counteracting medication side effects, or (c) balancing the ambiguity. The conclusion is that the study findings mainly support secondary substance use models in explaining the comorbidity of SMI and substance use. However, there is some support for the traditional self-medication hypothesis (SMH), iatrogenic vulnerability, and the supersensitivity model. This may be because the majority of the study participants reported having a mental illness with subsequent substance use. The expressed ambivalence to substance use also lends some support to bidirectional models. Key words: Psychotic disorder, models of comorbidity, self-medication, assertive community treatment, patient experiences, qualitative study (Published: 20 December 2013) Citation: Int J Qualitative Stud Health Well-being 2013, 8 : 21968 - http://dx.doi.org/10.3402/qhw.v8i0.21968

Trends in potentially inappropriate medication prescribing to nursing home patients: comparison of three cross-sectional studies.

Abstract: PURPOSE The aim of this study was to examine trends in potentially inappropriate medication (PIM) prescribing in Norwegian nursing homes. METHODS Patients aged ≥70 years were included from three cross-sectional studies conducted in 1997, 2005 and 2011. PIMs were analyzed according to the Norwegian General Practice-Nursing Home criteria (NORGEP-NH), use of single substances to avoid, combinations to avoid, and deprescribing items. Associations between sample and use of PIMs were examined by logistic regression, adjusted for age, gender, and ward. We established Pearsons r for correlations between numbers of drugs and PIMs. RESULTS Altogether, 4373 patients (mean age 85.7 years, 73.5% women) were included. The mean overall number of drugs per patient increased from 4.7 in 1997 to 6.9 in 2011 (p < 0.001). Use of any single substances to avoid increased from 36.8% in 1997 to 39.5% in 2011 (p = 0.002), use of any combinations to avoid from 16.3% to 27.0% (p < 0.001), and use of any deprescribing items from 46.0% to 55.3% (p < 0.001). Use of codeine-analgesics, nonsteroidal anti-inflammatory drugs, tricyclic antidepressants, long-acting benzodiazepines, and first generation antihistamines decreased significantly, while use of short-acting benzodiazepines, z-hypnotics, statins, and anti-dementia drugs increased significantly. A moderate strong correlation was detected between number of drugs and the three above-mentioned PIM categories, r = 0.34, r = 0.43, r = 0.37, respectively (all p < 0.001). CONCLUSIONS Although several PIMs were less commonly prescribed in recent years, increased overall use of PIMs may suggests worsening of prescribing quality for nursing home patients in Norway. Copyright © 2016 John Wiley & Sons, Ltd.

Post-discharge complications in frail older patients after surgery for colorectal cancer.

Abstract: Background The incidence of postoperative complications after colorectal cancer surgery varies between publications. Complications occurring after discharge from hospital are often not reported. The aims of this study were to investigate the proportion of frail older colorectal cancer patients who developed complications only after discharge, the severity of post-discharge complications, and the time point at which the most frequent complications occurred. Methods Patients were included if they were 65 years and older, screened positively for frailty and were scheduled for colorectal cancer surgery. Included patients were followed prospectively both in hospital and after discharge for 30 days after surgery, and complications were graded according to the Clavien-Dindo classification. Results We included 114 patients. Median age was 79 years. Twenty-two patients (19%) were discharged without complications, but developed complications after discharge. These patients had shorter length of stay (6.5 versus 10 days), were more often discharged to their own home without assistance, and had higher 5-year survival (76% vs 54%) than patients who developed complications in hospital. Post-discharge complications were most frequently grade II. The most common types of complications that occurred late in the postoperative course were urinary tract infections and superficial surgical site infections. Conclusions Complications after colorectal cancer surgery in frail older patients frequently arise after discharge from hospital. Doctors should be aware of this and inform their patients. This is increasingly important as length of stay after surgery decreases. When complications are used as a quality measure, it should be clear whether only in-hospital complications are registered.

Predictions for the decision-to-delivery interval for emergency cesarean sections in Norway

Abstract: Background. To explain the variation in decision-to-delivery intervals in emergency cesarean sections in Norway. Methods. A seven-month prospective registration of all emergency cesareans provided by 24 maternity units. The clinician in charge filled in a predesigned form for each delivery that obtained detailed information about obstetric history, the pregnancy, indication, the date and time of delivery, decision-to-delivery interval, seniority of the surgeon, and neonatal outcome until hospital discharge. To take account of the clustered nature of our observations, data were analyzed by multilevel regression. Results. 1,511 singleton emergency cesarean sections with known decision-to-delivery interval were included. The average decision-to-delivery interval for all emergency cesarean sections was 52.4 min, for acute cesarean sections 58.7 min, and for urgent emergency operations 11.8 min. Most of the decision-to-delivery interval variation was at patient level, not between departments. Several significa...