Pub Date : 2021-08-16DOI: 10.5324/nje.v29i1-2.4040
H. Sommerschild, C. Berg, C. Jonasson, Kari Jansdotter Husabø, M. N. Sharikabad
In this article we aim to give researchers and other users of drug utilization data a current overview of the twonationwide Norwegian drug databases located at the Norwegian Institute of Public Health (NIPH), withreference to some historical background. The first database, “The Norwegian Drug Wholesales Statistics”,dating back to 1974, provides total sale figures of all medicines on the market. The second database, “TheNorwegian Prescription Database” (NorPD), dates back to 2004 and covers prescription drugs dispensed bypharmacies. This database will be modernized during 2021 and renamed (“The Norwegian Prescribed DrugRegistry”, name not finally decided), and all historical data will be migrated to the modernized registry. In thefuture, the most valuable add-on to the modernized prescription database will be individual level data fromin-patients in hospitals and health care institutions, and the possibility to obtain aggregated data from eachinstitution. Together, the two nationwide databases will continue to be the cornerstones of drug utilization data in Norway and should be used more extensively to improve health to the best for individuals and society. Development in national e-health programs will play a key role in providing easier and less time-consuming access to data and improve conditions for linkage of drug data to other health registries in the near future.
{"title":"Data resource profile: Norwegian Databases for Drug Utilization and Pharmacoepidemiology","authors":"H. Sommerschild, C. Berg, C. Jonasson, Kari Jansdotter Husabø, M. N. Sharikabad","doi":"10.5324/nje.v29i1-2.4040","DOIUrl":"https://doi.org/10.5324/nje.v29i1-2.4040","url":null,"abstract":"In this article we aim to give researchers and other users of drug utilization data a current overview of the twonationwide Norwegian drug databases located at the Norwegian Institute of Public Health (NIPH), withreference to some historical background. The first database, “The Norwegian Drug Wholesales Statistics”,dating back to 1974, provides total sale figures of all medicines on the market. The second database, “TheNorwegian Prescription Database” (NorPD), dates back to 2004 and covers prescription drugs dispensed bypharmacies. This database will be modernized during 2021 and renamed (“The Norwegian Prescribed DrugRegistry”, name not finally decided), and all historical data will be migrated to the modernized registry. In thefuture, the most valuable add-on to the modernized prescription database will be individual level data fromin-patients in hospitals and health care institutions, and the possibility to obtain aggregated data from eachinstitution. Together, the two nationwide databases will continue to be the cornerstones of drug utilization data in Norway and should be used more extensively to improve health to the best for individuals and society. Development in national e-health programs will play a key role in providing easier and less time-consuming access to data and improve conditions for linkage of drug data to other health registries in the near future.","PeriodicalId":35548,"journal":{"name":"Norsk Epidemiologi","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41333527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-08-16DOI: 10.5324/nje.v29i1-2.4045
Ingvild Odsbu, Marte Handal, Vidar Hjellvik, Petter C. Borchgrevink, Thomas Clausen, Aleksi Hamina, Torgeir Gilje Lid, Ragnar Nesvåg, S. Skurtveit
Bakgrunn: Opioider for behandling av langvarige smerter kan forskrives på blå resept, men bør ikke brukessamtidig med andre vanedannende legemidler.Hensikt: Å undersøke bruk av opioider på blå resept i perioden 2009-2019, samt å studere bruk av andre vanedannendelegemidler (benzodiazepiner og z-hypnotika) blant dem som fikk opioider på blå resept i 2019.Metode: Data ble hentet fra Reseptregisteret. En prevalent opioidbruker i 2019 ble definert som en person medminst én utlevering av et smertestillende opioid på blå resept for langvarige smerter også i 2018. Bruk av andrevanedannende legemidler ble definert som minst én utlevering av et annet vanedannende legemiddel i løpet avsamme år.Resultater: Totalt 18 443 personer (67% kvinner) fikk utlevert opioider på blå resept i 2019, en økning fra5 568 i 2009 via 10 693 i 2016 og 16 133 i 2017. Av de 18 443 var 14 202 (77%) prevalente opioidbrukere.Blant de prevalente brukerne fikk 88% utlevert 100 mg orale morfinekvivalenter (OMEQ) eller mindre perdag. Totalt fikk 54% av de prevalente opioidbrukerne utlevert minst ett annet vanedannende legemiddel i 2019.Z-hypnotika var oftest forekommende blant de som brukte 100 mg OMEQ eller mindre per dag, mens benzodiazepineralene eller i kombinasjon med z-hypnotika dominerte blant opioidbrukerne som fikk utlevert merenn 100 mg OMEQ per dag. Mengden utlevert av andre vanedannende legemidler økte med mengden opioiderbrukt per dag. En større andel kvinner enn menn fikk utlevert andre vanedannende legemidler i 2019.Konklusjon: Studien indikerer at bruk av andre vanedannende legemidler forekommer hos en stor andel avdem som får forskrevet opioider på blå resept. Dette er tegn på et uheldig forskrivningsmønster som børstuderes nærmere.
{"title":"Bruk av andre vanedannende legemidler blant opioidbrukere med langvarige smerter","authors":"Ingvild Odsbu, Marte Handal, Vidar Hjellvik, Petter C. Borchgrevink, Thomas Clausen, Aleksi Hamina, Torgeir Gilje Lid, Ragnar Nesvåg, S. Skurtveit","doi":"10.5324/nje.v29i1-2.4045","DOIUrl":"https://doi.org/10.5324/nje.v29i1-2.4045","url":null,"abstract":"Bakgrunn: Opioider for behandling av langvarige smerter kan forskrives på blå resept, men bør ikke brukessamtidig med andre vanedannende legemidler.Hensikt: Å undersøke bruk av opioider på blå resept i perioden 2009-2019, samt å studere bruk av andre vanedannendelegemidler (benzodiazepiner og z-hypnotika) blant dem som fikk opioider på blå resept i 2019.Metode: Data ble hentet fra Reseptregisteret. En prevalent opioidbruker i 2019 ble definert som en person medminst én utlevering av et smertestillende opioid på blå resept for langvarige smerter også i 2018. Bruk av andrevanedannende legemidler ble definert som minst én utlevering av et annet vanedannende legemiddel i løpet avsamme år.Resultater: Totalt 18 443 personer (67% kvinner) fikk utlevert opioider på blå resept i 2019, en økning fra5 568 i 2009 via 10 693 i 2016 og 16 133 i 2017. Av de 18 443 var 14 202 (77%) prevalente opioidbrukere.Blant de prevalente brukerne fikk 88% utlevert 100 mg orale morfinekvivalenter (OMEQ) eller mindre perdag. Totalt fikk 54% av de prevalente opioidbrukerne utlevert minst ett annet vanedannende legemiddel i 2019.Z-hypnotika var oftest forekommende blant de som brukte 100 mg OMEQ eller mindre per dag, mens benzodiazepineralene eller i kombinasjon med z-hypnotika dominerte blant opioidbrukerne som fikk utlevert merenn 100 mg OMEQ per dag. Mengden utlevert av andre vanedannende legemidler økte med mengden opioiderbrukt per dag. En større andel kvinner enn menn fikk utlevert andre vanedannende legemidler i 2019.Konklusjon: Studien indikerer at bruk av andre vanedannende legemidler forekommer hos en stor andel avdem som får forskrevet opioider på blå resept. Dette er tegn på et uheldig forskrivningsmønster som børstuderes nærmere.","PeriodicalId":35548,"journal":{"name":"Norsk Epidemiologi","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47361504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-08-16DOI: 10.5324/nje.v29i1-2.4049
Marianne Lindstad, S. Skurtveit, Anne Bukten
SAMMENDRAGBakgrunn: Legemiddelbruk i den norske befolkningen er økende. Kunnskap om omfang, hvem brukerne er og bruksmønster er en forutsetning for optimalisering av legemiddelbruk i alle grupper av befolkningen. Samtidig finnes det ingen oppdaterte studier som viser bruk av forskrevne legemidler blant innsatte i Norge. Hensikten med denne studien er derfor å beskrive bruk av forskrevne psykofarmaka blant innsatte i fengsel før og under soning, samt undersøke hvilke faktorer som er assosiert med legemiddelbruk.Material og metode: Datamaterialet er fra «The Norwegian Offender Mental Health and Addiction Study», NorMA-studien, som ble gjennomført i perioden 2013-2014 ved 57 fengselsenheter i Norge. Totalt svarte 1495 innsatte (96 kvinner) på spørreskjema. Vi undersøkte selvrapportert bruk av psykofarmaka knyttet til sovemedisin, beroligende legemidler, antidepressiva, LAR-legemidler, smertestillende legemidler og ADHD- legemidler. Vi brukte logistiske regresjoner for å undersøke sammenhenger mellom ulike bakgrunnsfaktorer og bruk av ulike legemidler under soning.Resultater: Sovemedisin var mest brukt, både før og under soning. Tjue prosent av innsatte brukte sove- medisin daglig under soning. Innsatte brukte mer psykofarmaka enn den generelle befolkningen, med unntak av smertestillende legemidler. Under soning var bruk av de fleste undersøkte psykofarmaka assosiert med betydelige psykiske plager, skadelig rusbruk, å motta økonomiske sosiale ytelser samt å ha hatt en oppvekst preget av rus og psykiske problemer.Konklusjon: Våre funn viser at innsattes psykiske helse og russituasjon bør ha høy prioritet under soning. Det er forventet at innsatte bruker mer forskrevne psykofarmaka enn den generelle befolkningen. At den generelle befolkningen bruker mer smertestillende enn innsatte, bør derfor undersøkes nærmere. Lindstad M, Skurtveit S, Bukten A. Too much or too little medication? A national study of prescribedpsychotropic drugs among inmates in Norwegian prisons. Norsk Epidemiologi 2021; 29 (1-2): 85-95.ENGLISH SUMMARYBackground: Prescription drug use in the Norwegian population is increasing. Knowledge of who the usersareand usage patterns is a prerequisite for optimizing prescription drug use in all groups of the population.There are no updated studies describing prescription drug use among prisoners in Norway. The purpose ofthis study is to describe the use of prescribed psychotropic drugs among inmates in prison before and duringimprisonment and to investigate factors associated with prescription drug use while in prison.Material and method: The study is based on self-reported data from "The Norwegian Offender MentalHealth and Addiction Study" (NorMA) which was conducted in the period 2013-2014 at 57 prison units inNorway. A total of 1495 inmates (96 women) responded to the questionnaire. We investigated self-reporteduse of psychotropic drugs related to: hypnotics, anxiolytics, antidepressants, OMT-medications, pain medicationand ADHD-medication
{"title":"For mye eller for lite medisiner? En nasjonal studie av forskrevne psykofarmaka blant innsatte i norske fengsler","authors":"Marianne Lindstad, S. Skurtveit, Anne Bukten","doi":"10.5324/nje.v29i1-2.4049","DOIUrl":"https://doi.org/10.5324/nje.v29i1-2.4049","url":null,"abstract":"SAMMENDRAGBakgrunn: Legemiddelbruk i den norske befolkningen er økende. Kunnskap om omfang, hvem brukerne er og bruksmønster er en forutsetning for optimalisering av legemiddelbruk i alle grupper av befolkningen. Samtidig finnes det ingen oppdaterte studier som viser bruk av forskrevne legemidler blant innsatte i Norge. Hensikten med denne studien er derfor å beskrive bruk av forskrevne psykofarmaka blant innsatte i fengsel før og under soning, samt undersøke hvilke faktorer som er assosiert med legemiddelbruk.Material og metode: Datamaterialet er fra «The Norwegian Offender Mental Health and Addiction Study», NorMA-studien, som ble gjennomført i perioden 2013-2014 ved 57 fengselsenheter i Norge. Totalt svarte 1495 innsatte (96 kvinner) på spørreskjema. Vi undersøkte selvrapportert bruk av psykofarmaka knyttet til sovemedisin, beroligende legemidler, antidepressiva, LAR-legemidler, smertestillende legemidler og ADHD- legemidler. Vi brukte logistiske regresjoner for å undersøke sammenhenger mellom ulike bakgrunnsfaktorer og bruk av ulike legemidler under soning.Resultater: Sovemedisin var mest brukt, både før og under soning. Tjue prosent av innsatte brukte sove- medisin daglig under soning. Innsatte brukte mer psykofarmaka enn den generelle befolkningen, med unntak av smertestillende legemidler. Under soning var bruk av de fleste undersøkte psykofarmaka assosiert med betydelige psykiske plager, skadelig rusbruk, å motta økonomiske sosiale ytelser samt å ha hatt en oppvekst preget av rus og psykiske problemer.Konklusjon: Våre funn viser at innsattes psykiske helse og russituasjon bør ha høy prioritet under soning. Det er forventet at innsatte bruker mer forskrevne psykofarmaka enn den generelle befolkningen. At den generelle befolkningen bruker mer smertestillende enn innsatte, bør derfor undersøkes nærmere. \u0000Lindstad M, Skurtveit S, Bukten A. Too much or too little medication? A national study of prescribedpsychotropic drugs among inmates in Norwegian prisons. Norsk Epidemiologi 2021; 29 (1-2): 85-95.ENGLISH SUMMARYBackground: Prescription drug use in the Norwegian population is increasing. Knowledge of who the usersareand usage patterns is a prerequisite for optimizing prescription drug use in all groups of the population.There are no updated studies describing prescription drug use among prisoners in Norway. The purpose ofthis study is to describe the use of prescribed psychotropic drugs among inmates in prison before and duringimprisonment and to investigate factors associated with prescription drug use while in prison.Material and method: The study is based on self-reported data from \"The Norwegian Offender MentalHealth and Addiction Study\" (NorMA) which was conducted in the period 2013-2014 at 57 prison units inNorway. A total of 1495 inmates (96 women) responded to the questionnaire. We investigated self-reporteduse of psychotropic drugs related to: hypnotics, anxiolytics, antidepressants, OMT-medications, pain medicationand ADHD-medication","PeriodicalId":35548,"journal":{"name":"Norsk Epidemiologi","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47074226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.5324/nje.v29i1-2.4052
Oteiza Francisco, Hanna Isabel Løyland, C. Bugge, I. Kristiansen, H. Støvring
Background: There is ample evidence for several pharmaceutical treatments that adherence in terms oftreatment duration and dose is suboptimal. The actual drug intake cannot be observed directly in prescriptiondatabases, which only register drug redeemed and a limited number of patient characteristics. Consequently,the actual dose and duration of treatment must be inferred from observed redemptions. Persistence can thenbe expressed as treatment duration (also referred to as drug survival).Method: We used data from the Norwegian Prescription Database (NorPD) on redemptions of statins (ATCcodeC10AA) for the period 2010-2019 to explore three methods for determining prescription durations andin turn persistence (treatment duration): (i) The DDD-method using the number of DDD redeemed; (ii) Thedose-unit approach using the number of tablets redeemed; (iii) The reverse waiting time distribution method(WTD), which estimates prescription duration as the 90th percentile of the distribution within which patientsin ongoing treatment will have a new subsequent redemption. The three methods for estimating prescriptionduration were then used to estimate treatment duration using Kaplan Meier (KM) survival functions. For theDDD-method and the dose-unit approach we conducted sensitivity analyses assuming that one DDD or onetablet would last for 1.00, 1.25 or 2.00 days. We also tested the impact of grace periods in sensitivity analyses.Results: Treatment duration and drug survival varied substantially for the same patients depending on thechosen method, duration of a DDD or a tablet, and inclusion of grace periods. The 25th percentile of treatmentduration was 100 days for the DDD approach with one DDD per day, 100 days with the dose-unit approachwith one tablet per day and 453 days with the WTD approach.Conclusion: When estimating treatment duration from prescription databases one should be aware that thesemeasures of persistence are highly influenced by the chosen methodology. The choice of method should beinformed by the clinical context with a preference for use of methods based on a formal model.
{"title":"Persistence of statin treatment – the impact of analytic method when estimating drug survival","authors":"Oteiza Francisco, Hanna Isabel Løyland, C. Bugge, I. Kristiansen, H. Støvring","doi":"10.5324/nje.v29i1-2.4052","DOIUrl":"https://doi.org/10.5324/nje.v29i1-2.4052","url":null,"abstract":"Background: There is ample evidence for several pharmaceutical treatments that adherence in terms oftreatment duration and dose is suboptimal. The actual drug intake cannot be observed directly in prescriptiondatabases, which only register drug redeemed and a limited number of patient characteristics. Consequently,the actual dose and duration of treatment must be inferred from observed redemptions. Persistence can thenbe expressed as treatment duration (also referred to as drug survival).Method: We used data from the Norwegian Prescription Database (NorPD) on redemptions of statins (ATCcodeC10AA) for the period 2010-2019 to explore three methods for determining prescription durations andin turn persistence (treatment duration): (i) The DDD-method using the number of DDD redeemed; (ii) Thedose-unit approach using the number of tablets redeemed; (iii) The reverse waiting time distribution method(WTD), which estimates prescription duration as the 90th percentile of the distribution within which patientsin ongoing treatment will have a new subsequent redemption. The three methods for estimating prescriptionduration were then used to estimate treatment duration using Kaplan Meier (KM) survival functions. For theDDD-method and the dose-unit approach we conducted sensitivity analyses assuming that one DDD or onetablet would last for 1.00, 1.25 or 2.00 days. We also tested the impact of grace periods in sensitivity analyses.Results: Treatment duration and drug survival varied substantially for the same patients depending on thechosen method, duration of a DDD or a tablet, and inclusion of grace periods. The 25th percentile of treatmentduration was 100 days for the DDD approach with one DDD per day, 100 days with the dose-unit approachwith one tablet per day and 453 days with the WTD approach.Conclusion: When estimating treatment duration from prescription databases one should be aware that thesemeasures of persistence are highly influenced by the chosen methodology. The choice of method should beinformed by the clinical context with a preference for use of methods based on a formal model.","PeriodicalId":35548,"journal":{"name":"Norsk Epidemiologi","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70786702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.5324/nje.v29i1-2.4048
El Khalil Nebghouha, A. Lupattelli, H. Nordeng
Aims: The aim of this study was two-fold: i) to describe factors associated with antithyroid drug (ATD) treatmentduring gestation among women with hyperthyroidism in pregnancy, ii) to investigate the impact of ATDtreatment during gestation on pregnancy outcomes.Methods: Women with hyperthyroidism in pregnancy and ATD treatments were identified through linkage ofthree national registries (2008-2018): The Medical Birth Registry of Norway, the Norwegian PrescriptionRegistry and the Norwegian Patient Registry. Pregnancies were categorized as ATD treated or untreated basedon filled prescriptions indicating ATD exposure during pregnancy. ATD treatment was examined by trimester(T1, T2/T3) and by substance carbimazole (CMZ), propylthiouracil (PTU) and by both CMZ/PTU. Generalizedestimating equations analysis with a robust variance estimator was used to estimate adjusted odds ratio (aOR)and adjusted standardized mean difference (aSMD) with 95% confidence interval (CI).Results: We identified 1699 pregnancies with hyperthyroidism during gestation. Hyperthyroidism was treatedwith ATD in 44.4% of the pregnancies, while 55.6% were untreated. Pregnant women treated with ATD hadmore often asthma compared to untreated women. Prenatal exposure to CMZ was associated with increased riskof preterm birth (aOR 1.8, 95% CI 1.1-2.8) whereas PTU exposure in the first trimester was associated with anincreased risk of cardiac malformations (aOR 9.0, 95% CI 1.8-44.7). There was no association between ATDtreatment in pregnancy and maternal preeclampsia (aOR 0.8, 95% CI 0.4-1.3) and gestational hypertension (aOR0.9, 95% CI 0.5-1.8).Conclusion: This nationwide registry study found an association between treatment with carbimazole and increasedrisk of preterm birth. Exposure to propylthiouracil in the first trimester was associated with an increasedrisk of cardiac malformations. These findings should be interpreted in light of international findings on the riskof untreated hyperthyroidism and the potential risk of ATD treatment for the mother and child.
目的:本研究的目的有两个方面:1)描述妊娠期甲状腺功能亢进妇女抗甲状腺药物(ATD)治疗的相关因素，2)调查妊娠期抗甲状腺药物治疗对妊娠结局的影响。方法:通过三个国家登记处(2008-2018)的联系确定妊娠期甲状腺功能亢进和ATD治疗的妇女:挪威医学出生登记处、挪威处方登记处和挪威患者登记处。根据怀孕期间暴露于ATD的处方，将怀孕分为治疗或未治疗。ATD治疗分别在妊娠3个月(T1、T2/T3)、卡马唑(CMZ)、丙基硫脲嘧啶(PTU)和CMZ/PTU两种方法进行检测。采用稳健方差估计器的广义估计方程分析，以95%置信区间(CI)估计调整优势比(aOR)和调整标准化平均差(aSMD)。结果:我们发现1699例妊娠期甲状腺功能亢进。ATD治疗甲亢的孕妇占44.4%，而未治疗的占55.6%。与未接受治疗的孕妇相比，接受ATD治疗的孕妇患哮喘的几率更高。产前暴露于CMZ与早产风险增加相关(aOR为1.8,95% CI为1.1-2.8)，而妊娠早期暴露于PTU与心脏畸形风险增加相关(aOR为9.0,95% CI为1.8-44.7)。妊娠期atd治疗与母体子痫前期(aOR 0.8, 95% CI 0.4-1.3)和妊娠期高血压(aOR0.9, 95% CI 0.5-1.8)无关联。结论:这项全国性的登记研究发现卡马唑治疗与早产风险增加之间存在关联。妊娠早期暴露于丙硫脲嘧啶与心脏畸形的风险增加有关。这些发现应该根据国际上关于未经治疗的甲亢风险和ATD治疗对母亲和孩子的潜在风险的研究结果来解释。
{"title":"Antithyroid drug treatment and pregnancy outcomes among women with hyperthyroidism in pregnancy: A Norwegian population-based registry-linkage study","authors":"El Khalil Nebghouha, A. Lupattelli, H. Nordeng","doi":"10.5324/nje.v29i1-2.4048","DOIUrl":"https://doi.org/10.5324/nje.v29i1-2.4048","url":null,"abstract":"Aims: The aim of this study was two-fold: i) to describe factors associated with antithyroid drug (ATD) treatmentduring gestation among women with hyperthyroidism in pregnancy, ii) to investigate the impact of ATDtreatment during gestation on pregnancy outcomes.Methods: Women with hyperthyroidism in pregnancy and ATD treatments were identified through linkage ofthree national registries (2008-2018): The Medical Birth Registry of Norway, the Norwegian PrescriptionRegistry and the Norwegian Patient Registry. Pregnancies were categorized as ATD treated or untreated basedon filled prescriptions indicating ATD exposure during pregnancy. ATD treatment was examined by trimester(T1, T2/T3) and by substance carbimazole (CMZ), propylthiouracil (PTU) and by both CMZ/PTU. Generalizedestimating equations analysis with a robust variance estimator was used to estimate adjusted odds ratio (aOR)and adjusted standardized mean difference (aSMD) with 95% confidence interval (CI).Results: We identified 1699 pregnancies with hyperthyroidism during gestation. Hyperthyroidism was treatedwith ATD in 44.4% of the pregnancies, while 55.6% were untreated. Pregnant women treated with ATD hadmore often asthma compared to untreated women. Prenatal exposure to CMZ was associated with increased riskof preterm birth (aOR 1.8, 95% CI 1.1-2.8) whereas PTU exposure in the first trimester was associated with anincreased risk of cardiac malformations (aOR 9.0, 95% CI 1.8-44.7). There was no association between ATDtreatment in pregnancy and maternal preeclampsia (aOR 0.8, 95% CI 0.4-1.3) and gestational hypertension (aOR0.9, 95% CI 0.5-1.8).Conclusion: This nationwide registry study found an association between treatment with carbimazole and increasedrisk of preterm birth. Exposure to propylthiouracil in the first trimester was associated with an increasedrisk of cardiac malformations. These findings should be interpreted in light of international findings on the riskof untreated hyperthyroidism and the potential risk of ATD treatment for the mother and child.","PeriodicalId":35548,"journal":{"name":"Norsk Epidemiologi","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70786616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-05-09DOI: 10.5324/NJE.V28I1-2.3052
U. Moksnes, R. J. Reidunsdatter
Aim: Adolescence represent an important period for positive mental health development. The aim of the present paper was to investigate gender differences as well as the level, stability and predictive role of mental health (symptoms of depression/anxiety and mental well-being) and self-esteem in adolescents during a school year.Methods: The study sample consisted of a cohort of 351 students aged 15–21 years in Mid-Norway. In a survey administrated at the beginning and end of the 2016/2017 school year, mental well-being was assessed with Warwick-Edinburgh Mental Well-Being Scale, depression/anxiety with Hopkins Symptom Checklist and self-esteem with the Rosenberg Self-Esteem Scale. Two models were tested for prediction; self-esteem on mental health (vulnerability model) and mental health on self-esteem (scar model).Results: Girls reported significantly higher depression/anxiety than boys and showed a slightly significant increase in depression/anxiety, stress and self-esteem during the two assessments. Boys scored significantly higher on mental well-being and self-esteem and reported stable mental health during the school year. Selfesteem significantly predicted depression/anxiety and mental well-being. Mental well-being and depression/ anxiety also significantly predicted self-esteem.Conclusion: The results suggest that self-esteem and mental health are reciprocally associated. The results underline the gender differences in overall mental health in adolescents and thus the potential importance of acknowledging gender when working on universal strategies for positive mental health development.
{"title":"Self-esteem and mental health in adolescents – level and stability during a school year","authors":"U. Moksnes, R. J. Reidunsdatter","doi":"10.5324/NJE.V28I1-2.3052","DOIUrl":"https://doi.org/10.5324/NJE.V28I1-2.3052","url":null,"abstract":"Aim: Adolescence represent an important period for positive mental health development. The aim of the present paper was to investigate gender differences as well as the level, stability and predictive role of mental health (symptoms of depression/anxiety and mental well-being) and self-esteem in adolescents during a school year.Methods: The study sample consisted of a cohort of 351 students aged 15–21 years in Mid-Norway. In a survey administrated at the beginning and end of the 2016/2017 school year, mental well-being was assessed with Warwick-Edinburgh Mental Well-Being Scale, depression/anxiety with Hopkins Symptom Checklist and self-esteem with the Rosenberg Self-Esteem Scale. Two models were tested for prediction; self-esteem on mental health (vulnerability model) and mental health on self-esteem (scar model).Results: Girls reported significantly higher depression/anxiety than boys and showed a slightly significant increase in depression/anxiety, stress and self-esteem during the two assessments. Boys scored significantly higher on mental well-being and self-esteem and reported stable mental health during the school year. Selfesteem significantly predicted depression/anxiety and mental well-being. Mental well-being and depression/ anxiety also significantly predicted self-esteem.Conclusion: The results suggest that self-esteem and mental health are reciprocally associated. The results underline the gender differences in overall mental health in adolescents and thus the potential importance of acknowledging gender when working on universal strategies for positive mental health development.","PeriodicalId":35548,"journal":{"name":"Norsk Epidemiologi","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43144783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-05-09DOI: 10.5324/NJE.V28I1-2.3050
Oda Lekve Brandseth, Malin Torstveit Håvarstein, H. Urke, E. Haug, T. Larsen
Knowledge about factors in school that can promote adolescents’ mental health is of great value for national health policies and health promotion work. This cross-sectional study investigated levels of mental wellbeing measured with the Warwick-Edinburgh Mental Well-being Scale and the relationship with teacher support and class belonging among 574 Norwegian high school students, aged 16-17 (55.1% boys). The data stem from the COMPLETE-project. Results showed that students reported an average mental wellbeing of 3.50 (SD 0.88, range 1-5), with significant differences across gender, study specialization area and socioeconomic status groups. Class belonging partially mediated the observed relationship between teacher support and mental well-being after adjusting for covariates. The findings indicate that a supportive teacher may be a significant factor for both students’ class belonging and mental well-being, and suggests that school policies and programs should include a focus on promoting teachers’ supportive behavior.
{"title":"Mental well-being among students in Norwegian upper secondary schools: the role of teacher support and class belonging","authors":"Oda Lekve Brandseth, Malin Torstveit Håvarstein, H. Urke, E. Haug, T. Larsen","doi":"10.5324/NJE.V28I1-2.3050","DOIUrl":"https://doi.org/10.5324/NJE.V28I1-2.3050","url":null,"abstract":"Knowledge about factors in school that can promote adolescents’ mental health is of great value for national health policies and health promotion work. This cross-sectional study investigated levels of mental wellbeing measured with the Warwick-Edinburgh Mental Well-being Scale and the relationship with teacher support and class belonging among 574 Norwegian high school students, aged 16-17 (55.1% boys). The data stem from the COMPLETE-project. Results showed that students reported an average mental wellbeing of 3.50 (SD 0.88, range 1-5), with significant differences across gender, study specialization area and socioeconomic status groups. Class belonging partially mediated the observed relationship between teacher support and mental well-being after adjusting for covariates. The findings indicate that a supportive teacher may be a significant factor for both students’ class belonging and mental well-being, and suggests that school policies and programs should include a focus on promoting teachers’ supportive behavior.","PeriodicalId":35548,"journal":{"name":"Norsk Epidemiologi","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45743456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-05-09DOI: 10.5324/NJE.V28I1-2.3047
Siv Kvernmo, Ronja Sæterhaug Bye
Kvernmo S, Bye RS. The prevalence of anxiety- and depression symptoms in Sami and non-Samihigh school students in Finnmark county in 1994 and 2014. Nor J Epidemiol 2019; 28 (1-2): 15-25.ENGLISH SUMMARYAs much as 15-20% of children and adolescents in Norway, aged 3-18 years, are suffering from anxiety,depressive or behavioral problems. Recent studies have shown an increase in the prevalence of emotionalproblems among adolescents during the last decades. The aim of this study is to examine the prevalenceand the sociodemographic and psychosocial predictors of anxiety and depression symptoms in IndigenousSami and non-Sami adolescents in 1994 to 2014.Data from 1655 high school students in the Young in North (Ung i Nord) study from 1994 was comparedto data from 1856 high school students in Ungdata, conducted in 2014 in the same area. Similar andcomparable measures were applied in the two studies with SCL-12 as the main measure. The resultsshowed an increase in the prevalence of depression and anxiety symptoms from 1994 compared to 2014,but a decrease in behavioral problems. At both years females reported more problems. No significantethnic differences occurred in rates of problems between indigenous Sami and non-Sami adolescents at anytime point. Across gender and ethnic groups, self-esteem and the students' relationship to the school werethe two strongest predictors.Conclusion: This study confirmed findings from other studies of an increase of rates of anxiety anddepression symptoms in older adolescents over the last decades, but also in types of significant predictors.Our findings entail a future need for prevention and treatment offers to adolescents suffering from anxietyand depression problems.
{"title":"Forekomsten av angst- og depresjonssymptomer hos samiske og ikke-samiske elever i videregående skole i Finnmark i 1994 og 2014","authors":"Siv Kvernmo, Ronja Sæterhaug Bye","doi":"10.5324/NJE.V28I1-2.3047","DOIUrl":"https://doi.org/10.5324/NJE.V28I1-2.3047","url":null,"abstract":"Kvernmo S, Bye RS. The prevalence of anxiety- and depression symptoms in Sami and non-Samihigh school students in Finnmark county in 1994 and 2014. Nor J Epidemiol 2019; 28 (1-2): 15-25.ENGLISH SUMMARYAs much as 15-20% of children and adolescents in Norway, aged 3-18 years, are suffering from anxiety,depressive or behavioral problems. Recent studies have shown an increase in the prevalence of emotionalproblems among adolescents during the last decades. The aim of this study is to examine the prevalenceand the sociodemographic and psychosocial predictors of anxiety and depression symptoms in IndigenousSami and non-Sami adolescents in 1994 to 2014.Data from 1655 high school students in the Young in North (Ung i Nord) study from 1994 was comparedto data from 1856 high school students in Ungdata, conducted in 2014 in the same area. Similar andcomparable measures were applied in the two studies with SCL-12 as the main measure. The resultsshowed an increase in the prevalence of depression and anxiety symptoms from 1994 compared to 2014,but a decrease in behavioral problems. At both years females reported more problems. No significantethnic differences occurred in rates of problems between indigenous Sami and non-Sami adolescents at anytime point. Across gender and ethnic groups, self-esteem and the students' relationship to the school werethe two strongest predictors.Conclusion: This study confirmed findings from other studies of an increase of rates of anxiety anddepression symptoms in older adolescents over the last decades, but also in types of significant predictors.Our findings entail a future need for prevention and treatment offers to adolescents suffering from anxietyand depression problems.","PeriodicalId":35548,"journal":{"name":"Norsk Epidemiologi","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48354077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-05-09DOI: 10.5324/NJE.V28I1-2.3049
T. H. Stea, K. Ridder, S. H. Haugland
Background: Young people who are not in education, employment or training (NEET) have been identified as a vulnerable group at risk of poor social functioning, lower educational achievement, limited job opportunities and financial hardship. Being NEET has also been associated with increased risk of mental and physical health problems, but only a few studies have identified the prevalence of certain health-risk behaviors among NEET youth. The present study contributes to fill the existing knowledge gaps by investigating a broad range of risk behaviors in this vulnerable group compared to their high school peers.Methods: This cross-sectional study included 96 NEET youth and 384 age and gender-matched high school students. A self-report questionnaire was used to assess differences in several risk behaviors, including substance use, low consumption of healthy food and high consumption of unhealthy food and beverages, low leisure time physical activity and low sleep duration. Logistic regression models were adjusted for gender, age and parental education.Results: NEET youth had higher odds of using cannabis (OR 2.2; 95% CI 1.1-4.3), smokeless tobacco (1.7;1.0-2.8), smoking cigarettes (2.6;1.5-4.4), having an irregular consumption of breakfast (2.6;1.5-4.5), lunch (3.1;1.8-5.4) and dinner (1.9;1.1-3.2), having low consumption of vegetables (3.0;1.3-6.7), fruit and berries (5.3;1.6-18.1) and fish (3.0;1.8-5.1) and short sleep duration on weekends (2.6;1.4-4.9) than students. On the other hand, being NEET was associated with decreased odds of short sleep duration on weekdays compared to their high school peers (0.3;0.2-0.5). No differences in alcohol intoxication, consumption frequency of evening meals, consumption of unhealthy food items and beverages and leisure time physical activity were shown between these groups.Conclusions: NEET youth have higher odds of using tobacco, short sleep duration on weekends and lower consumption of healthy food items including vegetables, fruit and fish compared to high school students. These results contribute to identify risk behaviors that are more prevalent among NEET youth compared to students and needs to be addressed through targeted intervention studies.
{"title":"Comparison of risk-behaviors among young people who are not in education, employment or training (NEET) versus high school students. A cross-sectional study","authors":"T. H. Stea, K. Ridder, S. H. Haugland","doi":"10.5324/NJE.V28I1-2.3049","DOIUrl":"https://doi.org/10.5324/NJE.V28I1-2.3049","url":null,"abstract":"Background: Young people who are not in education, employment or training (NEET) have been identified as a vulnerable group at risk of poor social functioning, lower educational achievement, limited job opportunities and financial hardship. Being NEET has also been associated with increased risk of mental and physical health problems, but only a few studies have identified the prevalence of certain health-risk behaviors among NEET youth. The present study contributes to fill the existing knowledge gaps by investigating a broad range of risk behaviors in this vulnerable group compared to their high school peers.Methods: This cross-sectional study included 96 NEET youth and 384 age and gender-matched high school students. A self-report questionnaire was used to assess differences in several risk behaviors, including substance use, low consumption of healthy food and high consumption of unhealthy food and beverages, low leisure time physical activity and low sleep duration. Logistic regression models were adjusted for gender, age and parental education.Results: NEET youth had higher odds of using cannabis (OR 2.2; 95% CI 1.1-4.3), smokeless tobacco (1.7;1.0-2.8), smoking cigarettes (2.6;1.5-4.4), having an irregular consumption of breakfast (2.6;1.5-4.5), lunch (3.1;1.8-5.4) and dinner (1.9;1.1-3.2), having low consumption of vegetables (3.0;1.3-6.7), fruit and berries (5.3;1.6-18.1) and fish (3.0;1.8-5.1) and short sleep duration on weekends (2.6;1.4-4.9) than students. On the other hand, being NEET was associated with decreased odds of short sleep duration on weekdays compared to their high school peers (0.3;0.2-0.5). No differences in alcohol intoxication, consumption frequency of evening meals, consumption of unhealthy food items and beverages and leisure time physical activity were shown between these groups.Conclusions: NEET youth have higher odds of using tobacco, short sleep duration on weekends and lower consumption of healthy food items including vegetables, fruit and fish compared to high school students. These results contribute to identify risk behaviors that are more prevalent among NEET youth compared to students and needs to be addressed through targeted intervention studies.","PeriodicalId":35548,"journal":{"name":"Norsk Epidemiologi","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47306267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-05-09DOI: 10.5324/NJE.V28I1-2.3055
T. H. Stea, E. Abildsnes, A. Strandheim, S. H. Haugland
Objectives: An increasing proportion of young Norwegians are categorised as too ill to attend upper secondary education, and poor physical and mental health may reduce their opportunities to return to school or find paid employment. This study examined the differences in self-perceived health, mental health, and prevalence of pain between Norwegian adolescents, who are not in education, employment or training (NEET) compared to adolescents who attend upper secondary school (age 16-21 years).Design: Cross-sectional study.Participants and setting: A total of 96 NEET youth and 384 age and gender matched adolescents attending upper secondary school in the south of Norway participated in the study.Main outcome measures: Self-perceived health, mental health and pain.Results: Multivariable analyses, adjusted for parental education, showed that more NEET girls reported poor self-perceived health (odds ratio 3.2; 95% CI 1.4–7.5) and poor mental health (2.4;1.0–5.2) when compared to girls who were attending school. The results showed no difference in the prevalence of various types of pain between girls who were attending or not attending school, and among boys the results showed no differences in health problems assessed in this study.Conclusion: The study indicates that NEET girls have poorer self-perceived health and poorer mental health when compared to girls who are attending upper secondary school. It will be essential to identify the causes of these health problems. This may provide a basis for specially adapted measures that could help more people in the target group return to school or paid employment.
{"title":"Do young people who are not in education, employment or training (NEET) have more health problems than their peers? A cross-sectional study among Norwegian adolescents","authors":"T. H. Stea, E. Abildsnes, A. Strandheim, S. H. Haugland","doi":"10.5324/NJE.V28I1-2.3055","DOIUrl":"https://doi.org/10.5324/NJE.V28I1-2.3055","url":null,"abstract":"Objectives: An increasing proportion of young Norwegians are categorised as too ill to attend upper secondary education, and poor physical and mental health may reduce their opportunities to return to school or find paid employment. This study examined the differences in self-perceived health, mental health, and prevalence of pain between Norwegian adolescents, who are not in education, employment or training (NEET) compared to adolescents who attend upper secondary school (age 16-21 years).Design: Cross-sectional study.Participants and setting: A total of 96 NEET youth and 384 age and gender matched adolescents attending upper secondary school in the south of Norway participated in the study.Main outcome measures: Self-perceived health, mental health and pain.Results: Multivariable analyses, adjusted for parental education, showed that more NEET girls reported poor self-perceived health (odds ratio 3.2; 95% CI 1.4–7.5) and poor mental health (2.4;1.0–5.2) when compared to girls who were attending school. The results showed no difference in the prevalence of various types of pain between girls who were attending or not attending school, and among boys the results showed no differences in health problems assessed in this study.Conclusion: The study indicates that NEET girls have poorer self-perceived health and poorer mental health when compared to girls who are attending upper secondary school. It will be essential to identify the causes of these health problems. This may provide a basis for specially adapted measures that could help more people in the target group return to school or paid employment.","PeriodicalId":35548,"journal":{"name":"Norsk Epidemiologi","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46845057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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