Kristin Lork, Louise Danielsson, Maria E H Larsson, Kristina Holmgren
{"title":"Experiences of rehabilitation coordination among people on sick leave with mental health problems.","authors":"Kristin Lork, Louise Danielsson, Maria E H Larsson, Kristina Holmgren","doi":"10.1080/02813432.2024.2361242","DOIUrl":"10.1080/02813432.2024.2361242","url":null,"abstract":"<p><strong>Purpose: </strong>Return to work often requires collaboration between different stakeholders. Rehabilitation coordination is a resource in coordinating efforts during sick leave to facilitate return to work. The purpose of the present study was to describe how people at risk for sick leave or on sick leave with mental health problems experienced rehabilitation coordination.</p><p><strong>Materials and method: </strong>The study had a qualitative approach using qualitative content analysis as described by Graneheim and Lundman. Eleven semi-structured interviews were conducted with persons at risk for sick leave or on sick leave due to mental health problems and with experience of rehabilitation coordination.</p><p><strong>Results: </strong>The participants experience of rehabilitation coordination were described by the overarching theme <i>Building a bridge with many bricks between the person and society</i>. The theme was formed by four categories and eleven subcategories reflecting the complex context of rehabilitation coordination. The categories were <i>Collaboration in a new setting, Unburdened within certain limits, The way back to work is a joint project</i> and <i>Recognising challenges beyond the person.</i></p><p><strong>Conclusions: </strong>People with mental health problems experienced rehabilitation coordination as a meaningful link between healthcare and work. However, rehabilitation coordination needs to be more recognised within healthcare to increase accessibility. It seems important that interventions are directed not only towards the person, but also include the workplace for a sustainable return to work.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141248481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Heba Sourkatti, Juha Pajula, Teemu Keski-Kuha, Juha Koivisto, Mika Hilvo, Jaakko Lähteenmäki
{"title":"Predictive modeling for identification of older adults with high utilization of health and social services.","authors":"Heba Sourkatti, Juha Pajula, Teemu Keski-Kuha, Juha Koivisto, Mika Hilvo, Jaakko Lähteenmäki","doi":"10.1080/02813432.2024.2372297","DOIUrl":"10.1080/02813432.2024.2372297","url":null,"abstract":"<p><strong>Aim: </strong>Machine learning techniques have demonstrated success in predictive modeling across various clinical cases. However, few studies have considered predicting the use of multisectoral health and social services among older adults. This research aims to utilize machine learning models to detect high-risk groups of excessive health and social services utilization at early stage, facilitating the implementation of preventive interventions.</p><p><strong>Methods: </strong>We used pseudonymized data covering a four-year period and including information on a total of 33,374 senior citizens from Southern Finland. The endpoint was defined based on the occurrence of unplanned healthcare visits and the total number of different services used. Input features included individual's basic demographics, health status and past usage of healthcare resources. Logistic regression and eXtreme Gradient Boosting (XGBoost) methods were used for binary classification, with the dataset split into 70% training and 30% testing sets.</p><p><strong>Results: </strong>Subgroup-based results mirrored trends observed in the full cohort, with age and certain health issues, e.g. mental health, emerging as positive predictors for high service utilization. Conversely, hospital stay and urban residence were associated with decreased risk. The models achieved a classification performance (AUC) of 0.61 for the full cohort and varying in the range of 0.55-0.62 for the subgroups.</p><p><strong>Conclusions: </strong>Predictive models offer potential for predicting future high service utilization in the older adult population. Achieving high classification performance remains challenging due to diverse contributing factors. We anticipate that classification performance could be increased by including features based on additional data categories such as socio-economic data.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141493238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aina Enckell, Merja K Laine, Hanna-Maria Roitto, Marko Raina, Timo Kauppila
{"title":"Changes in location and number of nurse consultations as the supply of general practitioners decreases in primary health care: six-year register-based follow-up cohort study in the city of Vantaa, Finland.","authors":"Aina Enckell, Merja K Laine, Hanna-Maria Roitto, Marko Raina, Timo Kauppila","doi":"10.1080/02813432.2024.2375548","DOIUrl":"10.1080/02813432.2024.2375548","url":null,"abstract":"<p><strong>Objective: </strong>To investigate whether the location and the number of nurse consultations have changed in response to the continuously decreasing number of GP consultations in the fourth-largest city in Finland. It has been suggested that nurse consultations are replacing GP consultations.</p><p><strong>Design: </strong>A retrospective register-based follow-up cohort study.</p><p><strong>Setting: </strong>Public primary health care in the City of Vantaa, Finland.</p><p><strong>Subjects: </strong>All documented face-to-face office-hour consultations with practical and registered nurses, and consultations with practical and registered nurse in the emergency department of Vantaa primary health care between 1 January 2009 and 31 December, 2014.</p><p><strong>Main outcome measures: </strong>Change in the number of consultations with practical and registered nurses between 2009 and 2014 in primary health care both during office-hours and in the emergency department.</p><p><strong>Results: </strong>Over the follow-up period, the monthly median number of practical nurse consultations in the emergency department per 1000 inhabitants increased from 1.6 (interquartile range [IQR] 1.3-1.7) to 10.5 (10.3-12.2) (<i>p</i> < 0.001) and registered nurse consultations from a median of 3.6 (3.0-4.0) to 14.5 (13.0-16.6) (<i>p</i> < 0.001). However, there was no significant change in the median monthly number of office-hour consultations with practical or registered nurses.</p><p><strong>Conclusions: </strong>It appears that in primary health care, medical consultations have shifted from GPs to nurses with lower education levels, and from care during office-hours to emergency care.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141555451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Reflections of nurses and primary healthcare managers on integrating hospital at home into public primary healthcare services: a Norwegian focus group study.","authors":"Lillian Karlsen, Bente Prytz Mjølstad, Bjarte Bye Løfaldli, Anne-Sofie Helvik","doi":"10.1080/02813432.2024.2373310","DOIUrl":"10.1080/02813432.2024.2373310","url":null,"abstract":"<p><strong>Background: </strong>Hospital at home (HaH) is an innovative approach to healthcare delivery that brings specialized services to patients' homes. HaH services are typically available in urban areas where hospitals can easily reach nearby patients. An integrated care model that utilizes the public primary healthcare system may extend HaH services to include patients residing further away from hospitals. However, there is limited evidence of primary healthcare employees' views on integrating HaH care into primary healthcare services. This study aimed to explore the reflections of primary healthcare employees on integrating HaH care into primary healthcare services.</p><p><strong>Methods: </strong>Ten focus group interviews were conducted with homecare nurses and managers of primary healthcare services in five municipalities in Mid-Norway. Reflexive thematic analysis was used to analyze the data.</p><p><strong>Results: </strong>The analysis resulted in three key themes regarding the integration of HaH care into primary healthcare. Participants discussed how they capture the distinctiveness of HaH care within the primary healthcare landscape. Moreover, they identified that the introduction of HaH care reveals opportunities to address challenges. Lastly, the study uncovered a strong primary healthcare commitment and a sense of professional pride among the participants. This resilience and dedication among primary healthcare employees appeared as an incentive to make the integration of HaH work.</p><p><strong>Conclusions: </strong>This study offers valuable insights into integrating HaH into primary healthcare services, highlighting opportunities to address challenges. The resilience and dedication of primary healthcare employees underscore their commitment to adapting to and thriving with HaH care. To establish a sustainable HaH care model, it is important to address geographical limitations, consider the strain on providers, maintain robust relationships, enhance funding, and formalize decision-making processes.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141493239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"To neutrally offer or strongly recommend? General practitioners' perspectives on screening for gestational diabetes according to the national guideline in Norway.","authors":"Ingeborg Forthun, Kathy Ainul Møen, Stefán Hjörleifsson","doi":"10.1080/02813432.2024.2378204","DOIUrl":"10.1080/02813432.2024.2378204","url":null,"abstract":"<p><strong>Objective: </strong>To explore general practitioners' experiences and reflections on how the current Norwegian guideline for screening for gestational diabetes affects their clinical practice.</p><p><strong>Design: </strong>A qualitive study in which data were collected through semi-structured focus group interviews and analyzed thematically.</p><p><strong>Setting and subjects: </strong>Five focus groups conducted in 2020 among GPs in Norway; three interviews took place face-to-face and two were held digitally. The total number of participants was 31.</p><p><strong>Results: </strong>GPs acknowledged the potential benefits of more extensive screening, but had concerns about the medicalization of pregnancy, stating that some women experienced considerable anxiety. The GPs expressed doubts about the guideline's evidence base but differed in how they interpreted what the guideline was asking them to do. Some offered eligible women the opportunity to be screened, while other set up a screening appointment without consulting the women first. For some, fear of incrimination made them recommend screening without being convinced that it was the right thing for the patient.</p><p><strong>Conclusions: </strong>It is unclear whether the guideline for gestational diabetes requires GPs to recommend screening to pregnant women or if they should provide neutral information about the availability of screening. This ambiguity should be addressed, and the guideline evaluated against the core principles of general practice.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sanna Lakoma, Henna Pasanen, Kaisla Lahdensuo, Jaakko Pehkonen, Jutta Viinikainen, Paulus Torkki
{"title":"Quality of the digital gp visits and characteristics of the users: retrospective observational study.","authors":"Sanna Lakoma, Henna Pasanen, Kaisla Lahdensuo, Jaakko Pehkonen, Jutta Viinikainen, Paulus Torkki","doi":"10.1080/02813432.2024.2380921","DOIUrl":"10.1080/02813432.2024.2380921","url":null,"abstract":"<p><strong>Objectives: </strong>This study compares the demographics, diagnoses, re-admission rates, sick leaves, and prescribed medications of patients accessing digital general practitioner (GP) visits with those of patients opting for traditional face-to-face appointments in a primary health care setting.</p><p><strong>Design: </strong>The study adopted a retrospective analysis of patient record data collected in 2019, comparing visits to a digital primary health center with traditional health center visits.</p><p><strong>Setting: </strong>Primary health care.</p><p><strong>Participants: </strong>The data encompassed patients who utilized the digital clinic and those who visited public health centers for primary health care services.</p><p><strong>Main outcome measures: </strong>The study assessed demographics, health diagnoses, prescribed medications, sick leave recommendations, re-admission rates, and differences in costs between digital clinic and face-to-face visits. Secondary outcomes included a comparative analysis of medication categories, resolution rates for health problems, and potential impacts on health care utilization.</p><p><strong>Results: </strong>Digital clinic users were typically younger, more educated, and predominantly female compared with health centre users. Digital visits were well-suited for uncomplicated infections, while health centre appointments were associated with a higher prevalence of chronic conditions. Medication patterns differed between the two modalities, with digital clinic users receiving generic over-the-counter drugs and antibiotics, whereas health centre visits commonly involved cardiac and antihypertensive medications. Sick leave recommendations were slightly higher in the digital clinic, but the difference was not significant. Approximately 70% of health problems addressed in the digital clinic were successfully resolved, and the cost of digital visits was about 50,3% of face-to-face appointments.</p><p><strong>Conclusion: </strong>Digital health care services offer a cost-efficient alternative for specific health problems, appealing to younger, educated individuals, when compared to the users of public health center, and may enable improvement of cost-effectiveness combined with acceptable demand management and patient segmentation practices. The results highlight the potential benefits of digital clinics, particularly for uncomplicated cases, while also emphasizing the importance of suitable referral mechanisms for in-person consultations.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141734996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Gatekeeping and referral of patients holding private health insurance: a survey among general practitioners in Norway.","authors":"Jørgen Breivold, Karin Isaksson Rø, Stein Nilsen, Merethe Kristine Kousgaard Andersen, Jørgen Nexøe, Stefán Hjörleifsson","doi":"10.1080/02813432.2024.2380923","DOIUrl":"10.1080/02813432.2024.2380923","url":null,"abstract":"<p><strong>Objective: </strong>Private health insurance is becoming more common in Norway. The aim of this study was to investigate GPs' opinions on private health insurance, and their experiences from consultations where health insurance can affect decisions about referring.</p><p><strong>Design: </strong>A web based cross-sectional survey.</p><p><strong>Setting: </strong>Norwegian general practice.</p><p><strong>Subjects: </strong>All GPs in Norway were in 2019 invited to participate in an online survey.</p><p><strong>Main outcome measures: </strong>The GPs' opinions and experiences regarding health insurance were reported as proportions. Multiple logistic regression was used to test associations between how frequently GPs refer patients without further considerations and variables concerning their characteristics, opinions, and experiences.</p><p><strong>Results: </strong>Of 1,309 GPs (response rate 27%), 93% stated that private health insurance raises the risk of overtreatment and 90% considered such insurance to contribute to inequality in health. Frequently being pressured to refer in the absence of a medical indication was reported by 42%. Moreover, 28% often or always chose to refer patients without further consideration, and this was associated with perceptions of pressure with an adjusted odds ratio (AOR) of 3.80, 95% confidence interval (CI) 2.73-5.29, and unpleasant reactions from patients following refusals (AOR 1.63, 95% CI 1.14-2.33).</p><p><strong>Conclusion: </strong>Although most participating GPs associated private health insurance with overtreatment and inequality in health, more than one in four choose to refer without further consideration. GPs' experience of pressure to refer and negative reactions from patients when they consider referrals not to be medically indicated, raises the risk of medical overuse for patients holding private health insurance.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141749057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sofia Olofsson, Fredric Karlsson, Miriam Pikkemaat, Björn Ekman, Mattias Rööst, Hans Thulesius, Veronica Milos Nymberg
{"title":"Physicians' intentions to use digital tools - a comparative survey, before and after the COVID-19 pandemic, in Southern Sweden.","authors":"Sofia Olofsson, Fredric Karlsson, Miriam Pikkemaat, Björn Ekman, Mattias Rööst, Hans Thulesius, Veronica Milos Nymberg","doi":"10.1080/02813432.2024.2346133","DOIUrl":"10.1080/02813432.2024.2346133","url":null,"abstract":"<p><strong>Objectives: </strong>To describe changes in Swedish primary care physicians' use of, attitudes and intentions toward digital tools in patient care between 2019 and 2022.</p><p><strong>Design: </strong>A survey using a validated questionnaire measuring physician's intentions to use digital tools based on the theory of planned behavior.</p><p><strong>Setting: </strong>Sample of primary health care centers in southern Sweden.</p><p><strong>Subjects: </strong>Primary care physicians.</p><p><strong>Main outcome measures: </strong>Self-reported use and intentions to use, digital tools including digital consultations by text or video, chronic disease monitoring and artificial intelligence (AI) and the associations between attitudes, subjective norms, perceived behavioral control and behavioral intentions to use digital tools, in 2019 compared to 2022.</p><p><strong>Results: </strong>In both 2019 (<i>n</i> = 198) and 2022 (<i>n</i> = 93), physicians reported high intentions to use digital tools. Self-reported use of video was slightly higher in 2022 (<i>p</i> = .03). No other changes were seen in the self-reported use or behavioral intentions to use digital tools.</p><p><strong>Conclusion: </strong>The slow adoption of patient-related digital tools in Swedish primary health care does not seem to be explained by a low intention to use them among physicians. Future research on implementation of digital tools should include a focus on contextual factors such as organizational, technical and cultural barriers.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140865852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D Veldkamp, N Pooters, H J Schers, R Akkermans, T C Olde Hartman, A A Uijen
{"title":"Changes in analgesic prescriptions in Dutch general practice.","authors":"D Veldkamp, N Pooters, H J Schers, R Akkermans, T C Olde Hartman, A A Uijen","doi":"10.1080/02813432.2024.2387423","DOIUrl":"10.1080/02813432.2024.2387423","url":null,"abstract":"<p><strong>Background: </strong>Increases in opioid prescriptions have been described; however, recent trends and prescribing patterns of analgesics in Dutch general practice are largely unknown.</p><p><strong>Objective: </strong>To investigate recent changes in the number of analgesic prescriptions, and the indications for prescribing strong opioids. Furthermore, we aim to identify risk factors for chronic opioid use in Dutch general practice.</p><p><strong>Design and setting: </strong>A retrospective cohort study from 1 July 2013 to 31 June 2022, using a primary care practice based research network.</p><p><strong>Subjects: </strong>Patients with ≥1 prescription for analgesics during the study period were included.</p><p><strong>Main outcome measure: </strong>Changes in the number of prescriptions for paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs) and opioids in Dutch general practice during the 9-year study period. Moreover, we analyzed indications for prescribing strong opioids by the general practitioner (GP).</p><p><strong>Results: </strong>A total of 18,433 analgesic users were identified. Over time, prescriptions for paracetamol, NSAIDs and weak opioids decreased, while the number of strong opioid prescriptions increased. General practitioners prescribed more strong opioids for non-malignant pain, whereas prescriptions for malignant pain remained stable over time. Risk factors for chronic opioid use (≥90 days) included older age, lower educational level, smoking status and having a history of a musculoskeletal or psychological disorder, a malignancy or sexual, physical or psychological abuse.</p><p><strong>Conclusions: </strong>Considering the increase in strong opioid prescriptions for benign conditions, GPs need to be vigilant for patients who are at risk for chronic use. Regular monitoring and awareness for psychosocial factors in treatment of chronic pain may be key in preventing harms associated with persistent opioid use.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lena Bornhöft, Susanne Bernhardsson, Lena Nordeman, Anna Grimby-Ekman, Maria Dottori, Maria E H Larsson
{"title":"Monitoring handgrip strength to motivate lifestyle choices for patients with diabetes type 2 - a pragmatic randomised controlled trial.","authors":"Lena Bornhöft, Susanne Bernhardsson, Lena Nordeman, Anna Grimby-Ekman, Maria Dottori, Maria E H Larsson","doi":"10.1080/02813432.2024.2373298","DOIUrl":"10.1080/02813432.2024.2373298","url":null,"abstract":"<p><strong>Methods: </strong>Measurement of HGS with Jamar dynamometers was added to annual check-ups for patients with T2DM by diabetes nurses in primary care with feedback about normal values for age and sex in the intervention group. The control group had standard check-ups. Change in self-reported PA level was measured with questionnaires.</p><p><strong>Results: </strong>Seven clinics and 334 patients participated. The intervention led to similar effects on PA in both groups. Patients with T2DM had comparable HGS to the general public. Regression analyses showed statistically significantly higher HGS in the intervention group than in the control group at follow-up and no improvement in PA, HbA1c, or waist circumference. Increased HGS was found for older people, men, and people with normal-to-high inclusion HGS, while patients with low inclusion HGS reduced their strength levels.</p><p><strong>Conclusions: </strong>Measuring HGS and giving feedback to patients with T2DM can lead to increased HGS but does not seem to affect general PA level, HbA1c, or waist circumference. People over 65 years, men, and people with normal-to-high HGS were influenced positively by the intervention. Patients with low HGS may need personalised support to increase physical activity and improve function.<b>ClinicalTrials registration:</b> NCT03693521.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141498882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}