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Papers by Mikael Hoffmann

Research paper thumbnail of Timeline of and Expectations for the National Medication List in Sweden

Studies in health technology and informatics, May 18, 2023

Research paper thumbnail of Opioid availability statistics from the International Narcotics Control Board do not reflect the medical use of opioids: comparison with sales data from Scandinavia

Scandinavian Journal of Pain, Jul 27, 2021

Research paper thumbnail of Challenges with Medication Management and the National Medication List in Sweden: An Interview Study from a Human, Organizational, and Technology Perspective

Studies in health technology and informatics, May 18, 2023

Research paper thumbnail of Evidence synthesis based on non-randomised studies—a critical review of studies leading to conclusions on fall risk properties of loop diuretics/beta-blockers

European Journal of Clinical Pharmacology, Oct 10, 2019

Research paper thumbnail of Incidence in pharmacoepidemiology: A conceptual framework for incidence of a single substance or group of substances with statins as an example

Basic & Clinical Pharmacology & Toxicology

A framework for analysing incidence in pharmacoepidemiology and drug statistics is suggested usin... more A framework for analysing incidence in pharmacoepidemiology and drug statistics is suggested using statins as an example. A new case of statin use (first‐ever use or recurrence of treatment) can be defined as new on the group (NoG), new on substance whether new on the group or not (NoS), new on substance and new on the group (NoS_and_NoG), new on substance and not new on the group (NoS_not_NoG).MethodIndividual‐level dispensations of statins 2006–2019 for 1 017 058 individuals with at least one dispensation 2019 in Sweden.ResultsWith 12‐month run‐in, corresponding to at least 8 months without treatment, the incidence proportion of NoG was 13.39 new cases per 1000 inhabitants and 8.40 with 10‐year run‐in. Thus, 37% had first been treated with any statin between 12 months and 10 years before the index date.For atorvastatin, NoS was 10.69, NoS_and_NoG 9.99, and NoS_not_NoG 0.70 per 1000 inhabitants. 0.70 per 1000 inhabitants or 6.6% of new cases of atorvastatin represented a change fro...

Research paper thumbnail of Incidence in pharmacoepidemiology—Basic definitions and types of misclassification

Basic & Clinical Pharmacology & Toxicology, 2022

The definition of a new case is a vital step in incidence studies in both epidemiology and pharma... more The definition of a new case is a vital step in incidence studies in both epidemiology and pharmacoepidemiology, although with significant differences in methodology between the fields. We define and apply a framework for two different types of new cases of drug use, first‐ever and recurrent, and show how the associated misclassifications related to length of run‐in period can be expressed by the positive predictive value (PPV).In the study, we consider individual‐level dispensations of statins 2006–2019 for 1,017,058 individuals with at least one dispensation in 2019 in Sweden. The incidence proportion for statins for both sexes of all ages in Sweden 2019 varied from 17.4/1000 with a run‐in of 8 months, 9.45/1000 with 5 years and 8.4/1000 with 10 years. The PPV was 49% with 8 months and 89% for 5 years using 10 years as gold standard.We conclude that the interpretation of incidence and thus the selection of an appropriate run‐in period, in pharmacoepidemiology, depends on whether f...

Research paper thumbnail of Comment on Häuser et al.: Medical use of opioids in Europe—Methodological concerns about data from the International Narcotics Control Board

European Journal of Pain, 2022

Research paper thumbnail of Guiding principles for the use of knowledge bases and real-world data in clinical decision support systems: report by an international expert workshop at Karolinska Institutet

Expert Review of Clinical Pharmacology, 2020

Research paper thumbnail of Do patients or their physicians more accurately assess long-term risk associated with hypertension? A population-based study

Scandinavian Journal of Primary Health Care, 2020

Research paper thumbnail of PERson-centredness in hypertension management using information technology (PERHIT): a protocol for a randomised controlled trial in primary health care

Research paper thumbnail of Use of hormone therapy (HT) among Swedish women with contraindications – A pharmacoepidemiological cohort study

Research paper thumbnail of 14-Year Survey in a Swedish County Reveals a Pronounced Increase in Bloodstream Infections (BSI). Comorbidity - An Independent Risk Factor for Both BSI and Mortality

PLOS ONE, 2016

we assessed the incidence, risk factors and outcome of BSI over a 14-year period (2000)(2001)(200... more we assessed the incidence, risk factors and outcome of BSI over a 14-year period (2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013) in a Swedish county. retrospective cohort study on culture confirmed BSI among patients in the county of O ¨stergo ¨tland, Sweden, with approximately 440,000 inhabitants. A BSI was defined as either community-onset BSI (CO-BSI) or hospital-acquired BSI (HA-BSI).

Research paper thumbnail of Hormone therapy might be underutilized in women with early menopause

Human reproduction (Oxford, England), 2015

Are Swedish women age 40-44 years with assumed early menopause 'undertreated' by hormone ... more Are Swedish women age 40-44 years with assumed early menopause 'undertreated' by hormone therapy (HT)? Many women with probable early menopause discontinue their HT after a short period of time. Thus, they fail to complete the recommended replacement up to age 51-52 years, the average age of menopause. Spontaneous early menopause occurs in ∼5% of women age 40-45 years. Regardless of the cause, women who experience hormonal menopause due to bilateral oophorectomy before the median age of spontaneous menopause are at increased risk of cardiovascular disease, neurological disease, osteoporosis, psychiatric illness and even death. The study is descriptive, and epidemiological and was based on the use of national registers of dispensed drug prescriptions (HT) linking registers from the National Board of Health and Welfare and Statistics Sweden from 1 July 2005 until 31 December 2011. The study population consisted of 310 404 women, 40-44 years old on 31 December 2005 who were fol...

Research paper thumbnail of Interactive Visualization of Prescriptions of Drugs to Individuals within Large Populations—Analyses of Temporal Relationships of Events

Research paper thumbnail of Patients' information on their prescribed current treatment†

Journal of Pharmaceutical Health Services Research, 2012

Objective To investigate how many patients, with five or more prescriptions in the Swedish Nation... more Objective To investigate how many patients, with five or more prescriptions in the Swedish National Prescription Repository (NPR) had received (1) the Medication List (ML) from the electronic medical record and (2) the Prescription List (PL) on prescriptions stored in the NPR and how these lists were used. Methods Patients >18 years of age, with five or more prescriptions stored electronically in the NPR, collecting medicines on prescription for themselves at nine pharmacies all around Sweden were interviewed about their knowledge of, and if they had received, the ML, the PL and/or the pharmacy record on medicines purchased on prescription during the last 15 months, and what documentation they used to track their current, prescribed treatment. Key findings A total of 777 consensual patients (485 women) were interviewed. Of these, 32% were aware of the ML, but only 13% had received the ML at least once a year, and only 9% used the ML to track their current, prescribed medicines. V...

Research paper thumbnail of Phases in development of an interactive mobile phone-based system to support self-management of hypertension

Integrated Blood Pressure Control, 2014

Research paper thumbnail of Use of hormone therapy in Swedish women aged 80 years or older

Research paper thumbnail of Knowledge of reproductive physiology and hormone therapy in 53- to 54-year-old Swedish women

Research paper thumbnail of Attitudes towards the menopause and hormone therapy over the turn of the century

Research paper thumbnail of Women's conception of the menopausal transition – a qualitative study

Journal of Clinical Nursing, 2007

Aim. To explore, with a qualitative approach, whether the conception of menopause varies between... more Aim. To explore, with a qualitative approach, whether the conception of menopause varies between women seeking medical advice because of climacteric symptoms and, if so, to describe these different conceptions.Background. For many women, the menopausal transition is a troublesome period of life, often associated with decreased well‐being and a number of symptoms. Besides the hormonal changes, many other factors such as psychological, sociological and lifestyle factors affect how women perceive their menopause.Method. Semi‐structured interviews were held with 20 women after their first‐time visits at outpatient clinics of gynaecology for discussion of climacteric symptoms. The interviews were audio‐taped, transcribed and analysed using a phenomenographic approach.Results. A wide variation of conceptions was revealed. Two main categories were identified including different physical changes with varying symptoms and both positive and negative psychological changes. The menopausal t...

Research paper thumbnail of Timeline of and Expectations for the National Medication List in Sweden

Studies in health technology and informatics, May 18, 2023

Research paper thumbnail of Opioid availability statistics from the International Narcotics Control Board do not reflect the medical use of opioids: comparison with sales data from Scandinavia

Scandinavian Journal of Pain, Jul 27, 2021

Research paper thumbnail of Challenges with Medication Management and the National Medication List in Sweden: An Interview Study from a Human, Organizational, and Technology Perspective

Studies in health technology and informatics, May 18, 2023

Research paper thumbnail of Evidence synthesis based on non-randomised studies—a critical review of studies leading to conclusions on fall risk properties of loop diuretics/beta-blockers

European Journal of Clinical Pharmacology, Oct 10, 2019

Research paper thumbnail of Incidence in pharmacoepidemiology: A conceptual framework for incidence of a single substance or group of substances with statins as an example

Basic & Clinical Pharmacology & Toxicology

A framework for analysing incidence in pharmacoepidemiology and drug statistics is suggested usin... more A framework for analysing incidence in pharmacoepidemiology and drug statistics is suggested using statins as an example. A new case of statin use (first‐ever use or recurrence of treatment) can be defined as new on the group (NoG), new on substance whether new on the group or not (NoS), new on substance and new on the group (NoS_and_NoG), new on substance and not new on the group (NoS_not_NoG).MethodIndividual‐level dispensations of statins 2006–2019 for 1 017 058 individuals with at least one dispensation 2019 in Sweden.ResultsWith 12‐month run‐in, corresponding to at least 8 months without treatment, the incidence proportion of NoG was 13.39 new cases per 1000 inhabitants and 8.40 with 10‐year run‐in. Thus, 37% had first been treated with any statin between 12 months and 10 years before the index date.For atorvastatin, NoS was 10.69, NoS_and_NoG 9.99, and NoS_not_NoG 0.70 per 1000 inhabitants. 0.70 per 1000 inhabitants or 6.6% of new cases of atorvastatin represented a change fro...

Research paper thumbnail of Incidence in pharmacoepidemiology—Basic definitions and types of misclassification

Basic & Clinical Pharmacology & Toxicology, 2022

The definition of a new case is a vital step in incidence studies in both epidemiology and pharma... more The definition of a new case is a vital step in incidence studies in both epidemiology and pharmacoepidemiology, although with significant differences in methodology between the fields. We define and apply a framework for two different types of new cases of drug use, first‐ever and recurrent, and show how the associated misclassifications related to length of run‐in period can be expressed by the positive predictive value (PPV).In the study, we consider individual‐level dispensations of statins 2006–2019 for 1,017,058 individuals with at least one dispensation in 2019 in Sweden. The incidence proportion for statins for both sexes of all ages in Sweden 2019 varied from 17.4/1000 with a run‐in of 8 months, 9.45/1000 with 5 years and 8.4/1000 with 10 years. The PPV was 49% with 8 months and 89% for 5 years using 10 years as gold standard.We conclude that the interpretation of incidence and thus the selection of an appropriate run‐in period, in pharmacoepidemiology, depends on whether f...

Research paper thumbnail of Comment on Häuser et al.: Medical use of opioids in Europe—Methodological concerns about data from the International Narcotics Control Board

European Journal of Pain, 2022

Research paper thumbnail of Guiding principles for the use of knowledge bases and real-world data in clinical decision support systems: report by an international expert workshop at Karolinska Institutet

Expert Review of Clinical Pharmacology, 2020

Research paper thumbnail of Do patients or their physicians more accurately assess long-term risk associated with hypertension? A population-based study

Scandinavian Journal of Primary Health Care, 2020

Research paper thumbnail of PERson-centredness in hypertension management using information technology (PERHIT): a protocol for a randomised controlled trial in primary health care

Research paper thumbnail of Use of hormone therapy (HT) among Swedish women with contraindications – A pharmacoepidemiological cohort study

Research paper thumbnail of 14-Year Survey in a Swedish County Reveals a Pronounced Increase in Bloodstream Infections (BSI). Comorbidity - An Independent Risk Factor for Both BSI and Mortality

PLOS ONE, 2016

we assessed the incidence, risk factors and outcome of BSI over a 14-year period (2000)(2001)(200... more we assessed the incidence, risk factors and outcome of BSI over a 14-year period (2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013) in a Swedish county. retrospective cohort study on culture confirmed BSI among patients in the county of O ¨stergo ¨tland, Sweden, with approximately 440,000 inhabitants. A BSI was defined as either community-onset BSI (CO-BSI) or hospital-acquired BSI (HA-BSI).

Research paper thumbnail of Hormone therapy might be underutilized in women with early menopause

Human reproduction (Oxford, England), 2015

Are Swedish women age 40-44 years with assumed early menopause 'undertreated' by hormone ... more Are Swedish women age 40-44 years with assumed early menopause 'undertreated' by hormone therapy (HT)? Many women with probable early menopause discontinue their HT after a short period of time. Thus, they fail to complete the recommended replacement up to age 51-52 years, the average age of menopause. Spontaneous early menopause occurs in ∼5% of women age 40-45 years. Regardless of the cause, women who experience hormonal menopause due to bilateral oophorectomy before the median age of spontaneous menopause are at increased risk of cardiovascular disease, neurological disease, osteoporosis, psychiatric illness and even death. The study is descriptive, and epidemiological and was based on the use of national registers of dispensed drug prescriptions (HT) linking registers from the National Board of Health and Welfare and Statistics Sweden from 1 July 2005 until 31 December 2011. The study population consisted of 310 404 women, 40-44 years old on 31 December 2005 who were fol...

Research paper thumbnail of Interactive Visualization of Prescriptions of Drugs to Individuals within Large Populations—Analyses of Temporal Relationships of Events

Research paper thumbnail of Patients' information on their prescribed current treatment†

Journal of Pharmaceutical Health Services Research, 2012

Objective To investigate how many patients, with five or more prescriptions in the Swedish Nation... more Objective To investigate how many patients, with five or more prescriptions in the Swedish National Prescription Repository (NPR) had received (1) the Medication List (ML) from the electronic medical record and (2) the Prescription List (PL) on prescriptions stored in the NPR and how these lists were used. Methods Patients >18 years of age, with five or more prescriptions stored electronically in the NPR, collecting medicines on prescription for themselves at nine pharmacies all around Sweden were interviewed about their knowledge of, and if they had received, the ML, the PL and/or the pharmacy record on medicines purchased on prescription during the last 15 months, and what documentation they used to track their current, prescribed treatment. Key findings A total of 777 consensual patients (485 women) were interviewed. Of these, 32% were aware of the ML, but only 13% had received the ML at least once a year, and only 9% used the ML to track their current, prescribed medicines. V...

Research paper thumbnail of Phases in development of an interactive mobile phone-based system to support self-management of hypertension

Integrated Blood Pressure Control, 2014

Research paper thumbnail of Use of hormone therapy in Swedish women aged 80 years or older

Research paper thumbnail of Knowledge of reproductive physiology and hormone therapy in 53- to 54-year-old Swedish women

Research paper thumbnail of Attitudes towards the menopause and hormone therapy over the turn of the century

Research paper thumbnail of Women's conception of the menopausal transition – a qualitative study

Journal of Clinical Nursing, 2007

Aim. To explore, with a qualitative approach, whether the conception of menopause varies between... more Aim. To explore, with a qualitative approach, whether the conception of menopause varies between women seeking medical advice because of climacteric symptoms and, if so, to describe these different conceptions.Background. For many women, the menopausal transition is a troublesome period of life, often associated with decreased well‐being and a number of symptoms. Besides the hormonal changes, many other factors such as psychological, sociological and lifestyle factors affect how women perceive their menopause.Method. Semi‐structured interviews were held with 20 women after their first‐time visits at outpatient clinics of gynaecology for discussion of climacteric symptoms. The interviews were audio‐taped, transcribed and analysed using a phenomenographic approach.Results. A wide variation of conceptions was revealed. Two main categories were identified including different physical changes with varying symptoms and both positive and negative psychological changes. The menopausal t...