Search

Carlo Pirazzi,1 Lina Håkansson,1 Carola Gustafsson,1 Elmir Omerovic,1,2 Olov Wiklund,2 Rosellina Margherita Mancina21Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden; 2Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, Wallenberg Laboratory, University of Gothenburg, Gothenburg, SwedenBackground: Premature coronary artery disease (CAD) is a major cause of mortality and morbidity. Increased low-density lipoprotein-cholesterol (LDL-C) level is a major risk factor for CAD and thus the main target for its prevention. Familial Hypercholesterolemia (FH) is a genetic inherited disorder characterized by high LDL-C, and subsequent premature CAD development. Early drug treatment with lipid-lowering medications in FH prevents cardiovascular disease onset. The FH prevalence in the Northern European general population is 0.3%, and it is estimated that it explains 20% of premature CAD cases in individuals with familial clustering. Despite the wide number of papers showing the prevalence of clinical FH in cardiovascular disease, the prevalence of genetic FH in individuals with premature CAD is not yet well known. Here, we examined the prevalence of genetically determined FH in individuals with premature CAD.Patients and methods: 66 patients who underwent coronary angiography with suspected premature acute coronary syndrome (age

Helena Norberg,1 Marcia Håkansson Lindqvist,2 Maria Gustafsson1 1Department of Integrative Medical Biology, Umeå University, Umeå, Sweden; 2Department of Education, Mid Sweden University, Sundsvall, SwedenCorrespondence: Helena Norberg, Department of Integrative Medical Biology, Umeå University, Umeå, S-901 87, Sweden, Tel +46 90 786 68 21, Email helena.norberg@umu.sePurpose: To develop an in-depth understanding of older individuals’ attitudes and perceptions of medication management and care after discharge from hospital-to-home.Patients and Methods: A qualitative study using semi-structured interviews with selected individuals 75 years and older, discharged from hospital within the last 6– 12 months, living at home, and managing their own medications. Face-to-face interviews were audio-recorded, transcribed and analyzed with thematic analysis.Results: Among the 15 respondents, mean age was 83.5 years (range 75– 95 years), 67% were women, and 60% lived alone. The majority (80%) managed their medications with a pill organizer or directly from the pill boxes, while 20% used dose dispensed medications. The analysis of the data led to six themes: Medication adherence, Personal responsibility, Transitions of care, Beliefs about medications, Participation (experience of participation, willingness to participate) and Accessibility (easier to reach hospital than primary care, navigating in the care system, continuity, personal chemistry).Conclusion: The included respondents who were older individuals, living at home and managing their own medications, expressed that they were medical adherent and self-managing. Two important aspects which were seen were difficulties to reach primary care on their own initiative and the lack of continuity with the same physician over a longer period of time.Keywords: medication adherence, qualitative research, transitional care, shared decision making, self management