Jørund Straand

• Skow, Marius; Brænd, Anja Maria; Emilsson, Louise; Høye, Sigurd; Straand, Jørund & Fossum, Guro Haugen (2026). Antibiotic treatment for acute sinusitis and subsequent health care use and work absence: a nationwide registry study from Norway. Family Practice. ISSN 0263-2136. 43(2). doi: 10.1093/fampra/cmag001. Full text in Research Archive Show summary

  Background Acute sinusitis is common in general practice. Although typically self-limiting, antibiotics are frequently prescribed despite guideline recommendations to restrict use. It remains unclear whether antibiotic treatment reduces subsequent health care use or work absence. Objective T o assess how initial treatment with or without antibiotics for acute sinusitis is associated with subsequent health care use and work absence, and to compare phenoxymethylpenicillin (PcV) versus other antibiotics. Methods Nationwide registry-based observational cohort study of adults with acute sinusitis (ICPC-2: R75) diagnosed in Norwegian general practice 2012–2019. We compared GP visits, Ear, Nose, and Throat (ENT) specialist visits, repeat antibiotic prescriptions, and sick leave days in antibiotic-treated and untreated episodes. We estimated adjusted differences in outcomes between groups using linear regression (daily outcomes) and negative binomial regression (weekly counts). Results We included 627 211 episodes from 413 449 patients. Antibiotics were prescribed in 59% of episodes; 53% received PcV. During the index week, antibiotic use was associated with 1.7 fewer GP visits, 0.1 fewer ENT visits, and 25.1 more sick leave days per 100 episodes. Corresponding figures for the following 4 weeks were: 0.9 fewer GP contacts, 10.7 fewer sick leave days, and 0.6 more antibiotic prescriptions. PcV was associated with slightly more GP visits and re-prescribing than other antibiotics. Conclusions Acute sinusitis is followed by a short-term increase in health care use and work absence. Initial antibiotic use was associated with modest short-term differences, but no meaningful reduction in overall follow-up. Findings are consistent with recommendations for restrictive prescribing and narrow-spectrum use when appropriate.

• Skoglund, Ingmarie; Heltveit-Olsen, Silje Rebekka; Brænd, Anja Maria Lyche; Fossum, Guro Haugen; Straand, Jørund & Sundvall, Sofia [Show all 8 contributors for this article] (2026). In uncharted territory: managing the COVID-19 pandemic in Swedish regions and municipalities from a primary health care perspective. Scandinavian Journal of Primary Health Care. ISSN 0281-3432. 44(1). doi: 10.1080/02813432.2026.2660327. Full text in Research Archive Show summary

  Objective To explore experiences and challenges faced by regional and municipal health care leaders during the COVID-19 pandemic, with a focus on primary health care and care of older adults. Design A longitudinal qualitative study based on two rounds of semi-structured interviews 2–3 months apart. Setting and participants Fifteen health care leaders strategically recruited from regions and municipalities across Sweden. The first interviews took place in November–December 2020, the second in January–March 2021. Results Four themes were identified. The first captured the challenge of navigating uncharted territory during an unprecedented crisis. The second addressed ethical dilemmas arising from public health priorities. The third highlighted the growing significance and evolving role of infection prevention and control. Finally, the fourth illustrated how initially productive and solution-oriented local collaboration and communication gradually gave way to tensions and conflicting responsibilities. Conclusions In the early phases of the pandemic, the Swedish Public Health Agency’s leadership and measures were generally appreciated, although the initial response was widely perceived as slow and insufficient. The high mortality among older adults was regarded as a major failure, raising ethical concerns and exposing tensions in collaboration between actors. Pandemic work was experienced as exhausting yet meaningful, and the field of infection prevention and control gained increased recognition and status. Some distinctive features of Sweden’s pandemic response – such as decentralised decision-making and an emphasis on individual responsibility – may have been shaped by the constitutional prohibition of ministerial rule and the substantial autonomy granted to regional and local authorities.

• Tibelles, Hatuia Bø; Kirkebøen, Lars Johannessen; Jenum, Anne Karen; Straand, Jørund; Berg, Tore Julsrud & Buhl, Esben Selmer (2025). Young-onset type 2 diabetes and associations with high disability rate, low educational level and immigrant background: A study from Norwegian general practice. BMJ Open. 15(9). doi: 10.1136/bmjopen-2024-096521. Full text in Research Archive
• Svaland, Malene; Brænd, Anja Maria; Heltveit-Olsen, Silje Rebekka; Rørtveit, Guri; Høye, Sigurd & Straand, Jørund [Show all 7 contributors for this article] (2025). Fear of the Unknown: Pandemic Concerns Among Non-hospitalized COVID-19 Infected or Quarantined Norwegian Adults. Disaster Medicine and Public Health Preparedness. ISSN 1935-7893. 19. doi: 10.1017/dmp.2025.10117. Full text in Research Archive Show summary

  Objective We aimed to explore concerns and feeling of safety among quarantined and non-hospitalized COVID-19 patients. Methods We conducted a qualitative study of free text answers from participants of an online survey. The survey was conducted between March 2020 and June 2021. COVID-19 positive adults in home isolation and adults in quarantine were eligible for participation. 698 participants answered one or more of three open-ended questions about concerns and safety. We analyzed free-text answers using thematic analysis according to Braun and Clarke with an inductive approach. Results Analysis of the free-text answers from all participants identified three main themes: (1) Fear of the unknown, (2) Views on personal care and public health measures, and (3) Concern for the future of a country in crisis. Participants’ feelings revolved around health-related concerns and societal related concerns. They were concerned about their own and other’s health, and possible long-term consequences of COVID-19 infection. Some participants were satisfied with the health care system, others thought follow-ups, testing, vaccination, and information would increase their feeling of safety. Conclusions People quarantined and isolated due to the COVID-19 pandemic had concerns regarding personal health and societal consequences of infection control measures. Health care follow-ups and individualized information would increase participants’ feeling of safety.

• Tibelles, Hatuia Bø; Jenum, Anne Karen; Kirkebøen, Lars Johannessen; Berg, Tore Julsrud; Claudi, Tor & Cooper, John [Show all 10 contributors for this article] (2024). High prevalence of retinopathy in young-onset type 2 diabetes and possible sex differences: insights from Norwegian general practice. BMJ Open Diabetes Research & Care. 12(1). doi: 10.1136/bmjdrc-2023-003624. Full text in Research Archive Show summary

  Introduction People with young-onset type 2 diabetes (YOD), defined as diabetes diagnosis before age 40, have a high lifetime risk of vascular complications. We aimed to estimate the prevalence of YOD among adults with type 2 diabetes (T2D) in Norwegian general practice and explore associations between age at diabetes diagnosis and retinopathy overall and in men and women. Research design and methods We collected cross-sectional data from general practice electronic medical records of 10 241 adults with T2D in 2014, and repeated measurements of hemoglobin A1c (HbA1c) from 2012 to 2014. Using multivariate logistic regression, we assessed associations between YOD and later-onset T2D, sex and retinopathy. Results Of all individuals with T2D, 10% were diagnosed before 40 years of age in both sexes. Compared with later-onset T2D, HbA1c increased faster in YOD, and at the time of diagnosis HbA1c was higher in men, particularly in YOD. Retinopathy was found in 25% with YOD, twice as frequently as in later onset. After adjustments for confounders (age, country of origin, education, body mass index), OR of retinopathy was increased in both men with YOD (OR 2.6 (95% CI 2.0 to 3.5)) and women with YOD (OR 2.2 (1.5 to 3.0)). After further adjustments for potential mediators (diabetes duration and HbA1c), the higher OR persisted in men with YOD (OR 1.8 (1.3 to 2.4)) but was attenuated and no longer significant for women with YOD. Conclusions Retinopathy prevalence was more than twice as high in YOD as in later-onset T2D. The increased likelihood of retinopathy in YOD was partly mediated by higher HbA1c and longer T2D duration, but after accounting for these factors it remained higher in men with YOD.

• Heltveit-Olsen, Silje Rebekka; Lunde, Lene; Brænd, Anja Maria; Spehar, Ivan; Høye, Sigurd & Skoglund, Ingmarie [Show all 10 contributors for this article] (2024). Local management of the COVID-19 pandemic in Norway: a longitudinal interview study of municipality chief medical officers. Scandinavian Journal of Primary Health Care. ISSN 0281-3432. 42(1), p. 214–224. doi: 10.1080/02813432.2023.2301562. Full text in Research Archive Show summary

  Objective - To explore the experiences and views of Norwegian Municipality Chief Medical Officers (MCMOs) on preparedness, collaboration, and organization during the COVID-19 pandemic to gain insight into local crisis management of value for future pandemic responses.<p> <p>Design - Longitudinal qualitative interview study. We conducted semi-structured digital interviews with nine MCMOs working in different municipalities in Norway from September to December 2020. Five MCMOs were re-interviewed from January to April 2021. We used thematic analysis to analyze the data.<p> <p>Results - Through the analysis, three major themes were identified in the material; 1) The view of preparedness changed from being low-priority and dormant to the desire to strengthen preparedness as a permanent measure; 2) The nature of the pandemic forced a change in internal and external communication and collaboration for the MCMOs towards direct dialogue, teamwork and digital networking; 3) The pandemic changed the role and position of the MCMO within the municipal organization. Although most MCMOs were given a leading role in the municipal pandemic response, some MCMOs experienced that they were not positioned to fully exercise their intended role. In our material, de-authorization of the MCMO role seemed to coincide with the increasing size and organizational complexity of the municipality.<p> <p>Conclusions - The Norwegian pandemic response and outcome have been regarded as successful internationally. Although the MCMOs managed to implement flexible and quick responses facilitated by teamwork, dialogue, and joint sensemaking, they also identified several challenges and shortcomings of the Norwegian pandemic preparedness requiring organizational and financial changes to sustain future health system resilience.

• Fiske, Mari; Moen, Anne; Mdala, Ibrahimu & Straand, Jørund (2024). Malnutrition and Polypharmacy in Older Adult Patients Receiving Home Care Nursing Services: A Cross-sectional Study. Journal of the American Medical Directors Association. ISSN 1525-8610. doi: 10.1016/j.jamda.2023.11.016. Full text in Research Archive Show summary

  Objective We studied the nutritional status of older adult adults receiving home nursing care using demographic data, household category, polypharmacy, and potentially inappropriate medications (PIMs). Design Cross-sectional study. Setting and Participants Two Norwegian municipalities during 2017-2019; home nursing service clients aged ≥70 years. Methods Inclusion of patients and data collection were done by nurses working in the home services. Recorded data were participants’ age, sex, living alone or with others, nutritional status (Mini Nutritional Assessment–Short Form and body mass index), regular prescription drugs, and potentially inappropriate medications (PIMs) according to the Norwegian General Practice Nursing home (NORGEP-NH) criteria. Descriptive statistics and logistic regression were used. Results Of the 270 patients (mean age 84.2 years; 64.8% females; 188 living alone), 25 (9.3%) were malnourished and 154 (57%) at risk of malnutrition; in addition, 14.8% had a BMI <21 and 27.8% had lost weight in the previous 3 months. The odds for being at malnutrition risk was higher if living with others vs living alone: adjusted odds ratio (OR) 2.23 (1.20-4.13). Female sex, older age, and better mobility was associated with living alone. The mean number of regular drugs was 7.3. Overall, 43.3% of the participants used at least 1 PIM. Using 0 to 5 drugs vs ≥6 drugs (polypharmacy) was associated with higher odds for malnutrition risk: adjusted OR 1.97 (1.04-3.75). Compared with well-nourished patients, those at risk for or who were malnourished used fewer cardiovascular and musculoskeletal drugs. Exposure to PIMs was not associated with nutritional status. Conclusions and Implications Two-thirds of home nurse clients were either malnourished or at risk for malnutrition. Living with others or using fewer daily drugs implied increased risk for malnourishment, probably reflecting differences in morbidity and possible inappropriateness of medication use. Future research on nutritional status and medication use should aim for including more clinical data than simple drug counts.

• Straand, Jørund & Wit, Niek de (2024). The transition of general practice into an academic discipline: tracing the origins through the first four professors in general practice/family medicine. Scandinavian Journal of Primary Health Care. ISSN 0281-3432. doi: 10.1080/02813432.2024.2335537. Full text in Research Archive
• Skow, Marius; Fossum, Guro Haugen; Høye, Sigurd; Straand, Jørund; Emilsson, Louise & Brænd, Anja Maria (2023). Antibiotic treatment of respiratory tract infections in adults in Norwegian general practice. JAC-Antimicrobial Resistance (JAC-AMR). 5(1). doi: 10.1093/jacamr/dlac135. Full text in Research Archive Show summary

  Objectives To analyse the prevalence of respiratory tract infection (RTI) episodes with and without antibiotic prescriptions in adult patients in Norwegian general practice during the period 2012–2019. Methods Observational study linking data from the Norwegian Control and Payment for Health Reimbursements Database and the Norwegian Prescription Database. Episodes of acute RTIs in patients aged 18 years or older were identified and linked to antibiotic prescriptions dispensed within 7 days after diagnosis. We analysed annual infection rates and antibiotic prescription rates and antibiotics prescribed for the different RTI conditions. Results RTI episode rate per 1000 inhabitants was 312 in 2012 and 277 in 2019, but showed no linear trend of change during the study period (P = 0.205). Antibiotic prescription rate decreased from 37% of RTI episodes in 2012 to 23% in 2019 (P < 0.001). The reduction in prescribing was most pronounced for episodes coded with ICPC-2 symptom diagnoses, as well as upper RTIs, influenza, acute bronchitis and sinusitis. Prescriptions for phenoxymethylpenicillin decreased from 178 746 in 2012 to 143 095 in 2019, but increased as proportion of total antibiotic prescriptions from 40% in 2012 to 53% in 2019 (P < 0.001). Conclusions This study demonstrates stable RTI episode rates and reduced antibiotic prescription rates for RTIs for adults in Norwegian general practice 2012–2019. We also observed a shift towards relatively more use of phenoxymethylpenicillin and less broad-spectrum antibiotics. These changes are in line with the aims of the Norwegian strategy against antibiotic resistance.

• Fossum, Guro Haugen; Brænd, Anja Maria; Heltveit-Olsen, Silje Rebekka; Rørtveit, Guri; Høye, Sigurd & Straand, Jørund (2023). Symptoms, symptom severity, and contact with primary health care among nonhospitalized COVID-19 patients: a Norwegian web-based survey. Scandinavian Journal of Primary Health Care. ISSN 0281-3432. 41(4), p. 427–434. doi: 10.1080/02813432.2023.2266477. Full text in Research Archive Show summary

  Objective Dependent on clinical setting, geography and timing during the pandemic, variable symptoms of COVID-19 have been reported. Our aim was to describe self-reported symptom intensity and contact with primary health care among nonhospitalized COVID-19 patients. Design Web-based survey. Setting Norway between March 2020 and July 2021. Subjects Adults in home isolation. Main outcome measures Participants reported possible COVID-19 symptoms, duration of symptoms, score of symptom severity (Likert scale 0–3), risk factors, comorbidity, and questions regarding follow-up and information from primary health care. Results Of 477 participants, 379 (79%) had PCR-confirmed COVID-19, 324 (68%) were females, and 90% were younger than 60 years. Most common symptoms were “fatigue and/or muscle ache” (80%), nasal symptoms (79%), and headache (73%). The mean severity of symptoms was generally low. Symptoms with the highest mean scores were “fatigue and/or muscle ache” (1.51, SD 1.02) and headache (1.27 (SD 1.00). Mean scores for severity ranged from 0.28 (nausea) to 1.51 (fatigue and/or muscle ache). Women reported higher symptom scores than men. For “affected sense of smell and/or taste”, patients either reported a high symptom score (24%) or no affliction at all (49%). A third of the participants (32%) were followed-up by primary care health personnel, and almost 40% had sought or received information about COVID-19 from general practitioners. Conclusion The mean severity of symptoms among nonhospitalized adult COVID-19 patients was generally low. We found large variations in the occurrence and severity of symptoms between patients.

• Forthun, Ingeborg; Rørtveit, Guri; Fossum, Guro Haugen; Jørgensen, Pål; Halvorsen, Peder Andreas & Nilsen, Stein [Show all 9 contributors for this article] (2023). Søvnforstyrrelser og forskrivning av hypnotika i allmennpraksis – en PraksisNett-studie. SØVN. ISSN 1891-5493. p. 11–15. Full text in Research Archive Show summary

  Søvnforstyrrelser er svært utbredt i befolkningen. Insomni er den vanligste søvnforstyrrelsen med en forekomst på omkring 10-20 %. Forekomsten ser ut til å være økende i befolkningen. Blant pasienter på venterommet hos norske fastleger er forekomsten så høy som rundt 50 % ifølge to tidligere studier. Insomni utgjør en risikofaktor for utvikling av psykiske lidelser og er identifisert som en mulig kausal årsaksfaktor for en rekke negative helseutfall. Selv om sovemedisiner kun er anbefalt ved akutte søvnplager, er forskrivning av sovemedisiner også for langvarige plager svært vanlig. Medikamentgruppen hypnotika inkluderer benzodiazepiner, benzodiazepinlignende sovemidler (z preparater) og melatoninpreparater. I klinisk praksis benyttes av og til også andre preparater enn hypnotika mot søvnproblemer, inkludert antidepressiva, antihistaminer og antipsykotika.

• Skow, Marius Andre Hybbestad; Fossum, Guro Haugen; Høye, Sigurd; Straand, Jørund; Brænd, Anja Maria & Emilsson, Louise (2023). Hospitalizations and severe complications following acute sinusitis in general practice: a registry-based cohort study. Journal of Antimicrobial Chemotherapy. ISSN 0305-7453. 78(9), p. 2217–2227. doi: 10.1093/jac/dkad227. Full text in Research Archive Show summary

  Objectives To investigate complication rates of acute sinusitis in general practice, and whether antibiotic prescribing had an impact on complication rate. Methods All adult patients diagnosed with sinusitis in Norwegian general practice between 1 July 2012 and 30 June 2019 were included. GP consultation data from the Norwegian Control and Payment for Health Reimbursements Database were linked with antibiotic prescriptions (Norwegian Prescription Database) and hospital admissions (Norwegian Patient Registry). Main outcomes were sinusitis-related hospitalizations and severe complications within 30 days. Logistic regression was used to estimate associations between antibiotic prescriptions, prespecified risk factors, individual GP prescribing quintile, and outcomes. Results A total of 711 069 episodes of acute sinusitis in 415 781 patients were identified. During the study period, both annual episode rate (from 30.2 to 21.2 per 1000 inhabitants) and antibiotic prescription rate (63.3% to 46.5%; P < 0.001) decreased. Yearly hospitalization rate was stable at 10.0 cases per 10 000 sinusitis episodes and the corresponding rate of severe complications was 3.2, with no yearly change (P = 0.765). Antibiotic prescribing was associated with increased risk of hospitalization [adjusted OR 1.8 (95% CI 1.5–2.1)] but not with severe complications. Individual GP prescribing quintile was not associated with any of the outcomes, whereas risk factors such as previous drug abuse, or head injury, skull surgery or malformations, and being immunocompromised were significantly associated with increased risk of both outcomes. Conclusions Severe complications of acute sinusitis were rare and no protective effect of high prescribing practice among GPs was found. Recommendations to further reduce antibiotic prescribing are generally encouraged, except for high-risk groups.

• Kristoffersen, Espen Saxhaug; Bjorvatn, Bjørn; Halvorsen, Peder Andreas; Nilsen, Stein; Fossum, Guro Haugen & Fors, Egil Andreas [Show all 12 contributors for this article] (2022). The Norwegian PraksisNett: a nationwide practice-based research network with a novel IT infrastructure. Scandinavian Journal of Primary Health Care. ISSN 0281-3432. 40(2), p. 217–226. doi: 10.1080/02813432.2022.2073966. Full text in Research Archive Show summary

  Clinical research in primary care is relatively scarce. Practice-based research networks (PBRNs) are research infrastructures to overcome hurdles associated with conducting studies in primary care. In Norway, almost all 5.4 million inhabitants have access to a general practitioner (GP) through a patient-list system. This gives opportunity for a PBRN with reliable information about the general population. The aim of the current paper is to describe the establishment, organization and function of PraksisNett (the Norwegian Primary Care Research Network). Materials and Methods We describe the development, funding and logistics of PraksisNett as a nationwide PBRN. Results PraksisNett received funding from the Research Council of Norway for an establishment period of five years (2018–2022). It is comprised of two parts; a human infrastructure (employees, including academic GPs) organized as four regional nodes and a coordinating node and an IT infrastructure comprised by the Snow system in conjunction with the Medrave M4 system. The core of the infrastructure is the 92 general practices that are contractually linked to PraksisNett. These include 492 GPs, serving almost 520,000 patients. Practices were recruited during 2019–2020 and comprise a representative mix of rural and urban settings spread throughout all regions of Norway. Conclusion Norway has established a nationwide PBRN to reduce hurdles for conducting clinical studies in primary care. Improved infrastructure for clinical studies in primary care is expected to increase the attractiveness for studies on the management of disorders and diseases in primary care and facilitate international research collaboration. This will benefit both patients, GPs and society in terms of improved quality of care.

• Heltveit-Olsen, Silje Rebekka; Lunde, Lene; Brænd, Anja Maria Lyche; Spehar, Ivan; Høye, Sigurd & Skoglund, Ingmarie [Show all 10 contributors for this article] (2022). Experiences and management strategies of Norwegian GPs during the COVID-19 pandemic: a longitudinal interview study. Scandinavian Journal of Primary Health Care. ISSN 0281-3432. doi: 10.1080/02813432.2022.2142796. Full text in Research Archive Show summary

  Objective: When the COVID-19 pandemic reached Norway, primary health care had to reorganize to ensure safe patient treatment and maintain infection control. General practitioners (GPs) are key health care providers in the municipalities. Our aim was to explore the experiences and management strategies of Norwegian GPs during the COVID-19 pandemic - over time, and in the context of a sudden organizational change.<p> <p>Design: Longitudinal qualitative interview study with two interview rounds. The first round of interviews was conducted from September–December 2020, the second round from January–April 2021. In the first interview round, we performed eight semi-structured interviews with GPs from eight municipalities in Norway. In the second round, five of the GPs were re-interviewed. Consecutive interviews were performed 2–4 months apart. To analyze the data, we used thematic analysis. <p>Results: The COVID-19 pandemic required GPs to balance several concerns, such as continuity of care and their own professional efforts. Several GPs experienced challenges in the collaboration with the municipality and in relation to defining their own professional position. Guided by The Norwegian Association of General practitioners, The Norwegian College of General Practice and collegial support, they found viable solutions and ended up with a feeling of having adapted to a new normal. <p>Conclusions: Although our study demonstrates that the GPs adapted to the changing conditions, the current municipal health care models are not ideal. There is a need for clarification of responsibilities between GPs and the municipality to facilitate a more coordinated future pandemic response.

• Østrem, Anders; Bruusgaard, Kari A.; Hellem, Elisabet & Straand, Jørund (2021). Lungerehabilitering av kolspasienter i primærhelsetjenesten - en pilotundersøkelse i to norske kommuner. Fysioterapeuten. ISSN 0016-3384. 88(6), p. 10–15. Full text in Research Archive
• Straand, Jørund & Sandvik, Hogne (2021). Professor Niels Berner Sørenssen (1774-1857) - teori og praksis i en medisinsk brytningstid. Michael quarterly. Supplement. ISSN 1893-0808. 18, p. 218–238. Full text in Research Archive
• Eide, Torunn Bjerve; Straand, Jørund & Brænd, Anja Maria (2021). Good communication was valued as more important than accessibility according to 707 Nordic primary care patients: a report from the QUALICOPC study. Scandinavian Journal of Primary Health Care. ISSN 0281-3432. 39(3), p. 296–304. doi: 10.1080/02813432.2021.1928837. Full text in Research Archive Show summary

  Objective To explore Nordic patients’ ranking of the importance of different aspects of general practice. Design Patients ranked the importance of 47 statements reflecting five quality domains: communication, involvement, accessibility, continuity, and comprehensiveness. Setting Nordic general practice. Subjects Patients ≥18 years in general practitioners waiting rooms. Main outcome measures Items rated as important or very important by ≥ 90% in all countries were identified. Associations with patient characteristics were analysed by logistic regression. Results 209 Danish, 175 Norwegian, 129 Finnish, 112 Swedish and 82 Icelandic patients responded. Ten statements were ranked as important or very important by ≥90% in each country. Six pertained to communication, three to patient involvement and one to the comprehensiveness of care. No items regarding accessibility or continuity exceeded the 90% limit. The item most frequently rated as very important was ‘I understand what the GP explains’’. Female patients were more likely to value personal treatment (OR = 2.9; 95%CI 1.5–5.5) and receiving instructions if things went wrong (1.7; 1.2–2.2). Older patients >65 years put less emphasis than those <35 on whether the GP takes them seriously (0.4; 0.3–0.5) and on the importance of instructions (0.5; 0.4–0.7). Patients with chronic diseases were less concerned (0.6; 0.4–0.8) with receiving instructions, but valued strongly that a GP knows when to refer (2.2; 1.5–3.3). Conclusion Patients in all countries assigned high value to good communication. Availability was deemed important but came secondary to good communication.

• Fog, Amura Francesca; Mdala, Ibrahimu; Engedal, Knut & Straand, Jørund (2020). Variation between nursing homes in drug use and in drug-related problems. BMC Geriatrics. doi: 10.1186/s12877-020-01745-y. Full text in Research Archive Show summary

  BACKGROUND: Residents at nursing homes (NHs) are at particular risk for drug related harm. Regular medication reviews using explicit criteria for pharmacological inappropriateness and classification of drug related problems (DRPs) have recently been introduced as measures to improve the quality of medication use and for making the treatment more uniform across different institutions. Knowledge about variation in DRPs between NHs is scarce. To explore if increased attention towards more appropriate drug treatment in NHs have led to more uniform treatment, we have analyzed variations between different nursing homes' drug use and DRPs. METHODS: Cross-sectional medication review study including 2465 long-term care residents at 41 NHs in Oslo, Norway. Regular drug use was retrieved from the patients' medical records. DRPs were identified by using STOPP/START and NORGEP criteria and a drug-drug interactions database. NHs were grouped in quartiles based on average levels of drug use. The upper and lower quartiles were compared using independent samples t-test and associations between drug use and DRPs were tested by logistic regression. RESULTS: Patients' mean age was 85.9 years, 74.2% were women. Mean numbers of regular drugs per patient was 6.8 and varied between NHs from 4.8 to 9.3. The proportion of patients within each NH using psychotropic and analgesic drugs varied largely: antipsychotics from three to 50%, benzodiazepines from 24 to 99%, antidepressants from nine to 75%, anti-dementia drugs from no use to 42%, opioids from no use to 65% and paracetamol from 16 to 74%. Mean DRPs per patient was 2.0 and varied between NHs from 0.5 to 3.4. The quartiles of NHs with highest and lowest mean drugs per patient (7.7 vs. 5.7, p < 0.001) had comparable mean number of DRPs per patient (2.2 vs. 1.8, p = 0.2). Using more drugs and the use of opioids, antipsychotics, benzodiazepines and antidepressants were associated with more DRPs. CONCLUSIONS: The use of psychotropic and analgesic drugs was high and varied substantially between different NHs. Even if the use of more drugs, opioids and psychotropic drugs was associated with DRPs, no difference was found in DRPs between the NHs with highest vs. lowest drug use.

• Romskaug, Rita; Wyller, Torgeir Bruun; Straand, Jørund; Kersten, Hege & Molden, Espen (2020). Prescribed Doses of CYP2D6-Metabolized Drugs and Hemodynamic Responses in Relation to CYP2D6 Genotype Among Older Patients Exposed to Polypharmacy. Drugs & Aging. ISSN 1170-229X. 37(6), p. 425–433. doi: 10.1007/s40266-020-00763-0. Full text in Research Archive Show summary

  Background: Many drugs with dose-dependent effects on hemodynamic variables are metabolized by cytochrome P450 2D6 (CYP2D6). The aim of this study was to compare prescribed dosages and hemodynamic responses of such drugs in relation to pharmacogenetic variability in CYP2D6 metabolism among patients aged ≥ 70 years exposed to polypharmacy. Materials and methods: We included 173 patients with detailed information about drug use. The patients were retrospectively subjected to CYP2D6 genotyping, which comprised the most common variant alleles encoding reduced, absent, or increased CYP2D6 metabolism. In order to compare dosages across different CYP2D6-metabolized drugs, all prescribed daily doses were harmonized to the 'percent of a daily defined dose' (DDD). The mean harmonized DDD was compared between genotype-predicted normal metabolizers (NMs) and patients with reduced or absent CYP2D6 enzyme activity, defined as intermediate or poor metabolizers (IMs/PMs). Blood pressure, pulse, and patient proportions with orthostatism and bradycardia were also compared between genotype subgroups. Results: The genotype-predicted phenotype subgroups comprised 79 NMs (45.7%), 75 IMs (43.4%), and 16 PMs (9.2%). There were no differences in dosing of CYP2D6 substrates between NMs and IMs/PMs (p = 0.76). A higher proportion of CYP2D6 IMs/PMs experienced orthostatism (p = 0.03), while there were no significant subgroup differences for the other hemodynamic variables. Conclusion: In this real-life clinical setting of patients aged ≥ 70 years, dosing of CYP2D6 substrates were not adjusted according to genotype-predicted CYP2D6 metabolism. The increased occurrence of orthostatism in patients with reduced/absent CYP2D6 metabolism may indicate that individualized dosing based on genotype has the potential to prevent adverse effects in these vulnerable patients.

• Rolfsjord, Ingrid; Mdala, Ibrahimu & Straand, Jørund (2019). Sykebesøk på sykehjem: Får vaktlegen nok pasientinformasjon? :. Sykepleien Forskning. ISSN 1890-2936. p. 15–15. doi: 10.4220/sykepleienf.2019.75498. Full text in Research Archive
• Fog, Amura Francesca; Straand, Jørund; Engedal, Knut & Blix, Hege Salvesen (2019). Drug use differs by care level. A cross-sectional comparison between older people living at home or in a nursing home in Oslo, Norway. BMC Geriatrics. 19(1). doi: 10.1186/s12877-019-1064-8. Full text in Research Archive Show summary

  Background Drug consumption increases with age, but there are few comparisons of drug use between old people living at home or in a nursing home. To identify areas of concern as well as in need for quality improvement in the two settings, we compared drug use among people aged ≥70 years living at home or in a nursing home. Methods Cross-sectional observational study from Oslo, Norway. Information about drug use by people living at home in 2012 was retrieved from the Norwegian Prescription Database. Drug use in nursing homes was recorded within a comprehensive medication review during November 2011–February 2014. Prevalence rates and relative risk (RR) with 95% confidence intervals were compared between uses of therapeutic groups with prevalence rates of ≥5%. Drug use was compared for the total population and by gender and age group. Results Older people (both genders) in nursing homes (n = 2313) were more likely than people living at home (n = 48,944) to use antidementia drugs (RR = 5.7), antipsychotics (RR = 4.0), paracetamol (RR = 4.0), anxiolytics (RR = 3.0), antidepressants (RR = 2.8), dopaminergic drugs (RR = 2.7), antiepileptic drugs (RR = 2.4), loop diuretics (RR = 2.3), cardiac nitrates (RR = 2.1) or opioids (RR = 2.0). By contrast, people living in a nursing home were less commonly prescribed statins (RR = 0.2), nonsteroidal antiinflammatory drugs (NSAIDs) (RR = 0.3), osteoporosis drugs (RR = 0.3), thiazide diuretics (RR = 0.4), calcium channel blockers (RR = 0.5) or renin–angiotensin inhibitors (RR = 0.5). Each of the populations had only minor differences in drug use by gender and a trend towards less drug use with increasing age (p <  0.01). Conclusions Drug use by older people differs according to care level, and so do areas probably in need for quality improvement and further research. In nursing home residents, this relates to a probable overuse of psychotropic drugs and opioids. Among older people living at home, the probable overuse of NSAIDs and a possible underuse of cholinesterase inhibitors and osteoporosis drugs should be addressed.

• Fetveit, Arne; Straand, Jørund; Bjorvatn, Bjørn & Kristoffersen, Espen Saxhaug (2019). Self-reported sleeplessness in 12,655 persons living in the north of Norway: The Tromsø Study. Sleep Science. ISSN 1984-0659. 12(3), p. 147–155. doi: 10.5935/1984-0063.20190070. Full text in Research Archive Show summary

  Sleep disturbances cause great impairment in quality of life. In this cross-sectional study, we analysed questionnaire-collected data from 12,655 persons (30-87 years) who participated in the sixth survey of the Tromsø Study carried out in 2007-2008. First, using this community-based sample representative of the general population of northern Norway, we performed a simple screening to identify individuals with self-reported sleeplessness among those survey participants who provided information about their sleep patterns. Self-reported sleeplessness was defined as responding “More than once a week” to the research question “How often have you suffered from sleeplessness during the last 12 months?” Second, we analysed the associations between selfreported sleeplessness and the following variables: age, gender, living with a spouse or not, level of education, employment status, income, smoking, alcohol consumption, body mass index, level of self-reported health, and psychological distress. Self-reported sleeplessness had a prevalence of 12.6% in this study population. For both men and women, the variables having the strongest association with sleeplessness were low levels of self-reported health (men, OR=8.70; women, OR=5.73) and the presence of psychological distress (men, OR=4.15; women, OR=2.76). In men, high levels of household income and education were both inversely related to the frequency of self-reported sleeplessness, while being unemployed was much more strongly associated with sleeplessness than being employed. We conclude that sleeplessness was frequent in this large population sample, affecting up to one in eight individuals. Subjects with self-reported sleeplessness had a distinctly different socio-economic profile and self-perceived health than those without complaints of sleeplessness.

• Kristoffersen, Espen Saxhaug; Benth, Jurate Saltyte; Straand, Jørund; Russell, Michael Bjørn & Lundqvist, Christofer (2019). Validity of self-reported assessment of severity of dependence scale in medication-overuse headache. Scandinavian Journal of Pain. ISSN 1877-8860. 19(4), p. 837–841. doi: 10.1515/sjpain-2019-0022. Full text in Research Archive
• Romskaug, Rita; Skovlund, Eva; Straand, Jørund; Molden, Espen; Kersten, Hege & Pitkala, Kaisu H [Show all 8 contributors for this article] (2019). Effect of clinical geriatric assessments and collaborative medication reviews by geriatrician and family physician for improving health-related quality of life in home-dwelling older patients receiving polypharmacy: a cluster randomized clinical trial. JAMA Internal Medicine. ISSN 2168-6106. doi: 10.1001/jamainternmed.2019.5096. Full text in Research Archive Show summary

  Importance: Polypharmacy and inappropriate drug regimens are major health concerns among older adults. Various interventions focused on medication optimization strategies have been carried out, but the effect on patient-relevant outcomes remains uncertain. Objective: To investigate the effect of clinical geriatric assessments and collaborative medication reviews by geriatrician and family physician (FP) on health-related quality of life and other patient-relevant outcomes in home-dwelling older patients receiving polypharmacy. Design, Setting, and Participants: Cluster randomized, single-blind, clinical trial. Norwegian FPs were recruited from March 17, 2015, to March 16, 2017, to participate in the trial with their eligible patients. Participants were home-dwelling patients 70 years or older, using at least 7 medications regularly, and having their medications administered by the home nursing service. Patients in the control group received usual care. Randomization occurred at the FP level. A modified intent-to-treat analysis was used. Intervention: The intervention consisted of 3 main parts: (1) clinical geriatric assessment of the patients combined with a thorough review of their medications; (2) a meeting between the geriatrician and the FP; and (3) clinical follow-up. Main Outcomes and Measures: The primary outcome was health-related quality of life as assessed by the 15D instrument (score range, 0-1; higher scores indicate better quality of life, with a minimum clinically important change of ±0.015) at week 16. Secondary outcomes included changes in medication appropriateness, physical and cognitive functioning, use of health services, and mortality. Results: Among 174 patients (mean [SD] age, 83.3 [7.3] years; 67.8% women; 87 randomized to the intervention group and 87 randomized to the control [usual care] group) in 70 FP clusters (36 intervention and 34 control), 158 (90.8%) completed the trial. The mean (SD) 15D instrument score at baseline was 0.708 (0.121) in the intervention group and 0.714 (0.113) in the control group. At week 16, the mean (SD) 15D instrument score was 0.698 (0.164) in the intervention group and 0.655 (0.184) in the control group, with an estimated between-group difference of 0.045 (95% CI, 0.004-0.086; P = .03). Several secondary outcomes were also in favor of the intervention. There were more drug withdrawals, reduced dosages, and new drug regimens started in the intervention group. Conclusions and Relevance: This study’s findings indicate that, among older patients exposed to polypharmacy, clinical geriatric assessments and collaborative medication reviews carried out by a geriatrician in cooperation with the patient’s FP can result in positive effects on health-related quality of life.

• Lundqvist, Christofer; Gossop, Michael; Russell, Michael Bjørn; Straand, Jørund & Kristoffersen, Espen Saxhaug (2019). Severity of Analgesic Dependence and Medication-overuse Headache. Journal of addiction medicine. ISSN 1932-0620. 13(5), p. 346–353. doi: 10.1097/ADM.0000000000000504. Full text in Research Archive
• Espelid, Ivar✝; Simonsen, Kristian Anton; Skaare, Anne B; Willumsen, Tiril; Straand, Jørund & Gjelstad, Svein [Show all 9 contributors for this article] (2018). Forskningsnettverk med leger og tannleger: et pilotprosjekt med datauttrekk fra elektronisk pasientjournal. Den norske tannlegeforenings Tidende. ISSN 0029-2303. 128(1), p. 8–14. Full text in Research Archive
• Skaare, Anne B; Simonsen, Kristian Anton; Espelid, Ivar✝; Straand, Jørund; Gjelstad, Svein & Klock, Kristin [Show all 9 contributors for this article] (2018). Medikamentelt utløst munntørrhet hos to pasientgrupper: Et pilotprosjekt blant leger og tannleger basert på data fra elektroniske pasientjournaler og spørreskjema. Den norske tannlegeforenings Tidende. ISSN 0029-2303. 128(1), p. 16–23. Full text in Research Archive
• Eide, Torunn Bjerve; Straand, Jørund & Rosvold, Elin Olaug (2018). Patients´ and GPs´ expectations regarding healthcare-seeking behavior: a Norwegian comparative study. British Journal of General Practice Open. doi: 10.3399/bjgpopen18X101615. Full text in Research Archive Show summary

  Background GPs are Norwegian patients' first contact point with the healthcare system for most medical problems. However, little is known regarding GPs' expectations towards their patients' healthcare-seeking behaviour, or whether doctors and patients have coinciding expectations of what GPs can do for their patients. Aim To investigate patients' and GPs’ expectations regarding patients’ healthcare-seeking behaviour in primary care, and to make comparisons between the two. Design & setting Norwegian data from the Quality and Costs of Primary Care in Europe (QUALICOPC) questionnaire study, with information from GPs and their patients. Method Binary logistic regression was used to investigate associations between expectations, sex and age of GPs and patients, list size, and geographical location of practice. Results are presented as odds ratios (ORs) with 95% confidence intervals (CIs). Expectation differences between GPs and patients were analysed using generalised estimating equations (GEEs). Due to multiple testing, Bonferroni correction was used to define significance level at P≤0.002. Results In total, 198 GPs (39.1% female) and 1529 patients (61.9% female) responded. No associations with sex or age were found for the GPs' expectations regarding patients' healthcare-seeking behaviour. Among patients, fewer males than females expected that most people would see their GP for sprained ankle (OR 0.7, 95% CI = 0.5 to 0.9), finger cut (OR 0.6, 95% CI = 0.4 to 0.7), smoking cessation (OR 0.6, 95% CI = 0.5 to 0.8), or anxiety (OR 0.4, 95% CI = 0.3 to 0.6). Older patients (aged >65 years) found it more important than younger patients to see a doctor in the presence of medical symptoms. GPs had higher expectations than their patients that people in general would see them for deteriorated vision (OR 4.2, 95% CI = 2.5 to 6.9), sexual problems (OR 1.8, 95% CI =1.3 to 2.6), and anxiety (OR 3.0, 95% CI =1.5 to 6.0). Conclusion For several common health problems, males are less likely than females to believe that people will see their GP. GPs may overestimate to what degree their patients will see them for a number of common medical problems.

• Sundseth, Anne Cathrine; Gjelstad, Svein; Straand, Jørund & Rosvold, Elin Olaug (2018). General practitioners' prescriptions of benzodiazepines, Z-hypnotics and opioid analgesics for elderly patients during direct and indirect contacts. A cross-sectional, observational study. Scandinavian Journal of Primary Health Care. ISSN 0281-3432. 36(2), p. 115–122. doi: 10.1080/02813432.2018.1459164. Full text in Research Archive Show summary

  OBJECTIVE: To describe Norwegian general practitioners' (GPs') prescription patterns of benzodiazepines, Z-hypnotics and opioid analgesics (BZO-drugs) to elderly (≥70 years) patients. DESIGN, SUBJECTS AND SETTING: Cross sectional, observational study. Contact- and prescription data from 148 Norwegian GPs, issued for elderly patients during eight months in 2008. GP-patient contacts were categorized as direct contacts (DC: face-to-face consultations) or indirect contacts (IC: via third party, phone or mail). Explanatory variables were characteristics linked to the GPs, patients, and practices. During analyses, GPs' number of listed patients, share of which for elderly patients, and total number of patient consultations during the period (proxy for practice activity), were categorized in quintiles (Q1-5) by number of GPs. MAIN OUTCOME MEASURES: Number of BZO-drug prescriptions and quantities issued during direct- and indirect GP-patient contacts. RESULTS: In total, 62% of BZO-prescriptions were issued during ICs. Of all prescriptions, 66% were large quantum packages (50 tablets or more), 62% out of which were prescribed during ICs. During the study period, 50% of the patients received repeat prescriptions. Prescribing during ICs was associated with low over all practice activity (Q1) and many (Q5) older patients on the GP's lists. CONCLUSION: GPs' BZO-drug prescribing to elderly occur more frequently during ICs than within DCs, and are more commonly issued as large quantity packages. This indicates that regular- or long-term use among elderly is common, contrasting with previous and current national guidelines, which recommend regular clinical assessments and short time or intermittent use of BZO-drugs. Key Points GPs frequently prescribe benzodiazepines, Z-hypnotics and opioid (BZO) drugs for elderly people. BZO-drugs are frequently issued during indirect GP-patient contacts and in relatively large quantities, indicating regular or long-term use. GPs' BZO-drug prescribing patterns contrast with national guidelines recommending clinical assessment and short time or intermittent use of BZO-drugs.

• Espelid, Ivar; Simonsen, Kristian Anton; Skaare, Anne B; Willumsen, Tiril; Straand, Jørund & Gjelstad, Svein [Show all 9 contributors for this article] (2018). Forskningsnettverk med leger og tannleger. Den norske tannlegeforenings Tidende. ISSN 0029-2303. 128(1), p. 8–14. Full text in Research Archive
• Straand, Jørund & Cooper, Jeanette (2018). Legemiddelkonsulentbesøk i allmennpraksis observert av femteårsstudenter. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 138(1), p. 1–9. doi: 10.4045/tidsskr.17.0078. Full text in Research Archive
• Dalbak, Lene Gjelseth; Schirmer, Henrik; Straand, Jørund; Mdala, Ibrahimu; Solberg, Ole Geir & Melbye, Hasse (2018). Impaired left ventricular filling is associated with decreased pulse oximetry values. Scandinavian Cardiovascular Journal. ISSN 1401-7431. 52(4), p. 211–217. doi: 10.1080/14017431.2018.1464662. Full text in Research Archive
• Rognstad, Sture; Brekke, Mette; Gjelstad, Svein; Straand, Jørund & Fetveit, Arne (2018). Potentially inappropriate prescribing to older patients: Criteria, prevalence and an intervention to reduce it: The Prescription Peer Academic Detailing (Rx-PAD) Study - A cluster-randomized, educational intervention in Norwegian general practice. Basic & Clinical Pharmacology & Toxicology. ISSN 1742-7835. 123(4), p. 380–391. doi: 10.1111/bcpt.13040. Full text in Research Archive
• Rognstad, Sture; Brekke, Mette; Mdala, Ibrahimu; Fetveit, Arne; Gjelstad, Svein & Straand, Jørund (2018). Characteristics of General Practitioners (GPs) responding to an educational intervention to minimize inappropriate prescriptions. Subgroup analyses of 449 GPs participating in the Prescription Peer Academic Detailing (Rx-PAD) study. British Journal of General Practice Open. doi: 10.3399/bjgpopen18X101373. Full text in Research Archive
• Næss, Gro; Kirkevold, Marit; Hammer, Wenche; Straand, Jørund & Wyller, Torgeir Bruun (2017). Nursing care needs and services utilised by home-dwelling elderly with complex health problems: Observational study. BMC Health Services Research. 17(1). doi: 10.1186/s12913-017-2600-x. Full text in Research Archive Show summary

  Background In Norway, as in many Western countries, a shift from institutional care to home care is taking place. Our knowledge is limited regarding which needs for nursing interventions patients being cared for in their home have, and how they are met. We aimed at assessing aspects of health and function in a representative sample of the most vulnerable home-dwelling elderly, to identify their needs for nursing interventions and how these needs were met. Methods In this observational study we included patients aged 75+ living in their own homes in Oslo, who received daily home care, had three or more chronic diagnoses, received daily medication, and had been hospitalized during the last year. Focused attention and cognitive processing speed were assessed with the Trail Making Test A (TMT-A), handgrip strength was used as a measure of sarcopenia, mobility was assessed with the “Timed Up-and-Go” test, and independence in primary activities of daily living by the Barthel Index. Diagnoses and medication were collected from electronic medical records. For each diagnosis, medication and functional impairment, a consensus group defined which nursing service that the particular condition necessitated. We then assessed whether these needs were fulfilled for each participant. Results Of 150 eligible patients, 83 were included (mean age 87 years, 25% men). They had on average 6 diagnoses and used 9 daily medications. Of the 83 patients, 61 (75%) had grip strength indicating sarcopenia, 27 (33%) impaired mobility, and 69 (83%) an impaired TMT-A score. Median amount of home nursing per week was 3.6 h (interquartile range 2.6 to 23.4). Fulfilment of pre-specified needs was >60% for skin and wound care in patients with skin diseases, observation of blood glucose in patients taking antidiabetic drugs, and in supporting food intake in patients with eating difficulties. Most other needs as defined by the consensus group were fulfilled in <10% of the patients. Conclusions We identified a very frail group of home-dwelling patients. For this group, resources for home nursing should probably be used in a more flexible and pro-active way to aim for preserving functional status, minimize symptom burden, and prevent avoidable hospitalisations.

• Eide, Torunn Bjerve; Straand, Jørund; Björkelund, Cecilia; Kosunen, Elise; Thorgeirsson, Ofeigur & Vedsted, Peter [Show all 7 contributors for this article] (2017). Differences in medical services in Nordic general practice: a comparative survey from the QUALICOPC study. Scandinavian Journal of Primary Health Care. ISSN 0281-3432. 35(2), p. 153–161. doi: 10.1080/02813432.2017.1333323. Full text in Research Archive Show summary

  Objective: We aim to describe medical services provided by Nordic general practitioners (GPs), and to explore possible differences between the countries. Design and setting: We did a comparative analysis of selected data from the Nordic part of the study Quality and Costs of Primary Care in Europe (QUALICOPC). Subjects: A total of 875 Nordic GPs (198 Norwegian, 80 Icelandic, 97 Swedish, 212 Danish and 288 Finnish) answered identical questionnaires regarding their practices. Main outcome measures: The GPs indicated which equipment they used in practice, which procedures that were carried out, and to what extent they were involved in treatment/follow-up of a selection of diagnoses. Results: The Danish GPs performed minor surgical procedures significantly less frequent than GPs in all other countries, although they inserted IUDs significantly more often than GPs in Iceland, Sweden and Finland. Finnish GPs performed a majority of the medical procedures more frequently than GPs in the other countries. The GPs in Iceland reported involvement in a more narrow selection of conditions than the GPs in the other countries. The Finnish GPs had more advanced technical equipment than GPs in all other Nordic countries. Conclusions: GPs in all Nordic countries are well equipped and offer a wide range of medical services, yet with a substantial variation between countries. There was no clear pattern of GPs in one country doing consistently more procedures, having consistently more equipment and treating a larger diversity of medical conditions than GPs in the other countries. However, structural factors seemed to affect the services offered.

• Kristoffersen, Espen Saxhaug; Straand, Jørund; Russell, Michael Bjørn & LUNDQVIST, CHRISTOFER (2017). Lasting improvement of medication-overuse headache after brief intervention - a long-term follow-up in primary care. European Journal of Neurology. ISSN 1351-5101. 24(7), p. 883–891. doi: 10.1111/ene.13318. Full text in Research Archive
• Brænd, Anja Maria; Straand, Jørund & Klovning, Atle (2017). Clinical drug trials in general practice: how well are external validity issues reported? BMC Family Practice. 18(1). doi: 10.1186/s12875-017-0680-7. Full text in Research Archive Show summary

  Background When reading a report of a clinical trial, it should be possible to judge whether the results are relevant for your patients. Issues affecting the external validity or generalizability of a trial should therefore be reported. Our aim was to determine whether articles with published results from a complete cohort of drug trials conducted entirely or partly in general practice reported sufficient information about the trials to consider the external validity. Methods A cohort of 196 drug trials in Norwegian general practice was previously identified from the Norwegian Medicines Agency archive with year of application for approval 1998–2007. After comprehensive literature searches, 134 journal articles reporting results published from 2000 to 2015 were identified. In these articles, we considered the reporting of the following issues relevant for external validity: reporting of the clinical setting; selection of patients before inclusion in a trial; reporting of patients’ co-morbidity, co-medication or ethnicity; choice of primary outcome; and reporting of adverse events. Results Of these 134 articles, only 30 (22%) reported the clinical setting of the trial. The number of patients screened before enrolment was reported in 61 articles (46%). The primary outcome of the trial was a surrogate outcome for 60 trials (45%), a clinical outcome for 39 (29%) and a patient-reported outcome for 25 (19%). Clinical details of adverse events were reported in 124 (93%) articles. Co-morbidity of included participants was reported in 54 trials (40%), co-medication in 27 (20%) and race/ethnicity in 78 (58%). Conclusions The clinical setting of the trials, the selection of patients before enrolment, and co-morbidity or co-medication of participants was most commonly not reported, limiting the possibility to consider the generalizability of a trial. It may therefore be difficult for readers to judge whether drug trial results are applicable to clinical decision-making in general practice or when developing clinical guidelines.

• Fog, Amura Francesca; Kvalvaag, Gunnar; Engedal, Knut & Straand, Jørund (2017). Drug-related problems and changes in drug utilization after medication reviews in nursing homes in Oslo, Norway. Scandinavian Journal of Primary Health Care. ISSN 0281-3432. 35(4), p. 329–335. doi: 10.1080/02813432.2017.1397246. Full text in Research Archive
• Kristoffersen, Espen Saxhaug; Straand, Jørund; Benth, Jurate Saltyte; Russell, Michael Bjørn & LUNDQVIST, CHRISTOFER (2017). Predictors of successful primary care detoxification treatment for medication-overuse headache. Acta Neurologica Scandinavica. ISSN 0001-6314. 136(5), p. 486–494. doi: 10.1111/ane.12759. Full text in Research Archive
• Nyborg, Gunhild; Brekke, Mette; Straand, Jørund; Gjelstad, Svein & Romøren, Maria (2017). Potentially inappropriate medication use in nursing homes: an observational study using the NORGEP-NH criteria. BMC Geriatrics. 17:220, p. 1–11. doi: 10.1186/s12877-017-0608-z. Full text in Research Archive Show summary

  Background Frail residents in the nursing home sector call for extra care in prescribing. The Norwegian General Practice Nursing Home (NORGEP-NH) list of 34 explicit criteria for potentially inappropriate medication use in nursing homes was developed explicitly for this population. The aim of this study was to employ the NORGEP-NH Criteria to study the extent of potentially inappropriate medication use among nursing home residents and explore possible associated factors. Methods Cross-sectional observational pharmacoepidemiological study from residents in nursing homes in the county of Vestfold, Norway. Data collected 2009–11 included residents’ demographic and clinical status and all medications, regular and on demand. Results 881 patients from 30 institutions (mean 85.9 years, 68.6% female), were included. According to NORGEP-NH, 43.8% were prescribed at least one potentially inappropriate regular medication, and 9.9% regularly received three or more potentially inappropriate medications. When also including a) the NORGEP-NH Deprescribing Criteria and b) including drugs prescribed for use as needed, 92.7% of all residents received medication that needs particular surveillance according to the NORGEP-NH. 69.7% of the nursing home residents used at least one psychotropic drug regularly. Female residents received more often than males at least one potentially inappropriate regular medication (OR 1.60, p=0.007). Regarding the prescription of three or more concomitant psychotropic medications, odds ratio for females was 1.79 (p=0.03) compared to males. Residents with the best performance in activities of daily living, and residents residing in long-term wards, had higher risk of using three or more psychotropic drugs. Use of multiple psychoactive drugs increased the risk of falls in the course of an acute episode of infection or dehydration (odds ratio 1.70, p=0.009). Conclusions Prevalence of potentially inappropriate medications in nursing homes according to the NORGEP-NH was extensive, and especially the use of multiple psychotropic drugs. The high prevalence found in this study shows that there is a need for higher awareness of medication use and side effects in the elderly population. Trial registration Retrospectively registered. Data obtained from clinical trial NCT01023763 registered with ClinicalTrials.gov 12/01/2009.

• Eide, Torunn Bjerve; Straand, Jørund; Melbye, Hasse; Rørtveit, Guri; Hetlevik, Irene & Rosvold, Elin Olaug (2016). Patient experiences and the association with organizational factors in general practice: Results from the Norwegian part of the international, multi-centre, cross-sectional QUALICOPC study. BMC Health Services Research. 16(428). doi: 10.1186/s12913-016-1684-z. Full text in Research Archive Show summary

  Background General practitioners (GPs) constitute a vital part of a strong primary health care system. We need further knowledge concerning factors that may affect the patients’ experiences in their meetings with the GPs. We investigated to what degree organizational factors and GP characteristics are associated with patients’ communicative experiences in a consultation. Methods We used data from the Norwegian part of the international, multi-center study Quality and Costs of Primary Care in Europe (QUALICOPC). We included 198 Norwegian GPs and 1529 patients. The patients completed a survey concerning experiences in a consultation with a GP on the inclusion day. The GPs completed a survey regarding organizational aspects of their own practice. Main outcome measures were seven statements concerning how the patients experienced the communication with the GP during the consultation. A generalized estimating equation logistic regression model was used to identify variations in patient experiences associated with characteristics of the GPs and their practices. Results The patients reported overall positive experiences with their GP consultations. Patients who consulted a GP with a short patient list were less likely than patients who consulted a GP with a medium sized list to regard the GP as polite (Odds Ratio (OR) 0.2; 95 % CI 0.1–0.7), to report that the GP asked questions about their health problems (OR 0.6; 0.4–1.0) or that the GP used sufficient time (OR 0.5; CI 0.3–0.9). Patients who consulted a GP with a long patient list compared to patients who consulted a GP with a medium sized list were less likely to feel that they could cope better after the GP visit (OR 0.5; 0.3–0.9) and more likely to feel that the GP hardly looked at them while talking (OR 1.8; 1.0–3.0). No associations with patient experiences were found with the average duration of the consultations, whether the GP worked in a fee-for-service model or whether the GP was the patient’s regular doctor. Conclusions Norwegian patients report predominantly positive experiences when consulting a GP. Positive communication experiences are most likely to be reported when the GP has a medium sized patient list.

• Brænd, Anja Maria; Straand, Jørund; Jakobsen, Rune Bruhn & Klovning, Atle (2016). Publication and non-publication of drug trial results: A 10-year cohort of trials in Norwegian general practice. BMJ Open. 6(4). doi: 10.1136/bmjopen-2015-010535. Full text in Research Archive Show summary

  Objectives Previously, we identified a 10-year cohort of protocols from applications to the Norwegian Medicines Agency 1998–2007, consisting of 196 drug trials in general practice. The aim of this study was to examine whether trial results were published and whether trial funding and conflicts of interest were reported. Design Cohort study of trials with systematic searches for published results. Setting Clinical drug trials in Norwegian general practice. Methods We performed systematic literature searches of MEDLINE, Embase and CENTRAL to identify publications originating from each trial using characteristics such as test drug, comparator and patient groups as search terms. When no publication was identified, we contacted trial sponsors for information regarding trial completion and reference to any publications. Main outcome measures We determined the frequency of publication of trial results and trial characteristics associated with publication of results. Results Of the 196 trials, 5 were never started. Of the remaining 191 trials, 71% had results published in a journal, 11% had results publicly available elsewhere and 18% of trials had no results available. Publication was more common among trials with an active comparator drug (χ2 test, p=0.040), with a larger number of patients (total sample size≥median, p=0.010) and with a longer trial period (duration≥median, p=0.025). Trial funding was reported in 85% of publications and increased over time, as did reporting of conflicts of interest among authors. Among the 134 main journal articles from the trials, 60% presented statistically significant results for the investigational drug, and the conclusion of the article was favourable towards the test drug in 78% of papers. Conclusions We did not identify any journal publication of results for 29% of the general practice drug trials. Trials with an active comparator, larger and longer trials were more likely to be published.

• Kristoffersen, Espen Saxhaug; Straand, Jørund; Russell, Michael Bjørn & LUNDQVIST, CHRISTOFER (2015). Disability, anxiety and depression in patients with medication-overuse headache in primary care - the BIMOH study. European Journal of Neurology. ISSN 1351-5101. 23, p. 28–35. doi: 10.1111/ene.12850. Full text in Research Archive
• Kristoffersen, Espen Saxhaug; Straand, Jørund; Vetvik, Kjersti; Benth, Jurate Saltyte; Russell, Michael Bjørn & LUNDQVIST, CHRISTOFER (2015). Brief intervention by general practitioners for medication-overuse headache, follow-up after 6 months: a pragmatic cluster-randomised controlled trial. Journal of Neurology. ISSN 0340-5354. Published ahead of print. doi: 10.1007/s00415-015-7975-1. Full text in Research Archive

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• Straand, Jørund; Gradmann, Christoph; Lindbæk, Morten & Simonsen, Gunnar Skov (2025). The history of antibiotic development and resistance (Third Edition). In Quah, Stella R. (Eds.), International Encyclopedia of Public Health. Academic Press. ISSN 9780323972802. doi: 10.1016/B978-0-323-99967-0.00076-4. Full text in Research Archive Show summary

  The identification and development of specific biological or chemical medicines to control bacteria and cure patients suffering from infectious disease was a major scientific innovation in medicine. But following widespread use of antimicrobials, bacterial resistance emerged and spread toward an increasing number of antibiotics. Worldwide antibiotic overuse and misuse are important for the selection of bacterial resistance which has become a substantial global threat against public health. Declining supplies of new antibiotics strengthens this concern. Strategies for counteracting the threatening inability of antibiotics to control infectious disease are based on the approach to “think globally while acting locally.”

• Skow, Marius; Emilsson, Louise; Høye, Sigurd; Straand, Jørund; Brænd, Anja Maria & Fossum, Guro Haugen (2024). BIHULEBETENNELSE I ALLMENNPRAKSIS: PÅVIRKER ANTIBIOTIKA RISIKOEN FOR LANGVARIGE OG KOMPLISERTE PASIENTFORLØP? Full text in Research Archive Show summary

  Bakgrunn: Akutt bihulebetennelse er en vanlig tilstand i allmennpraksis, hvor antibiotika ofte foreskrives, til tross for økende dokumentasjon som viser at ukompliserte tilfeller sjelden har nytte av slik behandling. Risikoen for alvorlige komplikasjoner er lav, og tidligere studier fra norsk allmennpraksis har ikke vist noen vesentlig beskyttende effekt av antibiotika når det gjelder å forhindre sykehusinnleggelser eller alvorlige komplikasjoner etter akutt bihulebetennelse. Denne studien fokuserer på såkalte milde komplikasjoner av akutt bihulebetennelse, med vekt på antall konsultasjoner i allmennpraksis, bruk av spesialisthelsetjenester, sykefravær og antibiotikabruk. Målet med studien er å undersøke forekomsten av forlengede og kompliserte pasientforløp ved akutt bihulebetennelse som behandles utenfor sykehus, og å sammenligne utfallet blant pasienter som behandles med antibiotika, med de som ikke gjør det. Metode: Ved å koble data fra flere nasjonale helseregistre, analyserer vi episoder av akutt bihulebetennelse hos voksne pasienter diagnostisert i allmennpraksis i perioden 2012–2019. For hver episode samler vi inn opplysninger om antibiotikaresepter, legekonsultasjoner, sykemeldinger og kontakter hos øre-nese-hals-spesialister og poliklinikker. Vi bruker en «difference-in-difference»-metode for å sammenligne utfallet av episoder behandlet med og uten antibiotika, ved å undersøke forekomsten av de ulike utfallsmålene i 12 uker etter en akutt bihulebetennelsesepisode, sammenlignet med 12 uker før episoden. Resultater: Vår kohort består over 600 000 episoder av akutt bihulebetennelse. Analysene er ikke ferdige på tidspunktet for innsending av sammendraget, men foreløpige resultater vil bli presentert på møtet. Konklusjoner: Konklusjonene er foreløpig ikke klare og vil bli trukket basert på den endelige analysen av våre data.

• Straand, Jørund; Gradmann, Christoph; Lindbæk, Morten & Simonsen, Gunnar Skov (2024). Antibiotikaresistens – historien om da bakteriene slo tilbake. Michael. ISSN 1893-9651. 21(2), p. 184–201. doi: 10.5617/michael.11441. Full text in Research Archive Show summary

  Bakterier er dynamiske organismer som gjennom sin plastisitet og kontinuerlige tilpasning til omgivelsene illustrerer evolusjon gjennom naturlig utvalg og «survival of the fittest». Økt forekomst av antibiotikaresistens er et naturlig og forventet svar på utstrakt bruk av antibiotika. Dette forklarer hvorfor historien om utvikling og utbredelse av antibiotika følges av en parallell historie: historien om antibiotikaresistens – her dels omtalt som sett fra et norsk ståsted. I løpet av rundt 90 år med utstrakt bruk av antimikrobielle legemidler er erkjennelsen om hvordan antibiotikabruk og resistens henger sammen gradvis blitt mer og mer tydelig, fra spredte enkelttilfeller på 1930-tallet til dagens globale pandemi av resistente og multiresistente mikrober. Mikrobene har bevist sin evne til å utvikle resistens mot så å si samtlige antimikrobielle midler som er utviklet siden 1930-tallet.

• Straand, Jørund; Gradmann, Christoph; Lindbæk, Morten & Simonsen, Gunnar Skov (2024). Antibiotika - oppdagelse og utvikling fra før bakteriologiens gjennombrudd til i dag. Michael. ISSN 1893-9651. 21(2), p. 165–183. doi: 10.5617/michael.11416. Full text in Research Archive Show summary

  Oppdagelse og utvikling av antibakterielle legemidler er blant de største triumfene innen moderne medisin og i menneskehetens historie. Takket være antibiotika og kjemoterapeutika ble leger i stand til å behandle alvorlige infeksjonssykdommer og helbrede pasienter som ellers var levnet små sjanser til overlevelse. Ikke rart at antibakterielle midler ble opplevd som mirakelmedisiner da de ble tilgjengelige. Artikkelen gir en historisk framstilling av oppdagelse og utvikling av antibiotika, fra før bakteriologiens gjennombrudd mot slutten av 1800-tallet og fram til vår tid. Dagens situasjon kjennetegnes av økende antibiotika-resistens samtidig som tilgangen på nye og effektive antibiotika langt på vei har stoppetopp.

• Skow, Marius Andre Hybbestad; Brænd, Anja Maria; Emilsson, Louise; Høye, Sigurd; Straand, Jørund & Fossum, Guro Haugen (2024). Complicated courses of sinusitis in general practice in an era of antibiotic stewardship. Full text in Research Archive
• Bellika, Johan Gustav; Bjorvatn, Bjørn; Halvorsen, Peder Andreas; Jørgensen, Pål; Emberland, Knut Erik & Fossum, Guro Haugen [Show all 7 contributors for this article] (2024). Personvernet som fundament for fremtidens digitale helsevesen. Full text in Research Archive
• Skow, Marius; Emilsson, Louise; Straand, Jørund; Høye, Sigurd & Fossum, Guro Haugen (2024). Complicated courses of sinusitis in general practice in an era of antibiotic stewardship. Full text in Research Archive
• Sandvik, Hogne & Straand, Jørund (2023). Terapeutiske beslutninger og handlinger. In Hunskaar, Steinar (Eds.), Allmennmedisin. Gyldendal Akademisk. ISSN 9788205579866. p. 122–130. Full text in Research Archive
• Tellnes, Gunnar; Straand, Jørund & Kolstad, Nils (2023). Ole Didrik Lærum. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 143(4). doi: 10.4045/tidsskr.23.0073. Full text in Research Archive Show summary

  Professor dr.med. og tidligere rektor ved Universitetet i Bergen Ole Didrik Lærum døde 24. januar 2023 i sin hjembygd Voss, 82 år gammel. Han var en god venn og en viktig samarbeidspartner for mange, både i Norge og i sitt rike internasjonale nettverk. Han var en dyktig formidler og høyt verdsatt lærer for legestudentene i Bergen. Ole Didrik var kjent som patolog og kreftforsker, og på dette området var han aktiv helt frem til sommeren 2022, bl.a. ved universitetet og Finsenlaboratoriet i København. Han har preget organiseringen og rammevilkårene for forskning i Norge. Blant annet var han styreleder i Norges forskningsråd og preses i Det Norske Videnskaps-Akademi. Han mottok mange utmerkelser, som Anders Jahres medisinske pris til yngre forskere og utnevnelse til kommandør av St. Olavs Orden. Som medlem av Universitetsrådet var han spesielt engasjert da organiseringen av høyere utdanning var oppe til behandling i 1990-årene. Her fikk hans vurderinger og synspunkter stor betydning. Ole Didrik var levende interessert i kunst, kultur og medisinsk historie. Han skrev mange lokalhistoriske bøker og deltok i flere orkestre. I den gamle doktorgården på Voss har han bygd opp et medisinsk museum om distriktslegens liv og virke. Alle gjenstandene i museet er registrert elektronisk og dermed sikret for ettertiden. Legestudenter fra avgangskullet 1977 i Bergen hadde stor glede av å gjenoppleve Ole Didriks formidlingskunst da vi ved markeringen av vårt 40-årsjubileum besøkte hans museum. Han var en hedersmann og vil bli husket som en av de aller fremste personlighetene i norsk medisin og akademia. Som person fremstod han som vennlig og lyttende og med god sans for humor.

• Tibballs, Katrina Louise Bø; Kirkebøen, Lars Johannessen; Jenum, Anne Karen; Straand, Jørund & Buhl, Esben Selmer (2023). EDUCATION LEVEL AND COUNTRY BACKGROUND IN YOUNG-ONSET TYPE 2 DIABETES. Full text in Research Archive Show summary

  EDUCATION LEVEL AND COUNTRY BACKGROUND IN YOUNG-ONSET TYPE 2 DIABETES Background Type 2 diabetes (T2D) is associated with socioeconomic status and country background, but knowledge about the influence of these factors in young-onset T2D (YOD) is sparce. We aimed to examine the risk of YOD according to education level and country background. Methods Cross-sectional data from 2014 on 10241 individuals with T2D from Norwegian general practices (ROSA 4 study) were linked to data from Statistics Norway on country background and education level. Using separate data for the population of Norway, ROSA 4 individuals were compared with individuals matched for age, sex and residential area. Poisson regression analyses of T2D risk by country background and education compared YOD (diagnosis before age 40) with later onset T2D. Results In ROSA 4, 10% had YOD. Of these, 39% had non-Western background (22% South Asians) vs. 20% in the matched population. Among South Asians 29% of T2D was diagnosed before age 40 vs 7% of those with Norwegian background. Compulsory education was the highest education level in 36% in ROSA 4 vs 26% in the matched population. In YOD, these shares were 41% and 21%. T2D risk was increased in non-Western background compared to Norwegian background, particularly in South Asians (Incidence rate ratio, IRR 4.2 (4.0-4.5)). The risk was doubled in YOD (IRR 8.9 (8.0-9.8)). T2D risk was increased in individuals with lower education levels and the effect was larger in YOD (see table). There was an interaction between education level and country background in their association with YOD risk, individuals with Norwegian background, but not to South Asians, with low education having increased risk. Conclusion Non-Western background is associated with increased risk of T2D onset at a younger age. South Asians have particularly high risk. Low education is a risk factor for young-onset T2D in Norwegians, but not in South Asian immigrants.

• Straand, Jørund & Emilsson, Louise (2023). Alderdom. In Hunskaar, Steinar (Eds.), Allmennmedisin. Gyldendal Akademisk. ISSN 9788205579866. p. 953–964. Full text in Research Archive
• Skow, Marius; Fossum, Guro Haugen; Høye, Sigurd; Straand, Jørund; Brænd, Anja Maria & Emilsson, Louise (2023). Luftveisinfeksjoner og antibiotikaforskrivning i allmennpraksis. Full text in Research Archive
• Tibballs, Katrina Louise Bø; Kirkebøen, Lars Johannessen; Jenum, Anne Karen; Straand, Jørund & Buhl, Esben Selmer (2023). Country background, education level, employment and disability in young-onset type 2 diabetes. Full text in Research Archive Show summary

  Country background, education level, employment and disability in young-onset type 2 diabetes Background and Aims Young-onset type 2 diabetes (YOD – diagnosis before age 40) entails high disease burden and is mainly managed in general practice. Knowledge of how socioeconomic status and country background impact YOD risk is sparce. We aimed to study effects of education level and country background on YOD risk and effects of YOD on employment and disability. Materials and Methods Cross-sectional data on 10241 individuals with type 2 diabetes (T2D) from Norwegian general practices (ROSA 4 study, 2014), linked to data on country background, education level, disability benefits and employment, were compared with population data matched for age, sex and residential area. Using negative binomial regression and adjusting for age and sex, we analyzed YOD risk by country background and education level, and the effects of YOD on risk of disability and labour market absence. Results T2D risk was increased in non-Western compared to Norwegian background. South Asians exhibited the greatest risk increase, five-fold for T2D (adjusted incidence rate ratio, aIRR 4.7 (4.3-5.2)) and nine-fold for YOD (aIRR 8.9 (7.3-11.0)). T2D risk in low education was almost double that in high education, with YOD risk significantly higher than for later onset T2D (see table). There was significant interaction between low education and country background, with only Westerners exhibiting a substantially increased risk of YOD (aIRR 3.2 (2.4-4.4)). Disability risk was doubled in T2D (aIRR 2.2 (2.0-2.3) and three-fold higher in YOD (aIRR 3.1 (2.7-3.5) than in the population. Workforce participation was only reduced in T2D diagnosed before age 50. Conclusion Non-Western, particularly South Asian background and low education was associated with increased risk of YOD. Low education was an important YOD risk factor only for Westerners. Risk of disability and labour market absence was significantly higher in YOD than in later onset T2D and in the general population.

• Fossum, Guro Haugen; Brænd, Anja Maria Lyche; Heltveit-Olsen, Silje Rebekka; Høye, Sigurd; Rørtveit, Guri & Straand, Jørund (2022). CovidNor - The Patient Study. Full text in Research Archive
• Straand, Jørund (2022). Allmennmedisin 50 år (som) universitetsfag i Bergen. Per Fugelli: La ikke dette bli de selvgodes hvileskjær. Utposten. ISSN 0800-5680. 51(7), p. 20–23. Full text in Research Archive
• Heltveit-Olsen, Silje Rebekka; Lunde, Lene; Brænd, Anja Maria; Spehar, Ivan; Høye, Sigurd & Skoglund, Ingmarie [Show all 10 contributors for this article] (2022). Experiences and management strategies of Norwegian GPs during the COVID-19 pandemic: A longitudinal interview study. Full text in Research Archive
• Straand, Jørund & Hunskaar, Steinar (2022). Videre- og etterutdanning for allmennleger - en kjerneoppgave. Michael. ISSN 1893-9651. 19, p. 261–278. Full text in Research Archive
• Straand, Jørund; Malterud, Kirsti & Hunskaar, Steinar (2022). Forskningen på 1990-tallet: medgang avler medgang. Michael. ISSN 1893-9651. 19, p. 137–153. Full text in Research Archive
• Skow, Marius; Fossum, Guro Haugen; Høye, Sigurd; Straand, Jørund; Emilsson, Louise & Brænd, Anja Maria (2022). Antibiotic treatment of adult patients with respiratory tract infections in Norwegian general practice: A nationwide registry-based study. Full text in Research Archive
• Straand, Jørund (2020). Institutt for helse og samfunn 10 år: Hvem og hvor stammer vi fra? Bidrag til instituttets "slektshistorie". Full text in Research Archive
• Straand, Jørund (2019). Allmennmedisinsk kanon: mens allmennpraksis er urgammel har det medisinske faget allmennmedisin en kort historie. Full text in Research Archive
• Straand, Jørund (2019). "De mørke Maaneders indflydelse paa Blodet" - klinisk forskning i norsk allmennpraksis anno 1909. Full text in Research Archive
• Straand, Jørund (2019). Allmennmedisin - urgammel praksis, ungt fag. Full text in Research Archive
• Straand, Jørund (2019). Blodtrykket: diagnosen og behandlingen. Full text in Research Archive
• Straand, Jørund (2019). PraksisNett – en infrastruktur for klinisk forskning i allmennpraksis. Full text in Research Archive
• Straand, Jørund (2019). Avdeling for allmennmedisin - 50 års historie på 40 minutter. Full text in Research Archive
• Straand, Jørund (2019). Allmennmedisin som forskningsbasert fag. Grunnlaget for de ulike forskningstradisjonene i medisinen. Full text in Research Archive
• Straand, Jørund (2019). Når vi ikke kan stole på forskningsresultatene: Publication bias. Full text in Research Archive
• Straand, Jørund (2019). Formidling av forskningsresultater – til kolleger og til publikum. Full text in Research Archive
• Straand, Jørund (2019). Fra idé til prosjekt 2: Planlegging er halve jobben. Arbeidsplan (”protokoll”) for prosjektet. Hva hører hjemme i en forskningsprotokoll? Full text in Research Archive
• Straand, Jørund; Bentzen, Niels; Björkelund, Cecilia; Sigurdsson, Johann Agust & Puustinen, Raimo (2019). Birth and growth of academic general practice in the Nordic countries. Full text in Research Archive
• Straand, Jørund (2019). Forskningsbehov og forskningsressurser i norsk allmennmedisin. Utposten. ISSN 0800-5680. 48(5), p. 15–17. Full text in Research Archive
• Straand, Jørund; Bentzen, Niels; Björkelund, Cecilia; Sigurdsson, Johann Agust & Puustingen, Rob (2019). Birth and growth of academic practice in the Nordic countries. 21st Nordic Congress of General Practice 17-20 June 2019, Aalborg, Denmark. Full text in Research Archive
• Straand, Jørund (2018). 101lærerike kasuistikker fra allmennpraksis. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 138(5). doi: 10.104045/tidsskr.17.1002. Full text in Research Archive
• Eide, Torunn Bjerve; Straand, Jørund & Rosvold, Elin Olaug (2018). How can a general practitioner help? Patients’ and doctors’ views on reasons for visiting a GP; results from Norway. Full text in Research Archive
• Bjorvatn, Bjørn; Straand, Jørund; Halvorsen, Peder Andreas; Wensaas, Knut-Arne; Bellika, Johan Gustav & Fors, Egil Andreas [Show all 10 contributors for this article] (2018). PraksisNett - et nettverk av fastlegepraksiser. En storsatsing på forskning i allmennpraksis. p. 40–43. Full text in Research Archive
• Straand, Jørund (2018). En ektefødt sekstiåtter på universitetet. 20(19), p. 57–57. Full text in Research Archive Show summary

  Om allmennmedisin som universitetsfag 50 år (1968-2018)

• Romskaug, Rita; Molden, Espen; Straand, Jørund; Kersten, Hege; Skovlund, Eva & Pitkälä, Kaisu [Show all 7 contributors for this article] (2017). Cooperation for improved pharmacotherapy in elderly people receiving polypharmacy: The COOP Study. Full text in Research Archive
• Brænd, Anja Maria; Straand, Jørund & Klovning, Atle (2017). Clinical drug trials in general practice: How well are external validity issues reported? Full text in Research Archive
• Romskaug, Rita; Molden, Espen; Straand, Jørund; Kersten, Hege; Skovlund, Eva & Pitkala, Kaisu H [Show all 7 contributors for this article] (2017). Cooperation between geriatricians and general practitioners for improved pharmacotherapy in home-dwelling elderly people receiving polypharmacy - the COOP Study: Study protocol for a cluster randomised controlled trial. Trials. 18(1). doi: 10.1186/s13063-017-1900-0. Full text in Research Archive Show summary

  Background: Polypharmacy and inappropriate drug use is associated with negative health outcomes among older people. Various interventions for improving drug treatment have been evaluated, but the majority of studies are limited by the use of surrogate outcomes or suboptimal design. Thus, the potential for clinically significant improvements from different interventions is still unclear. The main objective of this study is therefore to evaluate the effect upon patient-relevant endpoints of a cooperation between geriatricians and general practitioners on complex drug regimens in home-dwelling elderly people. Methods: This is a cluster randomised, single-blind, controlled trial where general practitioners are invited to participate with patients from their lists. The patients must be 70 years or older, use at least seven different medications and have their medications administered by the home nursing service. We plan to recruit 200 patients, with randomisation at physician level. The intervention consists of three main parts: (1) clinical geriatric assessment of the patient, combined with a thorough review of their medications; (2) a meeting between the geriatrician and general practitioner, where the two physicians combine their competence and knowledge and discuss the drug list systematically; (3) clinical follow-up, depending on the medication changes that have been done. The study period is 24 weeks, and the patients are assessed at baseline, 16 and 24 weeks. The primary outcome measure is health-related quality of life according to the 15D instrument. Secondary outcome measures include physical and cognitive functioning, medication appropriateness, falls, carer burden, use of health services (hospital or nursing home admissions, use of home nursing services) and mortality. Discussion: Our choice of patient-relevant outcome measures will hopefully provide new knowledge on the potential for clinical improvements after performing comprehensive medication reviews in home-dwelling elderly people receiving polypharmacy. Trial registration ClinicalTrials.gov, NCT02379455. Registered on 27 February 2015.

• Eide, Torunn Bjerve; Straand, Jørund & Rosvold, Elin Olaug (2017). Nordic general practitioners´ role in the treatment and follow-up of common medical conditions. Full text in Research Archive
• Eide, Torunn Bjerve; Straand, Jørund & Rosvold, Elin Olaug (2017). Differences in Nordic general practitioners´ participation in treatment and follow-up of common medical conditions. Full text in Research Archive
• Ruths, Sabine; Straand, Jørund; A, Nygaard Harald & Hodneland, Fernande (2017). Drug treatment of heart failure – do nursing home residents deserve better? Full text in Research Archive
• Rosvold, Elin Olaug; Ruths, Sabine; Janssen, S & Straand, Jørund (2016). Turning general practitioners into researchers. Experiences from the Norwegian research school in general practice. Full text in Research Archive
• Eide, Torunn Bjerve; Straand, Jørund & Rosvold, Elin Olaug (2016). Procedures, tests and medical equipment in Nordic general practice. Full text in Research Archive
• Rosvold, Elin Olaug; Straand, Jørund; Ruths, Sabine; Klovning, Atle; Sigurdsson, Johann Agust & Melbye, Hasse [Show all 7 contributors for this article] (2016). Research training in general practice. Experience from the Norwegian Research School in General Practice. Full text in Research Archive
• Rosvold, Elin Olaug; Ruths, Sabine; Janssen, Siri Evju & Straand, Jørund (2016). Turning general practitioners into researchers. Experiences from The Norwegian Research School in General Practice (NAFALM). Full text in Research Archive
• Eide, Torunn Bjerve; Melbye, Hasse; Straand, Jørund & Rosvold, Elin Olaug (2015). Are patient experiences in general practice affected by independent organizational factors? Full text in Research Archive
• Rosvold, Elin Olaug; Straand, Jørund; Kvalvaag, Gunnar & Os, Ingrid (2015). Clinical rotations in nursing homes in medical education. Full text in Research Archive
• Brænd, Anja Maria; Straand, Jørund & Klovning, Atle (2015). Clinical drug trials in Norwegian general practice: Publication output and missing trial data. Full text in Research Archive
• Kristoffersen, Espen Saxhaug; Straand, Jørund; Russell, Michael Bjørn & LUNDQVIST, CHRISTOFER (2015). BRIEF INTERVENTION FOR MEDICATION-OVERUSE HEADACHE IN PRIMARY CARE (THE BIMOH STUDY) – AN OPEN LONG-TERM FOLLOW-UP. Full text in Research Archive
• LUNDQVIST, CHRISTOFER; Gossop, Michael; Russell, Michael Bjørn; Straand, Jørund & Kristoffersen, Espen Saxhaug (2015). Dependence like behaviour in medication-overuse headache. Full text in Research Archive
• Kristoffersen, Espen Saxhaug; Straand, Jørund; Russell, Michael Bjørn & LUNDQVIST, CHRISTOFER (2015). Brief Intervention for Medication-Overuse Headache in primary care (the BIMOH study): an open long-term follow-up. Full text in Research Archive
• Kristoffersen, Espen Saxhaug; Straand, Jørund; Russell, Michael Bjørn & LUNDQVIST, CHRISTOFER (2015). Brief Intervention for Medication-Overuse Headache in primary care (the BIMOH study): an open long-term follow-up. European Journal of Neurology. ISSN 1351-5101. 22, p. 78–78. Full text in Research Archive
• Kristoffersen, Espen Saxhaug; Straand, Jørund; Russell, Michael Bjørn & LUNDQVIST, CHRISTOFER (2015). Brief intervention for medication-overuse headache in primary care (the bimoh study) – An open long-term follow-up. Full text in Research Archive

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