Silje Bjørnsen Haavaag

• Hjelle, Ellen Gabrielsen; Nielsen, Tove Lise; Bragstad, Line Kildal; Kruse, Naja Benigna; Vester, Louise Buus & Haavaag, Silje Bjørnsen [Vis alle 16 forfattere av denne artikkelen] (2026). Feasibility and acceptability of the cross-national multisectoral OPTIM-PARK intervention for people affected with Parkinson’s disease and their family carers. BMC Health Services Research. doi: 10.1186/s12913-026-14912-5. Fulltekst i vitenarkiv Vis sammendrag

  Abstract Background Parkinson’s disease (PD) is a common neurological disease worldwide. Management of PD is complex, requiring person-centred care to address the physical, emotional, social, and economic impacts of the disease. The OPTIM-PARK intervention was developed to enhance the process of living with PD for people affected and their family carers (FCs) by designing inter- and multisectoral collaboration and incorporating a coordinator role in four European countries: Denmark, Norway, Spain, and the United Kingdom. The aim of this cross-national study was to evaluate the feasibility and acceptability of the OPTIM-PARK intervention in community settings. Methods A mixed-methods convergent design was applied, including quantitative analysis of registrations, outcome measures and an Acceptability scale, as well as qualitative analysis of Logs and Mapping of Resources, and semistructured interviews. The focus of the three months intervention was a PD coordinator who undertook a personalized needs assessment and provided information and support, strengthened multi- and intersectoral collaboration, and optimized access to and use of community resources and other third sector support systems. Results A total of 130 participants were included in the intervention, 72 people with PD and 58 of their FCs. The intervention was typically provided in three consultations. The PD coordinator focus was on individualized support through active listening in the delivery of healthcare interventions. Inclusion of FCs were highly valued. Completion of the outcome measures was feasible, 105 (81%) participants were able to complete outcomes at both time points with <5% missing data. Most participants (92%) found it easy to answer the questionnaires, the use of digital tools for data collection was found beneficial if the participant were comfortable with the digital format. Conclusions To the best of our knowledge this is the first cross-national European study exploring the feasibility of a PD coordinator focussed support to enhance the process of living with PD. The findings suggest that the OPTIM-PARK intervention was feasible and well-received in a community setting across different countries, suggesting potential for wider application and further evaluation in a larger-scale trial.

• Amundsen, Olav; Moger, Tron Anders; Holte, Jon Helgheim; Haavaag, Silje Bjørnsen; Bragstad, Line Kildal & Hellesø, Ragnhild [Vis alle 8 forfattere av denne artikkelen] (2026). Use of primary care physiotherapy and its associations with clinical and socioeconomic outcomes in musculoskeletal disorders: a cohort study. Scandinavian Journal of Primary Health Care. ISSN 0281-3432. 44(1). doi: 10.1080/02813432.2026.2660328. Fulltekst i vitenarkiv Vis sammendrag

  Isolating the effects of outpatient care on hospitalisation in observational data is challenging. We estimate the effects of factors believed to influence hospital admissions in patients with COPD. The factors were related to outpatient care and social factors, motivated by recommendations in COPD guidelines and the literature. We applied linked national and municipal registry data on 25,369 COPD patients in Oslo and Trondheim 2008–2019. Yearly frequency and type of healthcare contacts (respiratory and non-respiratory, across providers), together with comorbidities, were used as proxies for patients’ health status. We constructed samples matched on the full set of proxy variables to estimate the effect of each factor on future COPD hospital admissions. Overall, 9.8% of follow up years had at least one COPD hospital admission. Findings indicated beneficial effects of several of the factors. Care interaction between general practitioner (GP) and other health providers, follow-up by GP within 30 days after COPD hospital discharge and counselling/psychotherapy by GP showed significant reductions of 2.9, 4.9 and 1.4% points in the rate of next-year COPD hospital admissions, respectively. The effects are noteworthy when extrapolated to the entire Norwegian COPD population. A reduction of 1% point could result in up to 1,500 fewer patients experiencing one or more COPD hospital admissions during a year. In the absence of detailed clinical information, creating samples that are multidimensionally matched on health service use and comorbidities as pragmatic proxies for health status could be a viable approach for estimating the effects of other factors.

• Moger, Tron Anders; Holte, Jon Helgheim; Amundsen, Olav; Haavaag, Silje Bjørnsen; Edvardsen, Anne & Bragstad, Line Kildal [Vis alle 9 forfattere av denne artikkelen] (2026). Matching on health status to estimate the effects of outpatient care and social factors in patients with COPD: a Norwegian registry‑based study. BMC Health Services Research. 26(1). doi: 10.1186/s12913-026-14285-9. Fulltekst i vitenarkiv Vis sammendrag

  Isolating the effects of outpatient care on hospitalisation in observational data is challenging. We estimate the effects of factors believed to influence hospital admissions in patients with COPD. The factors were related to outpatient care and social factors, motivated by recommendations in COPD guidelines and the literature. We applied linked national and municipal registry data on 25,369 COPD patients in Oslo and Trondheim 2008–2019. Yearly frequency and type of healthcare contacts (respiratory and non-respiratory, across providers), together with comorbidities, were used as proxies for patients’ health status. We constructed samples matched on the full set of proxy variables to estimate the effect of each factor on future COPD hospital admissions. Overall, 9.8% of follow up years had at least one COPD hospital admission. Findings indicated beneficial effects of several of the factors. Care interaction between general practitioner (GP) and other health providers, follow-up by GP within 30 days after COPD hospital discharge and counselling/psychotherapy by GP showed significant reductions of 2.9, 4.9 and 1.4% points in the rate of next-year COPD hospital admissions, respectively. The effects are noteworthy when extrapolated to the entire Norwegian COPD population. A reduction of 1% point could result in up to 1,500 fewer patients experiencing one or more COPD hospital admissions during a year. In the absence of detailed clinical information, creating samples that are multidimensionally matched on health service use and comorbidities as pragmatic proxies for health status could be a viable approach for estimating the effects of other factors.

• Haavaag, Silje Bjørnsen; Obstfelder, Aud Uhlen; Hellesø, Ragnhild; Moger, Tron Anders; Amundsen, Olav & Tjerbo, Trond [Vis alle 9 forfattere av denne artikkelen] (2026). Patient Work in Long-Term Conditions. Qualitative Health Research. ISSN 1049-7323. doi: 10.1177/10497323261430632. Fulltekst i vitenarkiv Vis sammendrag

  Long-term conditions are one of the major causes to morbidity and death worldwide. Management of such conditions in healthcare settings has been framed as a challenge for healthcare systems, and people living with long-term conditions often experience fragmented care. Integrated care approaches have been advocated as the solution, but few studies include the work done by patients and its significance for care processes. The present study aimed to explore the work of people with long-term conditions in the unfolding of their care trajectories. The study is based on semi-structured interviews of people living with chronic obstructive pulmonary disease and musculoskeletal disorders. The participants were all home-dwelling and living in Norway. Reflexive thematic analysis was used to guide the analysis. Theory about work as theorized by Strauss et al. was central to the analysis. The persons highlight that they feel that it is up to them to ask questions and initiate care, that they monitor their bodies to be equipped to act adequately when changes occur, and that they engage in deliberative interaction with healthcare personnel. The findings add depth to current knowledge and highlight that people living with long-term conditions participate in the unfolding of their care trajectories by doing comprehensive work. Framing what people with long-term conditions do when participating in their care trajectories as work brings forth aspects of healthcare use that may be less visible for healthcare personnel and enables addressing individual care trajectories as intertwined with patient work.

• Moger, Tron Anders; Holte, Jon Helgheim; Amundsen, Olav; Haavaag, Silje Bjørnsen; Døhl, Øystein & Bragstad, Line Kildal [Vis alle 9 forfattere av denne artikkelen] (2025). Predictors, Healthcare Utilization and Costs Related to Short-Term Stays in Patients with COPD: A Registry-Based Analysis in Norway. Clinical Epidemiology. Volume 17, s. 707–719. doi: 10.2147/clep.s521958. Fulltekst i vitenarkiv Vis sammendrag

  Background: Chronic obstructive pulmonary disease (COPD) incurs significant healthcare costs, often accompanied by multimorbidity. Advanced patients may need short-term stays for rehabilitation, treatment, or respite to maintain home living. Aim: To identify predictors for a first short-term stay and study the healthcare utilization and costs compared with similar patients without a short-term stay. Patients and Methods: Data on COPD patients in the cities Oslo and Trondheim 2010–2019 and including information on specialist, primary and long-term care, diagnoses, sociodemographics and -economics were collected from national and municipal registries, resulting in a sample of 24,613 patients. Using discrete time survival models, we identified predictors for a short-term stay. We described the costs before and after admission, and the duration of living at home, compared to non-recipients matched on age, comorbidities and healthcare use. Results: Depression, anxiety, mental disorders, alcoholism, prior hospitalization and reception of home care were associated with higher odds of short-term stays. One to two GP visits for respiratory diseases, being in the top quartile for GP visits for non-respiratory diseases, visits to specialists, and physiotherapist visits for non-respiratory issues were significantly associated with lower odds of short-term institutional stay. Patients admitted to short-term stays incurred markedly higher costs both in the year before admission and during subsequent years compared to matched non-recipients, primarily due to increased use of inpatient and home care services. Conclusion: Prior receipt of home care, unlike standard outpatient services, was linked to a higher likelihood of short-term stays. This suggests that some outpatient services may delay the need for such stays, or that patients already in municipal services are more readily admitted. Additionally, patients with psychosocial issues may have greater care needs, indicating that resource allocation aligns with these needs. The findings suggest that by the time short-term stays are required, health deterioration has already become considerable.

• Moger, Tron Anders; Holte, Jon Helgheim; Amundsen, Olav; Haavaag, Silje Bjørnsen; Døhl, Øystein & Bragstad, Line Kildal [Vis alle 9 forfattere av denne artikkelen] (2024). The in- and outpatient health care use of patients with COPD before and after initiation of home care: a registry study from Norway. Scandinavian Journal of Primary Health Care. ISSN 0281-3432. 43(1). doi: 10.1080/02813432.2024.2404056. Fulltekst i vitenarkiv Vis sammendrag

  Objective: Chronic obstructive pulmonary disease (COPD) is a common condition associated with age, multimorbidity and frequently involves the use of health care across levels. Understanding the factors associated with the initiation of long-term care is important when planning the future need for services. We describe healthcare use before and after the reception of any home care. We further studied the associations between healthcare use and first registered home care service and from first registered home care service to nursing home admission or death. Design and subjects: Patients residing in Oslo or Trondheim at the time of first contact with a COPD primary diagnosis, 2009–2018. Patient data were linked across national and municipal registries, covering healthcare and sociodemographics. The sample consisted of 16,738 individuals. Results: There was a marked increase in inpatient and outpatient hospital contacts in the years prior to and after the reception of any home care. Adjusted for comorbidities and sociodemographics, high numbers of GP consultations, and inpatient and outpatient hospital contacts for respiratory diagnoses were associated with a significantly higher likelihood of receiving home care the next year (hazard odds ratios > 1.3). Following the reception of home care, the type of home care service received (e.g. home nursing or short-term rehabilitation/treatment) was more important than outpatient services in predicting next-year nursing home admission or death. Conclusion: Including data on prior outpatient care when predicting future need for home care is beneficial. A high frequency (top 10%) of yearly GP, in- or outpatient hospital contacts can imply that the patient may be in need of home care in the near future.

• Amundsen, Olav; Moger, Tron Anders; Holte, Jon Helgheim; Haavaag, Silje Bjørnsen; Bragstad, Line Kildal & Hellesø, Ragnhild [Vis alle 8 forfattere av denne artikkelen] (2024). Patient characteristics and healthcare use for high-cost patients with musculoskeletal disorders in Norway: a cohort study. BMC Health Services Research. 24(1). doi: 10.1186/s12913-024-12051-3. Fulltekst i vitenarkiv Vis sammendrag

  Background: A high proportion of healthcare costs can be attributed to musculoskeletal disorders (MSDs). A small proportion of patients account for most of the costs, and there is increasing focus on addressing service overuse and high costs. We aimed to estimate healthcare use contributing to high costs over a five-year period at the individual level and to examine if healthcare use for high-cost patients is in accordance with guidelines and recommendations. These findings contribute to the understanding of healthcare use for high-cost patients and help in planning future MSD-care. Methods: This study combined Norwegian registries on healthcare use, diagnoses, demographic, and socioeconomic factors. Patients (≥ 18 years) were included by their first MSD-contact in 2013–2015. We analysed healthcare use during the subsequent five years. Descriptive statistics were used to compare high-cost (≥ 95th percentile) and non-high-cost patients. Total healthcare contacts and costs for high-cost patients were examined stratified by number of hospitalisations and surgical treatments. Healthcare use of General Practitioners (GPs), physiotherapy, chiropractor and Physical Medicine and Rehabilitation physicians prior to the first hospitalisation or surgical treatment for a non-traumatic MSD was registered. Results: High-cost patients were responsible for 61% of all costs. Ninety-four percent of their costs were related to hospital treatment. Ninety-nine percent of high-cost patients had at least one hospitalisation or surgical procedure. Out of the high-cost patients, 44% had one registered hospitalisation or surgical procedure, 52% had two to four and 4% had five or more. Approximately 30–50% of patients had seen any healthcare personnel delivering conservative treatment other than GPs the year prior to their first hospitalisation/surgical treatment for a non-traumatic MSD. Conclusion: Most healthcare costs were concentrated among a small proportion of patients. In contrast to guidelines and recommendations, less than half had been to a healthcare service focused on conservative management prior to their first hospitalisation or surgical treatment for a non-traumatic MSD. This could indicate that there is room for improvement in management of patients before hospitalisation and surgical treatment, and that ensuring sufficient capacity for conservative care and rehabilitation can be beneficial for reducing overall costs.

• Moger, Tron Anders; Holte, Jon Helgheim; Amundsen, Olav; Haavaag, Silje Bjørnsen; Edvardsen, Anne & Bragstad, Line Kildal [Vis alle 9 forfattere av denne artikkelen] (2024). Associations between outpatient care and later hospital admissions for patients with chronic obstructive pulmonary disease - a registry study from Norway. BMC Health Services Research. 24(1). doi: 10.1186/s12913-024-10975-4. Fulltekst i vitenarkiv Vis sammendrag

  Background Although chronic obstructive pulmonary disease (COPD) admissions put a substantial burden on hospitals, most of the patients’ contacts with health services are in outpatient care. Traditionally, outpatient care has been difficult to capture in population-based samples. In this study we describe outpatient service use in COPD patients and assess associations between outpatient care (contact frequency and specific factors) and next-year COPD hospital admissions or 90-day readmissions. Methods Patients over 40 years of age residing in Oslo or Trondheim at the time of contact in the period 2009–2018 were identified from the Norwegian Patient Registry (in- and outpatient hospital contacts, rehabilitation) and the KUHR registry (contacts with GPs, contract specialists and physiotherapists). These were linked to the Regular General Practitioner registry (characteristics of the GP practice), long-term care data (home and institutional care, need for assistance), socioeconomic and–demographic data from Statistics Norway and the Cause of Death registry. Negative binomial models were applied to study associations between combinations of outpatient care, specific care factors and next-year COPD hospital admissions and 90-day readmissions. The sample consisted of 24,074 individuals. Results A large variation in the frequency and combination of outpatient service use for respiratory diagnoses (GP, emergency room, physiotherapy, contract specialist and outpatient hospital contacts) was apparent. GP and outpatient hospital contact frequency were strongly associated to an increased number of next-year hospital admissions (1.2–3.2 times higher by increasing GP frequency when no outpatient hospital contacts, 2.4-5 times higher in combination with outpatient hospital contacts). Adjusted for healthcare use, comorbidities and sociodemographics, outpatient care factors associated with lower numbers of next-year hospitalisations were fees indicating interaction between providers (7% reduction), spirometry with GP or specialist (7%), continuity of care with GP (15%), and GP follow-up (8%) or rehabilitation (18%) within 30 days vs. later following any current year hospitalisations. For 90-day readmissions results were less evident, and most variables were non-significant. Conclusion As increased use of outpatient care was strongly associated with future hospitalisations, this further stresses the need for good communication between providers when coordinating care for COPD patients. The results indicated possible benefits of care continuity within and interaction between providers.

• Hjelle, Ellen Gabrielsen; Smidt, Helle Rønn; Haahr, Anita; Haavaag, Silje Bjørnsen; Sørensen, Dorthe & Navarta-Sánchez, Maria Victoria [Vis alle 8 forfattere av denne artikkelen] (2023). Filling the gap in service provision. Partners as family carers to people with Parkinson's disease: A Scandinavian perspective. Chronic Illness. ISSN 1742-3953. doi: 10.1177/17423953231174470. Fulltekst i vitenarkiv Vis sammendrag

  Objectives: The purpose of this study was to explore the expectations of and experiences with the public healthcare system of domestic partners of people with Parkinson`s disease (PD) in Denmark and Norway. Methods: A qualitative exploratory design was applied. The sample consisted of 14 people from Denmark (n=9) and Norway (n=5) living with a partner with PD. Semi-structured individual interviews were conducted between June and September 2020, digitally recorded, transcribed ver- batim and analysed using a reflexive thematic analysis approach combining inductive and deductive approaches. Results: The main themes were ‘negotiating systems of support’ and ‘balancing being both a part- ner and a family carer’. Partners take responsibility for the people with whom they live and attempt to fill gaps in the public healthcare system. The most frequently described needs were more information, service coordination as the illness progressed and acknowledgement of the complex role. Discussion: A recommendation for practice is recognition of the complex roles of partners to people with PD and reaching out to both regularly to determine needs. This may enhance the col- laboration between partner carers, people with PD and healthcare providers, ensure sustainability of the system and optimise living with PD in the family.

• Amundsen, Olav; Moger, Tron Anders; Holte, Jon Helgheim; Haavaag, Silje Bjørnsen; Bragstad, Line Kildal & Hellesø, Ragnhild [Vis alle 8 forfattere av denne artikkelen] (2023). Combination of health care service use and the relation to demographic and socioeconomic factors for patients with musculoskeletal disorders: a descriptive cohort study. BMC Health Services Research. 23(1). doi: 10.1186/s12913-023-09852-3. Fulltekst i vitenarkiv Vis sammendrag

  Background Patients with musculoskeletal disorders (MSDs) access health care in different ways. Despite the high prevalence and significant costs, we know little about the different ways patients use health care. We aim to fill this gap by identifying which combinations of health care services patients use for new MSDs, and its relation to clinical characteristics, demographic and socioeconomic factors, long-term use and costs, and discuss what the implications of this variation are. Methods The study combines Norwegian registers on health care use, diagnoses, comorbidities, demographic and socioeconomic factors. Patients (≥ 18 years) are included by their first health consultation for MSD in 2013–2015. Latent class analysis (LCA) with count data of first year consultations for General Practitioners (GPs), hospital consultants, physiotherapists and chiropractors are used to identify combinations of health care use. Long-term high-cost patients are defined as total cost year 1–5 above 95th percentile (≥ 3 744€). Results We identified seven latent classes: 1: GP, low use; 2: GP, high use; 3: GP and hospital; 4: GP and physiotherapy, low use; 5: GP, hospital and physiotherapy, high use; 6: Chiropractor, low use; 7: GP and chiropractor, high use. Median first year health care contacts varied between classes from 1–30 and costs from 20€-838€. Eighty-seven percent belonged to class 1, 4 or 6, characterised by few consultations and treatment in primary care. Classes with high first year use were characterised by higher age, lower education and more comorbidities and were overrepresented among the long-term high-cost users. Conclusion There was a large variation in first year health care service use, and we identified seven latent classes based on frequency of consultations. A small proportion of patients accounted for a high proportion of total resource use. This can indicate the potential for more efficient resource use. However, the effect of demographic and socioeconomic variables for determining combinations of service use can be interpreted as the health care system transforming unobserved patient needs into variations in use. These findings contribute to the understanding of clinical pathways and can help in the planning of future care, reduction in disparities and improvement in health outcomes for patients with MSDs.

• Navarta-Sánchez, Maria Victoria; Palmar-Santos, Ana; Pedraz-Marcos, Azucena; Reidy, Claire; Soilemezi, Dia & Haahr, Anita [Vis alle 12 forfattere av denne artikkelen] (2023). Perspectives of people with Parkinson's disease and family carers about disease management in community settings: A cross-country qualitative study. Journal of Clinical Nursing (JCN). ISSN 0962-1067. 32(15-16), s. 5201–5218. doi: 10.1111/jocn.16636. Fulltekst i vitenarkiv Vis sammendrag

  Aim: To explore perceptions of people with Parkinson's disease and family carers about the use and impact of health and social care services, community and voluntary sector resources for the management of Parkinson's disease.<p> <p>Background: Resources from outside the formal health care system and collaborations between different levels and sectors could address the unmet needs of people with Parkinson's disease and their family carers and improve the management of Parkinson's disease in the community setting. <p>Design: A qualitative exploratory study was carried out in Denmark, Norway, Spain and the United Kingdom and was reported using the COREQ. Methods: Individual semi-structured interviews were conducted with people with Parkinson's disease and family carers between May and August 2020. Interviews were digitally recorded, transcribed verbatim and analysed using thematic analysis. A meta-ethnographic approach was used to analyse and synthesise cross-national findings. <p>Results: Forty-seven people with Parkinson's disease and 39 family carers participated in the four countries. Four themes and eight sub-themes emerged: (1) Personalised care for needs throughout the Parkinson's disease journey; (2) Accessibility of different types of support systems (including initiatives to support emotional well-being, physical rehabilitation, information on the healthcare services, voluntary associations and community groups); (3) Multiagency collaborations, a more comprehensive approach; (4) Acknowledgment of people with Parkinson's and family carers own role in Parkinson's disease management. <p>Conclusions: An integrated and person-and-community-centred approach, which includes the participation of the health, social, voluntary and community sectors, is desired by people with Parkinson's disease and their family carers to improve the management of Parkinson's in the community setting. These findings could contribute to the creation of more sustainable care systems at the European level that would better respond to individual and changing needs in people with Parkinson's disease and their family carers, and in other long-term conditions. <p>Patient or Public Contribution: The Patient and Public Involvement groups contributed to the design of the study, the interview guides and validation of findings. <p>Relevance to Clinical Practice: This study will inform the management of Parkinson's disease at the community level and the use of resources not only directly linked to the health system. Taking into account all the actors that provide care and support to people with Parkinson’ disease and family carers facilitates the creation of strategies that better respond to individual needs. Nurses and other health and social care professionals in the community and specialist levels of care should collaborate to develop multisectoral strategies that promote personalised and integrated care throughout the Parkinson's journey.

• Soilemezi, Dia; Palmar-Santos, Ana; Navarta-Sánchez, Maria Victoria; Roberts, Helen; Pedraz-Marcos, Azucena & Haahr, Anita [Vis alle 11 forfattere av denne artikkelen] (2022). Understanding support systems for Parkinson's disease management in community settings: A cross‐national qualitative study. Health Expectations. ISSN 1369-6513. doi: 10.1111/hex.13691. Fulltekst i vitenarkiv Vis sammendrag

  Background Health and social care systems face difficulties in managing multimorbidity, disease burden and complex needs in long-term conditions such as Parkinson's disease. Objective This study aimed to develop a European understanding of how health and social care professionals can collaborate with stakeholders from different organizations and sectors to enhance the management of Parkinson's disease in a community setting by identifying the existing gaps in this process and how people with Parkinson's disease and their family carers could benefit from these partnerships. Methods A mixed-methods sequential study was conducted in Denmark, Norway, Spain and the United Kingdom. The findings from the qualitative phase are presented. Individual semistructured interviews were analysed using Braun's and Clarke's thematic analysis. A meta-ethnography approach was used to analyse and synthesize cross-national findings. Results A total of 41 healthcare professionals and 39 stakeholders from different disciplines and sectors were interviewed in the four countries. The participants acknowledged a lack of awareness of available resources and poor communication between the different support systems in the management of Parkinson's disease. To promote multiagency collaborations, the participants highlighted the need to organize services along the Parkinson's disease journey, patient involvement and strategic involvement of carers in organizing resources and Parkinson's disease care pathways. According to the participants, the benefits from multiagency partnerships could lead to an enhanced continuity of care and specialized knowledge, mobilization of resources in the community, personalized support and improved access to services. Conclusions Policymakers are called upon to create formal structures that facilitate multisectoral collaborations to promote an integrated system of care for the management of Parkinson's disease in the community. To address this challenge, we propose five strategies showing how organizations can work together to optimize the use of resources and enhance the management of Parkinson's disease throughout the illness trajectory. Patient or Public Contribution Patient and Public Involvement groups made up of stakeholders, healthcare professionals, patients with Parkinson's disease and family carers participated in the design of the study, the development of the interview guides and the validation of the findings.

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• Hjelle, Ellen Gabrielsen; Nielsen, Tove Lise; Bragstad, Line Kildal; Kruse, Naja Benigna; Vester, Louise Buus & Haavaag, Silje Bjørnsen [Vis alle 16 forfattere av denne artikkelen] (2026). OPTIM-PARK - A cross-national multisectoral intervention for people affected with Parkinson’s disease and their family carers. Fulltekst i vitenarkiv Vis sammendrag

  Introduction/Rationale: Parkinson’s disease (PD) is a common neurological disorder that requires a complex approach. Objectives: The OPTIM-PARK intervention was developed to improve the living with PD through intersectoral collaboration and follow up by a coordinator in Denmark, Norway, Spain, and the UK. Methods/Approach: The three-month OPTIM-PARK intervention included face-to-face, digital or telephone consultations with a PD coordinator who had a background in occupational therapy, physical therapy, or nursing. Participants had at least one initial meeting and one follow-up after three months, with additional meetings as needed. The meetings were conducted with people with PD, family carers, or both, based on preference. Coordinators logged the follow up and used a template to guide the meetings, detailing resources beneficial to people with PD and family carers across "Body function and structure," "Activity and participation," and "Environmental factors." Each country identified local resources fitting these classifications. Results/Practice Implications: Fifty-eight coordinator logs were collected. Most intervention topics were raised by the participant with PD, while family carers focused on the person with PD needs, providing direct help or increasing training and general follow-up. Key issues included disease management, exercise, home care, practical help, and social support. The OPTIM-PARK intervention highlighted the importance of tailored, person-centered care and intersectoral collaboration in managing Parkinson’s disease. Conclusions and contribution to the occupational therapy profession The intervention shows how occupational therapists and other health care professionals, through personalized care and collaboration, can address complex needs, enhance quality of life, and support the management of long-term conditions, such as PD.

• Moger, Tron Anders; Vøllestad, Nina Køpke; Tjerbo, Trond; Amundsen, Olav; Holte, Jon Helgheim & Haavaag, Silje Bjørnsen [Vis alle 8 forfattere av denne artikkelen] (2025). Bruk av registerdata i analyse av tjenesteforløp for muskelskjelett- og KOLS-pasienter – et sammendrag av INOREG prosjektet. Fulltekst i vitenarkiv Vis sammendrag

  Bakgrunn: Muskel-/skjelettlidelser (MSK) og kronisk obstruktiv lungesykdom (KOLS) representerer to betydelige typer av kroniske sykdommer. I et tverrfaglig forskningsprosjekt ved Institutt for Helse og Samfunn, UiO, som ble introdusert på Helsetjenestekonferansen 2022, har vi analysert tjenesteforløpene for disse pasientgruppene ved hjelp av koblede registerdata. Formål: Beskrive pasientforløpene for de to pasientgruppene, finne faktorer i forløpene assosiert med utfall som sykehusinnleggelser, hjemmetjenester, høy fremtidig tjenestebruk og uførhet. Metode: Kvantitative og kvalitative analyser av pasientforløp. Kvantitative analyser baseres på data fra nasjonale registre, fra registre i pleie- og omsorgstjenestene i Oslo og Trondheim, samt internt fysioterapiregister. Resultater: Flere viktige avvik fra anbefalt oppfølging for pasientgruppene ble oppdaget i analysene. Noen eksempler er at mer enn 50 % av MSK-pasienter fikk kirurgi, uten å ha forsøkt konservativ behandling først, og at mer enn 10 % av KOLS-pasienter ikke mottar oppfølging for luftveisdiagnoser i året før en sykehusinnleggelse med KOLS. Samtidig hadde mange av pasientene med gjentatte KOLS-innleggelser begrenset oppfølging i primærhelsetjenesten i årene etter indeksinnleggelsen. For KOLS-pasienter observerer man videre en sterk økning i fastlegekontakter i året før man mottar hjemmetjenester, som har betydning for å predikere fremtidig tjenestebruk. På den positive siden fant vi at MSK-pasienter med dårlig prognose hadde fire ganger høyere sjanse for å rapportere et godt klinisk utfall dersom de hadde høy bruk av fysioterapi, som videre var assosiert med lavere sjanse for fremtidig uførhet. For pasienter med god/middels prognose var det ingen sammenheng mellom klinisk utfall og høy frekvens av fysioterapi. For KOLS-pasienter fant vi at bruk av samhandlingstakster, kontinuitet i fastlegeoppfølging, og psykososial støtte for særlig sårbare grupper var assosiert med lavere sannsynlighet for fremtidige akutte sykehusinnleggelser for KOLS. Konklusjon: Prosjektet illustrerer mulighetene ved bruk av administrative helseregisterdata. Samtidig finnes det flere begrensninger dersom man ikke har data på tvers av tjenestene, mer detaljerte kliniske data, samt pasientrapporterte utfallsmål

• Moger, Tron Anders; Hellesø, Ragnhild; Tjerbo, Trond; Holte, Jon Helgheim; Haavaag, Silje Bjørnsen & Bragstad, Line Kildal [Vis alle 8 forfattere av denne artikkelen] (2025). INOREG workshop, perspective paper. Fulltekst i vitenarkiv
• Moger, Tron Anders; Haavaag, Silje Bjørnsen; Vøllestad, Nina Køpke; Tjerbo, Trond; Holte, Jon Helgheim & Hellesø, Ragnhild [Vis alle 8 forfattere av denne artikkelen] (2025). INOREG workshop 2025. Fulltekst i vitenarkiv
• Moger, Tron Anders; Vøllestad, Nina Køpke; Tjerbo, Trond; Hellesø, Ragnhild; Bragstad, Line Kildal & Holte, Jon Helgheim [Vis alle 8 forfattere av denne artikkelen] (2024). INOREG workshop 2024. Fulltekst i vitenarkiv
• Amundsen, Olav; Moger, Tron Anders; Vøllestad, Nina Køpke; Tjerbo, Trond; Hellesø, Ragnhild & Bragstad, Line Kildal [Vis alle 8 forfattere av denne artikkelen] (2023). INOREG workshop 2023. Fulltekst i vitenarkiv
• Bragstad, Line Kildal; Nielsen, Tove Lise; Hjelle, Ellen Gabrielsen; Kruse, Naja Benigna; Vester, Louise Buus & Haahr, Anita [Vis alle 16 forfattere av denne artikkelen] (2023). The OPTIM-PARK project: Assessing acceptability of a cross-national multisectoral intervention for people affected by Parkinson's disease. Fulltekst i vitenarkiv
• Haahr, Anita; Vester, Louise Buus; Bragstad, Line Kildal; Nielsen, Tove Lise; Kruse, Naja Benigna & Hjelle, Ellen Gabrielsen [Vis alle 13 forfattere av denne artikkelen] (2023). Coordinated care in Parkinson's Disease. Fulltekst i vitenarkiv
• Hjelle, Ellen Gabrielsen; Nielsen, Tove Lise; Callesen, Jacob; Kruse, Naja Benigna; Vester, Louise Buus & Haahr, Anita [Vis alle 17 forfattere av denne artikkelen] (2023). Evaluating a cross-national multisevtoral OPTIM-PARK intervention for People with Parkinson's disease and their family carers in the community: a feasibility study. Fulltekst i vitenarkiv
• Haahr, Anita; Vester, Louise Buus; Bragstad, Line Kildal; Nielsen, Tove Lise; Kruse, Naja Benigna & Hjelle, Ellen Gabrielsen [Vis alle 13 forfattere av denne artikkelen] (2023). The Coordinator - someone to turn to. Experiences of the OPTIM-PARK intervention from people with Parkinson's disease and their family carers. Fulltekst i vitenarkiv
• Haavaag, Silje Bjørnsen (2022). "Du har Parkinson 365 dager i året" En kvalitativ studie om hjemmeboende personer med Parkinsons sykdom sine erfaringer fra møter med helsevesenet, med andre og seg selv. Fulltekst i vitenarkiv
• Bragstad, Line Kildal; Haavaag, Silje Bjørnsen & Hjelle, Ellen Gabrielsen (2022). OPTIM-PARK prosjektet. Fulltekst i vitenarkiv
• Navarta-Sánchez, Maria Victoria; Haahr, Anita; Bragstad, Line Kildal; Palmar-Santos, Ana; Roberts, Helen & Pedraz-Marcos, Azucena [Vis alle 17 forfattere av denne artikkelen] (2022). Optimization of community resources and systems of support to enhancethe process of living with Parkinson's Disease: A multicectoral intervention. Fulltekst i vitenarkiv
• Palmar-Santos, Ana; Navarta-Sánchez, Maria Victoria; Pedraz-Marcos, Azucena; Haahr, Anita; Sørensen, Dorthe & Bragstad, Line Kildal [Vis alle 9 forfattere av denne artikkelen] (2022). Manejo de la enfermedad de Parkinson en el ámbito comunitario en cuatro países europeos: ¿cómo optimizar los recursos? [Håndtering av Parkinsons sykdom på samfunnsnivå i fire europeiske land: hvordan optimalisere ressursene?]. Fulltekst i vitenarkiv
• Haavaag, Silje Bjørnsen & Bragstad, Line Kildal (2021). «Du har Parkinson 365 dager i året» En kvalitativ studie om hjemmeboende personer med Parkinsons sykdom sine erfaringer fra møter med helsevesenet, med andre og seg selv. Universitetet i Oslo. Fulltekst i vitenarkiv

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