Papers by Katri Hämeen-anttila
European Journal of Clinical Pharmacology
PURPOSE: The aim of this study was to measure patterns of complementary and alternative medicine ... more PURPOSE: The aim of this study was to measure patterns of complementary and alternative medicine (CAM) use among Finnish children and to explore whether CAM use among children is mainly complementary or alternative. METHODS: We carried out a cross-sectional population-based survey in spring 2007. The study population consisted of a representative sample (n = 6,000) of Finnish children under 12 years of age. A questionnaire was sent to their parents, and 4,032 questionnaires were returned (response rate 67 %). Pearson's chi-square test and logistic regression analysis were conducted to measure factors associated with CAM use. RESULTS: The prevalence of CAM use among children was 11 %. Fish oils and fatty acids (6 %) followed by probiotics (4 %) were the most commonly reported CAMs used. Being the first born, using vitamins and having at least one symptom predicted the use of CAMs. Parental use of vitamins and CAMs were also associated with CAM use among children. In the preceding...
The aim was to describe parental attitudes towards medicine use in children, and the factors asso... more The aim was to describe parental attitudes towards medicine use in children, and the factors associated with them. A cross-sectional population survey of a random sample of children under 12 years of age (n = 6,000) was carried out in Finland in the spring of 2007, with a response rate of 67%. A questionnaire was sent to their parents. A Principal Component Analysis was conducted for the attitudinal scale to determine parental attitudes. An attitudinal scale including 21 items on five-point Likert scale was used to determine parental attitudes towards medicines. Five principal components with 18 statements explained parental attitudes: General attitude towards medicines, Attitude towards prescription medicines, Attitude towards OTC medicines, Attitude towards the risks of medicines, and Attitude towards long-term use of pain-killers. These components were internally consistent and explained 54.7% of the total variance. Of the respondents, 15% were cautious towards medicine use, 84% ...
Research in Social and Administrative Pharmacy
BACKGROUND: Previous studies have indicated the use of medication by children to be dependent on ... more BACKGROUND: Previous studies have indicated the use of medication by children to be dependent on the attitudes of knowledge of their parents; however, little is known about sources parents might use in driving medication use decisions. OBJECTIVE: The aim of this study was to describe the information sources that parents use regarding their children's medication and their perceptions of the reliability of these information sources. METHODS: This study is part of a cross-sectional population survey with a random sample of 6000 children younger than 12 years. The response rate of the questionnaire was 67%. Parents were asked about the use of information sources and their perception of reliability with a list of 16 information sources. RESULTS: The information sources that parents reported having used were physicians (72%), patient information leaflets (PILs) (67%), public or school health nurses (52%), and pharmacists (44%). Regardless of the child's age, physicians were the pa...
Background The association between parental attitudes and medication administered to their childr... more Background The association between parental attitudes and medication administered to their children has been studied mainly regarding specific diseases and ailments, e.g. asthma, fever and pain. Little is known about how parental attitudes toward medicines in general are associated with how they medicate their children using self-medication. Objective The aim of this study was to identify how parental attitudes toward medicines are associated with how they medicate their children with self-medication including the use of over-the-counter (OTC) medicines and complementary and alternative medicines (CAMs). Setting A cross-sectional population-based study was conducted in the spring of 2007. The study sample consisted of a random sample of Finnish children under 12 years of age (n = 6,000). Method A questionnaire was sent to parents, and the parent who usually takes responsibility for the child´s medication was instructed to answer the questionnaire. Main outcome measure The responding...
Depression and anxiety, Jan 20, 2015
No previous studies have explored how closely women follow their psychotropic drug regimens durin... more No previous studies have explored how closely women follow their psychotropic drug regimens during pregnancy. This study aimed to explore patterns of and factors associated with low adherence to psychotropic medication during pregnancy. Multinational web-based study was performed in 18 countries in Europe, North America, and Australia. Uniform data collection was ensured via an electronic questionnaire. Pregnant women were eligible to participate. Adherence was measured via the 8-item Morisky Medication Adherence Scale (MMAS-8). The Beliefs about Prescribed Medicines Questionnaire (BMQ-specific), the Edinburgh Postnatal Depression Scale (EPDS), and a numeric rating scale were utilized to measure women's beliefs, depressive symptoms, and antidepressant risk perception, respectively. Participants reporting use of psychotropic medication during pregnancy (n = 160) were included in the analysis. On the basis of the MMAS-8, 78 of 160 women (48.8%, 95% CI: 41.1-56.4%) demonstrated low...
International journal of technology assessment in health care, 2014
The need to consider the patient perspective in health technology assessments (HTA) has been wide... more The need to consider the patient perspective in health technology assessments (HTA) has been widely recognized. In July 2012, the Finnish Medicines Agency (Fimea) published a national recommendation for integrating the patient perspective into the HTAs of pharmaceuticals. The aim of this study is to describe the development of the recommendation for integrating the patient perspective into the HTA process of pharmaceuticals in Finland. The development of the recommendation was based on a review of international recommendations and experiences of patient and public involvement in HTA. The draft recommendation was tested in two focus group discussions (n = 7 patients) and three individual interviews among diabetes patients (type 1 or 2) using long-acting insulin treatment. The recommendation was open for public consultation in April 2012 and revised according to the comments received. Patients will be involved in multiple stages of Fimea's HTA process. The recommendation includes ...
BMC complementary and alternative medicine, 2011
The use of complementary and alternative medicines (CAM) has been extensively studied globally am... more The use of complementary and alternative medicines (CAM) has been extensively studied globally among adult and paediatric populations. Parents, as a group, had not been studied to assess their knowledge and attitude to CAM and general medicine use. This study is necessary since parents' attitude to medicine use is known to influence their child's attitude to medicine use later in life. We therefore aim to assess the extent and types of CAM use among Finnish parents, and to determine the factors that promote the CAM use. Also, we aim to determine parents' attitude to general medicine use. Children less than 12 years old, as of spring 2007, were identified from the database of the Finnish Population Register Centre and were selected by random sampling. The parents of these children were identified and a questionnaire was sent to them. Only the parent who regularly takes care of the child's medicine was requested to fill the questionnaire. Cross-tabulations and Chi-squa...
Patient Education and Counseling
There is a growing need for balanced drug information customized for special target groups such a... more There is a growing need for balanced drug information customized for special target groups such as children [Food and Drug Administration. Prescription Drug Product Labeling; Medication Guide Requirements; Proposed Rule. Part VII. Department of Health and Human Services, 21 CRF Part 201, et al. Federal Register 1995;60:44182-252; Dickinson D, Raynor DK, Duman M. Patient information leaflets for medicines: using consumer testing to determine the most effective design. Patient Educ Couns 2001;43:147-59]. Pictograms are one aid that may be used to make information easier to read and understand. The aim of this study was to test whether children understand pictograms developed by the United States Pharmacopeia (USP) [The United States Pharmacopeial Convention Inc. USP Pictograms. Retrieved 11 March 2002 from http://www.usp.org/], and especially, if the pictograms improve children's understanding of medicine leaflet information. Finnish elementary school children aged 7 years (n=28),...
Pharmacy World & Science, 2010
Responses to the CMUQ by parents/primary care givers in this Australian sample indicate that phar... more Responses to the CMUQ by parents/primary care givers in this Australian sample indicate that pharmacists are considered an important and reliable source of information on children's medicine • Paediatric medicines use should be a focus of continuing and undergraduate pharmacy education.
Pharmacoepidemiology and Drug Safety, 2010
The aim of this study was to investigate the prevalence and concomitant use of prescription medic... more The aim of this study was to investigate the prevalence and concomitant use of prescription medicines and self-medication, including over-the-counter (OTC) medicines, vitamins, and complementary and alternative medicines (CAMs) among Finnish children aged under 12 years. We carried out a nationwide postal survey of the use of medicines by a representative sample (n = 6000) of Finnish children aged under 12 years in spring 2007. A response rate of 67% (n = 4032) was achieved. The current use of prescription medicines and the use of OTC medicines, vitamins, and CAMs in the preceding 2 days were the main outcome measures. In total, 17% of children had used prescription medicines and 50% some self-medication. The corresponding figures for OTC medicines, vitamins, and CAMs use were 17, 37, and 11%, respectively. Drugs for obstructive airway diseases were the most common prescription medicines, whereas analgesics and antipyretics, including non-steroidal-anti-inflammatory-medicines (NSAID), were the most common OTC medicines reported. Vitamin D was the most common vitamin, while fish oils and fatty acids were the most common CAMs used. Ten percent of the children had used prescription medicines and self-medication concomitantly. Most of the children's medication consists of self-medication, and especially of vitamin use. However, also a considerable proportion had used prescription medicines, and a minority prescription medicines and self-medication concomitantly. In three of the cases, a combination of prescription and OTC medicine with a potential risk for interactions were found. Physicians should be aware of this wide use of self-medication when prescribing medicines.
Pharmacoepidemiology and Drug Safety, 2009
The goal was to determine the prevalence of medicine use and to provide population-based informat... more The goal was to determine the prevalence of medicine use and to provide population-based information on factors associated with medicine use, including prescribed and over-the-counter (OTC) medicines, in children aged under 12 years. A cross-sectional population survey of a random sample of children aged under 12 years (n = 6000) was carried out in Finland in spring 2007, with a response rate of 67%. A questionnaire was sent to their parents. Current use of medicines prescribed by a physician and use of OTC medicines during the preceding two days were the main outcome measures. The prevalence of current prescribed medicine use was 17%, and the 2-day prevalence of OTC medicine use 17% (vitamins excluded). The use of prescribed medicines was higher among children with illnesses diagnosed by a physician. Additionally, predictors for the use of prescribed medicines were young age among boys, health status worse than good, and the use of any prescribed medicines by a parent. The predictors for the use of OTC medicines by the child were young age and fairly good to poor health status, and the use of OTC medicines by a parent. However, children with any illnesses diagnosed by a physician were less likely to use OTC medicines. A considerable proportion of children use prescription and OTC medicines in Finland. Young age and health-related factors, morbidity and health status, and parental medicine use predicted children's medicine use. Further studies are needed to examine the association between parents' and children's medicine use.
The aim of this study was to discover how well children understand medicine related topics and in... more The aim of this study was to discover how well children understand medicine related topics and in this way to evaluate their preparedness for two-way communication about these matters. The data were collected by conducting 14 focus group discussions (FGDs) among Finnish schoolchildren aged 7-8, 10-11 and 13-14 years. The main theme during the FGDs was the management of diseases with medicines. Both inductive and deductive analyses were used to analyse the data [Patton M. Qualitative evaluation and research methods. 2nd ed. Newbury Park: Sage Publications; 1990]. Children had superficial knowledge of and a negative attitude towards medicine use. They used medicine related vocabulary uncertainly implying that they do not fully comprehend all the information that they have gained. Children realized that there may be risks when using medicines and this understanding tended to increase by age. The results of this study indicate a need to educate children about medicines. In addition to school-based medicine education, health care professionals should communicate directly with children about their medicines at an appropriate cognitive level in order to increase their understanding and skills concerning health issues.
Health Policy, 2013
The Finnish Medicines Agency was mandated to develop a national medicines information strategy. T... more The Finnish Medicines Agency was mandated to develop a national medicines information strategy. The objectives of this study were to assess stakeholders' views on strengths, challenges and opportunities in medicines information for the basis of the strategy. Interviews among stakeholder representatives (n=28) from patient organizations, universities, pharmacies, and professional associations in medicine, pharmacy and nursing were conducted in 2011. Interview memos were thematically content-analysed. The draft strategy was finalized through two public hearings and a public consultation. Stakeholders highlighted the need to increase cooperation and coordination in medicines information. The existence of numerous quality- and evidence-based medicines information sources was identified as a strength; although the stakeholders were concerned about the fragmented and unequal access to them. The strengthening of the role of health care professionals in communicating about medicines was seen as an opportunity, but its realization requires improvements in basic and continuing education. Furthermore, the stakeholders emphasized the importance of uniform medicines information regardless of source. Stakeholders identified multiple strengths, challenges and opportunities in medicines information that were fundamental to developing the national medicines information strategy. An inventory of stakeholder perspectives can be recommended as a tool to support decision-making in pharmaceutical policy.
Health Policy, 2006
The aim of this article is to describe the process of developing a medicine education program for... more The aim of this article is to describe the process of developing a medicine education program for elementary and middle schools in Finland and the lessons learned during the process. Further described is how teachers evaluated the usefulness of the medicine education materials created during the process. By medicine education we mean education about the proper use of medicines, abuse of medicines being just a small part of it.
Health Education, 2005
Purpose – This study is part of a larger project, which aims to develop medicine education materi... more Purpose – This study is part of a larger project, which aims to develop medicine education materials for teachers. The aim of the present study was to discover children's interests in medicines and teachers' opinions on what should be taught about medicines to children of different ages. Furthermore, teachers' opinions were assessed about the importance of medicine education as a part of school health education. The aim of the recommendations, based on our research and the materials developed during this process, is to clarify what proper use of medicines can mean, and in this way help teachers fulfil the requirements of the new Finnish health education curriculum. Design/methodology/approach – Twelve focus group discussions were conducted among a convenience sample of first-graders (7-8 years, n=23), fourth-graders (10-11 years, n=24) and seventh-graders (13-14 years, n=19). A national representative survey was conducted to gather data from the teachers (n=284, response rate 71 percent). Findings – Children's interests and teachers' opinions on what could be taught about medicines to children of different ages were quite similar. However, fourth-graders were interested in many topics which teachers considered suitable for older children, for example, how medicines work, how to avoid adverse reactions, and abuse of medicines. The vast majority of the teachers (93 percent) considered teaching about the proper use of medicines so important that it should be included in the national curriculum of health education. Of the children, fourth-graders were the most interested in medicines. Originality/value – This is one of the first studies, which combine the opinions of children and teachers, on what to teach children of different ages about the proper use of medicines. During the study, evidence-based recommendations on what to teach children about medicines and teaching materials were created.
Health Education, 2006
... education materials accessible in the Internet (www.uku.fi/laakekasvatus, in Finnish with Eng... more ... education materials accessible in the Internet (www.uku.fi/laakekasvatus, in Finnish with English ... quite a lot about medicines already, and that they were interested in learning more about ... and furthermore, to concentrate more on preventive issues, such as a healthful lifestyle. ...
European Journal of Clinical Pharmacology, 2013
Drug-related problems (DRPs) are common in paediatric pharmacotherapy, but few studies describe t... more Drug-related problems (DRPs) are common in paediatric pharmacotherapy, but few studies describe them from the parents' perspective. In the present survey, we have investigated the lifetime prevalence and type of DRPs in children in Finland. This was a population-based survey of a random sample of 6,000 children below 12 years of age in 2007. A questionnaire was sent to their parents. The final response rate was 67% with a study population of 4,032. The main outcome measure was the lifetime prevalence and type of DRPs. The lifetime prevalence of DRPs was 21% (95% CI 20-22). The most common (82%) of the 1,346 reported DRPs were adverse drug events (ADEs). The prevalence of ADEs was 17% (95% CI 16-19), that of other DRPs 5.2% (95% CI 4.5-5.9). The prevalence of serious ADEs was 0.4% and that of unexpected ADEs was 0.8%. The most common system involved in the ADEs was the gastrointestinal tract, comprising 34% of the 1,106 ADEs. The most common of the 240 other DRPs were problems with the administration and dosing of medicine (86%). Overall, 64% of DRPs were related to anti-infectives. One fifth of the Finnish children below 12 years of age had experienced DRPs. Appropriate counselling, including possible adverse drug reactions and dosing directions, is important for parents and children at both the prescribing and dispensing of medicines for paediatric patients. Reporting of any suspected serious or unexpected ADEs is an essential part of efficient pharmacovigilance in paediatrics.
BMC Public Health, 2011
Background: Socioeconomic inequalities in health are a global problem, not only among the adult p... more Background: Socioeconomic inequalities in health are a global problem, not only among the adult population but also among children. However, studies concerning young children especially are rare. The aim of this study was to describe the health of Finnish children under 12 years of age, and the socioeconomic factors associated with health. The socioeconomic factors were parental education level, household net income, and working status.
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Papers by Katri Hämeen-anttila