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Thematic area: General Practice
Research | Sleep, musculoskeletal, infection and laboratory

SMIL

This research group focuses on sleep, musculoskeletal complaints, infection and laboratory medicine (SMIL), and our aim is to contribute to more practice-based clinical research with relevance for primary care.

The research group SMIL is affiliated with the Department of Global Public Health and Primary Care with close cooperation with Haukeland University Hospital where several of its members are also employed.

The Norwegian Primary Care Research Network - PraksisNett

The Norwegian Primary Care Research Network (in Norwegian: PraksisNett) is a research infrastructure that provides a foundation for enhancing the quality of primary care research in Norway. The infrastructure facilitates recruitment of primary care patients to clinical studies and increases the power and predictability of these studies.  

The Norwegian PCRN will motivate researchers to conduct clinical studies by facilitating reliable and secure access to GPs, patients and clinical data. It is organised as a two-layer interdependent model: A human, resource-based infrastructure consisting of a coordinating node and four interlinked regional research networks with associated clinical practices; and an advanced, secure IT infrastructure connecting the coordinating node, the regional research networks and the clinical practices, and providing users with individual access for data extraction and processing.

Current projects

The use of hypnotics in general practice (contact person Bjørn Bjorvatn)
Many patients in general practice use hypnotics. We will investigate whether a self-help book focusing on cognitive behavioral therapy for insomnia may reduce the use of hypnotics, as well as improve sleep. Patients using hypnotics will be recruited through the GPs to answer an online questionnaire on sleep and frequency of sleep medication use. Patients are divided into two groups, of which one group is sent the self-help book and the other group is sent a sheet of sleep hygiene advice (randomized controlled trial). Thereafter, patients are followed up after 3-6 months to see if sleep and hypnotic use have changed. We plan to start the study in 2020.

Sleep problems and infections in general practice (contact person Bjørn Bjorvatn)
It is well-known that sleep problems frequently occur along with somatic conditions. On the other hand, there is little knowledge about the degree of overlap between the occurrence of sleep problems and infection in primary care. The aim of this cross-sectional study is to map the prevalence of infections and sleep problems, and to investigate the extent to which there is an overlap between these conditions in an unselected group of adult patients who visit their GP. Data collection is planned for 2020.

Restless legs in general practice (contact person Bjørn Bjorvatn)
The study aims at identifying the prevalence of restless legs syndrome in Norwegian general practice. The association between restless legs, fatigue and gastrointestinal disorders will also be investigated. The study has been conducted in an unselected group of adult patients in the waiting room of the GP. The data collection is complete, but no statistical analyses have been conducted so far.

Musculoskeletal disorders and labor (contact person Jan Sture Skouen)
NORCE, the physiotherapy research group at IGS, PraksisNett general practitioners, OsloMet and NAV are working on an application to the Research Council in 2020. The application includes an RCT study on general practices and early, targeted evaluation of patients with musculoskeletal disorders. The main outcome measure is return to work. A special model will be tested which will make it easier to pick out the risk patients earlier and at the same time establish a better dialogue with NAV and the workplace.

Gastroenteritis in primary care (contact person Guri Rørtveit)
Gastroenteritis in primary care is a registry-based project in which we investigate the prevalence of gastroenteritis in primary care (GPs and out-of-hours services) over a 10-year period from 2006-2015. We study how the health services have been used, in addition to use of antibiotics, as well as changes over time.

Respiratory infections and urinary tract infections in primary care (contact person Guri Rørtveit)
Respiratory infections and urinary tract infections in primary care is a registry-based project in which we investigate the prevalence of respiratory infections and urinary infections in primary care (GPs and out-of-hours services) over a 10-year period from 2006-2015. We study how the health services have been used, in addition to use of  antibiotics, as well as changes over time.

The Campylobacter outbreak on Askøy (contact person Guri Rørtveit)
The campylobacter outbreak in Askøy in June 2019 affected around 2,000 people. More than 70 people were hospitalized and two people died, probably related to the outbreak. Askøy municipality has about 29000 inhabitants. Issues explored in this project are the extent of the outbreak, the clinical course of the patients, biological factors and the use of the health services. We use data from questionnaires, hospitals, GPs, out-of-hours services and registries, as well as biological material. Patients are recruited primarily through the municipality's SMS notification, but also via doctors and websites. The questionnaire is answered on a website and data is stored on a secure server at UiB. We follow a cohort of Askøy inhabitants at the start of the outbreak, and after 3, 7 and 12 months.

The Giardia outbreak in Bergen (contact person Guri Rørtveit)
The 2004 Giardia outbreak in Bergen affected around 5,000 people. A group of primary care researchers, infectious medicine practitioners and statisticians have worked together over the years to investigate short-term and long-term complications. Particular focus has been on post-infectious irritable bowel syndrome and chronic fatigue. Several doctoral projects have been completed based on this project, and one is still ongoing.

Tick-borne diseases in Norwegian general practice (contact person Knut Eirik R Eliassen)
Ongoing projects are "Other tick-borne infections among erytema migrans patients in Norway", "Clinical and microbiological aspects of erytema migrans in Norwegian primary care" and a study on erytema migrans's growth rate to assess how long an erytema migrans has lasted when it is detected. In these projects we collaborate with both Norwegian, Swedish and Danish researchers, including Sørlandet Hospital in Kristiansand, Statens Seruminstitut in Copenhagen and Linköping University.

Risk testing of diabetes in pharmacies (contact person Una Ørvim Sølvik)
The purpose of the project is to investigate whether pharmacies can be an arena for identifying people at high risk of developing diabetes. A selection of pharmacies recruited participants within six months. Participants filled out a diabetes risk form and those at high risk of developing diabetes were measured with HbA1c and referred to their GP for further follow-up.

Interference of antiphospholipid antibody on various PT-INR methods in warfarin treatment (contact person Una Ørvim Sølvik)
The purpose of the project is to provide a basis for guidelines for PT-INR monitoring of warfarin therapy in patients with antiphospholipid syndrome. We must, among other things, investigate whether any of the PT-INR analytical methods most commonly used in primary care in Norway are affected by antiphospholipid antibody (APA). It will also be investigated whether any of the analytical methods provides incorrect PT-INR results outside of therapeutic range due to interference by APA, and thus has the potential to cause erroneous warfarin dosing.

Factors associated with chronic kidney disease in patients with diabetes in Norway (contact person Una Ørvim Sølvik) 
The purpose of the study is to estimate the prevalence of chronic kidney disease in patients with type 1 and type 2 diabetes in Norway, and to compare characteristics with patients with diabetes without chronic kidney failure using data from the Norwegian Adult Diabetes Register. We will also estimate the proportion of patients who may benefit from treatment with sodium glucose Co transporter 2 (SGLT2; sodium-glucose cotransporter) inhibitor.

Experience with diagnosis and follow-up of people with type 2 diabetes in Norwegian primary care (contact person Una Ørvim Sølvik)
We conducted three different focus group interviews with Norwegian GPs, where the themes were identification and follow-up of risk patients and the diagnosis process and follow-up of patients with type 2 diabetes.