Multinational Observational Study to Understand Insulin Treatment Intensification: Japanese Subgroup Analysis of the MOSAIc Study

ObjectiveTo assess the effect of a real world, ongoing telehealth service on the use of secondary healthcare.DesignA retrospective observational study with anonymous matched controls.SettingPrimary and community healthcare. Patients were recruited over 4 years in 89 general practices in Liverpool, UK and remotely managed by a dedicated clinical team in Liverpool Community Health.Participants5154 patients with chronic obstructive pulmonary disease, heart failure or diabetes were enrolled in the programme, of whom 3562 satisfied the inclusion criteria of this study.InterventionAt least 9 weeks of telehealth including vital sign collection, questionnaires, education, support and informal coaching by clinical staff.Primary outcomeReduction in the number of emergency admissions in the 12 months after start, compared with the year before start. Secondary subgroup analysis to improve future targeting and personalisation of the service.ResultThe average number of emergency admissions for the intervention group at baseline is 0.35, 95% CI 0.32 to 0.38. The differential decrease in emergency admissions in the intervention group in comparison with the control group, the average treatment effect, is 0.08, 95 CI 0.05 to 0.11, corresponding to an average percentage decrease of 22.7%. In subgroup analysis, a score is calculated that can be used prospectively to predict individual benefit from the intervention. Patients with an above median score (37%) are predicted average reduction in emergency admissions of 0.15, 95% CI 0.09 to 0.2, corresponding to a percentage decrease in admissions of 25.3%.ConclusionThe telehealth intervention has a positive impact across a wide cohort of patients with different diseases. Prospective scoring of patients and allocation to targeted telehealth interventions is likely to improve the effectiveness and efficiency of the service.

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Real-world everolimus experience in postmenopausal HR+ HER2- advanced breast cancer women: Treat ER+ight Canadian prospective observational study 2nd subgroup analysis

Annals of Oncology ◽

10.1093/annonc/mdx365.042 ◽

2017 ◽

Vol 28 ◽

pp. v92

Author(s):

C. Doyle ◽

N. Califaretti ◽

S. Dent ◽

E. Chouinard ◽

S.R. Perri ◽

...

Keyword(s):

Breast Cancer ◽

Observational Study ◽

Advanced Breast Cancer ◽

Real World ◽

Subgroup Analysis ◽

Prospective Observational Study ◽

Advanced Breast

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What next after basal insulin? Treatment intensification with lixisenatide in Asian patients with type 2 diabetes mellitus

Journal of Diabetes ◽

10.1111/1753-0407.12515 ◽

2017 ◽

Vol 9 (6) ◽

pp. 562-574

Author(s):

Wing B. Chan ◽

Andrea Luk ◽

Wing S. Chow ◽

Vincent T.F. Yeung

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Basal Insulin ◽

Insulin Treatment ◽

Treatment Intensification ◽

Asian Patients

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LOOP, a cross-sectional, observational study investigating the clinical specialty setting as a determinant of disease management in psoriatic arthritis: Subgroup analysis results from Japan

PLoS ONE ◽

10.1371/journal.pone.0245954 ◽

2021 ◽

Vol 16 (1) ◽

pp. e0245954

Author(s):

Masato Okada ◽

Sarina Kurimoto ◽

Fabiana Ganz ◽

Wolf-Henning Boehncke

Keyword(s):

Psoriatic Arthritis ◽

Observational Study ◽

Subgroup Analysis ◽

The United States ◽

Musculoskeletal Symptoms ◽

Clinical Specialty ◽

Cross Sectional ◽

Multicenter Observational Study ◽

Dermatology Clinic ◽

The Mean

Background Psoriatic arthritis (PsA) is a progressive erosive joint disorder that causes functional impairment; therefore, early diagnosis and management are essential. This study evaluated the association between clinical specialty and the time to management in patients with PsA in Japan. Methods This was a subgroup analysis of a cross-sectional, multicenter, observational study that was conducted in 17 countries outside the United States, including 17 sites at 8 institutions in Japan, from June 2016 to October 2017. Data from consecutive patients (age ≥18 years) with a suspected or established diagnosis of PsA on a routine visit to a participating rheumatology/orthopedic or dermatology clinic in Japan were analyzed. The primary endpoints were time from onset of inflammatory musculoskeletal symptoms to PsA diagnosis, PsA diagnosis to first conventional synthetic disease-modifying antirheumatic drug (csDMARD), PsA diagnosis to first biologic DMARD (bDMARD), and first csDMARD to first bDMARD. Results Of 109 patients with a confirmed diagnosis of PsA, 39.4% (n = 43) and 60.6% (n = 66) were recruited by rheumatologists/orthopedists and dermatologists, respectively. Most patients were prescribed tumor necrosis factor inhibitors (58.7%) or methotrexate (56.0%). The mean duration from symptom onset to PsA diagnosis was significantly longer (p = 0.044) for patients treated by rheumatologists/orthopedists (70.6 months) than those treated by dermatologists (30.1 months). In the rheumatology/orthopedic and dermatology settings, the mean time from PsA diagnosis to first csDMARD administration was −0.9 and −2.9 months, and from PsA diagnosis to first bDMARD 21.4 and 14.9 months, respectively. The mean duration from administration of first csDMARD to first bDMARD was comparable in the rheumatology/orthopedic (31.8 months) and dermatology (31.5 months) settings. Conclusions Treatment approach was slightly different between rheumatology/orthopedic and dermatology setting in clinical practice in Japan, suggesting that an integrated dermo-rheumatologic approach can optimize the management of patients with PsA.

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