Complications after surgery for benign prostatic enlargement and medication use: A population-based cohort study in Ontario, Canada

2019 ◽  
Vol 18 (1) ◽  
pp. e1299
Author(s):  
R. Matta ◽  
J.R.H. Labossiere ◽  
C.J.D. Wallis ◽  
A.E. Hird ◽  
G.S. Kulkarni ◽  
...  
Keyword(s):  
Cohort Study ◽  
Medication Use ◽  
Population Based ◽  
Benign Prostatic Enlargement ◽  
Prostatic Enlargement

scholarly journals Complications after surgery for benign prostatic enlargement: a population-based cohort study in Ontario, Canada

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e032170
Author(s):  
Rano Matta ◽  
Erind Dvorani ◽  
Christopher Wallis ◽  
Amanda Hird ◽  
Joseph LaBossiere ◽  
...  
Keyword(s):  
Cohort Study ◽  
Postoperative Complication ◽  
Medical Therapy ◽  
Population Based ◽  
Secondary Outcome ◽  
Complication Rates ◽  
Benign Prostatic Enlargement ◽  
Specific Event ◽  
Prostatic Enlargement ◽  
Event Rates

ObjectivesTo examine the complication rates after benign prostatic enlargement (BPE) surgery and the effects of age, comorbidity and preoperative medical therapy.DesignA retrospective, population-based cohort study using linked administrative data.SettingOntario, Canada.Participants52 162 men≥66 years undergoing first BPE surgery between 1 January 2003 to 31 December 2014.InterventionMedical therapy preoperatively and surgery for BPE.Primary and secondary outcome measuresThe primary outcome was overall 30-day postoperative complication rates. Secondary outcomes included BPE-specific event rates (bleeding, infection, obstruction, trauma) and non-BPE specific event rates (cardiovascular, pulmonary, thromboembolic and renal). Multivariable analysis examined the association between preoperative medical therapy and postoperative complication rates.ResultsThe 30-day overall complication rate after BPE surgery was 2828 events/10 000 procedures and increased annually over the study period. Receipt of preoperative α-blocker monotherapy (relative rate (RR) 1.05; 95% CI 1.00 to 1.09; p=0.033) and antithrombotic medications (RR 1.27; 95% CI 1.22 to 1.31; p<0.0001) was associated with increased complication rates. Among the ≥80-year-old group, the rate of complications increased by 39% from 2003 to 2014 (RR 1.39; 95% CI 1.21 to 1.61; p<0.0001). The mean duration of medical and conservative management increased by a mean of 2.1 years between 2007 and 2014 (p<0.0001 for trend).ConclusionsThirty-day complication rates after BPE surgery have increased annually between 2003 and 2014. Preoperative medical therapy with alpha blockers or antithrombotics was independently associated with higher rates of complications. Over this time, the duration of conservative therapy also increased.

scholarly journals Benign prostatic enlargement is not associated with diabetes: a population-based study

Andrology ◽  
2015 ◽  
Vol 3 (5) ◽  
pp. 933-936 ◽  
Author(s):  
Y. L. Chiu ◽  
S. Kao ◽  
H. C. Lin ◽  
S. P. Liu ◽  
C. Y. Huang
Keyword(s):  
Population Based ◽  
Benign Prostatic Enlargement ◽  
Population Based Study ◽  
Prostatic Enlargement

scholarly journals Direct costs of overdiagnosed asthma: a longitudinal, population-based cohort study in British Columbia, Canada

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e031306 ◽  
Author(s):  
Bryan Ng ◽  
Mohsen Sadatsafavi ◽  
Abdollah Safari ◽  
J Mark FitzGerald ◽  
Kate M Johnson
Keyword(s):  
Cohort Study ◽  
Resource Use ◽  
Healthcare Costs ◽  
Challenge Test ◽  
Medication Use ◽  
Population Based ◽  
Methacholine Challenge ◽  
Physician Visits ◽  
Direct Healthcare Costs ◽  
Physician Diagnosis

ObjectivesA current diagnosis of asthma cannot be objectively confirmed in many patients with physician-diagnosed asthma. Estimates of resource use in overdiagnosed cases of asthma are necessary to measure the burden of overdiagnosis and to evaluate strategies to reduce this burden. We assessed differences in asthma-related healthcare resource use between patients with a confirmed asthma diagnosis and those with asthma ruled out.DesignPopulation-based, prospective cohort study.SettingParticipants were recruited through random-digit dialling of both landlines and mobile phones in the province of British Columbia, Canada.ParticipantsWe included 345 individuals ≥12 years of age with a self-reported physician diagnosis of asthma. The diagnosis of asthma was reassessed at the end of 12 months of follow-up using a structured algorithm, which included a bronchodilator reversibility test, methacholine challenge test, and if necessary medication tapering and a second methacholine challenge test.Primary and secondary outcome measuresSelf-reported annual asthma-related direct healthcare costs (2017 Canadian dollars), outpatient physician visits and medication use from the perspective of the Canadian healthcare system.ResultsAsthma was ruled out in 86 (24.9%) participants. The average annual asthma-related direct healthcare costs for participants with confirmed asthma were $C497.9 (SD $C677.9) and for participants with asthma ruled out, $C307.7 (SD $C424.1). In the adjusted analyses, a confirmed diagnosis was associated with higher direct healthcare costs (relative ratio (RR)=1.60, 95% CI 1.14 to 2.22), increased rate of specialist visits (RR=2.41, 95% CI 1.05 to 5.40) and reliever medication use (RR=1.62, 95% CI 1.09 to 2.35), but not primary care physician visits (p=0.10) or controller medication use (p=0.11).ConclusionsA quarter of individuals with a physician diagnosis of asthma did not have asthma after objective re-evaluation. These participants still consumed a significant amount of asthma-related healthcare resources. The population-level economic burden of asthma overdiagnosis could be substantial.

scholarly journals Natural history of benign prostatic enlargement: long-term longitudinal population-based study of prostate volume doubling times

2010 ◽  
Vol 105 (2) ◽  
pp. 214-219 ◽  
Author(s):  
Michael M. Lieber ◽  
Thomas Rhodes ◽  
Debra J. Jacobson ◽  
Michaela E. McGree ◽  
Cynthia J. Girman ◽  
...  
Keyword(s):  
Natural History ◽  
Prostate Volume ◽  
Population Based ◽  
Benign Prostatic Enlargement ◽  
Population Based Study ◽  
Prostatic Enlargement ◽  
History Of ◽  
Volume Doubling ◽  
Doubling Times

scholarly journals Population-Based Cohort Study of Anti-Infective Medication Use before and after the Onset of Type 1 Diabetes in Children and Adolescents

2014 ◽  
Vol 58 (8) ◽  
pp. 4666-4674 ◽  
Author(s):  
Soulmaz Fazeli Farsani ◽  
Patrick C. Souverein ◽  
Marja M. J. van der Vorst ◽  
Catherijne A. J. Knibbe ◽  
Anthonius de Boer ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Cohort Study ◽  
Children And Adolescents ◽  
Reference Group ◽  
Medication Use ◽  
Population Based ◽  
Second Line ◽  
Before And After ◽  
Reference Cohort

ABSTRACTA population-based cohort study was conducted in the Dutch PHARMO database to investigate prevalence and patterns of anti-infective medication use in children and adolescents with type 1 diabetes (T1D) before and after the onset of this disease. All patients <19 years with at least 2 insulin prescriptions (1999 to 2009) were identified (T1D cohort) and compared with an age- and sex-matched (ratio: 1 up to 4) diabetes-free reference group. The prevalence and average number of anti-infective use was studied from (up to) 8 years before until a maximum of 4 years after the onset of T1D. A total of 925 patients with T1D and 3,591 children and adolescents in the reference cohort (51% boys, mean age of 10.1 [standard deviation, 4.5] years) were included. The overall prevalence of anti-infective use (62.6 compared to 52.6%,P< 0.001) and average number of prescriptions (2.71 compared to 1.42 per child,P< 0.001) in the T1D cohort were significantly higher than those in the reference cohort after the onset of diabetes. This pattern was consistent across sex and age categories and already observed in the year before the onset of type 1 diabetes. Patients in the T1D cohort received more antibacterials (49.8 compared to 40%,P< 0.001), antimycotics (4.0 compared to 1.3%,P< 0.001), antivirals (2.5 compared to 0.4%,P< 0.001), and second-line antibiotics, such as aminoglycosides, quinolones, and third-generation cephalosporins and carbapenems. Our findings that elevated anti-infective use in the T1D cohort exists in the period before the onset of type 1 diabetes and the consumption of more second-line anti-infective compounds in this time period warrant further research.

scholarly journals Medication Use among Pregnant Women from the 2015 Pelotas (Brazil) Birth Cohort Study

2020 ◽  
Vol 17 (3) ◽  
pp. 989 ◽  
Author(s):  
Bárbara Heather Lutz ◽  
Vanessa Iribarrem Avena Miranda ◽  
Marysabel Pinto Telis Silveira ◽  
Tatiane da Silva Dal Pizzol ◽  
Sotero Serrate Mengue ◽  
...  
Keyword(s):  
Cohort Study ◽  
Pregnant Women ◽  
Birth Cohort ◽  
Medication Use ◽  
Population Based ◽  
Birth Cohort Study ◽  
Self Medication ◽  
Iron Salts ◽  
High Prevalence ◽  
Multiparous Women

Background: Medication use during pregnancy is a common practice that has been increasing in recent years. The aim of this study is to describe medication use among pregnant women from the 2015 Pelotas (Brazil) Birth Cohort Study. Methods: This paper relies on a population-based cohort study including 4270 women. Participants completed a questionnaire about the antenatal period, including information about medication use. We performed descriptive analyses of the sample and the medications used and adjusted analyses for the use of medications and self-medication. Results: The prevalence of medication use was 92.5% (95% CI 91.7–93.3), excluding iron salts, folic acid, vitamins, and other minerals. The prevalence of self-medication was 27.7% (95% CI 26.3–29.1). In the adjusted analysis, women who had three or more health problems during pregnancy demonstrated higher use of medicines. Self-medication was higher in lower income groups and among smokers and multiparous women (three pregnancies or more). Acetaminophen, scopolamine, and dimenhydrinate were the medications most commonly used. Conclusions: This study describes the pattern of drug use among pregnant women in a population-based cohort study, with a high prevalence of self-medication. Greater awareness of the risks of self-medication during pregnancy is required, focusing on groups more prone to this practice, as well as ensuring qualified multidisciplinary prenatal care.

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