scholarly journals Increased risk of adverse events in non-cancer patients with chronic and high-dose opioid use—A health insurance claims analysis

PLoS ONE ◽  
2020 ◽  
Vol 15 (9) ◽  
pp. e0238285
Author(s):  
Jakob M. Burgstaller ◽  
Ulrike Held ◽  
Andri Signorell ◽  
Eva Blozik ◽  
Johann Steurer ◽  
...  
Keyword(s):  
Health Insurance ◽  
Adverse Events ◽  
Cancer Patients ◽  
High Dose ◽  
Insurance Claims ◽  
Opioid Use ◽  
Claims Analysis ◽  
Increased Risk ◽  
Health Insurance Claims

scholarly journals Association between the course of hypnotics treatment for insomnia and work functioning impairment in Japanese workers

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243635
Author(s):  
Makoto Okawara ◽  
Tomohisa Nagata ◽  
Masako Nagata ◽  
Makoto Otani ◽  
Koji Mori ◽  
...  
Keyword(s):  
Health Insurance ◽  
Treatment Duration ◽  
Cross Sectional Study ◽  
Work Functioning ◽  
Insurance Claims ◽  
Cross Sectional ◽  
Healthcare Data ◽  
Japanese Workers ◽  
Increased Risk ◽  
Health Insurance Claims

Study objectives This cross-sectional study analyzed the effect of treatment with hypnotics for sleep disorders, particularly insomnia, on daytime work functioning by phase of treatment in Japanese workers. Methods Subjects were respondents (n = 36,375) to a questionnaire survey conducted in 2015 to assess work functioning impairment in 15 companies in Japan. The questionnaire results were analyzed together with the respondents’ healthcare data extracted from public health insurance claims. Work functioning impairment was measured using the Work Functioning Impairment Scale (WFun). The status of treatment for insomnia was determined using data on diseases and prescribed drugs extracted from health insurance claims from the past 16 months. The odds ratio of severe work functioning impairment according to on-treatment duration and off-treatment duration was estimated using logistic regression analysis. Results The risk of severe work functioning impairment was significantly higher in subjects with insomnia who were being treated with hypnotics for 1 month or longer compared to non-insomnia subjects. This increased risk tended to be reduced with longer on-treatment duration. For subjects who had previously received hypnotics treatment for insomnia, the risk of severe work functioning impairment was significantly increased in all subgroups stratified by time from discontinuation of the prescription. This increased risk tended to be reduced with longer off-treatment duration. Conclusions Workers who are or were receiving hypnotics to treat insomnia may have a higher risk of daytime functioning impairment. Those with protracted insomnia require careful assessment of the risks and benefits of prescription hypnotics.

scholarly journals Serum uric acid control for prevention of gout flare in patients with asymptomatic hyperuricaemia: a retrospective cohort study of health insurance claims and medical check-up data in Japan

2021 ◽  
pp. annrheumdis-2021-220439
Author(s):  
Ruriko Koto ◽  
Akihiro Nakajima ◽  
Hideki Horiuchi ◽  
Hisashi Yamanaka
Keyword(s):  
Uric Acid ◽  
Cohort Study ◽  
Health Insurance ◽  
Serum Uric Acid ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Disease Status ◽  
Insurance Claims ◽  
Health Insurance Claims ◽  
Gout Flare

ObjectivesIn patients with gout, treating to target serum uric acid levels (sUA) of ≤6.0 mg/dL is universally recommended to prevent gout flare. However, there is no consensus on asymptomatic hyperuricaemia. Using Japanese health insurance claims data, we explored potential benefits of sUA control for preventing gout flare in subjects with asymptomatic hyperuricaemia.MethodsThis retrospective cohort study analysed the JMDC Claims Database from April 2012 through June 2019. Subjects with sUA ≥8.0 mg/dL were identified, and disease status (prescriptions for urate-lowering therapy (ULT), occurrence of gout flare, sUA) was investigated for 1 year. Time to first onset and incidence rate of gout flare were determined by disease status subgroups for 2 years or more. The relationship between gout flare and sUA control was assessed using multivariable analysis.ResultsThe analysis population was 19 261 subjects who met eligibility criteria. We found fewer occurrences of gout flare, for both gout and asymptomatic hyperuricaemia, in patients who achieved sUA ≤6.0 mg/dL with ULT than in patients whose sUA remained >6.0 mg/dL or who were not receiving ULT. In particular, analysis by a Cox proportional-hazard model for time to first gout flare indicated that the HR was lowest, at 0.45 (95% CI 0.27 to 0.76), in subjects with asymptomatic hyperuricaemia on ULT (5.0<sUA ≤ 6.0 mg/dL), compared with untreated subjects (sUA ≥8.0 mg/dL).ConclusionsOccurrences of gout flare were reduced by controlling sUA at ≤6.0 mg/dL in subjects with asymptomatic hyperuricaemia as well as in those with gout.Trial registration numberUMIN000039985.

scholarly journals Prevalence of gout and asymptomatic hyperuricemia in the pediatric population: a cross-sectional study of a Japanese health insurance database

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Shuichi Ito ◽  
Tomoko Torii ◽  
Akihiro Nakajima ◽  
Takeshi Iijima ◽  
Hiroshi Murano ◽  
...  
Keyword(s):  
Uric Acid ◽  
Health Insurance ◽  
Pediatric Population ◽  
Gouty Arthritis ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Insurance Claims ◽  
Cross Sectional ◽  
Total Prevalence ◽  
Health Insurance Claims

Abstract Background Although gout is rare in children, chronic sustained hyperuricemia can lead to monosodium urate deposits progressing to gout, just as in adults. This study assessed prevalence and characteristics of gout and asymptomatic hyperuricemia, and incidence of gouty arthritis in the pediatric population, using data from Japanese health insurance claims. The diagnosis and treatment of pediatric gout and hyperuricemia were analyzed, and specific characteristics of those patients were assessed. Since Japanese guidelines recommend treatment with uric acid lowering drugs for asymptomatic hyperuricemia as well as for gout, these data were also used to investigate the real-world use of uric acid lowering drugs in a pediatric population. Methods This cross-sectional study was based on a 2016–2017 Japanese health insurance claims database, one of the largest epidemiology claims databases available in Japan, which included 356,790 males and 339,487 females 0–18 years of age. Outcomes were measured for prevalence, patient characteristics, treatment with uric acid lowering drugs for gout and asymptomatic hyperuricemia, and prevalence and incidence of gouty arthritis. Because uric acid can be elevated by some forms of chemotherapy, data from patients under treatment for malignancies were excluded from consideration. Results Total prevalence of gout and asymptomatic hyperuricemia in 0–18 year-olds was 0.040% (276/696,277 patients), with gout prevalence at 0.007% (48/696,277) and asymptomatic hyperuricemia at 0.033% (228/696,277). Prevalence of gout and asymptomatic hyperuricemia was highest in adolescent males, at 0.135% (176/130,823). The most common comorbidities for gout and asymptomatic hyperuricemia were metabolic syndrome at 42.8% (118/276) and kidney disease at 34.8% (96/276). Of the patients diagnosed with gout or asymptomatic hyperuricemia, 35.1% (97/276) were treated with uric acid lowering drugs. Gouty arthritis developed in 43.8% (21/48) of gout patients during the study, at an incidence of 0.65 flares/person-year. Conclusions Even the pediatric population could be affected by asymptomatic hyperuricemia, gout, and gouty arthritis, and uric acid lowering drugs are being used in this population even though those drugs have not been approved for pediatric indications. Such off-label use may indicate a potential need for therapeutic agents in this population. Trial registration UMIN000036029.

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