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

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.

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

BMC Pediatrics ◽

10.1186/s12887-020-02379-0 ◽

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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Real-world treatment of gout and asymptomatic hyperuricemia: A cross-sectional study of Japanese health insurance claims data

Modern Rheumatology ◽

10.1080/14397595.2020.1784556 ◽

2020 ◽

Vol 31 (1) ◽

pp. 261-269 ◽

Cited By ~ 4

Author(s):

Ruriko Koto ◽

Akihiro Nakajima ◽

Hideki Horiuchi ◽

Hisashi Yamanaka

Keyword(s):

Health Insurance ◽

Real World ◽

Claims Data ◽

Cross Sectional Study ◽

Sectional Study ◽

Insurance Claims ◽

Cross Sectional ◽

Insurance Claims Data ◽

Health Insurance Claims Data ◽

Health Insurance Claims

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FRI0678 PREVALENCE, PATIENT CHARACTERISTICS, AND TREATMENT OF GOUT AND ASYMPTOMATIC HYPERURICEMIA IN JAPAN: CROSS-SECTIONAL STUDY OF A HEALTH INSURANCE CLAIMS DATABASE

10.1136/annrheumdis-2019-eular.4466 ◽

2019 ◽

Author(s):

Ruriko Koto ◽

Akihiro Nakajima ◽

Hideki Horiuchi ◽

Hisashi Yamanaka

Keyword(s):

Health Insurance ◽

Patient Characteristics ◽

Cross Sectional Study ◽

Sectional Study ◽

Insurance Claims ◽

Cross Sectional ◽

Claims Database ◽

Health Insurance Claims

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2318. Prevalence of Influenza-like Illness in Sheltered Homeless Populations: A Cross-Sectional Study in Seattle, WA

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.1996 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S795-S795 ◽

Cited By ~ 1

Author(s):

Julia H Rogers ◽

Elisabeth Brandstetter ◽

Caitlin Wolf ◽

Jennifer Logue ◽

Ashley E Kim ◽

...

Keyword(s):

Health Insurance ◽

Lung Disease ◽

Chronic Lung Disease ◽

Respiratory Illness ◽

Cross Sectional Study ◽

Chronic Obstructive ◽

Sectional Study ◽

Cross Sectional ◽

Influenza Like Illness ◽

Increased Risk

Abstract Background Individuals experiencing homelessness are at an increased risk of respiratory illness due to high prevalence of underlying chronic conditions, inadequate ventilation and crowding in shelters, and difficulty accessing health services. Few studies have investigated the prevalence and transmission of viral respiratory infections within shelters. We sought to determine the prevalence and risk factors for influenza-like illness (ILI) at two homeless shelters in Seattle, WA. Methods Between January and April 2019, we conducted a cross-sectional study of adults experiencing homelessness who identified their primary residence as one of the two shelters in Seattle. Participants voluntarily enrolled if they self-reported at least two symptoms of acute respiratory illness in the past week. Demographic, clinical, and behavioral data were ascertained via questionnaire, and a mid-nasal swab was collected. ILI was defined as fever with cough or sore throat. Chronic lung disease was defined as chronic obstructive pulmonary disease, asthma, and/or chronic bronchitis. Results Among the 480 participants enrolled in the study, 204 (42.5%) reported ILI symptoms. Of those enrolled, 144 (30.0%) had chronic lung disease. The prevalence of ILI was higher among individuals with chronic lung disease (53.5% vs. 42.5%, P = 0.001). A total of 422 (87.9%) had health insurance; the prevalence of ILI was lower among those with health insurance (42.4% vs. 57.8%, P = 0.66). 216 (45.0%) of participants received flu vaccine; the prevalence of ILI was similar among those who received the vaccine than those that did not (42.6% vs. 42.4%, P = 1.00). 129 (30.6%) of those with health insurance sought care for their reported symptoms; ILI was more prevalent in those that sought care than those that did not throughout the observation period (33.8% vs. 21.7%, P = 0.002). Of those with ILI that sought care, 46 (54.8%, P = 0.42) received antivirals or antibiotics. Laboratory results for the corresponding mid-nasal swabs are pending. Conclusion A large proportion of our study population self-reported ILI and chronic lung disease. Despite high insurance coverage, a low proportion of homeless enrolled sought care for their symptoms or received treatment. Disclosures All authors: No reported disclosures.

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Increased Risk of Hospitalization for Heart Failure with Newly Prescribed Dipeptidyl Peptidase-4 Inhibitors and Pioglitazone Using the Korean Health Insurance Claims Database

Diabetes & Metabolism Journal ◽

10.4093/dmj.2015.39.3.247 ◽

2015 ◽

Vol 39 (3) ◽

pp. 247 ◽

Cited By ~ 18

Author(s):

Sunghwan Suh ◽

Gi Hyeon Seo ◽

Chang Hee Jung ◽

Mee-Kyoung Kim ◽

Sang-Man Jin ◽

...

Keyword(s):

Heart Failure ◽

Health Insurance ◽

Dipeptidyl Peptidase ◽

Insurance Claims ◽

Claims Database ◽

Dipeptidyl Peptidase 4 ◽

Increased Risk ◽

Dipeptidyl Peptidase 4 Inhibitors ◽

Health Insurance Claims

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Prevalence of type 2 diabetes by age, sex and geographical area among two million public assistance recipients in Japan: a cross-sectional study using a nationally representative claims database

Journal of Epidemiology & Community Health ◽

10.1136/jech-2020-216158 ◽

2021 ◽

pp. jech-2020-216158

Author(s):

Tami Sengoku ◽

Tatsuro Ishizaki ◽

Yoshihito Goto ◽

Tomohide Iwao ◽

Shosuke Ohtera ◽

...

Keyword(s):

Health Insurance ◽

Regional Differences ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Health Insurance Claims ◽

The City ◽

Crude Prevalence ◽

Age And Sex

BackgroundRecognising the importance of the social determinants of health, the Japanese government introduced a health management support programme targeted at type 2 diabetes (T2D) for public assistance recipients (PAR) in 2018. However, evidence of the T2D prevalence among PAR is lacking. We aimed to estimate T2D prevalence by age and sex among PAR, compared with the prevalence among health insurance enrollees (HIE). Additionally, regional differences in T2D prevalence among PAR were examined.MethodsThis was a cross-sectional study using 1-month health insurance claims of both PAR and HIE. The Fact-finding Survey data on Medical Assistance and the National Database of Health Insurance Claims data were used. T2D prevalence among PAR and HIE were assessed by age and sex, respectively. Moreover, to examine regional differences in T2D prevalence of inpatients and outpatients among PAR, T2D crude prevalence and age-standardised prevalence were calculated by prefecture. Multilevel logistic regression analysis was also conducted at the city level.ResultsT2D crude prevalence was 7.7% in PAR (inpatients and outpatients). Among outpatients, the prevalence was 7.5% in PAR and 4.1% in HIE, respectively. The mean crude prevalence and age-standardised prevalence of T2D (inpatients and outpatients) among 47 prefectures were 7.8% and 3.9%, respectively. In the city-level analysis, the OR for the prevalence of T2D by region ranged from 0.31 to 1.51.ConclusionThe prevalence of T2D among PAR was higher than HIE and there were regional differences in the prevalence of PAR. Measures to prevent the progression of diabetes among PAR by region are needed.

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Association between teleworking frequency and work functioning impairment: a nationwide cross-sectional study of Japanese full-time employees

10.1101/2021.11.04.21265947 ◽

2021 ◽

Author(s):

Satoshi Yamashita ◽

Tomohiro Ishimaru ◽

Tomohisa Nagata ◽

Seiichiro Tateishi ◽

Ayako Hino ◽

...

Keyword(s):

Influencing Factors ◽

Cross Sectional Study ◽

Full Time ◽

Work Functioning ◽

Sectional Study ◽

Cross Sectional ◽

Japanese Workers ◽

Commuting Time ◽

The Impact ◽

Self Administered Questionnaire

Objective: We examined the impact of teleworking frequency, including influencing factors and work functioning impairment. Methods: This online cross-sectional study was conducted using a self-administered questionnaire among 27,036 full-time Japanese workers. We used the Work Functioning Impairment Scale to measure work functioning impairment and performed multilevel logistic regression analysis. Results: We observed higher odds for work functioning impairment among employees who teleworked 4 or more days a week compared with those almost never teleworked: odds ratio (OR) 1.18, 95% confidence interval (CI) 1.07-1.3. After adjusting for influencing factors (teleworking preference, changes in working time, and commuting time), there was no significant association between teleworking frequency and work functioning impairment (OR 0.93, 95% CI 0.82-1.05). Conclusions: Frequent telework may cause work functioning impairment; this can be explained by the impact of influencing factors.

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