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Risk of major comorbidities among workers with hemophilia: A 14-year population-based study.

ABSTRACT: Multiple comorbidities, especially musculoskeletal dysfunction and cerebrovascular disease, remain barriers to normal social participation among persons with hemophilia (PWH). However, the relative health effects of such comorbidities on workers with hemophilia have seldom been explored. In this study, we investigated the incidence of comorbidities and their risk factors among workers with hemophilia.The study compared the incidence and risk factors of the major comorbidities of 411 workers with hemophilia enrolled in Taiwan's National Health Insurance Research Database between 1997 and 2010 with an age- and sex-matched general population.Compared with the general population, workers with hemophilia had higher risks for hemorrhagic stroke, arthritis/arthropathy, and knee/hip replacement among workers with hemophilia after multivariate adjustment, with hazard ratios (95% CI) of 4.60 (2.81-7.53), 4.03 (3.34-4.87), and 1.29 (1.10-1.41), respectively.Disorder of joints, hemophilia-related arthritis/arthropathy, hemorrhagic stroke, and knee/hip replacement remain significant comorbidities among workers with hemophilia, which will result in increased social burden. Policymakers and employers should apply appropriate interventions to help prevent productivity losses, reduced workforce participation, sick leave, and work disability among hemophilia workers.

SUBMITTER: Chu WM

PROVIDER: S-EPMC5944666 | biostudies-literature | 2018 Feb

REPOSITORIES: biostudies-literature

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Risk of major comorbidities among workers with hemophilia: A 14-year population-based study.

Chu Wei-Min WM Ho Hsin-En HE Wang Jiaan-Der JD Chan Wei-Cheng WC Liou Yi-Sheng YS Ho Wen-Chao WC Hu Sung-Yuan SY Tsan Yu-Tse YT

Medicine 20180201 6

Multiple comorbidities, especially musculoskeletal dysfunction and cerebrovascular disease, remain barriers to normal social participation among persons with hemophilia (PWH). However, the relative health effects of such comorbidities on workers with hemophilia have seldom been explored. In this study, we investigated the incidence of comorbidities and their risk factors among workers with hemophilia.The study compared the incidence and risk factors of the major comorbidities of 411 workers with ...[more]

PMID: 29419677

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Project description:BACKGROUND:The majority of patients with asthma have the mild form of the disease. Whether mild asthma patients receive appropriate asthma medications has not received much attention in the literature. We examined the trends in indicators of controller/reliever balance. METHODS:Using administrative health databases of British Columbia, Canada (2000 to 2013), we created a population-based cohort of adolescents/adults with mild asthma using validated case definition algorithms. Each patient-year of follow-up was assessed based on two markers of inappropriate medication prescription: whether the ratio of controller medications (inhaled corticosteroids [ICS] and leukotriene receptor antagonists [LTRA]) to total asthma-related prescriptions was low (cut-off 0.5 according to previous validation studies), and whether short-acting beta agonists (SABA) were prescribed inappropriately according to previously published criteria that considers SABA in relation to ICS prescriptions. Generalized linear models were used to evaluate trends and to examine the association between patient-, disease-, and healthcare-related factors and medication use. RESULTS:The final cohort consisted of 195,941 mild asthma patients (59.5% female; mean age at entry 29.6?years) contributing 1.83 million patient-years. In 48.8% of patient-years, controller medications were suboptimally prescribed, while in 7.2%, SABAs were inappropriately prescribed. There was a modest year-over-year decline in inappropriate SABA prescription (relative change -?1.3%/year, P?<?0.001) and controller-to-total-medications (relative change -?0.5%/year, P?<?0.001). Among the studied factors, the indices of type and quality of healthcare (namely respirologist consultation and receiving pulmonary function test) had the strongest associations with improvement in controller/reliever balance. CONCLUSIONS:Large number of mild asthma patients continue to be exposed to suboptimal combinations of asthma medications, and it appears there are modifiable factors associated with such phenomenon.

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Risk of major comorbidities among workers with hemophilia: A 14-year population-based study.

Publications

Risk of major comorbidities among workers with hemophilia: A 14-year population-based study.

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