Dataset Information

Factors correlated with drug use for constipation: perspectives from the 2016 open Japanese National Database.

ABSTRACT: BACKGROUND:The prevalence of chronic constipation is increased in females and with age or environmental (low temperature), racial, socioeconomic, and habitual risk factors. The impact of low outside temperature on constipation drug use remains unclear. Here, we investigated risk factors for constipation drug use by evaluating data from the Japanese National Database. METHODS:This ecological study used the 2016 open Japanese National Database of health insurance claims (prescriptions) to acquire the number of health insurance prescription claims in all 47 prefectures for drugs to relieve constipation, antihypertensives, vasodilators, as well as medical check-ups and questionnaire responses. Internet survey on room temperatures in 2010 were also used. Pearson correlation coefficients (r) between the number of population-based prescriptions for each item were calculated and multiple linear regression analysis (MLR) was performed. RESULTS:Prescriptions for magnesium laxatives significantly correlated with aging (r?=?0.58), vasodilators (r?=?0.53), being female (r?=?0.43), antihypertensives (r?=?0.39), and inversely with eating ?2?h before bedtime (r?=?-?0.37), total crime rate (r?=?-?0.33), insomnia (r?=?-?0.33), and population density (r?=?-?0.31). Stimulant laxatives (sennoside and picosulfate) were significantly correlated with antihypertensives (r?=?0.79), aging (r?=?0.69), vasodilators (r?=?0.67), and being female (r?=?0.56), and were inversely associated with average outside temperature (r?=?-?0.62), total crime rate (r?=?-?0.52), average income (r?=?-?0.51), and 30-min of vigorous exercise (r?=?-?0.44). Fecal interventions were significantly correlated with aging (r?=?0.55) and female (r?=?0.59), and inversely correlated with population density (r?=?-?0.41) and total crime rate (r?=?-?0.38). MLR analysis identified aging as the only significant risk factor for magnesium laxative use (partial slope [?]?=?1241.0). Female sex and antihypertensives were independent risk factors for stimulant laxative prescriptions (??=?44,547.0 and 0.2) and average outside temperature and 30-min of vigorous exercise were independent preventive factors (??=?-?616.8 and?-?219.1). CONCLUSION:We identified associations of magnesium laxatives with aging, stimulant laxatives with female sex, antihypertensives, low outside temperature and less 30?min of vigorous exercise.

SUBMITTER: Mihara H

PROVIDER: S-EPMC7444268 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Factors correlated with drug use for constipation: perspectives from the 2016 open Japanese National Database.

Mihara Hiroshi H Murayama Aiko A Nanjo Sohachi S Ando Takayuki T Tajiri Kazuto K Fujinami Haruka H Yamada Masaaki M Yasuda Ichiro I

BMC gastroenterology 20200824 1

<h4>Background</h4>The prevalence of chronic constipation is increased in females and with age or environmental (low temperature), racial, socioeconomic, and habitual risk factors. The impact of low outside temperature on constipation drug use remains unclear. Here, we investigated risk factors for constipation drug use by evaluating data from the Japanese National Database.<h4>Methods</h4>This ecological study used the 2016 open Japanese National Database of health insurance claims (prescriptio ...[more]

PMID: 32831027

Similar Datasets

Project description:ImportancePolysubstance use is a concern for patients treated for opioid use disorder (OUD). While buprenorphine can curtail harmful opioid use, co-occurring use of nonprescribed substances, such as cocaine, methamphetamine, and other opioids, may negatively affect treatment outcomes.ObjectiveTo characterize factors associated with urine drug positivity for nonprescribed substances among patients prescribed buprenorphine.Design, setting, and participantsThis cross-sectional study included patients who had been prescribed buprenorphine and who provided urine specimens for urine drug testing (UDT), as ordered by clinicians in primary care or behavioral health or at substance use disorder treatment centers, from 2013 to 2019. Specimens were analyzed by liquid chromatography-tandem mass spectrometry to assess positivity for several commonly used substances.ExposuresBuprenorphine prescription.Main outcomes and measuresPositivity for buprenorphine and several nonprescribed substances. Unadjusted trends in positivity for each nonprescribed substance were compared between specimens that did and did not test positive for buprenorphine. Multivariable logistic regression was used to examine factors associated with positivity; factors included patient age, sex, setting of care, payer, collection year, and census division.ResultsThe study included first UDT specimens from 150 000 patients, of whom 82 107 (54.74%) were men and 77 300 (51.53%) were aged 18 to 34 years. Across all specimens, 128 240 (85.49%) were positive for buprenorphine, and 71 373 (47.58%) were positive for 1 or more nonprescribed substances. From 2013 to 2019, positivity rates increased for most substances (eg, fentanyl: from 131 of 21 412 [0.61%] to 1464 of 13 597 [10.77%]). Factors associated with positivity varied widely by substance; for example, fentanyl positivity was highest for men (OR, 1.13; 95% CI, 1.06-1.21), patients aged 18 to 24 years (OR for patients ≥55 years, 0.46; 95% CI, 0.39-0.54), patients living in New England (OR, 1.19; 95% CI, 1.07-1.33), and patients with Medicaid (OR, 1.20; 95% CI, 1.11-1.31), whereas oxycodone positivity was greatest for women (OR for men, 0.84; 95% CI, 0.79-0.89), patients older than 55 years (OR, 1.42; 95% CI, 1.22-1.64), patients living in the South Atlantic (OR, 1.45, 95% CI, 1.33-1.58), and patients with private insurance (OR for Medicaid, 0.78; 95% CI, 0.73-0.84). Patients whose specimens were positive for buprenorphine were significantly less likely to be positive for other opioids (eg, fentanyl: OR for buprenorphine-negative samples, 6.71; 95% CI, 6.29-7.16; heroin: OR for buprenorphine-negative samples, 9.93; 95% CI, 9.31-10.59).Conclusions and relevanceIn this cross-sectional study, patterns of nonprescribed substance positivity among patients prescribed buprenorphine varied widely. This study highlights the utility of UDT in public health surveillance efforts related to patients treated with buprenorphine for OUD.

Project description:ObjectivesThere are few reports on regional differences in the supply/utilisation balance and provision of rehabilitation services. This study analysed those regional differences in Japan to help policymakers provide more uniform and efficient rehabilitation services and optimally allocate related resources.DesignAn ecological study.Setting47 prefectures and 9 regions in Japan in 2017.Primary and secondary outcome measuresPrimary measures were 'supply/utilisation (S/U) ratio', calculated by dividing rehabilitation supply converted to service units, by rehabilitation utilisation and 'utilisation/expected utilisation (U/EU) ratio', calculated by dividing utilisation by EU. The EU was defined as utilisation expected from the demography in each area. Data required to calculate these indicators were collected from open sources such as the National Database of Health Insurance Claims and Specific Health Checkups of Japan Open Data Japan.ResultsThe S/U ratios were higher in Shikoku, Kyusyu, Tohoku and Hokuriku regions, and lower in Kanto and Tokai regions. The number of rehabilitation providers per population was higher mostly in the western part of Japan and lower mostly in the eastern part. The U/EU ratios were also higher mostly in the western part, and lower mostly in the eastern part such as Tohoku and Hokuriku regions. The same trend was seen for cerebrovascular disease and musculoskeletal disorder rehabilitation, which accounted for approximately 84% of rehabilitation services. For disuse syndrome rehabilitation, such a trend did not exist, and the U/EU ratio differed by prefectures.ConclusionsThe large surplus in rehabilitation supply in the western part was attributed to the greater number of providers, while the smaller surplus in Kanto and Tokai regions was due to the smaller amount of supply. The number of rehabilitation services used was lesser in the eastern part such as Tohoku and Hokuriku regions, indicating regional differences in the provision of rehabilitation services.

Project description:BackgroundOpioid dependence is a public health crisis and surgery is a risk factor for long-term opioid use. Though minimally invasive surgery (MIS) is associated with less perioperative pain, demonstrating an association with less long-term opioid use would be another reason to justify adoption of minimally invasive techniques. We compared the rates for long-term opioid prescriptions among patients in a large national database who underwent minimally invasive and open colectomy.MethodsUsing the MarketScan Database, we retrospectively analyzed patients undergoing colon resection for benign and malignant diseases between 2013 and 2017. Among opioid-naïve patients who had ≥ 1 opioid prescriptions filled perioperatively (30 days before surgery to 14 days after discharge), propensity score matching was applied for group comparisons [open (OS) versus MIS, and laparoscopic (LS) versus robotic-assisted surgery (RS)]. The primary outcome was long-term opioid use defined as the proportion of patients with ≥ 1 long-term opioid prescriptions filled 90-180 days after discharge. Risks factors for long-term opioid use were assessed using logistic regression.ResultsAmong the 5413 matched pairs in the MIS versus OS cohorts, MIS significantly reduced long-term opioid use of 'any opioids' (13.3% vs. 20.9%), schedule II/III opioids (11.7% vs. 19.2%), and high-dose opioids (4.3% vs. 7.7%; all p < 0.001). Among the 1195 matched pairs in the RS versus LS cohorts, RS was associated with less high-dose opioids (2.1% vs. 3.8%, p = 0.015) 90-180 days after discharge. Other risk factors for long-term opioid use included younger age, benign indications, tobacco use, mental health conditions, and > 6 Charlson comorbidities.ConclusionMinimally invasive colectomy is associated with a significant reduction in long-term opioid use when compared to OS. Robotic-assisted colectomy was associated with less high-dose opioids compared to LS. Increasing adoption of minimally invasive surgery for colectomy and including RS, where appropriate, may decrease long-term opioid use.

Dataset Information

Factors correlated with drug use for constipation: perspectives from the 2016 open Japanese National Database.

Publications

Factors correlated with drug use for constipation: perspectives from the 2016 open Japanese National Database.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets