Validation of self-reported medication use for hypertension, diabetes, and dyslipidemia among employees of large-sized companies in Japan

Medication use before and during pregnancy in Japan: the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study

PURPOSE

To elucidate the status of medication use among pregnant women in Japan, by means of a multigenerational genome and birth cohort study: the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study (TMM BirThree Cohort Study).

METHODS

Questionnaires were distributed to pregnant women participating in the TMM BirThree Cohort Study (from July 2013 to March 2017) around 12 weeks (early pregnancy) and 26 weeks (middle pregnancy). We analysed medication use over three periods: (1) 12 months prior to pregnancy diagnosis, (2) the period between pregnancy diagnosis and around week 12 of pregnancy, and (3) post around week 12 of pregnancy.

RESULTS

In total, 19,297 women were included in the analysis. The proportion of pregnant women using medications was 49.0% prior to pregnancy diagnosis, 52.1% from diagnosis to week 12, and 58.4% post week 12 of pregnancy. The most frequently prescribed medications were loxoprofen sodium hydrate (5.5%) prior to pregnancy diagnosis, magnesium oxide (5.9%) from diagnosis to week 12, and ritodrine hydrochloride (10.5%) post week 12 of pregnancy. The number of women who used suspected teratogenic medications during early pregnancy was 96 prior to pregnancy diagnosis, 48 from diagnosis to week 12, and 54 post week 12 of pregnancy.

CONCLUSION

We found that ~ 50% of the pregnant women used medications before and during pregnancy and some took potential teratogenic medications during pregnancy. In birth genomic cohort study, it is expected that investigations into the safety and effectiveness of medications used during pregnancy will advance.

Achievement rate of target blood pressure in patients with hypertension treated by hypertension specialists and non-specialists in a real-world setting

Hypertension remains a major global healthcare issue. Considering that most Japanese patients with hypertension are managed by general practitioners, hypertension specialists should be involved in actual clinical practice. We investigated the blood pressure (BP), guidelines recommended for achievement rate of the target BP, and clinical variables of patients with hypertension treated by hypertension specialists and those treated by non-specialists in a real-world setting. Factors associated with the target BP achievement in this population were also investigated. Outpatients with hypertension from 12 medical facilities in Okinawa Prefecture were enrolled (n = 1469 [specialist group, 794; non-specialist group, 675]; mean age, 64.2 years; females, 45.8%). For all patients, BP and rate of the target BP achievement were 129.0 ± 15.5/74.6 ± 10.6 mmHg, and 51.8%, respectively. BP and the rate of target of BP achievement were 128.0 ± 15.1/73.4 ± 10.4 mmHg and 56.7% in the specialist group, and they were 130.1 ± 15.9/76.0 ± 10.8 mmHg and 46.1% in the non-specialist group. The urinary salt excretion and obesity rates were comparable between the specialist and non-specialist groups. Multivariable logistic analyses indicated that hypertension specialists and good medication adherence were positive factors, whereas obesity, chronic kidney disease, diabetes mellitus, and urinary salt excretion were inverse factors associated with target BP achievement in this population. Initiatives for salt reduction, medication adherence, and proper obesity management are crucial to improving BP management in patients with hypertension. Hypertension specialists are expected to play an essential role in them. For all patients, the target blood pressure (BP) achievement rate were 51.8%. Hypertension specialists and good medication adherence were positive factors in achieving target BP; conversely, obesity, diabetes mellitus, chronic kidney disease, and high urinary salt excretion were inverse factors in achieving target BP among patients with hypertension.

Validation studies of Japanese administrative health care data: A scoping review

PURPOSE

Large-scale administrative health care databases are increasingly being utilized for research. However, there has not been much literature that validated administrative data in Japan; a previous review identified six validation studies published between 2011 and 2017. We conducted a literature review of studies that assessed the validity of Japanese administrative health care data.

METHODS

We searched for studies published by March 2022 that compared individual-level administrative data with a reference standard from another data source, as well as studies that validated administrative data using other data within the same database. The eligible studies were also summarized based on characteristics which included data types, settings, reference standard used, numbers of patients, and conditions validated.

RESULTS

There were 36 eligible studies, including 29 that used external reference standard and seven that validated administrative data using other data within the same database. Chart review was the reference standard in 21 studies (range of the numbers of patients, 72-1674; 11 studies conducted in single institutions and nine studies in 2-5 institutions). Five studies used a disease registry as the reference standard. Diagnoses of cardiovascular diseases, cancer, and diabetes were frequently evaluated.

CONCLUSIONS

Validation studies are being conducted at an increasing rate in Japan, although most of them are small scale. Further large-scale comprehensive validation studies are necessary to effectively utilize the databases for research.

Short-term associations of ambient air pollution with hospital admissions for ischemic stroke in 97 Japanese cities

The short-term association between ambient air pollution and hospital admissions for ischemic stroke is not fully understood. We examined the association between four regularly measured major ambient air pollutants, i.e., sulfur dioxide (SO₂), nitrogen dioxide (NO₂), photochemical oxidants (O_x), and particulate matter with aerodynamic diameters ≤ 2.5 μm (PM_2.5), and hospital admissions for ischemic stroke by analyzing 3 years of nationwide claims data from 97 cities in Japan. We first estimated city-specific results by using generalized additive models with a quasi-Poisson regression, and we obtained the national average by combining city-specific results with the use of random-effect models. We identified a total of 335,248 hospital admissions for ischemic stroke during the 3-year period. Our analysis results demonstrated that interquartile range increases in the following four ambient air pollutants were significantly associated with hospital admissions for ischemic stroke on the same day: SO₂ (1.05 ppb), 1.05% (95% CI: 0.59-1.50%); NO₂ (6.40 ppb), 1.10% (95% CI: 0.61-1.59%); O_x (18.32 ppb), 1.43% (95% CI: 0.81-2.06%); and PM_2.5 (7.86 μg/m³), 0.90% (95% CI: 0.35-1.45%). When the data were stratified by the hospital admittees' medication use, we observed stronger associations with SO₂, NO₂, and PM_2.5 among the patients who were taking antihypertensive drugs and weaker associations with SO₂, NO₂, and O_x among those taking antiplatelet drugs. Short-term exposure to ambient air pollution was associated with increased hospital admissions for ischemic stroke, and medication use and season may modify the association.

Trends and Patterns in Traditional Chinese Medicine Use Among Chinese Population in Late Adulthood: An Eight-Year Repeated Panel Survey

Traditional Chinese medicine (TCM), originated from China, is different from Western medicine in theory and practice. This study aimed to document the longitudinal trends and the patterns by demographical characteristics in the prevalence of TCM among the middle-aged and elderly Chinese population. This study used nationally representative longitudinal survey data from the China Health and Retirement Longitudinal Study (CHARLS), covering approximately 20,000 individuals in each panel survey from 2011 to 2018. The questions regarding medication use in the questionnaire was used to identify the TCM users. The prevalence of using TCM for treating chronic diseases among the patients with chronic diseases stabilized between 2011 and 2018, while the prevalence of TCM use for any purpose among the overall population climbed from 19.03% (95% CI 18.37% to 19.69%) in 2011 to 23.91% (95% CI 23.23% to 24.60%) in 2015. Moreover, the prevalence of TCM use for nonchronic conditions among the overall population increased during the same period as well. The TCM users were more likely to be females and city dwellers. The increasing prevalence of TCM use for any purpose among the overall population reflects the increasing influence and potentials of TCM by year. With the expected rising demand in TCM for the following decades in China, more clinical trials on safety and healthcare policy regarding TCM are merited in the future.