The Prevalence, Characteristics, and Patient Burden of Severe Asthma Determined by Using a Japan Health Care Claims Database

Sato, Keiko; Ohno, Tomoya; Ishii, Takeo; Ito, Chie; Kaise, Toshihiko

doi:10.1016/j.clinthera.2019.08.015

Cited by 19 publications

(25 citation statements)

References 14 publications

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“…In this study that included 7,654 newly diagnosed asthma patients, the prevalence of severe asthma was stable during a 1-year follow-up period. Our result of a frequency of 2.7% of patients having severe asthma at 1 year is similar to that of 2.4% reported in a retrospective study performed in Japan that used a nationwide health care claims database [14], but somewhat lower than the commonly reported prevalence of 5-10% [15,16]. In a prior cross-sectional study in China [10], the investigators used different criteria for determining asthma severity that what was used in our study [17].…”

Section: Discussionsupporting

confidence: 85%

Newly Diagnosed Asthma in China: Initial Severity and Changes Over 1-year Management

Xuan

Zhao

et al. 2021

Preprint

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Background: The prevalence of adult asthma is increasing in China. However, there are no large sample, epidemiological data describing asthma severity at the time of new diagnosis and changes during follow-up management. Thus, the purpose of this study was to use a large health care database to examine asthma severity at initial diagnosis, and changes in severity over the first year of management.Methods: Data of patients with a first diagnosis of asthma were extracted from the SuValue electronic medical database. Inclusion criteria were: 1) At least 14 years old at the time of first diagnosis; 2) Initial diagnosis from 2001 to March 2019; 3) Followed-up for at least 12 months; 4) Had a follow-up visit every 3 months. Disease severity at diagnosis and at each follow-up visit, medications prescribed, and symptoms were collected and analysed.Results: A total of 7,654 adult patients with newly diagnosed asthma from tertiary hospitals (26.38%) and secondary hospitals (73.62%) who were followed-up for at least 12 months were included. Approximately 54% were females, and the proportion of patients over 60 years old was the highest (38%). Of all patients, 53.91% were not prescribed medications to control asthma, suggesting that these patients were mild asthma. Approximately 16% of patients were prescribed oral corticosteroid and/or inhaled corticosteroid and long-acting β2-agonist combination, suggesting moderate to severe asthma. The proportions of patients with moderate and severe decreased during the first 6 months, and then the proportions remained stable. The proportion of patients with severe asthma remained stable from the 6th month onward. At the end of the year 2.7% of patients had severe asthma. Patients with mild asthma tended to continue to have mild asthma in the following 3 months (> 76.19%). However, of the patients with mild and moderate asthma at 3 months, 92.85% and 75.1%, respectively, had a reduction in severity and had mild asthma at 12 months. On the other hand, 1.26% and 3.15%, respectively, progressed to severe asthma by 12 months.Conclusion: During the first year after an initial diagnosis of asthma patients diagnosed with mild asthma tended to not progress and remained stable with mild asthma over the year. The proportions of patients diagnosed with moderate and severe asthma remained stable over the year. Further study is needed to examine the clinical features of newly diagnosed patients with severe asthma who do not experience a reduction in severity in order to target these patients for more intensive treatment and reduce the disease burden.

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Section: Discussionsupporting

confidence: 85%

Newly Diagnosed Asthma in China: Initial Severity and Changes Over 1-year Management

Xuan

Zhao

et al. 2021

Preprint

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“…Severe asthma is estimated to affect 5-10% of the global asthma population and 8-11% of people with asthma in Japan [4,5]. A recent retrospective database study found an association between severe asthma and a significant disease burden in Japanese workers and their family members aged 15-65 years [6]. This study also suggests that Japanese patients with severe asthma are generally older than those with mild or moderate asthma.…”

Section: Introductionmentioning

confidence: 68%

“…The authors, using almost the same definitions as for the present study for asthma and severe asthma, determined that the prevalence of severe asthma was 2.4% among asthma patients. In that study, Meanwhile, the MDV database contains only records from hospitals; therefore, the outpatient visit assessment population of the present study may have included more severe cases than asthma patients in general and resulted in higher prevalence of severe asthma than those for the JMDC database study [6] across all comparable age categories. This study also assessed the burden of outpatient visits for severe asthma.…”

Section: Discussionmentioning

confidence: 99%

“…Recent studies have estimated the prevalence of severe asthma ranging from 2.4-12.7% in Japan; this variability may be explained by differences in the sources of patient data and the definitions of asthma used. One previous study used data from medical records collected by all types of facilities in a health insurance claims database managed by the Japan Medical Data Center (JMDC), which contained data from insured employees of large corporations and their family members [6]. The authors, using almost the same definitions as for the present study for asthma and severe asthma, determined that the prevalence of severe asthma was 2.4% among asthma patients.…”

Section: Discussionmentioning

confidence: 99%

“…This study also suggests that Japanese patients with severe asthma are generally older than those with mild or moderate asthma. However, the claims database used for this analysis and for other recent studies was limited only to employees, who are likely to retire around 60-65 years of age and therefore drop out from the database [4,6]. Furthermore, severe asthma places a disproportionately high burden on healthcare systems; in a number of geographic regions, it has been shown that the rates of healthcare resource utilization (HCRU) and healthcare costs are higher for patients with severe asthma compared with those with non-severe asthma [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Burden of Asthma in Elderly Japanese Patients: Using Hospital-Based Administrative Claims Data

Sato¹,

Ishii²,

Kaise³

2020

Pulm Ther

Self Cite

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Introduction: Data are lacking on severe asthma burden in elderly people in Japan. We assessed the prevalence and clinical/economic burden of severe asthma and asthma-related hospitalizations in elderly and younger Japanese patients. Methods: This retrospective study analyzed outpatient claims data and inpatient hospital discharge records among patients aged C 15 years with asthma (defined as C 2 prescriptions of inhaled corticosteroids [ICS] or ICS/long-acting beta-agonists [LABA]) between 1 July 2014 and 30 June 2017. We analyzed the outpatient visit assessment population with severe asthma (C 240-day prescription of highdose ICS and C 90-day prescription of C 1 additional controllers) and the asthma-related hospitalization population (C 1 hospital Digital Features To view digital features for this article go to

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Association between topical β-blocker use and asthma attacks in glaucoma patients with asthma: a cohort study using a claims database

Kido

Miyake

Akagi

et al. 2021

Graefes Arch Clin Exp Ophthalmol

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Purpose To investigate the association between the use of topical β-blockers and subsequent asthma attacks in glaucoma patients with asthma. Methods This was a retrospective longitudinal cohort study using an administrative claims database. All patients aged 20 years or older who were registered in the health insurance claims database updated and managed by JMDC Inc. (Tokyo, Japan). Patients who were newly prescribed eye drops for glaucoma treatment were identified between 2011 and 2017. The patients with glaucoma were divided into two groups: β-blocker users and non-β-blocker users, based on the presence of a β-blocker in the prescribed eye drops. We investigated whether the incidence of asthma attacks in patients with previously treated asthma differed between the two groups. Results We categorized 17,666 patients in the β-blocker-user group and 12,609 patients in the non-β-blocker-user group. A total of 580 patients in the β-blocker group (3.28%) and 847 in the non-β-blocker group (6.72%) underwent asthma treatment before the prescription of anti-glaucoma eye drops (P < 0.001). Furthermore, 94 patients in the β-blocker-user group (0.53%) and 278 in the non-β-blocker user group (2.20%) were undergoing current treatment for asthma (P < 0.001). The adjusted hazard ratios of asthma attacks were 0.73 (95% confidence interval, 0.46-1.16, P = 0.18) in patients with a history of asthma treatment and 1.22 (95% confidence interval, 0.56-2.70, P = 0.62) in patients with current asthma treatment, compared to the non-β-blocker-user group. Conclusion Our results clarified that several patients with asthma were prescribed topical β-blockers for glaucoma treatment. However, asthma attacks may not be significantly attributed to topical β-blockers, even in glaucoma patients under current asthma treatment. The administration of topical β-blockers to asthma patients could be a treatment option in the absence of other treatment options, if adequate informed consent is obtained. Further studies are needed to draw a firm conclusion on this clinical question. Key messagesβ-blockers may exacerbate asthma even when used topically due to their drug properties, but a direct causal relationship with asthma attacks has not been proven. This was a retrospective cohort study using a health insurance claims database to elucidate a clinical question that cannot be addressed as a prospective study. As a result, although contraindicated, a considerable number of asthma patients with glaucoma were treated with eye drops containing β-blockers. However, consequent asthma attacks may not be significantly attributed to using topical β-blockers.

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The Prevalence, Characteristics, and Patient Burden of Severe Asthma Determined by Using a Japan Health Care Claims Database

Cited by 19 publications

References 14 publications

Newly Diagnosed Asthma in China: Initial Severity and Changes Over 1-year Management

Newly Diagnosed Asthma in China: Initial Severity and Changes Over 1-year Management

Burden of Asthma in Elderly Japanese Patients: Using Hospital-Based Administrative Claims Data

Association between topical β-blocker use and asthma attacks in glaucoma patients with asthma: a cohort study using a claims database

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