Association of pharmacological treatments for hypertension, diabetes, and dyslipidemia with health checkup participation and identification of disease control factors among older adults in Tokyo, Japan
Association of pharmacological treatments for hypertension, diabetes, and dyslipidemia with health checkup participation and identification of disease control factors among older adults in Tokyo, Japan
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DOI：
10.1016/j.pmedr.2019.101033
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发表时间：
2020-03-01
影响因子：
2.8
通讯作者：
Ito, Hideki
中科院分区：
文献类型：
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作者：
Mitsutake, Seigo;Ishizaki, Tatsuro;Ito, Hideki
日本政府鼓励老年人参加旨在检测高血压、糖尿病和血脂异常等生活方式疾病的年度健康检查。然而，已经在接受这些疾病治疗的个人不太可能从参与健康检查中受益。这项对老年人的回顾性队列研究评估了这些疾病的药物治疗与健康体检参与率的关系，并确定了接受治疗的患者中的疾病控制因素。利用2013年9月至2014年8月期间居住在日本东京的820,215名75岁老年人的医疗索赔数据和健康体检数据，我们使用二元Logistic回归分析检验了药物治疗与健康体检参与率之间的关联。接下来，接受药物治疗的患者根据他们的血压、血红蛋白A1c水平和血脂水平被分为强化、中度或有限疾病控制；多项Logistic回归分析用于识别疾病控制因素。结果显示，接受药物治疗的患者比未接受治疗的患者更有可能参与健康检查(优势比：1.374；P<；0.001)。加强疾病控制的患者比中度控制的患者更有可能达到90岁并使用家庭医疗护理。我们的发现表明，将健康检查的重点从简单地识别高危患者转移到支持疾病管理可能是有益的。从将医疗索赔和健康检查数据联系起来的数据库中获得的信息可能会改善对老年人疾病控制的评估，并有助于简化医疗保健系统。
The Japanese government encourages older adults to participate in annual health checkups designed to detect lifestyle diseases such as hypertension, diabetes, and dyslipidemia. However, individuals who are already being treated for these diseases are unlikely to benefit from health checkup participation. This retrospective cohort study of older adults evaluated the associations of pharmacological treatments for these diseases with health checkup participation and identified the disease control factors among patients receiving treatments. Using medical claims data and health checkup data between September 2013 and August 2014 from 820,215 older adults aged >= 75 years residing in Tokyo, Japan, we examined the associations between pharmacological treatments and health checkup participation using binary logistic regression analysis. Next, patients receiving pharmacological treatments were categorized into intensive, moderate, or limited disease control based on their blood pressure, hemoglobin A1c levels, and lipid levels; multinomial logistic regression analyses were used to identify the disease control factors. The results showed that patients receiving pharmacological treatments were more likely (odds ratio: 1.374; P < 0.001) to participate in health checkups than patients not receiving treatments. Patients with intensive disease control were more likely to be aged >= 90 years and use home medical care than patients with moderate control. Our findings suggest that it may be beneficial to shift the focus of health checkups from simply identifying at-risk patients to also supporting disease management. Information obtained from databases that link medical claims and health checkup data may improve evaluations of disease control in older adults and help to streamline healthcare systems.