Article Text

Download PDFPDF

Comorbidities and the use of comedications in people living with HIV on antiretroviral therapy in Japan: a cross-sectional study using a hospital claims database
  1. Daniel J Ruzicka1,
  2. Kentaro Imai2,
  3. Kenichi Takahashi3,
  4. Toshio Naito4
  1. 1Medical Affairs, MSD K.K., Tokyo, Japan
  2. 2Oncology Clinical Development, Merck & Co., Inc., Kenilworth, New Jersey, USA
  3. 3Japan Development, MSD K.K., Tokyo, Japan
  4. 4Department of General Medicine, Juntendo University, Tokyo, Japan
  1. Correspondence to Daniel J Ruzicka; daniel.ruzicka{at}merck.com

Abstract

Objectives To investigate the prevalence of chronic comorbidities and the use of comedications in people living with HIV (PLWH) and on antiretrovirals in Japan, by using a hospital claims database.

Design Observational, retrospective, cross-sectional study.

Setting A hospital claims database of Japanese hospitals that have advanced medical treatment capabilities (ie, advanced treatment hospitals, general hospitals, acute care hospitals), which include those providing acute and chronic care (excluding nursing homes or hospices).

Participants A total of 1445 PLWH aged ≥18 years and with a prescription record of antiretrovirals between January 2010 and December 2015 were identified from the database.

Outcome measures The number and types of chronic comorbidities, as well as the number and types of comedications, in different age groups of the PLWH.

Results The median (range) age of patients was 45 (18–90) years, and 90.4% were men. Of the 1445 patients, 972 (67.3%) had at least one chronic comorbidity. Common chronic comorbidities included lipid disorders (31.6%), diabetes (26.8%), hypertension (18.2%) and hepatitis B/C coinfection (18.2%). Patients in the older age groups had greater numbers of chronic comorbidities. The most common chronic comorbidities in the older age groups were hypertension, diabetes and lipid disorders. The majority of patients used at least one comedication, and those in the older age groups used greater numbers of comedications. The most common therapeutic category of comedication included antacids, antiflatulents and antiulcerants (31.7%). Of 151 malignancies reported in 117 patients, 84 were AIDS-defining cancers and 67 were non-AIDS-defining cancers.

Conclusions Chronic comorbidities and comedications were common among PLWH in Japan taking antiretrovirals; particularly among older patients, who more frequently used comedications. This suggests the need for giving special attention to the appropriate management of this patient population.

  • comorbidity
  • HIV
  • epidemiology
  • Japan
  • infectious disease
  • polypharmacy

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

View Full Text

Statistics from Altmetric.com

Footnotes

  • Contributors DJR contributed to the study design. DJR, KI and KT contributed to the data analysis and interpretation. DJR, KI, KT and TN revised the manuscript draft critically and approved the final version of the manuscript to be published.

  • Funding This study was supported by MSD K.K., Tokyo, Japan.

  • Competing interests DJR, KI and KT are employees of MSD K.K., Tokyo, Japan. TN has received no funding for this study but received lecture fees from MSD K.K., Tokyo, Japan.

  • Patient consent Not required.

  • Ethics approval The requirement for informed consent was waived because this was an observational study using de-identified claims data and the Japanese Ethical Guidelines for Medical and Health Research Involving Human Subjects do not apply to a study exclusively using de-identified data.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data are available.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.