Public support for patients with intractable diseases in Japan : impact on clinical indicators from nationwide registries in patients with autosomal dominant polycystic kidney disease
© 2023. The Author(s), under exclusive licence to The Japanese Society of Nephrology..
BACKGROUND: Clinical practice guidelines recommend antihypertensive and tolvaptan therapies for patients with autosomal dominant polycystic kidney disease (ADPKD) in Japan. However, tolvaptan therapy may pose an economic burden. The Japanese Ministry of Health, Labour and Welfare supports patients with intractable diseases. This study aimed to confirm the impact of the intractable disease system in Japan on the clinical treatment of ADPKD.
METHODS: We analyzed the data of 3768 patients with ADPKD having a medical subsidy certificate from the Japanese Ministry of Health, Labour and Welfare in 2015-2016. The following quality indicators were use: the adherence rate to the 2014 clinical practice guideline for polycystic kidney disease (prescription rates of antihypertensive agents and tolvaptan in this cohort) and the number of Japanese patients with ADPKD nationwide started on renal replacement therapy in 2014 and 2020.
RESULTS: Compared with new applications from 2015 to 2016, the prescription rates of antihypertensives and tolvaptan for the indicated patients at the 2017 renewal application increased by 2.0% (odds ratio = 1.41, p = 0.008) and 47.4% (odds ratio = 10.1, p > 0.001), respectively. These quality indicators improved with antihypertensive treatment, especially in patients with chronic kidney disease stages 1-2 (odds ratio = 1.79, p = 0.013) and in those aged < 50 years (odds ratio = 1.70, p = 0.003). The number of patients with ADPKD who were started on renal replacement therapy in Japan decreased from 999 in 2014 to 884 in 2020 in the nationwide database (odds ratio = 0.83, p < 0.001).
CONCLUSIONS: The Japanese public intractable disease support system contributes to improvement of ADPKD treatment.
| Errataetall: | |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:27 |
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| Enthalten in: |
Clinical and experimental nephrology - 27(2023), 10 vom: 27. Okt., Seite 809-818 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Kataoka, Hiroshi [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 18.09.2023 Date Revised 04.11.2023 published: Print-Electronic ErratumIn: Clin Exp Nephrol. 2023 Nov 4;:. - PMID 37924433 Citation Status MEDLINE |
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| doi: |
10.1007/s10157-023-02372-8 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM358694396 |
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| 245 | 1 | 0 | |a Public support for patients with intractable diseases in Japan |b impact on clinical indicators from nationwide registries in patients with autosomal dominant polycystic kidney disease |
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| 500 | |a Date Revised 04.11.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a ErratumIn: Clin Exp Nephrol. 2023 Nov 4;:. - PMID 37924433 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023. The Author(s), under exclusive licence to The Japanese Society of Nephrology. | ||
| 520 | |a BACKGROUND: Clinical practice guidelines recommend antihypertensive and tolvaptan therapies for patients with autosomal dominant polycystic kidney disease (ADPKD) in Japan. However, tolvaptan therapy may pose an economic burden. The Japanese Ministry of Health, Labour and Welfare supports patients with intractable diseases. This study aimed to confirm the impact of the intractable disease system in Japan on the clinical treatment of ADPKD | ||
| 520 | |a METHODS: We analyzed the data of 3768 patients with ADPKD having a medical subsidy certificate from the Japanese Ministry of Health, Labour and Welfare in 2015-2016. The following quality indicators were use: the adherence rate to the 2014 clinical practice guideline for polycystic kidney disease (prescription rates of antihypertensive agents and tolvaptan in this cohort) and the number of Japanese patients with ADPKD nationwide started on renal replacement therapy in 2014 and 2020 | ||
| 520 | |a RESULTS: Compared with new applications from 2015 to 2016, the prescription rates of antihypertensives and tolvaptan for the indicated patients at the 2017 renewal application increased by 2.0% (odds ratio = 1.41, p = 0.008) and 47.4% (odds ratio = 10.1, p > 0.001), respectively. These quality indicators improved with antihypertensive treatment, especially in patients with chronic kidney disease stages 1-2 (odds ratio = 1.79, p = 0.013) and in those aged < 50 years (odds ratio = 1.70, p = 0.003). The number of patients with ADPKD who were started on renal replacement therapy in Japan decreased from 999 in 2014 to 884 in 2020 in the nationwide database (odds ratio = 0.83, p < 0.001) | ||
| 520 | |a CONCLUSIONS: The Japanese public intractable disease support system contributes to improvement of ADPKD treatment | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Antihypertensive | |
| 650 | 4 | |a Autosomal dominant polycystic kidney disease | |
| 650 | 4 | |a Clinical indicator | |
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| 700 | 1 | |a Shimada, Yosuke |e verfasserin |4 aut | |
| 700 | 1 | |a Kimura, Tomonori |e verfasserin |4 aut | |
| 700 | 1 | |a Nishio, Saori |e verfasserin |4 aut | |
| 700 | 1 | |a Nakatani, Shinya |e verfasserin |4 aut | |
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| 700 | 1 | |a Hattanda, Fumihiko |e verfasserin |4 aut | |
| 700 | 1 | |a Kawano, Haruna |e verfasserin |4 aut | |
| 700 | 1 | |a Hanaoka, Kazushige |e verfasserin |4 aut | |
| 700 | 1 | |a Hidaka, Sumi |e verfasserin |4 aut | |
| 700 | 1 | |a Ichikawa, Daisuke |e verfasserin |4 aut | |
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| 700 | 1 | |a Uchiyama, Kiyotaka |e verfasserin |4 aut | |
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| 700 | 1 | |a Shimabukuro, Wataru |e verfasserin |4 aut | |
| 700 | 1 | |a Fujimaru, Takuya |e verfasserin |4 aut | |
| 700 | 1 | |a Miura, Kenichiro |e verfasserin |4 aut | |
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| 700 | 1 | |a Muto, Satoru |e verfasserin |4 aut | |
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