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  1. Article ; Online: Impact of refractory and unexplained chronic cough on disease burden: a qualitative study.

    Ueda, Naoya / Yakushiji, Anzu / Schelfhout, Jonathan / Tokita, Shigeru / Kubo, Takekazu

    BMC pulmonary medicine

    2022  Volume 22, Issue 1, Page(s) 372

    Abstract: Background: Chronic cough lasting for > 8 weeks is a common medical condition that burdens patients. This study aimed to qualitatively describe knowledge, awareness, experiences, and subtypes of burdens (physical, social, psychological) among Japanese ... ...

    Abstract Background: Chronic cough lasting for > 8 weeks is a common medical condition that burdens patients. This study aimed to qualitatively describe knowledge, awareness, experiences, and subtypes of burdens (physical, social, psychological) among Japanese patients with refractory chronic cough (refractory to treatment of underlying relevant medical conditions) and unexplained chronic cough (symptoms of unexplained origin).
    Methods: This non-interventional, cross-sectional study was conducted between February and March 2021 among patients (aged ≥ 20 years) with self-reported refractory or unexplained chronic cough. Subjects with a history of comorbid respiratory conditions were excluded. Eligible subjects participated in a 60-min online semi-structured interview. Verbatim terms from interviews were qualitatively transcribed and generated into word clouds, followed by a clustering analysis in which meaningful clusters were chosen, manually coded, and utterances and burdens categorized.
    Results: A total of 21 participants (95.2% with refractory chronic cough, mean age 53.5 years, and 76.2% being males) with Leicester Cough Questionnaire mean ± standard deviation scores of physical 4.8 ± 1.1, psychological 4.4 ± 1.3, social 4.9 ± 1.4, and total 14.1 ± 3.5 were included. The word cloud identified the most frequently used word ('cough'); etiology ('asthma'); and words associated with change in states ('influence,' 'changing,' 'change') and expressions ('tough,' 'pain,' 'hard,' 'terrible,' 'unpleasant'). The patients experienced 'mental/social burden,' 'physical burden,' 'impact on sleep and meals,' 'impact on work and housework,' 'impact on communication,' 'impact on hobbies and leisure,' and 'economic burden.' By closed coding analysis, the situations or types of burden patients experienced from the cough were ordered sequentially as emotion, working style, acquaintanceship, hobbies and leisure, and sleeping pattern.
    Conclusions: The present study indicated that there were two types of participant clusters, in which one showed mainly the burdens in the social communications such as work-related communication and another one showed the burdens of relationships with others. Also, some participants highlighted 'mental burden,' on social life due to the current pandemic. To relieve these burdens, disease awareness and knowledge should be improved for patients with refractory and unexplained chronic cough. Trial registration The trial was registered under UMIN-CTR as UMIN000042772, on 17/12/2020. The study was approved by the Medical Corporation Toukeikai Kitamachi Clinic (IRB registration number: 11001110).
    MeSH term(s) Chronic Disease ; Cost of Illness ; Cough/psychology ; Cross-Sectional Studies ; Female ; Humans ; Male ; Middle Aged ; Qualitative Research
    Language English
    Publishing date 2022-10-01
    Publishing country England
    Document type Journal Article
    ZDB-ID 2059871-3
    ISSN 1471-2466 ; 1471-2466
    ISSN (online) 1471-2466
    ISSN 1471-2466
    DOI 10.1186/s12890-022-02171-z
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Clinical characteristics and drug utilisation patterns in patients with chronic cough: a retrospective cohort study using a Japanese claims database.

    Arai, Yoko / Okuyama, Kotoba / Onishi, Yoshie / Schelfhout, Jonathan / Tokita, Shigeru / Kubo, Takekazu

    BMC pulmonary medicine

    2022  Volume 22, Issue 1, Page(s) 429

    Abstract: Background: Although unmet medical needs for better care of patients with chronic cough exist in Japan, epidemiological information about these patients and their treatments is very limited.: Objectives: To describe patient characteristics, ... ...

    Abstract Background: Although unmet medical needs for better care of patients with chronic cough exist in Japan, epidemiological information about these patients and their treatments is very limited.
    Objectives: To describe patient characteristics, underlying cough-related diseases and drug utilisation patterns in patients with chronic cough, and their changes over time.
    Methods: This large retrospective claims database study enrolled subjects with chronic cough, identified either by a specific diagnostic cough code for chronic cough (Population 1) or by multiple cough-related diagnostic codes spanning > 8 weeks (Population 2). Within Population 2, patients with each of the three most frequent diagnostic cough codes were analysed as subgroups. Patient characteristics, underlying cough-related diseases and utilisation patterns for drugs used for cough were documented at the index date, during the 6-month pre-index period and during the 12-month post-index period.
    Results: 6,038 subjects were enrolled in the cohort (Population 1: N = 3,500; Population 2: N = 2,538). The mean age was 43.7 ± 12.2 years and 61.8% were women. The largest cough diagnosis subgroups in Population 2 were 'other coughs' (N = 1,444), 'cough-variant asthma' (N = 1,026) and 'atopic/allergic cough' (N = 105). At the index date, the most frequent underlying cough-related diseases were allergic rhinitis/nasal inflammation (N = 3,132; 51.9%), asthma (N = 2,517; 41.7%) and gastro-esophageal reflux disease (N = 829; 13.7%). At the index date, 4,860 participants (80.5%) were prescribed at least one cough-related treatment. 194 participants (4.0% of medication users) were prescribed central antitussives alone, principally in Population 1, and 2,331 (48.0%) were prescribed expectorants. Other frequently prescribed medications were antiallergic drugs (N = 2,588; 53.3%), antimicrobials (N = 1,627; 34.4%) and inhaled corticosteroids with long-acting beta-agonists (N = 1,404; 28.9%). Over time, cough diagnoses tended to be lost, with only 470 participants in Population 1 retaining a diagnostic code for chronic cough one year later. The frequency of underlying cough-related diseases was stable over time.
    Conclusions: Patients in this cohort with chronic cough are most frequently identified by a diagnostic cough code for chronic cough, followed by codes for other coughs, cough-variant asthma and atopic cough. Chronic cough frequently presents with an underlying cough-related disease, most frequently allergic rhinitis/nasal inflammation, asthma or GERD. Medication prescription for the underlying cough-related diseases was generally appropriate.
    MeSH term(s) Humans ; Female ; Adult ; Middle Aged ; Male ; Cough/drug therapy ; Cough/epidemiology ; Japan/epidemiology ; Retrospective Studies ; Drug Utilization ; Gastroesophageal Reflux/drug therapy ; Gastroesophageal Reflux/epidemiology ; Asthma/complications ; Asthma/drug therapy ; Asthma/epidemiology ; Rhinitis, Allergic ; Hypersensitivity, Immediate ; Inflammation
    Language English
    Publishing date 2022-11-21
    Publishing country England
    Document type Journal Article
    ZDB-ID 2059871-3
    ISSN 1471-2466 ; 1471-2466
    ISSN (online) 1471-2466
    ISSN 1471-2466
    DOI 10.1186/s12890-022-02180-y
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  3. Article ; Online: [Adherence to Oral Antihyperglycemic Agents (Dipeptidyl Peptidase-4 Inhibitors and Biguanides) and Its Associated Factors in Patients with Type 2 Diabetes].

    Hayashi, Ai / Kubo, Takekazu / Okuyama, Kotoba / Tokita, Shigeru / Kamei, Miwako

    Yakugaku zasshi : Journal of the Pharmaceutical Society of Japan

    2019  Volume 139, Issue 12, Page(s) 1569–1581

    Abstract: To investigate medication adherence to oral antihyperglycemic agents and its associated factors in Japanese type 2 diabetic patients, a questionnaire survey was conducted in 983 adult patients receiving once-daily (QD) or twice-daily (BID) dipeptidyl ... ...

    Abstract To investigate medication adherence to oral antihyperglycemic agents and its associated factors in Japanese type 2 diabetic patients, a questionnaire survey was conducted in 983 adult patients receiving once-daily (QD) or twice-daily (BID) dipeptidyl peptidase-4 inhibitors (DPP-4 inhibitor) or BID biguanides (BG) as monotherapy at 502 pharmacies in Japan. The percentage of patients with good adherence (the proportion of days in which patients took all pills as prescribed in the past 7 days ≥80%) was high (≥90%) in any dosing regimen with no significant difference among the groups. The following factors were identified as associating with good adherence: the longer duration of type 2 diabetes (≥1 year) (p=0.002), "Feeling your disease gets worse if you don't take medications" (p=0.031), "Not forgetting to bring along your medicine when you leave home" (p=0.007), "Feeling anxiety on taking medications for long period of time" (p=0.042), "Neither feeling nor not feeling anxiety on taking medications for a long period of time" (p=0.004), "Never run out of your medicine because you get a refill on time" (p=0.035), and the lower MMAS-4 score (p<0.001). Subgroup analyses revealed that adherence of younger patients (<65 years) with BG (BID) was lower than those with DPP-4 inhibitor (QD) (p=0.021). Additionally, around 60% of patients currently prescribed with QD preferred QD regimen, and ≥80% patients prescribed with BID equally preferred once-weekly or QD regimen, suggesting a large discrepancy exists between their preference and the actual regimen in patients on BID.
    MeSH term(s) Administration, Oral ; Adult ; Aged ; Anxiety ; Biguanides/administration & dosage ; Diabetes Mellitus, Type 2/drug therapy ; Diabetes Mellitus, Type 2/psychology ; Dipeptidyl-Peptidase IV Inhibitors/administration & dosage ; Female ; Humans ; Hypoglycemic Agents/administration & dosage ; Male ; Medication Adherence/statistics & numerical data ; Middle Aged ; Young Adult
    Chemical Substances Biguanides ; Dipeptidyl-Peptidase IV Inhibitors ; Hypoglycemic Agents
    Language Japanese
    Publishing date 2019-11-13
    Publishing country Japan
    Document type Journal Article
    ZDB-ID 200514-1
    ISSN 1347-5231 ; 0031-6903 ; 0372-7750 ; 0919-2085 ; 0919-2131
    ISSN (online) 1347-5231
    ISSN 0031-6903 ; 0372-7750 ; 0919-2085 ; 0919-2131
    DOI 10.1248/yakushi.18-00197
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Incidence rate and patient characteristics of severe hypoglycemia in treated type 2 diabetes mellitus patients in Japan: Retrospective Diagnosis Procedure Combination database analysis.

    Ikeda, Yuika / Kubo, Takekazu / Oda, Eisei / Abe, Machiko / Tokita, Shigeru

    Journal of diabetes investigation

    2018  Volume 9, Issue 4, Page(s) 925–936

    Abstract: Aims/introduction: To evaluate the incidence rate of and identify factors associated with severe hypoglycemic episodes in patients with treated type 2 diabetes mellitus.: Materials and methods: Using Diagnosis Procedure Combination hospital-based ... ...

    Abstract Aims/introduction: To evaluate the incidence rate of and identify factors associated with severe hypoglycemic episodes in patients with treated type 2 diabetes mellitus.
    Materials and methods: Using Diagnosis Procedure Combination hospital-based medical database, we carried out a retrospective cohort study to assess the incidence rate of severe hypoglycemia in treated type 2 diabetes mellitus patients. We evaluated the associations between severe hypoglycemia and age, sex, complications, and current use of insulin or sulfonylurea (SU) in a nested case-control study.
    Results: Of 166,806 eligible patients, 1,242 had episodes of severe hypoglycemia during the observational period. The incidence rate of the first hypoglycemic events was 3.70/1,000 patient years. Based on the nested case-control analysis, age was associated with hypoglycemic events with adjusted odds ratios (ORs) of 1.64 or 65-74-year-old patients and 3.79 for ≥75-year-old patients in comparison with 20-64-year-old patients. Comorbidities, such as cognitive impairment, cancer, macrovascular disease and diabetic complications (retinopathy, nephropathy and neuropathy), were associated with severe hypoglycemia, with adjusted ORs ranging from 1.25 to 3.80. Severe hypoglycemic events also increased in patients with current use of both SU and insulin, either SU or insulin, with adjusted ORs of 18.36, 6.31 or 14.07, respectively, compared with patients with other antihyperglycemic agents. In patients with an SU glimepiride, adjusted ORs increased dose-dependently from 3.65 (≤1 mg) to 13.34 (>2 mg).
    Conclusions: The incidence rate of severe hypoglycemia in this cohort was 3.70/1,000 patient years. Age, cognitive impairment, cancer, diabetic complications, current use of insulin + SU and SU dosage were identified as risk factors for severe hypoglycemia.
    MeSH term(s) Adult ; Aged ; Databases, Factual ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/drug therapy ; Diabetes Mellitus, Type 2/epidemiology ; Female ; Humans ; Hypoglycemia/chemically induced ; Hypoglycemia/epidemiology ; Hypoglycemic Agents/therapeutic use ; Incidence ; Insulin/therapeutic use ; Japan ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors ; Sulfonylurea Compounds/therapeutic use ; Young Adult
    Chemical Substances Hypoglycemic Agents ; Insulin ; Sulfonylurea Compounds
    Language English
    Publishing date 2018-01-16
    Publishing country Japan
    Document type Journal Article
    ZDB-ID 2625840-7
    ISSN 2040-1124 ; 2040-1116
    ISSN (online) 2040-1124
    ISSN 2040-1116
    DOI 10.1111/jdi.12778
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  5. Article ; Online: Retrospective analysis of medical costs and resource utilization for severe hypoglycemic events in patients with type 2 diabetes in Japan.

    Ikeda, Yuika / Kubo, Takekazu / Oda, Eisei / Abe, Machiko / Tokita, Shigeru

    Journal of diabetes investigation

    2018  Volume 10, Issue 3, Page(s) 857–865

    Abstract: Aims/introduction: The present study aimed to describe hospital utilization and examine actual medical costs for severe hypoglycemic events in patients with type 2 diabetes mellitus in Japan.: Materials and methods: Medical resource utilization ... ...

    Abstract Aims/introduction: The present study aimed to describe hospital utilization and examine actual medical costs for severe hypoglycemic events in patients with type 2 diabetes mellitus in Japan.
    Materials and methods: Medical resource utilization associated with severe hypoglycemia was evaluated using a receipt database of acute-care hospitals in Japan. Patients with type 2 diabetes treated with antihyperglycemic agents were included. Severe hypoglycemic events were identified and divided into two groups: with or without hospitalization. Total and attributable medical costs per event were calculated based on the actual medical treatment after severe hypoglycemic events. Attributable costs were estimated from the receipt codes directly associated with the treatment of severe hypoglycemia.
    Results: In the hospitalized patients, the median length of hospital stay was 11 days, and the median total and attributable medical costs were ¥402,081 and ¥302,341, respectively. The majority of the hospitalized patients underwent a radiographic examination and general blood tests. Apart from the hospitalization costs, the costs associated with diagnosis accounted for 29.6% of the total medical costs. In the outpatients, 60.6% visited hospitals only once for the severe hypoglycemic event, whereas 11.4% visited hospitals daily for a week after the severe hypoglycemic event. The mean number of hospital visits of the outpatient after a severe hypoglycemic event was 2.7 ± 2.6 days. The median total and attributable medical costs were ¥265,432 and ¥4,628, respectively.
    Conclusions: Significant medical resources are used for the treatment of severe hypoglycemic events of patients with type 2 diabetes in Japan.
    MeSH term(s) Aged ; Biomarkers/analysis ; Blood Glucose/analysis ; Cost-Benefit Analysis ; Diabetes Mellitus, Type 2/drug therapy ; Diabetes Mellitus, Type 2/economics ; Emergency Service, Hospital ; Female ; Follow-Up Studies ; Glycated Hemoglobin/analysis ; Health Care Costs ; Health Resources/economics ; Hospitalization/economics ; Humans ; Hypoglycemia/chemically induced ; Hypoglycemia/diagnosis ; Hypoglycemia/economics ; Hypoglycemia/therapy ; Hypoglycemic Agents/adverse effects ; Hypoglycemic Agents/economics ; Insulin/adverse effects ; Insulin/economics ; Japan ; Male ; Prognosis ; Retrospective Studies
    Chemical Substances Biomarkers ; Blood Glucose ; Glycated Hemoglobin A ; Hypoglycemic Agents ; Insulin ; hemoglobin A1c protein, human
    Language English
    Publishing date 2018-11-17
    Publishing country Japan
    Document type Journal Article
    ZDB-ID 2625840-7
    ISSN 2040-1124 ; 2040-1116
    ISSN (online) 2040-1124
    ISSN 2040-1116
    DOI 10.1111/jdi.12959
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  6. Article ; Online: Disease burden and quality of life of patients with chronic cough in Japan: a population-based cross-sectional survey.

    Kubo, Takekazu / Tobe, Keisuke / Okuyama, Kotoba / Kikuchi, Masashi / Chen, Yirong / Schelfhout, Jonathan / Abe, Machiko / Tokita, Shigeru

    BMJ open respiratory research

    2021  Volume 8, Issue 1

    Abstract: Background: Cough lasting 3-8 and >8 weeks are defined as subacute/prolonged cough and chronic cough (CC), respectively. Studies have revealed that CC negatively impact patients' quality of life (QoL). In Japan, there is limited data on the impact of CC ...

    Abstract Background: Cough lasting 3-8 and >8 weeks are defined as subacute/prolonged cough and chronic cough (CC), respectively. Studies have revealed that CC negatively impact patients' quality of life (QoL). In Japan, there is limited data on the impact of CC on health-related quality of life (HRQoL), work productivity and activity impairment (WPAI) and healthcare resource utilisation (HRU) using validated instruments. This study aimed to estimate the burden of CC and to compare the burden among patients with CC between subgroups.
    Methods: Data from two cross-sectional online surveys conducted between September and November 2019 were combined for the analysis. Eligible patients with cough were propensity score matched to non-cough respondents. Comparisons of general HRQoL, WPAI, HRU and other symptoms experienced were conducted between matched non-cough respondents and patients with cough. Among patients with CC, subgroup comparisons were performed to understand general HRQoL, WPAI, HRU, cough-related QoL (Leicester Cough Questionnaire and Hull Airway Reflux Questionnaire) between patients with CC of different severities, patients with refractory CC and patients with non-refractory CC and patients with CC whose underlying diseases were unknown and others.
    Results: Patients with CC (n=568) in Japan reported significantly poorer HRQoL, increased WPAI, more HRU and higher proportion of psychological and sleep problems, compared with matched non-cough respondents selected from 21 415 non-cough respondents. More patients with severe CC reported significantly poorer HRQoL, increased WPAI and worse cough-related QoL. Patients with refractory CC experienced significantly greater burden measured by cough-related QoL. No significant differences were observed between patients with CC whose underlying diseases were unknown and other patients with CC in terms of general HRQoL and cough-related QoL.
    Conclusions: This study showed that patients with CC in Japan experienced significant burden compared with non-cough respondents. Patients with more severe cough and refractory CC experienced worse cough-related QoL. These results highlighted the unmet need for better interventions and treatments to reduce the burden among patients with CC.
    MeSH term(s) Cost of Illness ; Cough/epidemiology ; Cross-Sectional Studies ; Health Surveys ; Humans ; Japan/epidemiology ; Quality of Life
    Language English
    Publishing date 2021-03-27
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2736454-9
    ISSN 2052-4439 ; 2052-4439
    ISSN (online) 2052-4439
    ISSN 2052-4439
    DOI 10.1136/bmjresp-2020-000764
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  7. Article ; Online: Web-based survey to evaluate the prevalence of chronic and subacute cough and patient characteristics in Japan.

    Tobe, Keisuke / Kubo, Takekazu / Okuyama, Kotoba / Kikuchi, Masashi / Chen, Yirong / Schelfhout, Jonathan / Abe, Machiko / Tokita, Shigeru

    BMJ open respiratory research

    2021  Volume 8, Issue 1

    Abstract: Background: Cough lasting 3-8 weeks and more than 8 weeks are defined as subacute/prolonged cough and chronic cough, respectively. Japanese chronic cough population has not been well studied. This study aimed to describe the prevalence and ... ...

    Abstract Background: Cough lasting 3-8 weeks and more than 8 weeks are defined as subacute/prolonged cough and chronic cough, respectively. Japanese chronic cough population has not been well studied. This study aimed to describe the prevalence and characteristics of chronic cough and subacute cough patients in Japan. This study also sought to compare between chronic cough patients who were not greatly satisfied with treatment effectiveness for resolving cough and other chronic cough patients.
    Methods: Data from a cross-sectional online 2019 Japan National Health and Wellness Survey and a supplemental chronic cough survey were used to understand respondents' chronic cough status and their cough-specific characteristics and experience. The prevalence, patient characteristics and cough-specific characteristics were summarised descriptively. Patients who were not greatly satisfied with treatment effectiveness and other chronic cough patients were compared for their characteristics and cough severity.
    Results: The point prevalence of chronic cough was 2.89% and 12-month period prevalence was 4.29%. Among all chronic cough patients analysed, the average age was 56 years old, 61.1% were males and 29.4% were current smokers. Patients were most frequently told by a physician that cough was related to allergic rhinitis, asthma and cough variant asthma. Only 44.2% of chronic cough patients had spoken with a physician about their cough, and half of chronic cough patients did not use any medications. Patients who were not greatly satisfied with treatment effectiveness had significantly greater cough severity during past 2 weeks compared with other chronic cough patients (Visual Analogue Scale 45.34 vs 39.63).
    Conclusions: This study described the prevalence and patient characteristics information of chronic cough patients in Japan. Furthermore, the study highlighted an unmet need for better diagnosis and treatments for chronic cough patients, especially among patients who were not greatly satisfied with treatment effectiveness and reported significantly worse cough severity.
    MeSH term(s) Cough/epidemiology ; Cross-Sectional Studies ; Humans ; Internet ; Japan/epidemiology ; Male ; Middle Aged ; Prevalence ; Surveys and Questionnaires
    Language English
    Publishing date 2021-07-15
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2736454-9
    ISSN 2052-4439 ; 2052-4439
    ISSN (online) 2052-4439
    ISSN 2052-4439
    DOI 10.1136/bmjresp-2020-000832
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  8. Article ; Online: Factors associated with reluctance to initiate or continue oral antihyperglycemic agent (OAHA) treatments in type 2 diabetes mellitus patients in Japan: An observational patient-reported study.

    Kubo, Takekazu / Okuyama, Kotoba / Zhao, Xiahong / Singh, Shikha Satendra / Tokita, Shigeru

    Diabetes & metabolic syndrome

    2019  Volume 13, Issue 2, Page(s) 1201–1207

    Abstract: Background: Type 2 Diabetes Mellitus (T2DM) is undertreated in Japan. We sought to understand the potential factors associated with reluctance to initiate/continue oral antihyperglycemic agents (OAHA) treatment in Japan.: Methods: A two-phase study ... ...

    Abstract Background: Type 2 Diabetes Mellitus (T2DM) is undertreated in Japan. We sought to understand the potential factors associated with reluctance to initiate/continue oral antihyperglycemic agents (OAHA) treatment in Japan.
    Methods: A two-phase study was conducted which included cognitive interviews in the first phase (N = 12) to ensure retrieval from memory of relevant information to respond to questions. The second phase included recruitment of respondents from an internet re-contact survey (N = 560) using NHWS or other Lightspeed panels. Patients' self-reported measures were collected to identify the potential barriers to T2DM treatment initiation or continuation. All measured variables were summarized descriptively using means and standard deviations for continuous variables, and frequencies and percentages for categorical variables.
    Results: A total of 560 respondents were assessed. Of those who were drug-naïve and ever been recommended prescription medication, only 17.3% were satisfied with how physicians presented the treatment options compared to current users or those who discontinued treatment (47.2% and 47.6% respectively). More than 50% of respondents did not realize neuropathic pain and end organ damage as potential consequences of untreated T2DM. 34.8% and 47.6% of drug-naïve and T2DM respondents who discontinued treatment were likely to start/restart treatment after realizing potential complications. Among those who discontinued treatment, 23.1% were extremely dissatisfied with their dosing frequency and less than 15% reported that their physicians discussed the importance of staying on medication long-term.
    Conclusion: The potential barriers addressed in this study should be considered when planning intervention strategies targeted at T2DM patients to promote their treatment in Japan.
    MeSH term(s) Biomarkers/analysis ; Diabetes Mellitus, Type 2/drug therapy ; Diabetes Mellitus, Type 2/epidemiology ; Diabetes Mellitus, Type 2/psychology ; Female ; Follow-Up Studies ; Humans ; Hypoglycemic Agents/therapeutic use ; Japan/epidemiology ; Male ; Medication Adherence/psychology ; Medication Adherence/statistics & numerical data ; Middle Aged ; Patient Reported Outcome Measures ; Pilot Projects ; Prognosis ; Qualitative Research ; Self Report ; Surveys and Questionnaires
    Chemical Substances Biomarkers ; Hypoglycemic Agents
    Language English
    Publishing date 2019-01-22
    Publishing country Netherlands
    Document type Journal Article ; Observational Study
    ZDB-ID 2273766-2
    ISSN 1878-0334 ; 1871-4021
    ISSN (online) 1878-0334
    ISSN 1871-4021
    DOI 10.1016/j.dsx.2019.01.034
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  9. Article ; Online: Association between sleep disturbance in Alzheimer's disease patients and burden on and health status of their caregivers.

    Okuda, Shoki / Tetsuka, Jumpei / Takahashi, Kenichi / Toda, Yasuo / Kubo, Takekazu / Tokita, Shigeru

    Journal of neurology

    2019  Volume 266, Issue 6, Page(s) 1490–1500

    Abstract: Background: Sleep disturbance in Alzheimer's disease (AD) patients may have a negative impact not only on patients themselves but also on the physical and mental health of their caregivers. Detailed analysis of these issues is lacking.: Objective: ... ...

    Abstract Background: Sleep disturbance in Alzheimer's disease (AD) patients may have a negative impact not only on patients themselves but also on the physical and mental health of their caregivers. Detailed analysis of these issues is lacking.
    Objective: This study investigated the association between sleep disturbance in AD patients and the burden on, and health status of, their caregivers in Japan.
    Methods: We conducted a cross-sectional web-based questionnaire survey among caregivers of AD patients with insomnia symptoms in Japan. Demographic data and Sleep Disorders Inventory (SDI) scores for patients, caregiver burden (Burden Index of Caregivers-11 [BIC-11]) and health status, including Pittsburgh Sleep Quality Index, Patient Health Questionnaire-9, and 12-Item Short Form Health Survey v2, were collected. Multivariate analysis was used to examine the association between the burden and health status of caregivers and sleep disturbance in their care recipients with AD.
    Results: A total of 496 caregivers of AD patients with insomnia symptoms were examined in this study. We found that the BIC-11 total score increased as the SDI score increased, indicating a significant positive association, even after adjusting for confounding factors. We also found an association between sleep disturbances of AD patients and health of caregivers (sleep quality, depression, and physical/mental quality of life).
    Conclusion: This study demonstrated that sleep disturbance in AD patients was associated with an increased burden and poorer health status of caregivers. Our findings highlight the importance of sleep management in AD patients.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Alzheimer Disease/complications ; Alzheimer Disease/nursing ; Caregivers ; Cost of Illness ; Cross-Sectional Studies ; Family ; Female ; Health Status ; Humans ; Male ; Middle Aged ; Quality of Life ; Sleep Initiation and Maintenance Disorders/etiology ; Sleep Initiation and Maintenance Disorders/nursing ; Young Adult
    Language English
    Publishing date 2019-04-09
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 187050-6
    ISSN 1432-1459 ; 0340-5354 ; 0012-1037 ; 0939-1517 ; 1619-800X
    ISSN (online) 1432-1459
    ISSN 0340-5354 ; 0012-1037 ; 0939-1517 ; 1619-800X
    DOI 10.1007/s00415-019-09286-0
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article: Rho-ROCK inhibitors for the treatment of CNS injury.

    Kubo, Takekazu / Yamashita, Toshihide

    Recent patents on CNS drug discovery

    2008  Volume 2, Issue 3, Page(s) 173–179

    Abstract: Injured axons in the adult central nervous system (CNS) exhibit almost no regeneration. Several myelin-associated proteins such as myelin-associated glycoprotein (MAG), Nogo, and oligodendrocyte-myelin glycoprotein (OMgp) have been identified as ... ...

    Abstract Injured axons in the adult central nervous system (CNS) exhibit almost no regeneration. Several myelin-associated proteins such as myelin-associated glycoprotein (MAG), Nogo, and oligodendrocyte-myelin glycoprotein (OMgp) have been identified as inhibitors of CNS axonal regeneration in the CNS. Recently, repulsive guidance molecule (RGM) was identified as a potential myelin-derived neurite outgrowth inhibitor in vitro and in vivo. These axonal growth inhibitors transmit inhibitory signals through common intracellular molecules such as RhoA and its effector Rho kinases (ROCK). The effects of these axonal growth inhibitors are blocked by inhibition of the Rho-ROCK pathway in vitro. Injuries to the adult CNS induce the activation of the Rho-ROCK pathway, and the inhibition of this pathway promotes axonal regeneration and functional recovery in the injured CNS. Therefore, the Rho-ROCK pathway is a promising target for drug development for the treatment of human CNS injuries such as spinal cord injuries. This review also discusses recent patents and future developments which are useful in the treatment of human CNS injuries.
    MeSH term(s) Animals ; Central Nervous System Diseases/drug therapy ; Central Nervous System Diseases/enzymology ; Enzyme Activation/drug effects ; Enzyme Inhibitors/therapeutic use ; Humans ; Models, Biological ; Myelin Sheath/drug effects ; Neurites/drug effects ; Neurites/physiology ; rho-Associated Kinases/antagonists & inhibitors ; rho-Associated Kinases/metabolism
    Chemical Substances Enzyme Inhibitors ; rho-Associated Kinases (EC 2.7.11.1)
    Language English
    Publishing date 2008-01-02
    Publishing country United Arab Emirates
    Document type Journal Article ; Review
    ZDB-ID 2253602-4
    ISSN 2212-3954 ; 1574-8898
    ISSN (online) 2212-3954
    ISSN 1574-8898
    DOI 10.2174/157488907782411738
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