Observational research on medical treatment of chronic respiratory disease patients using the receipt database

2018 Fiscal Year Final Research Report

• Project/Area Number: 16K09188
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Medical and hospital managemen
• Research Institution: Nippon Medical School
• Principal Investigator: Motegi Takashi 日本医科大学, 医学部, 講師 (30386205)
• Research Collaborator: KIDA kozui ; TSURU satoko ; NAKAYAMA takeo
• Project Period (FY): 2016-04-01 – 2019-03-31
• Keywords: COPD / レセプト / 医療の質 / 増悪 / 併存症 / 生活習慣

Outline of Final Research Achievements

In order to understand the actual condition of medical care for chronic obstructive pulmonary disease (COPD), we used a database of receipts and medical examinations managed by JMDC.(1) In the medical condition survey at COPD exacerbation, 35.4% received systemic steroids, and steroids using were significantly less in the clinic than in the hospital.The median period of steroid administration was 5 days, shorter than the conventional guideline recommendation period. (2) Co-morbidity survey in patients of COPD; 1505 COPD pts, 4515 controls.In male patients of COPD, the frequency of coexistence with ischemic heart disease was significantly higher than control, but in female patients, this tendency was not observed. Gender differences were found in the frequency of co-morbidities. Concerning lifestyle habits, males showed significantly lower physical activity than the control group, but females showed significant weight gain after adulthood than control.

Free Research Field

呼吸器内科学

Academic Significance and Societal Importance of the Research Achievements

慢性閉塞性肺疾患（COPD）は呼吸器領域における生活習慣病の一つで，主に喫煙が関連している．大半がプライマリケアで診療されているが，国内COPD研究の大半は病院が主体であり，COPD全体の診療実態を反映しているとは言い難い．他方，レセプトデータベースを用いた研究では実際に行われた診療が医療機関や外来・入院を問わず全て記録されるため，個々の患者における診療実態が反映される可能性がある．本研究はレセプトを用いたCOPDの診療実態調査であり，よりリアルワールドの診療を捉えることができる点で従来研究と異なる．ガイドラインで推奨されている診療がプライマリケアではまだ不十分であることが明らかとなった．