Factors associated with death, hospitalization, resignation, and sick leave from work among patients with schizophrenia in Japan: a nested case–control study using a large claims database
Abstract Background Premature mortality, frequent relapse that easily leads to hospitalization, and discontinuous employment are key challenges for the treatment of schizophrenia. We evaluated risk factors for important clinical outcomes (death, hospitalization, resignation, and sick leave from work...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2024-01-01
|
| Series: | BMC Psychiatry |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12888-023-05474-5 |
| _version_ | 1797362990820884480 |
|---|---|
| author | Ken Inada Yoshitaka Saito Kenji Baba Daisuke Fukui Yuriko Masuda Sachie Inoue Takahiro Masuda |
| author_facet | Ken Inada Yoshitaka Saito Kenji Baba Daisuke Fukui Yuriko Masuda Sachie Inoue Takahiro Masuda |
| author_sort | Ken Inada |
| collection | DOAJ |
| description | Abstract Background Premature mortality, frequent relapse that easily leads to hospitalization, and discontinuous employment are key challenges for the treatment of schizophrenia. We evaluated risk factors for important clinical outcomes (death, hospitalization, resignation, and sick leave from work) in patients with schizophrenia in Japan. Methods A nested case–control study was conducted for patients with schizophrenia identified in a Japanese claims database. For each outcome, the case was matched with up to four controls of the same age, sex, index year, and enrollment status (employee or dependent family). Potential risk factors were defined by prescriptions or diagnoses within 3 months prior to or in the month of the event. The association among potential risk factors and each outcome was evaluated using multivariable conditional logistic regression analysis with stepwise variable selection. Results The number of cases and eligible patients for each outcome were 144 and 38,451 (death), 1,520 and 35,225 (hospitalization), 811 and 18,770 (resignation), and 4,590 and 18,770 (sick leave), respectively. Depression was a risk factor for death (odds ratio [OR]: 1.92; 95% confidence interval [CI]: 1.12, 3.29), hospitalization (OR: 1.22; 95% CI: 1.05, 1.42), and sick leave from work (OR: 1.46; 95% CI: 1.36, 1.57). Other risk factors for death were hospitalization history, Charlson Comorbidity Index (CCI) score, and prescription for laxatives. Prescriptions for hypnotics, laxatives, and anticholinergics were risk factors for hospitalization. Prescriptions for hypnotics and anticholinergics were risk factors for resignation. CCI score, prescription for hypnotics, laxatives, and antidiabetics were risk factors for sick leave from work. Conclusions Our findings suggest that depression and some physical symptoms, such as constipation and extrapyramidal symptoms, are risk factors for important clinical outcomes in patients with schizophrenia. Attention should be paid to both depression and physical symptoms for the treatment of schizophrenia. |
| first_indexed | 2024-03-08T16:15:09Z |
| format | Article |
| id | doaj.art-4e5524a7887545479846113b8170d71a |
| institution | Directory Open Access Journal |
| issn | 1471-244X |
| language | English |
| last_indexed | 2024-03-08T16:15:09Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Psychiatry |
| spelling | doaj.art-4e5524a7887545479846113b8170d71a2024-01-07T12:38:31ZengBMCBMC Psychiatry1471-244X2024-01-012411810.1186/s12888-023-05474-5Factors associated with death, hospitalization, resignation, and sick leave from work among patients with schizophrenia in Japan: a nested case–control study using a large claims databaseKen Inada0Yoshitaka Saito1Kenji Baba2Daisuke Fukui3Yuriko Masuda4Sachie Inoue5Takahiro Masuda6Department of Psychiatry, Kitasato University School of MedicineDepartment of Psychiatry, Kitasato University School of Medicine Medical Science, Sumitomo Pharma Co., Ltd.Global Data Design Office, Sumitomo Pharma Co., Ltd.CRECON Medical Assessment IncCRECON Medical Assessment Inc Medical Science, Sumitomo Pharma Co., Ltd.Abstract Background Premature mortality, frequent relapse that easily leads to hospitalization, and discontinuous employment are key challenges for the treatment of schizophrenia. We evaluated risk factors for important clinical outcomes (death, hospitalization, resignation, and sick leave from work) in patients with schizophrenia in Japan. Methods A nested case–control study was conducted for patients with schizophrenia identified in a Japanese claims database. For each outcome, the case was matched with up to four controls of the same age, sex, index year, and enrollment status (employee or dependent family). Potential risk factors were defined by prescriptions or diagnoses within 3 months prior to or in the month of the event. The association among potential risk factors and each outcome was evaluated using multivariable conditional logistic regression analysis with stepwise variable selection. Results The number of cases and eligible patients for each outcome were 144 and 38,451 (death), 1,520 and 35,225 (hospitalization), 811 and 18,770 (resignation), and 4,590 and 18,770 (sick leave), respectively. Depression was a risk factor for death (odds ratio [OR]: 1.92; 95% confidence interval [CI]: 1.12, 3.29), hospitalization (OR: 1.22; 95% CI: 1.05, 1.42), and sick leave from work (OR: 1.46; 95% CI: 1.36, 1.57). Other risk factors for death were hospitalization history, Charlson Comorbidity Index (CCI) score, and prescription for laxatives. Prescriptions for hypnotics, laxatives, and anticholinergics were risk factors for hospitalization. Prescriptions for hypnotics and anticholinergics were risk factors for resignation. CCI score, prescription for hypnotics, laxatives, and antidiabetics were risk factors for sick leave from work. Conclusions Our findings suggest that depression and some physical symptoms, such as constipation and extrapyramidal symptoms, are risk factors for important clinical outcomes in patients with schizophrenia. Attention should be paid to both depression and physical symptoms for the treatment of schizophrenia.https://doi.org/10.1186/s12888-023-05474-5SchizophreniaDepressionDeathHospitalizationContinuous employmentJapan |
| spellingShingle | Ken Inada Yoshitaka Saito Kenji Baba Daisuke Fukui Yuriko Masuda Sachie Inoue Takahiro Masuda Factors associated with death, hospitalization, resignation, and sick leave from work among patients with schizophrenia in Japan: a nested case–control study using a large claims database BMC Psychiatry Schizophrenia Depression Death Hospitalization Continuous employment Japan |
| title | Factors associated with death, hospitalization, resignation, and sick leave from work among patients with schizophrenia in Japan: a nested case–control study using a large claims database |
| title_full | Factors associated with death, hospitalization, resignation, and sick leave from work among patients with schizophrenia in Japan: a nested case–control study using a large claims database |
| title_fullStr | Factors associated with death, hospitalization, resignation, and sick leave from work among patients with schizophrenia in Japan: a nested case–control study using a large claims database |
| title_full_unstemmed | Factors associated with death, hospitalization, resignation, and sick leave from work among patients with schizophrenia in Japan: a nested case–control study using a large claims database |
| title_short | Factors associated with death, hospitalization, resignation, and sick leave from work among patients with schizophrenia in Japan: a nested case–control study using a large claims database |
| title_sort | factors associated with death hospitalization resignation and sick leave from work among patients with schizophrenia in japan a nested case control study using a large claims database |
| topic | Schizophrenia Depression Death Hospitalization Continuous employment Japan |
| url | https://doi.org/10.1186/s12888-023-05474-5 |
| work_keys_str_mv | AT keninada factorsassociatedwithdeathhospitalizationresignationandsickleavefromworkamongpatientswithschizophreniainjapananestedcasecontrolstudyusingalargeclaimsdatabase AT yoshitakasaito factorsassociatedwithdeathhospitalizationresignationandsickleavefromworkamongpatientswithschizophreniainjapananestedcasecontrolstudyusingalargeclaimsdatabase AT kenjibaba factorsassociatedwithdeathhospitalizationresignationandsickleavefromworkamongpatientswithschizophreniainjapananestedcasecontrolstudyusingalargeclaimsdatabase AT daisukefukui factorsassociatedwithdeathhospitalizationresignationandsickleavefromworkamongpatientswithschizophreniainjapananestedcasecontrolstudyusingalargeclaimsdatabase AT yurikomasuda factorsassociatedwithdeathhospitalizationresignationandsickleavefromworkamongpatientswithschizophreniainjapananestedcasecontrolstudyusingalargeclaimsdatabase AT sachieinoue factorsassociatedwithdeathhospitalizationresignationandsickleavefromworkamongpatientswithschizophreniainjapananestedcasecontrolstudyusingalargeclaimsdatabase AT takahiromasuda factorsassociatedwithdeathhospitalizationresignationandsickleavefromworkamongpatientswithschizophreniainjapananestedcasecontrolstudyusingalargeclaimsdatabase |