Association of pharmacological treatments for hypertension, diabetes, and dyslipidemia with health checkup participation and identification of disease control factors among older adults in Tokyo, Japan

Seigo Mitsutake; Tatsuro Ishizaki; Rumiko Tsuchiya-Ito; Chie Teramoto; Sayuri Shimizu; Takuya Yamaoka; Akihiko Kitamura; Hideki Ito

doi:10.1016/j.pmedr.2019.101033

Association of pharmacological treatments for hypertension, diabetes, and dyslipidemia with health checkup participation and identification of disease control factors among older adults in Tokyo, Japan

Prev Med Rep. 2019 Dec 23:17:101033. doi: 10.1016/j.pmedr.2019.101033. eCollection 2020 Mar.

Authors

Seigo Mitsutake¹, Tatsuro Ishizaki¹, Rumiko Tsuchiya-Ito^{1

2}, Chie Teramoto³, Sayuri Shimizu⁴, Takuya Yamaoka¹, Akihiko Kitamura¹, Hideki Ito⁵

Affiliations

¹ Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
² Dia Foundation for Research on Ageing Societies, Tokyo, Japan.
³ Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
⁴ Institute for Health Economics and Policy, Tokyo, Japan.
⁵ Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan.

Abstract

The Japanese government encourages older adults to participate in annual health checkups designed to detect lifestyle diseases such as hypertension, diabetes, and dyslipidemia. However, individuals who are already being treated for these diseases are unlikely to benefit from health checkup participation. This retrospective cohort study of older adults evaluated the associations of pharmacological treatments for these diseases with health checkup participation and identified the disease control factors among patients receiving treatments. Using medical claims data and health checkup data between September 2013 and August 2014 from 820,215 older adults aged ≥ 75 years residing in Tokyo, Japan, we examined the associations between pharmacological treatments and health checkup participation using binary logistic regression analysis. Next, patients receiving pharmacological treatments were categorized into intensive, moderate, or limited disease control based on their blood pressure, hemoglobin A1c levels, and lipid levels; multinomial logistic regression analyses were used to identify the disease control factors. The results showed that patients receiving pharmacological treatments were more likely (odds ratio: 1.374; P < 0.001) to participate in health checkups than patients not receiving treatments. Patients with intensive disease control were more likely to be aged ≥ 90 years and use home medical care than patients with moderate control. Our findings suggest that it may be beneficial to shift the focus of health checkups from simply identifying at-risk patients to also supporting disease management. Information obtained from databases that link medical claims and health checkup data may improve evaluations of disease control in older adults and help to streamline healthcare systems.

Keywords: Administrative claims; Aged; BP, blood pressure; DBP, diastolic blood pressure; Diabetes Mellitus; Dyslipidemia; HDL-C, high-density lipoprotein cholesterol; Health services; Healthcare; Hypertension; LDL-C, low-density lipoprotein cholesterol; SBP, systolic blood pressure; TC, triglycerides.