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  • 1
    Online Resource
    Online Resource
    Receptivity to tobacco marketing and susceptibility to smoking among non-smoking male students in an urban setting in Lao PDR
    BMJ ; 2013
    In:  Tobacco Control Vol. 22, No. 6 ( 2013-11), p. 389-394
    Details
    In: Tobacco Control, BMJ, Vol. 22, No. 6 ( 2013-11), p. 389-394
    Type of Medium: Online Resource
    ISSN: 0964-4563 , 1468-3318
    URL: Article
    DOI: 10.1136/tobaccocontrol-2011-050125
    Language: English
    Publisher: BMJ
    Publication Date: 2013
    detail.hit.zdb_id: 2010882-5
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  • 2
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    Reduced long-term care cost by social participation among older Japanese adults: a prospective follow-up study in JAGES
    BMJ ; 2019
    In:  BMJ Open Vol. 9, No. 3 ( 2019-03), p. e024439-
    Details
    In: BMJ Open, BMJ, Vol. 9, No. 3 ( 2019-03), p. e024439-
    Abstract: Reducing costs related to functional disabilities and long-term care (LTC) is necessary in ageing societies. We evaluated the differences in the cumulative cost of public LTC insurance (LTCI) services by social participation. Design Prospective observational study. Setting Our baseline survey was conducted in March 2006 among people aged 65 or older who were not eligible for public LTCI benefits and were selected using a complete enumeration in Tokoname City, Japan. We followed up with their LTC services costs over a period of 11 years. Social participation was assessed by the frequency of participation in clubs for hobbies, sports or volunteering. We adopted a classical linear regression analysis and an inverse probability weighting (IPW), with multiple imputation of missing values. Participants Functionally independent 5377 older adults. Primary outcome measures The cumulative cost of public LTCI services for 11 years. Results Even when adjusting for the confounding variables, social participation at the baseline was negatively associated with the cumulative cost of LTCI services. The IPW model showed that in respondents who participated in hobby activities once a week or more, the cumulative cost of LTCI services for 11 years was lower, approximately US$3500 per person, in comparison to non-participants. Similarly, that in respondents who participated in sports group or clubs was lower, approximately US$6000 than non-participants. Conclusions Older adults’ participation in community organisations may help reduce future LTC costs. Promoting participation opportunities in the community could ensure the financial stability of LTCI services.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    DOI: 10.1136/bmjopen-2018-024439
    Language: English
    Publisher: BMJ
    Publication Date: 2019
    detail.hit.zdb_id: 2599832-8
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  • 3
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    Factors affecting the implementation of guideline-based prophylactic antiemetic therapy for chemotherapy-induced nausea and vomiting in Japan: a protocol for a hospital-based qualitative study
    BMJ ; 2022
    In:  BMJ Open Vol. 12, No. 6 ( 2022-06), p. e055473-
    Details
    In: BMJ Open, BMJ, Vol. 12, No. 6 ( 2022-06), p. e055473-
    Abstract: Chemotherapy-induced nausea and vomiting (CINV) decrease patients’ quality of life and negatively impact treatment outcomes. Although standard prophylactic antiemetic therapy for acute CINV recommended by guidelines is effective, poor guideline implementation is a worldwide problem. In Japan, prophylactic antiemetic therapy is relatively well implemented for chemotherapy associated with high emetogenic risk, while implementation gaps are observed for that with low emetogenic risk. Although most reports on factors influencing appropriate antiemetic prescription focus on physicians’ attitudes and behaviours, a more comprehensive exploration is needed since chemotherapy is expected to involve pharmacists, nurses and eventually hospital directors. The purpose of this qualitative study is to comprehensively explore the factors that influence the implementation of appropriate prophylactic antiemetic procedures at cancer care hospitals in Japan. Methods and analysis This study is a hospital-based qualitative study using semistructured individual interviews. The target population will be hospital directors, and chiefs (including proxies) of departments of oncology and/or chemotherapy, pharmacy and nursing, working in the hospitals, selected by purposive sampling. We will obtain information on antiemetics in chemotherapy regimens, antiemetic routine use and awareness of guidelines using prequestionnaires. Interviews will then be conducted online using an interview guide. The Consolidated Framework for Implementation Research will be used to collect and analyse the interview data. We will also create new codes inductively, as required. In addition, we will refer to the aggregate results of the Quality Indicator survey to determine the implementation of recommended antiemetic prescriptions for each hospital and discuss the relationship with influencing factors. Ethics and dissemination This study has been approved by the National Cancer Centre Ethics Approval Committee (approval number: 2020-305). The study findings will be disseminated via peer-reviewed journal publications and presentations to academics, policy-makers, and clinicians at scientific conferences.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    DOI: 10.1136/bmjopen-2021-055473
    Language: English
    Publisher: BMJ
    Publication Date: 2022
    detail.hit.zdb_id: 2599832-8
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  • 4
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    Limited potential of school textbooks to prevent tobacco use among students grade 1–9 across multiple developing countries: a content analysis study
    BMJ ; 2013
    In:  BMJ Open Vol. 3, No. 2 ( 2013), p. e002340-
    Details
    In: BMJ Open, BMJ, Vol. 3, No. 2 ( 2013), p. e002340-
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    DOI: 10.1136/bmjopen-2012-002340
    Language: English
    Publisher: BMJ
    Publication Date: 2013
    detail.hit.zdb_id: 2599832-8
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  • 5
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    Effect of the COVID-19 pandemic on outpatient care and rehabilitation in neuromuscular clinical practice in Japan: a health insurance claims database analysis
    BMJ ; 2023
    In:  BMJ Open Vol. 13, No. 6 ( 2023-06), p. e070818-
    Details
    In: BMJ Open, BMJ, Vol. 13, No. 6 ( 2023-06), p. e070818-
    Abstract: To evaluate the impact of the COVID-19 pandemic on outpatient care in Japanese patients with neuromuscular diseases (NMDs). Design This retrospective cohort study included patients between January 2018 and February 2019; the follow-up period was divided into ‘before COVID-19’ (March 2019–February 2020) and ‘during COVID-19’ (March 2020–February 2021). Setting JMDC claims database study. Participants Of the 10 655 557 patients identified, we included patients with spinal muscular atrophy (SMA; n=82), neuromyelitis optica (NMO; n=342), myasthenia gravis (MG; n=1347), Guillain-Barré syndrome (GBS; n=442) or autoimmune encephalitis/encephalopathy (AIE; n=133). Patients were required to have ≥1 month of data available, have a diagnosis of NMD during the enrolment period and be available for follow-up. Primary and secondary outcome measures We estimated the proportion of patients with 〉 30% change in outpatient consultation and rehabilitation visits before versus during the COVID-19 pandemic. Results Small reductions in the proportion of patients with outpatient consultation/rehabilitation visits were observed before versus during the pandemic. Compared with before the pandemic, 30.4%, 27.8%, 28.7%, 49.4% and 50.0% of patients showed a 〉 30% decrease in outpatient consultation visits and 58.6%, 75.0%, 50.0%, 76.3% and 84.6% showed a 〉 30% decrease in outpatient rehabilitation visits during the pandemic for SMA, NMO, MG, GBS and AIE, respectively. The median change in the number of outpatient consultation visits per year before versus during pandemic was −1.0 day for all NMDs, and that in outpatient rehabilitation visits per year was −6.0, –5.5, −1.5, –6.5 and −9.0 days for SMA, NMO, MG, GBS and AIE, respectively. The reduction in outpatient rehabilitation visits was greater in the absence versus presence of a neurology specialist. Conclusions Outpatient consultation and rehabilitation visits during the COVID-19 pandemic were affected in Japanese patients with NMDs. Longer-term evaluations are required to understand if these reductions in outpatient care would affect patient prognosis.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    URL: Article
    DOI: 10.1136/bmjopen-2022-070818
    DOI: 10.1136/bmjopen-2022-070818.supp1
    Language: English
    Publisher: BMJ
    Publication Date: 2023
    detail.hit.zdb_id: 2599832-8
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  • 6
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    Complex multimorbidity and mortality in Japan: a prospective propensity-matched cohort study
    BMJ ; 2021
    In:  BMJ Open Vol. 11, No. 8 ( 2021-08), p. e046749-
    Details
    In: BMJ Open, BMJ, Vol. 11, No. 8 ( 2021-08), p. e046749-
    Abstract: There are limitations to defining multimorbidity (MM) based on a simple count of diseases. To address these limitations, the concept of complex MM (CMM) focuses on how many body systems are affected in a single patient, rather than counting comorbid conditions. This study compared the prediction of mortality among older Japanese adults between CMM and conventional MM. Design A population-based prospective cohort study. Setting The Japan Gerontological Evaluation Study, a nationwide longitudinal cohort study, which ran from 2010 to 2016. Participants Functionally independent individuals who were older than 65 and had complete illness data at the time of baseline survey were eligible. Outcomes measure CMM was defined as the coexistence of 3 or more body system disorders at baseline. We calculated the propensity for each individual to develop CMM based on a wide array of characteristics, including socioeconomic status and health behaviours. Individuals with and without CMM were then matched on their propensity scores before we estimated overall survival using a log-rank test. Results Our 6-year follow-up included 38 889 older adults: 20 233 (52.0%) and 7565 (19.5%) adults with MM and CMM, respectively. In the MM-matched cohort (n=15 666 pairs), the presence of MM was significantly associated with increased mortality (HR 1.07; 95% CI 1.01 to 1.14; p=0.02 by the log-rank test). A similar mortality association was found in the CMM-matched cohort (n=7524 pairs, HR, 1.07; 95% CI 0.99 to 1.16; p=0.08 by the log-rank test). Conclusion This is the first study to report the association between CMM and mortality among older adults in Japan. MM and CMM predict mortality in older adults to a similar degree. This finding needs to be replicated with more precision in larger samples.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    DOI: 10.1136/bmjopen-2020-046749
    Language: English
    Publisher: BMJ
    Publication Date: 2021
    detail.hit.zdb_id: 2599832-8
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  • 7
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    Smoking cessation interventions and implementations in Japan: a study protocol for a scoping review and supplemental survey
    BMJ ; 2022
    In:  BMJ Open Vol. 12, No. 12 ( 2022-12), p. e063912-
    Details
    In: BMJ Open, BMJ, Vol. 12, No. 12 ( 2022-12), p. e063912-
    Abstract: Despite various tobacco control measures in Japan, smoking remains a leading cause of mortality. This manuscript outlines proposed methodology for scoping review that aims to describe the knowledge gaps for local-level smoking cessation interventions in Japan, their implementation barriers and facilitators, and the use of implementation strategies. Methods and analysis A scoping review will be conducted using the updated guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses-extension for Scoping Reviews to systematically search peer-reviewed journal articles and grey literature to identify studies on smoking cessation interventions in Japan. The six-stage scoping review model will involve (1) identifying the research question; (2) identifying relevant studies; (3) selecting studies; (4) charting data; (5) collating, summarising and reporting the results; and (6) consultation exercise. Since there is little information available on the implementation context in the literature, we will use grey literature to identify organisations implementing smoking cessation interventions and conduct a cross-sectional survey among them to supplement the information gap. Based on a literature review, findings will be organised on smoking cessation interventions in local settings (ie, communities, workplaces, schools and hospitals) at the population, provider and individual levels in Japan to understand knowledge gaps. We will adopt the consolidated framework for implementation research to identify implementation barriers and facilitators, and the expert recommendations for implementing change to identify implementation strategies. Ethics and dissemination This study does not require ethical committee approval. The scoping review method will be robust in searching available smoking cessation interventions in Japan. The findings of this study will be compiled as case studies of best practices on smoking cessation interventions and disseminated to relevant stakeholders at the public and private levels through publications, presentations in conferences and stakeholder meetings.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    URL: Article
    DOI: 10.1136/bmjopen-2022-063912
    DOI: 10.1136/bmjopen-2022-063912.supp1
    Language: English
    Publisher: BMJ
    Publication Date: 2022
    detail.hit.zdb_id: 2599832-8
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  • 8
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    Comprehensive and long-term surveys of COVID-19 sequelae in Japan, an ambidirectional multicentre cohort study: study protocol
    BMJ ; 2021
    In:  BMJ Open Respiratory Research Vol. 8, No. 1 ( 2021-11), p. e001015-
    Details
    In: BMJ Open Respiratory Research, BMJ, Vol. 8, No. 1 ( 2021-11), p. e001015-
    Abstract: The rapid spread of COVID-19 posed a global burden. Substantial number of people died of the disease in the acute phase of infection. In addition, a significant proportion of patients have been reported to suffer from post-acute phase symptoms, sequelae of COVID-19, which may negatively influence the quality of daily living and/or socioeconomic circumstances of the patients. However, no previous study has comprehensively and objectively assessed the quality of life of patients by using existing international scales. Further, evidence of socioeconomic consequences among patients with COVID-19 is scarce. To address the multidimensional issues from sequelae of COVID-19, evidence from comprehensive surveys beyond clinical perspectives is critical that investigates health, and social determinants of disease progression as well as socioeconomic consequences at a large scale. Methods and analysis In this study, we plan to conduct a nationwide and comprehensive survey for the sequelae of COVID-19 in a total of 1000 patients diagnosed at 27 hospitals throughout Japan. This study will evaluate not only the health-related status of patients from clinical perspectives but also the Health-related Quality of Life (HRQoL) scores, socioeconomic status and consequences to discuss the sequelae of the disease and the related risk factors. The primary endpoint is the frequency of long-term complications of COVID-19 infection. The secondary endpoints are risk factors for progression to sequelae of COVID-19 infection. The study will provide robust and important evidence as a resource to tackle the issues from the sequelae of COVID-19 from the multi-dimensional perspectives. Ethics and dissemination This trial was approved by the Keio University School of Medicine Ethics Committee (20200243, UMIN000042299). The results of this study will be reported at a society meeting or published in a peer-reviewed journal.
    Type of Medium: Online Resource
    ISSN: 2052-4439
    URL: Article
    DOI: 10.1136/bmjresp-2021-001015
    Language: English
    Publisher: BMJ
    Publication Date: 2021
    detail.hit.zdb_id: 2736454-9
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  • 9
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    Frequent outpatient attendance among people on the governmental welfare programme in Japan: assessing both patient and supplier characteristics
    BMJ ; 2020
    In:  BMJ Open Vol. 10, No. 10 ( 2020-10), p. e038663-
    Details
    In: BMJ Open, BMJ, Vol. 10, No. 10 ( 2020-10), p. e038663-
    Abstract: Using linkage data from two municipal public assistance databases and medical assistance claim data, this study aimed to identify characteristics associated with frequent outpatient attendance by people on public assistance, who can access medical care services without copayment in Japan, with simultaneous consideration of supplier factors. Design We performed a retrospective cohort study. Setting We used secondary data from the public assistance databases of two suburban municipalities in Japan. Participants The study population included all adults on public assistance in January 2016, who were observed until December 2016. A total of 6016 people was included in the analysis. Among them, 2956 (49.1%) were men, and 2030 (33.7%) were living alone. Outcome measure We adopted the definition of frequent outpatient attendance by the Japanese Ministry of Health, Labour and Welfare, visiting the same medical facility 15 times or more in a month for the same health problem. Results Of 6016 included people, 139 (2.3%) were engaged in frequent outpatient attendance. Multiple Poisson regression showed that, as for the individual factors, the adjusted incidence ratio for frequent outpatient attendance was 1.58 (95% CI 1.05 to 2.39) for people living alone (vs living with others). As for the suppliers, the adjusted incidence ratio for frequent outpatient attendance was 1.74 (95% CI 1.20 to 2.52) for private institutions (vs medical corporations). There were no significant associations between frequent outpatient attendance and individual disability certificate or long-term care needs. Conclusions This study suggests that among recipients of public assistance who can access medical services without copayment, social isolation may be associated with frequent outpatient attendance. Private clinics may also be associated with this phenomenon. Interventions to prevent social isolation—by for example, providing health and social care in a more integrated manner—may thus be efficacious in reducing the healthcare demands of socially vulnerable individuals.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    DOI: 10.1136/bmjopen-2020-038663
    Language: English
    Publisher: BMJ
    Publication Date: 2020
    detail.hit.zdb_id: 2599832-8
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