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  • ACID SUPPRESSION  (1)
  • BURDEN  (1)
  • 1
    Keywords: DISEASE ; RISK-FACTORS ; REGION ; OVERWEIGHT ; WAIST CIRCUMFERENCE ; BURDEN ; ILLNESS RATING-SCALE ; SEVERE OBESITY ; CARE COSTS ; AUGSBURG
    Abstract: Methods: this cross-sectional analysis used data of n = 3,108 individuals aged 58-82 from a population-based prospective cohort study. Body mass index (BMI) and waist-to-height ratio (WHtR) were calculated based on clinical examinations. Health service use was measured by a questionnaire for a 3-month period. Corresponding costs were calculated applying a societal perspective. Results: 21.8% of the sample were normal weight, 43.0% overweight, 25.5% obese class 1 and 9.6% obese class a parts per thousand yen2 according to BMI. In 42.6%, WHtR was a parts per thousand yen0.6. For normal weight, overweight, obese class 1 and obese class a parts per thousand yen2 individuals, mean costs (3-month period) of outpatient care were 384a,not sign, 435a,not sign, 475a,not sign and 525a,not sign (P 〈 0.001), mean costs of inpatient care were 284a,not sign, 408a,not sign, 333a,not sign and 652a,not sign (P = 0.070) and mean total costs 716a,not sign, 891a,not sign, 852a,not sign and 1,244a,not sign (P = 0.013). For individuals with WHtR 〈 0.6 versus a parts per thousand yen0.6, outpatient costs were 401a,not sign versus 499a,not sign (P 〈 0.001), inpatient costs 315a,not sign versus 480a,not sign (P = 0.016) and total costs 755a,not sign versus 1,041a,not sign (P 〈 0.001). Multiple regression analyses controlling for sociodemographic variables showed a significant effect of obesity on costs of outpatient care (class 1: +72a,not sign; class a parts per thousand yen2: +153a,not sign) and total costs (class a parts per thousand yen2: +361a,not sign) while the effect of overweight was not significant. WHtR a parts per thousand yen0.6 significantly increased outpatient costs by +79a,not sign and total costs by +189a,not sign. Conclusions: excess weight is associated with increased service use and cost in elderly individuals, in particular in obese class a parts per thousand yen2 individuals.
    Type of Publication: Journal article published
    PubMed ID: 25829392
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  • 2
    Keywords: THERAPY ; PHARMACOKINETICS ; GASTROESOPHAGEAL-REFLUX DISEASE ; ACID SUPPRESSION
    Abstract: Purpose We investigated the association between conditions of proton pump inhibitor (PPI) treatment failure and food intake in an elderly ambulatory population. Methods Our data originate from a large population-based cohort study. During a home visit done by a trained study physician, patients were asked for each medication to state whether it was taken in relation to a meal (before, concurrently with, and after) or independent of a meal. This information was analyzed for all patients taking a PPI daily and correlated to markers of PPI failure. Results Out of 2717 patients participating in a home visit and taking at least one medication, 383 took a PPI daily (14.1%). A PPI intake independent of meals was defined as incorrect and was observed in 64 patients, whereas 319 patients took their PPI in relation to a meal, which was defined as the correct intake. Treatment failure was observed in 10 out of 64 (15.6%) PPI users with incorrect intake and in 18 out of 319 (5.6%) PPI users with correct intake. The risk of treatment failure was threefold higher in patients taking their PPI independent of meals (OR 3.35; 95% CI 1.44-7.76). Conclusion The higher risk for PPI failure in patients taking PPIs independent of meals suggests that synchronized PPI administration with meals is indeed essential, and better counseling of patients is needed.
    Type of Publication: Journal article published
    PubMed ID: 24723311
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