Thyroid function tests before prescribing anti-dementia drugs: a retrospective observational study

Nobuo Sakata,1 Yasuyuki Okumura1,2 1Research Department, Institute for Health Economics and Policy, Association for Health Economics Research and Social Insurance and Welfare, Tokyo, Japan; 2Department of Psychiatry and Behavioral Science, Tokyo Metropolitan Institute of Medical Science, Tokyo, Jap...

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Autores principales:	Sakata N, Okumura Y
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	cognitive dysfunction drug treatment guideline adherence hypothyroidism Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/9120e82561184e3980e3b294f2c4300a
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spelling	oai:doaj.org-article:9120e82561184e3980e3b294f2c4300a2021-12-02T00:43:08ZThyroid function tests before prescribing anti-dementia drugs: a retrospective observational study1178-1998https://doaj.org/article/9120e82561184e3980e3b294f2c4300a2018-07-01T00:00:00Zhttps://www.dovepress.com/thyroid-function-tests-before-prescribing-anti-dementia-drugs-a-retros-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Nobuo Sakata,1 Yasuyuki Okumura1,2 1Research Department, Institute for Health Economics and Policy, Association for Health Economics Research and Social Insurance and Welfare, Tokyo, Japan; 2Department of Psychiatry and Behavioral Science, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan Purpose: Treatable causes of cognitive dysfunction, such as hypothyroidism, should be excluded by physicians before prescribing anti-dementia drugs. Many clinical guidelines for dementia recommend a thyroid function test (TFT) as one of the standard screening tests for cognitive dysfunction. This study aimed to investigate the national implementation rate of TFTs during the 365 days before the initiation of anti-dementia drugs. Patients and methods: In this retrospective observational study, using Japan’s nationwide claim database, we enrolled ≥65-year-old patients who were newly prescribed anti-dementia drugs between April 2015 and March 2016. The outcome of this study was the implementation of TFTs in the 365 days prior to the index date. We used demographic data, including age, sex, comorbidities, home-based/institutional care, and provider type, as covariates. Results: We identified 262,279 patients newly prescribed anti-dementia drugs; of these, only 32.6% underwent TFTs before the initiation of anti-dementia drug treatment. Patients treated in dementia care centers were twice as likely to undergo TFTs as those treated in clinics (57% vs 26%; adjusted risk ratio: 2.17; 95% confidence interval: 2.01–2.33). Conclusion: In Japan, patients with dementia often do not undergo TFTs before being prescribed anti-dementia drugs, particularly in a primary care setting. This suggests that the practice of screening treatable cognitive dysfunction should be audited. Keywords: cognitive dysfunction, drug treatment, guideline adherence, hypothyroidismSakata NOkumura YDove Medical Pressarticlecognitive dysfunctiondrug treatmentguideline adherencehypothyroidismGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 13, Pp 1219-1223 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	cognitive dysfunction drug treatment guideline adherence hypothyroidism Geriatrics RC952-954.6
spellingShingle	cognitive dysfunction drug treatment guideline adherence hypothyroidism Geriatrics RC952-954.6 Sakata N Okumura Y Thyroid function tests before prescribing anti-dementia drugs: a retrospective observational study
description	Nobuo Sakata,1 Yasuyuki Okumura1,2 1Research Department, Institute for Health Economics and Policy, Association for Health Economics Research and Social Insurance and Welfare, Tokyo, Japan; 2Department of Psychiatry and Behavioral Science, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan Purpose: Treatable causes of cognitive dysfunction, such as hypothyroidism, should be excluded by physicians before prescribing anti-dementia drugs. Many clinical guidelines for dementia recommend a thyroid function test (TFT) as one of the standard screening tests for cognitive dysfunction. This study aimed to investigate the national implementation rate of TFTs during the 365 days before the initiation of anti-dementia drugs. Patients and methods: In this retrospective observational study, using Japan’s nationwide claim database, we enrolled ≥65-year-old patients who were newly prescribed anti-dementia drugs between April 2015 and March 2016. The outcome of this study was the implementation of TFTs in the 365 days prior to the index date. We used demographic data, including age, sex, comorbidities, home-based/institutional care, and provider type, as covariates. Results: We identified 262,279 patients newly prescribed anti-dementia drugs; of these, only 32.6% underwent TFTs before the initiation of anti-dementia drug treatment. Patients treated in dementia care centers were twice as likely to undergo TFTs as those treated in clinics (57% vs 26%; adjusted risk ratio: 2.17; 95% confidence interval: 2.01–2.33). Conclusion: In Japan, patients with dementia often do not undergo TFTs before being prescribed anti-dementia drugs, particularly in a primary care setting. This suggests that the practice of screening treatable cognitive dysfunction should be audited. Keywords: cognitive dysfunction, drug treatment, guideline adherence, hypothyroidism
format	article
author	Sakata N Okumura Y
author_facet	Sakata N Okumura Y
author_sort	Sakata N
title	Thyroid function tests before prescribing anti-dementia drugs: a retrospective observational study
title_short	Thyroid function tests before prescribing anti-dementia drugs: a retrospective observational study
title_full	Thyroid function tests before prescribing anti-dementia drugs: a retrospective observational study
title_fullStr	Thyroid function tests before prescribing anti-dementia drugs: a retrospective observational study
title_full_unstemmed	Thyroid function tests before prescribing anti-dementia drugs: a retrospective observational study
title_sort	thyroid function tests before prescribing anti-dementia drugs: a retrospective observational study
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/9120e82561184e3980e3b294f2c4300a
work_keys_str_mv	AT sakatan thyroidfunctiontestsbeforeprescribingantidementiadrugsaretrospectiveobservationalstudy AT okumuray thyroidfunctiontestsbeforeprescribingantidementiadrugsaretrospectiveobservationalstudy
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Thyroid function tests before prescribing anti-dementia drugs: a retrospective observational study

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