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Title: Practice Patterns of Medications for Patients With Malignant Bowel Obstruction Using a Nationwide Claims Database and the Association Between Treatment Outcomes and Concomitant Use of H₂-Blockers/Proton Pump Inhibitors and Corticosteroids With Octreotide
Authors: Minoura, Takaaki
Takeuchi, Masato  kyouindb  KAKEN_id  orcid https://orcid.org/0000-0002-2990-2687 (unconfirmed)
Morita, Tatsuya
Kawakami, Koji
Author's alias: 箕浦, 孝晃
竹内, 正人
川上, 浩司
Keywords: Malignant bowel obstruction
octreotide
corticosteroid
claims database
palliative care
concomitant drugs
Issue Date: Feb-2018
Publisher: Elsevier BV
Journal title: Journal of pain and symptom management
Volume: 55
Issue: 2
Start page: 413
End page: 419.e2
Abstract: Context: Malignant bowel obstruction impairs the quality of life in patients with advanced cancer. Octreotide, acid-suppressing medications such as H₂-receptor antagonists (H₂-blockers) and proton pump inhibitors (PPIs), and corticosteroids are often used in combination for symptom control. Objectives: We evaluated the practice patterns of medications for patients hospitalized with malignant bowel obstruction using a large claims database in Japan. In addition, we explored the association of adding H₂-blockers/PPIs or corticosteroids to octreotide on treatment outcomes. Methods: We analyzed data from a nationwide medical claims database from April 2010 to March 2015 containing 975, 000 patients. We included all adult inpatients with cancer who used octreotide 300 μg/day or more and summarized each patient's medication use. We also assessed whether concomitant use of H₂-blockers/PPIs or corticosteroids was associated with the number of days of nasogastric tube (NGT) insertion; logistic regression was used to adjust the patients' baseline factors. Results: We included 3090 patients; octreotide alone was used in 1649 (53%) cases. A combination of octreotide and H₂-blockers or PPIs was used in 419 and 337 cases (14% and 11%), respectively; a combination of octreotide and corticosteroids was used in 374 cases (12%). Of the 1595 patients who underwent NGT insertion, those using corticosteroids with octreotide had a higher odds ratio of NGT removal within four days of insertion (adjusted odds ratio = 1.16; 95% CI = 1.08–1.23). Conclusion: Octreotide alone was used in the majority of patients, and the concomitant use of corticosteroids was more likely to be associated with early NGT removal.
Rights: © 2018. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/.
This is not the published version. Please cite only the published version.
この論文は出版社版でありません。引用の際には出版社版をご確認ご利用ください。
URI: http://hdl.handle.net/2433/243215
DOI(Published Version): 10.1016/j.jpainsymman.2017.10.019
PubMed ID: 29122616
Appears in Collections:Journal Articles

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