Details of a Researcher - Okamura, Tomonori

Papers - Okamura, Tomonori

Division display 121 - 140 of about 664 ／ All the affair displays >>

Electrocardiographic ST-T Abnormities Are Associated with Stroke Risk in the REGARDS Study

Sawano M., Yuan Y., Kohsaka S., Inohara T., Suzuki T., Okamura T., Howard G., Howard V.J., Judd S., Soliman E.Z., Cushman M.

Stroke (Stroke) 51 ( 4 ) 1100 - 1106 2020

Research paper (scientific journal), ISSN 00392499

© 2020 Lippincott Williams and Wilkins. All rights reserved. Background and Purpose-In previous studies, isolated nonspecific ST-segment and T-wave abnormalities (NSSTTAs), a common finding on ECGs, were associated with greater risk for incident coronary artery disease. Their association with incident stroke remains unclear. Methods-The REGARDS (Reasons for Geographic and Racial Differences in Stroke) study is a population-based, longitudinal study of 30 239 white and black adults enrolled from 2003 to 2007 in the United States. NSSTTAs were defined from baseline ECG using the standards of Minnesota ECG Classification (Minnesota codes 4-3, 4-4, 5-3, or 5-4). Participants with prior stroke, coronary heart disease, and major and minor ECG abnormalities other than NSSTTAs were excluded from analysis. Multivariable Cox proportional hazards regression was used to examine calculate hazard ratios of incident ischemic stroke by presence of baseline NSSTTAs. Results-Among 14 077 participants, 3111 (22.1%) had NSSTTAs at baseline. With a median of 9.6 years follow-up, 106 (3.4%) with NSSTTAs had ischemic stroke compared with 258 (2.4%) without NSSTTAs. The age-adjusted incidence rates (per 1000 person-years) of stroke were 2.93 in those with NSSTTAs and 2.19 in those without them. Adjusting for baseline age, sex, race, geographic location, and education level, isolated NSSTTAs were associated with a 32% higher risk of ischemic stroke (hazard ratio, 1.32 [95% CI, 1.05-1.67]). With additional adjustment for stroke risk factors, the risk of stroke was increased 27% (hazard ratio, 1.27 [95% CI, 1.00-1.62]) and did not differ by age, race, or sex. Conclusions-Presence of NSSTTAs in persons with an otherwise normal ECG was associated with a 27% increased risk of future ischemic stroke.

Access to Document (DOI)

Reference intervals of serum non-cholesterol sterols by gender in healthy Japanese individuals

Yoshida H., Tada H., Ito K., Kishimoto Y., Yanai H., Okamura T., Ikewaki K., Inagaki K., Shoji T., Bujo H., Miida T., Yoshida M., Kuzuya M., Yamashita S.

Journal of Atherosclerosis and Thrombosis (Journal of Atherosclerosis and Thrombosis) 27 ( 5 ) 409 - 417 2020

Research paper (scientific journal), ISSN 13403478

© 2020, Japan Atherosclerosis Society. All rights reserved. Aims: The present study was conducted to establish a practical method for measuring non-cholesterol sterols and reference intervals of serum levels. Methods: Healthy subjects (109 men and 151 women), four patients with sitosterolemia, and 10 heterozygous mutation carriers of ABCG5/ABCG8 genes were investigated. Then, three non-cholesterol sterols (sitosterol, campesterol, and lathosterol) of fasting serum samples were measured via a practical and highly sensitive gas chromatography (GC) method with 0.2 µg/mL as the lower limit of quantification. The coefficient of variation (CV) values for within-run reproducibility were 3.06%, 1.89%, and 1.77% for lathosterol, campesterol, and sitosterol, respectively. The CV values for between-run reproducibility were 2.81%, 2.06%, and 2.10% for lathosterol, campesterol, and sitosterol, respectively. Results: The serum levels of sitosterol and campesterol were significantly higher in women than in men, whereas the serum levels of lathosterol were significantly higher in men than in women. Because of these gender difference, the determination of reference intervals of the three sterol values was performed by considering gen-der. The reference intervals of sitosterol, campesterol, and lathosterol were 0.99–3.88, 2.14–7.43, and 0.77–3.60 µg/mL in men and 1.03–4.45, 2.19–8.34, and 0.64–2.78 µg/mL in women, respectively. The serum levels of sitosterol and campesterol were higher in patients with sitosterolemia (94.3±47.3 and 66.3±36.6 µg/mL, respectively) than in healthy subjects. Conclusion: These results demonstrate a practical and highly sensitive GC method to measure non-cholesterol sterol levels and gender-segregated reference intervals of sitosterol, campesterol, and lathosterol in Japanese healthy subjects.

Access to Document (DOI)

Impact of hypertension stratified by diabetes on the lifetime risk of cardiovascular disease mortality in Japan: a pooled analysis of data from the Evidence for Cardiovascular Prevention from Observational Cohorts in Japan study

Imai Y., Hirata T., Saitoh S., Ninomiya T., Miyamoto Y., Ohnishi H., Murakami Y., Iso H., Tanaka S., Miura K., Tamakoshi A., Yamada M., Kiyama M., Ueshima H., Ishikawa S., Okamura T.

Hypertension Research (Hypertension Research) 2020

Research paper (scientific journal), ISSN 09169636

© 2020, The Japanese Society of Hypertension. Lifetime risk is an informative estimate to motivate people to change lifestyle behaviors, especially from a younger age, in public health education. The impact of the combination of hypertension and diabetes on the lifetime risk of cardiovascular mortality has not been investigated in Asian populations. A pooled analysis of individual data from nine cohorts was performed. A total of 57,339 Japanese men and women were eligible for the analysis. We used the modified Kaplan–Meier approach and estimated the remaining lifetime risk of cardiovascular mortality starting from the index age of 35 years. Participants were classified into four categories defined by hypertension and diabetes. The lifetime risk was increased in the order of those without either risk, those without hypertension but with diabetes, those with hypertension but without diabetes, and those with both risks. The lifetime risk of cardiovascular mortality at the 35-year index age was as follows: 7.8% in men and 6.2% in women for those without either hypertension or diabetes, 13.2% in men and 9.5% in women for those without hypertension but with diabetes, 17.2% in men and 11.7% in women for those with hypertension but without diabetes, and 19.4% in men and 15% in women for those with both risks. These findings reinforce the need for a life-course perspective in the management of hypertension and diabetes from a younger age.

Access to Document (DOI)

Electrocardiographic ST-T Abnormities Are Associated with Stroke Risk in the REGARDS Study

Sawano M., Yuan Y., Kohsaka S., Inohara T., Suzuki T., Okamura T., Howard G., Howard V.J., Judd S., Soliman E.Z., Cushman M.

Stroke (Stroke) 51 ( 4 ) 1100 - 1106 2020

Research paper (scientific journal), ISSN 00392499

Access to Document (DOI)

[The search for a predictor of deterioration of the nonspecific stress index K6 among urban residents: The KOBE study].

Taya H, Kuwabara K, Higashiyama A, Sugiyama D, Hirata A, Sata M, Hirata T, Nishida Y, Kubo S, Kubota Y, Kadota A, Miyamatsu N, Nishimura K, Miyamoto Y, Okamura T

[Nihon koshu eisei zasshi] Japanese journal of public health 67 ( 8 ) 509 - 517 2020

Research paper (scientific journal), ISSN 0546-1766

Access to Document (DOI)

Acceleration of opportunistic atrial fibrillation screening for elderly patients in routine primary care.

Suzuki A, Okamura T, Sasaki M, Matsuoka H, Ikeda Y, Takahashi A, Akiyama S, Ono F, Yoshihara N, Akita Study group.

PloS one (PLoS ONE) 15 ( 12 ) e0244240 2020

Research paper (scientific journal), ISSN 1932-6203

Cardio-embolic ischemic stroke caused by atrial fibrillation is more severe compared with other types of stroke, such as lacunar infarction and atherothrombotic infarction in patients without atrial fibrillation. Therefore, it is important to prevent cardio-embolic ischemic stroke by detecting atrial fibrillation early in at-risk patients and administering appropriate anticoagulation therapy. This prospective observational study aimed to evaluate the effectiveness of opportunistic atrial fibrillation screening at 12 primary clinics in Japan. The study included a 12-month pre-campaign period and a 12-month campaign period. During the campaign period, an awareness campaign was conducted to encourage physicians to be mindful of screening patients aged 65 years for atrial fibrillation by checking their pulses and performing subsequent electrocardiography when an irregular pulse was detected. The primary outcome was the proportion of patients with newly diagnosed atrial fibrillation. A sub-analysis focusing on first-time outpatients was performed. There were 9921 and 10,282 patients with no history of atrial fibrillation in the pre-campaign and campaign periods, respectively. In the whole population, the proportion of patients with newly diagnosed atrial fibrillation was 0.9% throughout the pre-campaign and campaign periods. In the sub-analysis limited to first-time outpatients, the detection proportion increased from 1.6% to 1.9% during the campaign period. In terms of age stratification, a large increase in detection was observed, especially among patients aged 65–74 years (detection increased from 0.9% to 1.5%) and 85 years (detection increased from 2.9% to 3.3%) during the campaign period. Our findings suggest the feasibility of opportunistic atrial fibrillation screening in routine primary care practice in Japan. Of note, our findings suggest that opportunistic atrial fibrillation screening targeting first-time outpatients may be of clinical value.

Access to Document (DOI)

[Association of the combined estimated 24-h urinary Na/K ratio and body mass index with blood pressure: Cross-sectional data from the KOBE study].

Nozawa M, Kuwabara K, Kubota Y, Nishida Y, Kubo S, Hirata T, Higashiyama A, Hirata A, Hattori H, Sata M, Kadota A, Sugiyama D, Miyamatsu N, Miyamoto Y, Okamura T

[Nihon koshu eisei zasshi] Japanese journal of public health 67 ( 10 ) 722 - 733 2020

Research paper (scientific journal), ISSN 0546-1766

Access to Document (DOI)

Lipoprotein particles and coronary artery calcium in middle-aged US-White and Japanese men

Mahajan H., Zaid M., MacKey R., Kadota A., Vishnu A., Fujiyoshi A., Vasudha A., Hisamatsu T., Evans R., Okamura T., Miura K., Kuller L., Ueshima H., Sekikawa A.

Open Heart (Open Heart) 6 ( 2 ) e001119 2019.12

Research paper (scientific journal), ISSN 2398595X

© © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ. Objective This cross-sectional study examined whether contrasting distributions of nuclear magnetic resonance (NMR)-measured lipoproteins contribute to differences in the prevalence of subclinical atherosclerosis measured using coronary artery calcium (CAC) between the two groups of middle-aged males: the US-residing Caucasian (US-White) and Japan-residing Japanese (Japanese). Methods In a population-based study of 570 randomly selected asymptomatic men aged 40-49 years (270 US-White and 300 Japanese), we examined the relationship between race/ethnicity, NMR-measured lipoproteins and CAC (measured by Electron Beam CT and quantified using the Agatston method) using multivariable robust Poisson regression adjusting for traditional and novel risk factors for coronary heart disease (CHD). Results The US-White compared with the Japanese had significantly different NMR-measured lipoprotein particle distributions. The US-White had a significantly higher prevalence of CAC≥10 (CAC-prevalence) compared with the Japanese adjusting for CHD risk factors (prevalence ratio (PR)=2.10; 95% CI=1.24 to 3.48), and this difference was partially attenuated (∼18%) with further adjustment for lipoprotein levels (PR=1.73; 95% CI=1.02 to 3.08). There was no reclassification improvement with further addition of lipoproteins particle concentrations/size to a model that already included traditionally measured lipids (low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides), cardiovascular risk factors, and inflammatory markers (net reclassification improvement index=-2% to 3%). Conclusions Variations in the distribution of NMR-measured lipoprotein particles partially accounted for the difference in the CAC-prevalence between middle-aged US-White and Japanese men.

Access to Document (DOI)

Association of Electrocardiographic Left Atrial Abnormality and B-type Natriuretic Peptide in a Large Japanese Cohort: A Report From the Nippon Data2010 Research Group

Shoji Satoshi, Kohsaka Shun, Sawano Mitsuaki, Okamura Tomonori, Hirata Aya, Sugiyama Daisuke, Ohkubo Takayoshi, Nakamura Yasuyuki, Watanabe Makoto, Kadota Aya, Ueshima Hirotsugu, Okayama Akira, Miura Katsuyuki

CIRCULATION 140 2019.11

Research paper (scientific journal), ISSN 0009-7322

Double Product Privilege in Predicting All-cause and Cardiovascular Disease Mortality Compare to Heart Rate and Blood Pressure Separately, the Nippon-data 80 Study

Liu Yiwei, Sugiyama Daisuke, Hirata Aya, Miura Katsuyuki, Ueshima Hirotsugu, Kadota Aya, Ohkubo Takayoshi, Okayama Akita, Kondo Keiko, Okamura Tomonori

CIRCULATION 140 2019.11

Research paper (scientific journal), ISSN 0009-7322

Age-related and seasonal change in serum osmolarity and water intake in a healthy population

Nishikawa T., Miyamatsu N., Higashiyama A., Nishida Y., Kubota Y., Hirata T., Sugiyama D., Kuwabara K., Miyamoto Y., Okamura T.

EUROPEAN JOURNAL OF PUBLIC HEALTH 29 2019.11

Research paper (scientific journal), ISSN 1101-1262

Association between dyslipidemia and plasma levels of branched-chain amino acids in the Japanese population without diabetes mellitus

Fukushima K., Harada S., Takeuchi A., Kurihara A., Iida M., Fukai K., Kuwabara K., Kato S., Matsumoto M., Hirata A., Akiyama M., Tomita M., Hirayama A., Sato A., Suzuki C., Sugimoto M., Soga T., Sugiyama D., Okamura T., Takebayashi T.

Journal of Clinical Lipidology (Journal of Clinical Lipidology) 13 ( 6 ) 932 - 939.e2 2019.11

Research paper (scientific journal), ISSN 19332874

© 2019 National Lipid Association Background: Branched-chain amino acids (BCAAs) play a key role in energy homeostasis. Objective: We aimed to investigate the association between plasma BCAA levels and dyslipidemia in the Japanese population without diabetes mellitus. Methods: This cross-sectional study included 4952 participants without diabetes mellitus, enrolled in the Tsuruoka Metabolomic Cohort Study. Plasma BCAA levels were measured by capillary electrophoresis–mass spectrometry. Correlations between lipid and BCAA profiles were evaluated by sex-stratified multiple linear regression analyses, after adjusting for confounders. Logistic regression was used to identify associations between BCAAs and metabolic dyslipidemia (MD) defined as triglyceride levels ≥150 mg/dL, high-density lipoprotein cholesterol levels ≤40 mg/dL for men and ≤50 mg/dL for women, or low-density lipoprotein cholesterol (LDL-C) levels ≥140 mg/dL. Results: In both sexes, the levels of individual BCAAs and the total BCAA levels correlated positively with triglyceride levels and negatively with high-density lipoprotein cholesterol levels. Valine, leucine, and total BCAA levels were weakly and positively correlated with LDL-C levels. Increased BCAA levels showed positive associations with MD. However, associations between BCAAs and elevated LDL-C levels were unclear. Furthermore, the associations between BCAA levels and MD regardless of fasting blood sugar (FBS) levels (high or low). Although valine, leucine, and total BCAA levels were weakly associated with elevated LDL-C levels in the high-FBS group, no such association was observed in the low-FBS group. Conclusions: BCAAs might be associated with MD independently of the FBS level and might play an important role in lipid metabolism and dyslipidemia.

Access to Document (DOI)

Serum modified HDL was associated with cardiovascular disease in a Japanese community-based cohort

Okamura T., Sata M., Iida M., Kakino A., Harada S., Hirata A., Usami Y., Sugiyama D., Sawamura T., Takabayashi T.

EUROPEAN JOURNAL OF PUBLIC HEALTH 29 361 - 361 2019.11

Research paper (scientific journal), ISSN 1101-1262

Presence of intimate family and cancer screening behavior: a cross-sectional study of 4237 workers

Miyamatsu N., Shima A., Morino A., Azuma S., Ichikawa M., Godai K., Kawatsu Y., Nishikawa T., Tanaka H., Okamura T.

EUROPEAN JOURNAL OF PUBLIC HEALTH 29 320 - 320 2019.11

Research paper (scientific journal), ISSN 1101-1262

Being conscious of water intake positively associated with sufficient non-alcohol drink intake regardless of seasons and reasons in healthy Japanese; the KOBE study: A cross sectional study

Nishikawa T., Miyamatsu N., Higashiyama A., Kubota Y., Nishida Y., Hirata T., Sugiyama D., Kuwabara K., Kubo S., Miyamoto Y., Okamura T.

International Journal of Environmental Research and Public Health (International Journal of Environmental Research and Public Health) 16 ( 21 ) 2019.11

Research paper (scientific journal), ISSN 16617827

© 2019 by the authors. Licensee MDPI, Basel, Switzerland. The present study sought to clarify if being conscious of water intake (CWI) is associated with sufficient non-alcohol drink (NAD) intake. We used data of healthy participants without diabetes, aged 40–74 years, in the Kobe Orthopedic and Biomedical Epidemiologic (KOBE) study. The association between being CWI and NAD intake was evaluated by multivariate linear regression analyses after adjusting for age, sex, surveyed months (seasons), alcohol drinking, health-awareness life habits, socioeconomic factors, serum osmolarity, estimated daily salt intake, and reasons for NAD intake. Among 988 (698 women and 290 men) participants eligible for the present analyses, 644 participants (65.2%) were CWI and 344 participants (34.8%) were not CWI (non-CWI). The most popular reason for being CWI was to avoid heat stroke in summer and to prevent ischemic cerebral stroke in winter. The CWI group took more NAD, especially decaffeinated beverages, than the non-CWI group (1846.7 ± 675.1 mL/day vs. 1478.0 ± 636.3 ml/day, p < 0.001). There was a significant association between being CWI and NAD intake in multivariate linear regression analyses ever after adjusting for the relevant variables (β = 318.1, p < 0.001). These findings demonstrated CWI, regardless of the reasons and the seasons, was associated with high NAD intake in Japanese healthy population.

Access to Document (DOI)

Impact of care coordination on oral anticoagulant therapy among patients with atrial fibrillation in routine clinical practice in Japan: A prospective, observational study

Ono F., Akiyama S., Suzuki A., Ikeda Y., Takahashi A., Matsuoka H., Sasaki M., Okamura T., Yoshihara N.

BMC Cardiovascular Disorders (BMC Cardiovascular Disorders) 19 ( 1 ) 235 2019.10

Research paper (scientific journal)

© 2019 The Author(s). Background: Care coordination between general practitioners (GPs) and cardiovascular specialists is expected to play a key role in establishing appropriate oral anticoagulant (OAC) treatment in atrial fibrillation (AF) patients. The aim of this study was to assess the impact of care coordination on oral anticoagulant therapy in the management of AF in Japan. Methods: This study was a multi-center, single-arm, prospective cohort study with retrospective chart and claims data review for historical controls. The study included three study periods: a 12-month pre-campaign period; a 12-month campaign period for AF screening and care coordination; and a 3-month post-campaign period for follow-up of care coordination. During the campaign period, patients aged ≥65 years who attended participating GP clinics underwent opportunistic AF screening by GPs under the campaign. At the discretion of the GP, newly diagnosed AF patients after the screening were referred to a cardiovascular specialist for care coordination. To assess the impact of care coordination and evaluate the effects of the campaign, implementation of care coordination, antithrombotic therapies, and patient-reported outcomes were compared between patients with and without care coordination, and between patients during the pre-campaign and campaign periods. Results: There were 86 newly diagnosed AF patients during the pre-campaign period and 90 during the campaign period. The percentage of patients with care coordination increased from 3.5% (3/86) in the pre-campaign period to 14.4% (n = 13/90) during the campaign period. The percentage of patients who received OAC therapies, according to the definition from the Japanese AF medication guideline, increased from 55.8% (48/86) to 71.1% (64/90) during the campaign period regardless of care coordination. Younger patients were referred to cardiovascular specialists for care coordination. Implementation of OAC therapy did not differ between patients with and without care coordination. Adherence to OAC therapy was low regardless of care coordination. Conclusions: This GP-targeted campaign was effective at raising awareness regarding the implementation of care coordination and appropriate OAC therapy at local clinical practices in Japan. Improvement of adherence to OAC therapy in elderly patients is a critical issue, and measures such as education programs targeted to patients and healthcare professionals should be undertaken.

Access to Document (DOI)

Explaining the decline in coronary heart disease mortality rates in Japan: Contributions of changes in risk factors and evidence-based treatments between 1980 and 2012

Ogata S., Nishimura K., Guzman-Castillo M., Sumita Y., Nakai M., Nakao Y.M., Nishi N., Noguchi T., Sekikawa A., Saito Y., Watanabe T., Kobayashi Y., Okamura T., Ogawa H., Yasuda S., Miyamoto Y., Capewell S., O'Flaherty M.

International Journal of Cardiology (International Journal of Cardiology) 291 183 - 188 2019.09

Research paper (scientific journal), ISSN 01675273

© 2019 The Authors Background: We aimed to quantify contributions of changes in risks and uptake of evidence-based treatment to coronary heart disease (CHD) mortality trends in Japan between 1980 and 2012. Methods: We conducted a modelling study for the general population of Japan aged 35 to 84 years using the validated IMPACT model incorporating data sources like Vital Statistics. The main outcome was difference in the number of observed and expected CHD deaths in 2012. Results: From 1980 to 2012, age-adjusted CHD mortality rates in Japan fell by 61%, resulting in 75,700 fewer CHD deaths in 2012 than if the age and sex-specific mortality rates had remained unchanged. Approximately 56% (95% uncertainty interval [UI]: 54–59%) of the CHD mortality decrease, corresponding to 42,300 (40,900–44,700) fewer CHD deaths, was attributable to medical and surgical treatments. Approximately 35% (28–41%) of the mortality fall corresponding to 26,300 (21,200–31,000) fewer CHD deaths, was attributable to risk factor changes in the population, 24% (20–29%) corresponding to 18,400 (15,100–21,900) fewer and 11% (8–14%) corresponding to 8400 (60,500–10,600) fewer from decreased systolic blood pressure (8.87 mm Hg) and smoking prevalence (14.0%). However, increased levels of cholesterol (0.28 mmol/L), body mass index (BMI) (0.68 kg/m2), and diabetes prevalence (1.6%) attenuated the decrease in mortality by 2% (1–3%), 3% (2–3%), and 4% (1–6%), respectively. Conclusions: Japan should continue their control policies for blood pressure and tobacco, and build a strategy to control BMI, diabetes, and cholesterol levels to prevent further CHD deaths.

Access to Document (DOI)

THE IMPACT OF DISTRIBUTION SHIFTS IN A POPULATION'S CARDIOVASCULAR RISK FACTORS ON HEALTHY LIFE EXPECTANCY IN JAPAN

Tsukinoki R., Murakami Y., Miura K., Okamura T., Kadota A., Hayakawa T., Okayama A., Ueshima H.

JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH 73 A57 - A57 2019.09

Research paper (scientific journal), ISSN 0143-005X

Access to Document (DOI)

DEVELOPMENT OF A CARDIOVASCULAR DISEASE RISK PREDICTION MODEL FOR POPULATION HEALTH PLANNING IN JAPAN: EPOCH-JAPAN STUDY

Murakami Y., Okamura T., Miura K., Ueshima H.

JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH 73 A91 - A91 2019.09

Research paper (scientific journal), ISSN 0143-005X

Access to Document (DOI)

Variation in process quality measures of diabetes care by region and institution in Japan during 2015–2016: An observational study of nationwide claims data

Sugiyama T., Imai K., Ihana-Sugiyama N., Tanaka H., Yanagisawa-Sugita A., Sasako T., Higashi T., Okamura T., Yamauchi T., Ueki K., Ohsugi M., Kadowaki T.

Diabetes Research and Clinical Practice (Diabetes Research and Clinical Practice) 155 107750 2019.09

Research paper (scientific journal), ISSN 01688227

© 2019 The Authors Aims: To calculate process quality measures of diabetes care in Japan using nationwide exclusive claims database. Methods: Using the National Database of health insurance claims during 2015–2016, the proportions of outpatients who received recommended examinations at least annually among those with regular antidiabetic medication were calculated as quality indicators, reported altogether and by prefecture and institutional certification (from the Japan Diabetes Society). Distributions of institutional-level quality indicators were also reported. Results: Among 4,154,452 outpatients, 96.7% underwent HbA1c or glycated albumin examination. Retinopathy examination was conducted among 46.5% of patients [prefecture (range): 37.5%–51.0%, institutional certification: 44.8% (without) vs. 59.8% (with)]. Urinary qualitative examination was conducted among 67.3% of patients at institutions with <200 beds (prefecture: 54.1%–81.9%, institutional certification: 66.8% vs. 92.8%), whereas urinary quantitative albumin or protein examination was conducted among 19.4% of patients (prefecture: 10.8%–31.6%, institutional certification: 18.7% vs. 54.8%). Distributions of institutional-level quality indicators showed that most institutions without institutional certification seldomly order urinary quantitative examination. Conclusions: Although the quality indicator for glycaemic control examination was favourable, some aspects of diabetes care were suboptimal and varied greatly by prefecture and institution; individual and organisational efforts to improve quality of diabetes care would be needed in Japan.

Access to Document (DOI)

　 Previous page - Next page 　