Burden of comorbidities among Japanese patients with atrial fibrillation: a case study of dyspepsia

Abstract

Yoshikazu Kinoshita,1 Marco DiBonaventura,2 Bruno Rossi,3 Kazuya Iwamoto,4 Edward C Y Wang,5 Jean-Baptiste Briere51Department of Gastroenterology and Hepatology, Shimane University School of Medicine, Izumo, Japan; 2Health Sciences Practice, Kantar Health, New York, NY, USA; 3Market Access, 4Medical Affairs Cardiovascular and Neurology, 5Health Economics and Outcomes Research, Bayer Yakuhin Ltd, Osaka, JapanBackground: The aim of this study was to investigate the link between atrial fibrillation (AF) and dyspepsia, as well as the contribution of dyspepsia to the overall burden of AF.Methods: The 2008, 2009, and 2010 Japan National Health and Wellness Survey (NHWS) datasets were used in this study. The NHWS is an Internet-based survey administered to the adult population in Japan using a random stratified sampling framework to ensure demographic representativeness. The presence of dyspepsia was compared between those with and without AF. Among those with AF, the effect of dyspepsia on health status, work productivity, and activity impairment was examined, along with health care resource use using multivariable regression modeling and controlling for baseline differences.Results: Among patients with AF (n = 565), the three most commonly reported comorbidities were hypertension (38.76%), dyspepsia (37.35%), and overactive bladder (28.72%). Patients with AF had 48.59% greater odds of reporting dyspepsia than those without AF (P < 0.05). Patients with dyspepsia used more AF medications (2.05 versus 1.54) and had been diagnosed more recently (9.97 versus 10.58 years). Dyspepsia was associated with significantly worse physical health status (P < 0.05) and significantly more absenteeism, overall work impairment, activity impairment, physician visits, and emergency room visits (all P < 0.05).Conclusion: Patients with AF in Japan experience a number of comorbidities, with dyspepsia being the most common noncardiovascular comorbidity. Given the prevalence and additional burden of this comorbidity across both humanistic and economic outcomes, the management of dyspepsia among patients with AF should be an area of greater focus.Keywords: atrial fibrillation, dyspepsia, health status, work productivity, health care resource use