IMS Disease Analyzer Database Research Articles

Anti-seizure medication is not associated with an increased risk to develop cancer in epilepsy patients

ObjectiveWhether anti-seizure medication (ASM) increases the risk for cancer has been debated for decades. While for some ASM, a carcinoma-promoting effect has been suspected, carcinoma-protective effects have been shown for other ASM. However, the issue remains unresolved as data from preclinical and clinical studies have been inconsistent and contradictory.MethodsWe collected anonymous patient data from practice neurologists throughout Germany between 2009 and 2018 using the IMS Disease Analyzer database (QuintilesIMS, Frankfurt, Germany). People with epilepsy (PWE) with an initial cancer diagnosis and antiepileptic therapy prior to the index date were 1:1 matched with a control group of PWE without cancer according to age, gender, index year, Charlson Comorbidity Index, and treating physician. For both groups, the risk to develop cancer under treatment with different ASMs was analyzed using three different models (ever use vs. never use (I), effect per one (II) and per five therapy years (III).ResultsA total of 3152 PWE were included (each group, n = 1,576; age = 67.3 ± 14.0 years). The risk to develop cancer was not significantly elevated for any ASM. Carbamazepine was associated with a decreased cancer risk (OR Model I: 0.699, p < .0001, OR Model II: 0.952, p = .4878, OR Model III: 0.758, p < .0004).SignificanceOur findings suggest that ASM use does not increase the risk of cancer in epilepsy patients.

PDB1 Type 1 Diabetes Is Associated with Urinary System and Genital TRACT Disorders in Women

Type 1 diabetes can lead to different complications including macro- and microvascular disorders, and osteoporosis. However, only limited data on the association between type 1 diabetes (T1D) and urinary system and genital tract disorders was published. The aim of this work was to estimate this association among women with T1D treated in gynecological practices in Germany. This retrospective cross-sectional study included women aged 16 years or older with T1D diagnosis between January 2015 and December 2018 from 268 gynecological practices in Germany (IMS Disease Analyzer database). T1D patients were 1:5 matched with patients without diabetes by age, and physician. The main outcome of the study was the prevalence of different urinary system, breast, pelvic organ and genital tract disorders documented between the first T1D diagnosis documentation between and the last outpatient visit. Multivariate logistic regression models were fitted with all study disorders as dependent variables, and T1D as impact variable. In each model, the effect of T1d on the defined disorder was adjusted for all other study disorders. The present study included 1,357 women with and 1,357 women without T1D (mean age 45.6 years). T1D was significantly associated with acute vulvitis (OR: 2.12 (95% CI: 1.56-2.90), other specified urinary incontinence (OR: 1.64 (95% CI: 1.19-2.26), acute cystitis (OR: 1.46 (95% CI: 1.10-1.95), and absent, scanty and rare menstruation (OR: 1.37 (95% CI: 1.13-1.67). These findings may have implications for the future care of women with T1D. First, the focus should not only be on diabetes management but also on recognizing and treating additional comorbidities including urinary system and genital tract disorders. Further studies are required to investigate the association between T1D and increased risk of urinary system and genital tract disorders.

Prevalence of urinary system, pelvic organ, and genital tract disorders among women with type 1 diabetes in Germany

AimType 1 diabetes can lead to various long-term complications including macro- and microvascular disorders and osteoporosis. However, published data on the association between type 1 diabetes (T1D) and urinary system and genital tract disorders is limited. The aim of this work was to estimate the prevalence and incidence of urinary system- and genital tract disorders among women with T1D treated in gynecological practices in Germany. MethodsThis retrospective cohort study included women aged 16 years or older with T1D diagnosis between January 2015 and December 2018 from 268 gynecological practices in Germany (IMS Disease Analyzer database). T1D patients were matched 1:5 by age and physician with non-diabetic patients. The main outcome of the study was the prevalence of different urinary system, pelvic organ and genital tract disorders documented between the first documentation of T1D diagnosis and the last outpatient visit. All study disorders were included as dependent variables in multivariate logistic regression models, while T1D was applied as an impact variable. In each model, the effect of T1D on the defined disorder was adjusted for all other study disorders. ResultsThe present study included 1357 women with and 6785 women without T1D (mean age 45.6 years). T1D was significantly associated with acute vulvitis (OR: 2.12 (95% CI: 1.56–2.90), other specified urinary incontinence (OR: 1.64 (95% CI: 1.19–2.26), acute cystitis (OR: 1.46 (95% CI: 1.10–1.95), and absent, scanty and rare menstruation (OR: 1.37 (95% CI: 1.13–1.67). ConclusionThese findings may have implications for the future care of women with T1D. Firstly, the focus should not be on diabetes management alone, but also on identifying and handling additional associated comorbidities including urinary system and genital tract disorders. Secondly, the data suggest that patients with T1D should be asked specifically about symptoms they may be experiencing that are related to the associated disorders identified.

Dementia prevention and primary care: Estimation of the target population

The prevention of dementia, especially the cardiovascular prevention of cognitive disorders, is increasingly coming into the focus of health services research. The aim of this study is to determine the possible target population for dementia prevention approaches as well as frequency of health examinations (HE) in individual general practitioner offices (GP). 987 GP practices, which are covered by the nationwide IMS Disease Analyzer database (IQVIA) have been investigated for the prevalence of the following diagnoses, which are considered risk factors for the development of dementia Hypertension, obesity, hearing loss in each age group 45-65 and diabetes and depression in the age group 65 and older. In addition, it was recorded how many of these patients received a HE). In a sample of 2,398,405 patients receiving primary care, the target population relevant for dementia prevention measures in 2018 consisted of 191,883 patients with hypertension, 23,308 with obesity, 5,059 with hearing loss, 120,200 with diabetes and 43,233 with depression. More than a quarter of these patients have already had a HE. In 2018, patients with hypertension (N=51), diabetes (N=30.5) and depression (N=11.3) were the most frequently treated patients, less frequently patients with obesity (N=8.2) and hearing loss (N=1.6). On the basis of defined diagnoses in certain phases of life, a manageable group of patients can be identified who are eligible for specific dementia preventive interventions. The implementation of dementia preventive interventions in practices will be more difficult for the less frequent treatment diagnoses obesity and hearing loss than for the much more frequent treatment diagnoses hypertension, diabetes and depression.

Real-world treatment patterns in patients with nontuberculous mycobacterial lung disease in general and pneumologist practices in Germany

BackgroundNontuberculous mycobacterial lung disease (NTMLD) is a rare, progressive disease with an increasing incidence worldwide. AimsThe aim of this retrospective study was to analyze the baseline characteristics and management of NTMLD in general and pneumologist practices in Germany. MethodsThis retrospective study included patients with a culture-confirmed diagnosis of NTMLD documented between October 1, 2014 and September 30, 2019 by 125 general practitioners (GP) and 31 office-based pulmonologists from the IMS Disease Analyzer Database (IQVIA). ResultsA total of 159 patients managed by German GPs (mean age 59 ± 19 years, 51% female) and 236 patients managed by pulmonologists (mean age 62 ± 14 years, 58% female) were analyzed. In total, 45% (72/159) and 40% (94/236) of patients managed by GPs and pulmonologists respectively received antibiotic therapy for NTMLD. This therapy lasted for ≥ 6 months in 42%, for ≥ 12 months in 24%, and ≥ 18 months in 8% of patients. The average therapy duration was longer in patients treated by pulmonologists (241 ± 196 days) than in patients treated by GPs (113 ± 152 days). A total of 27% of patients managed by GPs and 45% of those managed by pulmonologists respectively received guideline-based therapy (GBT), defined as combination therapy with macrolide (azi-/ clarithromycin) + ethambutol + rifabutin/rifampicin, at least once; however, almost all patients (100% in the GP group, 96% in the pulmonologist group) also received non-GBT regimens intermediately. ConclusionsA considerable number of patients with NTMLD were not managed in accordance with the German guidelines and a substantial proportion also discontinue therapy prematurely. NTMLD management should be improved through appropriate referral pathways and collaboration between expert centers and primary or secondary care physicians.

Increased prevalence of depression, anxiety, and adjustment and somatoform disorders in transsexual individuals

BackgroundThe aim of this study was to explore rates of depression, anxiety, and adjustment and somatoform disorders in a large sample of transsexual individuals (TSI), compared with matched non-TSI cohorts from general practices in Germany. MethodsIndividuals initially documented as transsexual (index date) between January 2010 and December 2018 were identified in 468 general practices (GP) from the IMS Disease Analyzer database (IQVIA). Non-transsexual women (NTSW) and men (NTSM) were matched (1:1) with transsexual individuals by age, index year, and physician. The main outcome measure was the prevalence of depression, anxiety, and adjustment and somatoform disorders among TSI compared to NTSW and NTSM. ResultsA total of 535 TSI, 535 NTSW, and 535 NTSM were analyzed (mean age in each group was 35 years). Depression was documented in 20% of TSI versus 7.7% of NTSW and 5.5% of NTSM (p < 0.001), reaction to severe stress and adjustment disorders in 10% of TSI versus 4.3% of NTSW and 2.9% of NTSM (p < 0.001), somatoform disorders in 9.7% of TSI versus 5.8% of NTSW and 5.8% of NTSM (p 0.016), and anxiety disorders in 5.8% of TSI versus 1.9% of NTSW and 1.6% of NTSM, (p < 0.001). ConclusionOur findings indicate a need to promote TSI mental health. Furthermore, primary care physicians and psychiatrists should be aware of the importance of detecting and treating mental disorders in TSI and thereby improve their quality of life.

Changes in the utilization of blood glucose test strips among patients using intermittent-scanning continuous glucose monitoring in Germany.

To compare the daily consumption of blood glucose test strips (BGTSs) prior to and after the initiation of intermittent-scanning continuous glucose monitoring (iscCGM). This study included 1343 adults (≥18 years) with type 1 (T1D) or type 2 diabetes (T2D; mean age 51.4 years; 39.1% women) from the IMS Disease Analyzer database with an initial prescription of iscCGM in Germany between January 2015 and July 2018 (index date). We compared the average daily BGTS consumption after the index date versus prior to the index date. A multivariate logistic regression model was used to investigate the association between predefined variables and the probability of no longer using BGTSs after the index date. The mean (SD) daily BGTS consumption per patient decreased from 2.7 (3.0) prior to the index date to 1.4 (2.4) after the index date, and was similar in patients with T1D and those with T2D, in women and men, and across different age groups, as well in patients treated in diabetologist practices and those treated in general practices. In total, 40% of patients continued to use BGTSs, and 30% used them at least once daily. Male sex and glycated haemoglobin concentration (<6.5%), as well as less frequent use of BGTSs prior to the index date, were positively associated with non-use of BGTS after the index date. The daily consumption of BGTS was greatly reduced after the initiation of iscCGM use in patients with diabetes. However, some patients still used BGTSs in addition to iscCGM.

Switching the manufacturer of antiepileptic drugs is associated with higher risk of seizures: A nationwide study of prescription data in Germany.

Despite bioequivalence, the exchangeability of antiepileptic drugs in clinical settings is disputed. Therefore, we investigated the risk for recurrent seizures after switching the manufacturer of the same drug in a large German cohort. Anonymous patient data from practice neurologists throughout Germany between 2011 and 2016 were collected using the IMS Disease Analyzer database (QuintilesIMS, Frankfurt, Germany). People with epilepsy were included if at least 2 prescriptions within 360 days and 1 within 180 days prior to the index date were available. The cohort was separated into a seizure group and seizure-free controls. Both groups were matched 1:1 according to age, gender, insurance status, and treating physician. The risk for breakthrough seizures after a manufacturer switch of the same antiepileptic drug was analyzed using multivariate regression models. A total of 3,530 people with epilepsy were included (each group, n = 1,765; age = 53.7 ± 19.8 years). Patients with seizures had switched the drug manufacturer more often than controls (26.8% vs 14.2%; odds ratio [OR] = 1.35, 95% confidence interval [CI] = 1.08-1.69, p = 0.009), both from branded to generic (5.5% vs 2.4%; OR = 1.85, 95% CI = 1.30-2.64, p < 0.001) and between generic drugs (14.7% vs 7.1%; OR = 1.45, 95% CI = 1.13-1.87, p = 0.004). In previously seizure-free patients, switching the manufacturer of antiepileptic medications was associated with a higher risk for seizure recurrence. Our retrospective approach does not allow us to determine whether other changes in medical care at the same time could contribute to the recurrence. However, it would be prudent to avoid switching the manufacturer of anticonvulsants in seizure-free patients. Ann Neurol 2018;84:918-925.

Risk of dementia in German patients treated with antidepressants in general or psychiatric practices .

To study the impact of the use of antidepressants on dementia in German patients with depression treated in general (GPs) or psychiatric practices (PPs). Patients with a first-time documentation of depression with known severity level between 2010 and 2013 (index date) were identified by 1,126 general practitioners and 176 psychiatrists in the IMS Disease Analyzer database. We included patients between the ages of 60 and 80 years who had not previously received prescriptions for antidepressant drugs and had not been diagnosed with all-cause dementia prior to or on the index date. The main outcome of the study was the risk of dementia depending on antidepressant therapy. Cox proportional hazards models (dependent variable: incident dementia) were used to adjust for confounders and to estimate the effect of antidepressant therapy. A total of 22,838 patients treated in GPs and 33,112 patients treated in PPs were included in this study. Of those, 9,570, 30,321, and 16,059 individuals suffered from mild, moderate, and severe depression, respectively. Antidepressant drug use was associated with a decreased risk of dementia in patients affected by moderate (HR=0.86, 95% CI: 0.77-0.95) or severe depression (HR=0.83, 95% CI: 0.73-0.94). The use of antidepressants decreased dementia risk in patients with moderate or severe depression. .

Development and validation of the Japanese version of the Short Dark Triad (SD3-J): Comparing with the Japanese version of the Dark Triad Dirty Dozen

To investigate the prescribing trend of contraceptives in adolescent girls aged 12-18 years and to compare prescribing patterns of the most frequently used contraceptives among this population in Germany in 2007 and 2011.A retrospective cohort study was conducted to analyze contraceptive prescriptions written by gynecologists in 2007 and 2011 in Germany by using the IMS Disease Analyzer database (IMS HEALTH). All adolescent girls aged 12-18 years with at least 1 prescription of a contraceptive drug in 2007 or 2011 were identified. The prevalence of contraceptive prescriptions was calculated and the types of contraceptive substances prescribed were examined.A total of 21,026 teenage girls in 2007 and 18,969 in 2011 received contraceptive prescriptions. The prevalence of contraceptive prescribing rose significantly between 2007 and 2011 (P < .001). The percentage of teen girls who received prescriptions of levonorgestrel and chlormadinone pills was significantly higher in 2011 compared to 2007 (P < .001). However, the portion of contraceptive pills containing drospirenone or desogestrel significantly decreased in 2011 compared to 2007 (P < .01).There was a significant increase in contraceptive prescription usage among adolescent girls between 2007 and 2011 in Germany. However, the prescription behavior of doctors also changed; they consequently prescribed contraceptives with more evidence. Further research is needed to better understand the various factors associated with contraceptive use among this population.

Caesarean section and its impact on fertility and time to a subsequent pregnancy in Germany: a database analysis in gynecological practices.

To analyze the impact of caesarean section (CS) on fertility and time to pregnancy in German gynecological practices. Women initially diagnosed for the first time with a vaginal delivery (VD) or CS between 2000 and 2013 were identified by 227 gynecologists in the IMS Disease Analyzer database. They were included if they were aged between 16 and 40years, and were not previously diagnosed with female sterility. The two main outcomes were the first-time diagnosis of female sterility and the time between the first delivery and the next pregnancy within 10years. A multivariate Cox regression model was used to predict these outcomes on the basis of patient characteristics. 6483 patients were included in the CS group and 6483 in the VD group. Mean age was 30.6years and the proportion of individuals with private health insurance amounted to 9.0%. Within 10years of the index date, 19.5% of women who delivered by CS and 18.3% of women who delivered vaginally were diagnosed with sterility (p value=0.0148). CS and polycystic ovary syndrome significantly increased the risk of sterility. Within 10years of the index date, 57.9% of women who underwent a CS and 64.0% of women who delivered vaginally were pregnant for the second time (p value <0.001). CS, polycystic ovary syndrome, and the deterioration of menstrual cycle significantly decreased the chance of becoming pregnant a second time. CS is associated with an increased risk of sterility and a decreased number of subsequent pregnancies in Germany.

Impact of caesarean section on mode of delivery, pregnancy-induced and pregnancy-associated disorders, and complications in the subsequent pregnancy in Germany.

Objectives: To analyze the impact of caesarean section (CS) on mode of delivery, pregnancy-induced and pregnancy-associated disorders, as well as complications in the subsequent pregnancy within German gynecological practices.Methods: 1,801 women with CS and 1,801 matched women with vaginal delivery (VD) from the IMS Disease Analyzer database were included. The impact of previous CS on the mode of delivery and pregnancy-associated disorders as well as complications prior to or during birth in the subsequent pregnancy were analyzed. Cox regressions were used to determine the influence of CS with regard to these outcomes.Results: Medical abortion and single spontaneous delivery were significantly less frequent in women with a history of CS compared to VD (OR equal to 0.52 and 0.04 respectively), whereas CS after CS was the significantly more common mode of delivery (79.0% versus 9.3%, OR=36.47). Gestational hypertension without significant proteinuria, gestational hypertension with significant proteinuria, and polyhydramnios were more frequent in women with CS than in women with VD (OR equal to 6.80, 1.71, and 2.29). Hemorrhage and maternal care for known or suspected disproportion were more common in the CS group than in the VD group (OR equal to 1.34 and 3.75). Prolonged pregnancy, preterm labor, abnormalities arising from forces of labor, and perineal laceration during delivery were significantly less frequent in women with CS than in women with VD (OR between 0.32 and 0.75), whereas long labor was more common (OR=2.09).Conclusion: Women with CS were more likely to undergo further CS and to develop major pregnancy-associated diseases in the following pregnancy compared to women with VD.

Impact of metformin on metastases in patients with breast cancer and type 2 diabetes

AimTo analyze the impact of glucose-lowering drugs on metastases in women living in Germany who have been diagnosed with breast cancer (BC) and type 2 diabetes mellitus (T2DM). MethodsWomen initially diagnosed with BC (2004–2013) were identified in the IMS Disease Analyzer database. Patients with a documentation of metastases at index date or during the following six months were excluded. We selected T2DM women between 40 and 90years of age who received glucose-lowering therapy (metformin, sulfonylureas, incretins, insulins, other medications). The primary outcome was the diagnosis of metastases recorded in the database between the index date and the end of follow-up. A multivariate Cox regression model was used to predict BC metastases on the basis of patient characteristics and glucose-lowering medication. ResultsA total of 4,953 women with BC and diabetes were included in the study. The mean age was 71.4years and 4.7% of patients had private health insurance coverage. Mean HbA1C was 7.1% and mean BMI was 30.6kg/m2. After 5years follow-up, 9.2% of patients with metformin and 12.3% of patients without exhibited metastases (log-rank p-value=0.011), whereas 6.2% of patients with incretins and 11.0% of patients without incretins exhibited metastases (both log-rank p-values <0.001). Metformin (HR=0.73, 95% CI: 0.58-0.92) and incretins (HR=0.62, 95% CI: 0.45-0.84) both significantly decreased the risk of metastases. None of the other variables were significantly associated with diagnosis of metastases. ConclusionThe use of metformin and incretins in women with T2DM and BC may reduce the risk of metastases.

0490: Prasugrel use in “real life”: report from outpatient settings in France

of the study is to provide descriptive statistics on patterns of prasugrel usage in outpatient settings in France. The aim was to observe if the guidance for the use of Prasugrel from the European label was respected. This retrospective study was conducted to describe treatment patterns of prasugrel in outpatient settings in France using the IMS Disease Analyzer database, which collects electronic medical records of patients followed by a national representative of 1200 French general practitioners (GPs). Anonymous data are collected prospectively and continuously during each follow-up visit. The study population consisted of patients who had at least 1 prescription of prasugrel in outsetting starting from launch to 3 years post launch. The patients were followed from the date of the first prasugrel prescription recorded in the data base (index date) until they died, changed of GP or reached the end of the study, whichever came first. In France, the IMS Disease Analyzer included 1.052 patients receiving at least one prescription of prasugrel from January 2010 until October 2012. 85% (n=894) were male (n=894), the mean age was 58.5 years. 5.7% of patients were aged more than 75 years, and 5.0% weighed 60kg or less. Only 0.2% (n=2) had a history of TIA/stroke among this cohort. Prasugrel was prescribed at a daily maintenance dose of 10mg for 99.8% of patients (1.050 patients). Concomitant medications were usual (aspirin, lipid lowering agents, beta blockers, angiotensin-converting-enzyme (ACE)-inhibitors. 55.1% of patients received an anti-ulcer medication (mainly Proton Pump Inhibitor [PPI). The persistence with prasugrel using the MPR (Medication Possession Ratio) was respectively 60.7% and 63.2% for patients with at 6 months (n=504) and 12 months follow-up (n=213). 13.7% of patients were switched from another thienopyridine (primarily clopidogrel). In prasugrel-treated patients, respect of Prasugrel indications was highly fulfilled. Almost all patients received aspirin combined to prasugrel. Of note, half of patients were treated with an anti-ulcer medication. The main results reflect a good usage of prasugrel by French GPs, in collaboration with cardiologists, with a satisfying understanding and implementation of the European label, in contrast with recent American registry’s findings.

Do patients with lactose intolerance exhibit more frequent comorbidities than patients without lactose intolerance? An analysis of routine data from German medical practices.

BackgroundThe increase in food intolerances poses a burgeoning problem in our society. Food intolerances not only lead to physical impairment of the individual patient but also result in a high socio-economic burden due to factors such as the treatment required as well as absenteeism. The present study aimed to explore whether lactose intolerant (LI) patients exhibit more frequent comorbidities than non-LI patients.MethodsThe study was conducted on a case-control basis and the results were determined using routine data analysis. Routine data from the IMS Disease Analyzer database were used for this purpose. A total of 6,758 data records were processed and analyzed.ResultsThere were significant correlations between LI and the incidence of osteoporosis, changes in mental status, and the presence of additional food intolerances. Comparing 3,379 LI vs. 3,379 non-LI patients, 34.5% vs. 17.7% (P<0.0001) suffered from abdominal pain; 30.6% vs. 17.2% (P<0.0001) from gastrointestinal infections; and 20.9% vs. 16.0% (P=0.0053) from depression. Adjusted odds ratios (OR) were the highest for fructose intolerance (n=229 LI vs. n=7 non-LI; OR 31.06; P<0.0001), irritable bowel syndrome (n=247 LI vs. n=44 non-LI; OR 5.23; P<0.0001), and bloating (n=351 LI vs. n=68 non-LI; OR 4.94; P<0.0001).ConclusionThe study confirms that LI should not be regarded as an isolated illness but considered a possible trigger for further diseases. Additional research is necessary to assert more precise statements.

Cancer is associated with intraoperative and postprocedural complications and disorders.

To analyze the impact of cancer on intraoperative and postprocedural complications (IPCs) in Germany. Patients with first diagnosis of IPCs between 2010 and 2015 were identified in 982 general practitioners in the IMS Disease Analyzer database. Controls were included after individual matching (1:1) to IPC cases by age, gender, type of health insurance (private or statutory) and the physician. Demographic data included: age, sex and health insurance type (private or statutory). Clinical data included: cancer, diabetes, coronary heart disease including myocardial infarction, stroke including TIA, heart failure, chronic respiratory diseases, fractures and depression. A multivariate logistic model was used to calculate the risk of IPC on the basis of patient characteristics. A total of 5817 IPC patients and 5817 controls were included in this study. The mean age was 63.9 years, the proportion of people with private health insurance coverage was equal to 3.0 %, and the proportion of men was equal to 36.0 % in both groups; 21.5 % of IPC patients and 5.8 % of controls had cancer (p value <0.0001). Moreover, diabetes, coronary heart disease, stroke, heart failure, chronic respiratory disease, fractures and depression were also significantly more common in IPC patients than in controls. Cancer had a negative impact on the risk of IPC (OR 4.27, 95 % CI 3.76-4.85 and p value <0.0001). Coronary heart diseases, depression, fractures and chronic respiratory diseases were also significantly associated with an increased risk of IPC. The present study indicates that cancer increases the risk of IPCs and may reduce the clinical benefits of surgery.

Prevalence of depression, anxiety and their risk factors in German women with breast cancer in general and gynecological practices

To analyze the prevalence of depression, anxiety and their risk factors in German women with breast cancer (BC) in general and gynecological practices (GP, GYP). Women initially diagnosed with BC between 2009 and 2013 were identified by 1202 general practitioners and 244 gynecologists in the IMS Disease Analyzer database. They were included only if they had not suffered from depression or an anxiety disorder within the 12 months prior to the index date. The main outcome was the first diagnosis of depression or an anxiety disorder within 5 years after index date. A multivariate Cox regression model was used to predict these diagnoses on the basis of patient characteristics. A total of 24,537 patients in GP were available for the study, as well as 20,018 patients in GYP. The mean age was 65.8 and 62.5 years in GP and GYP, respectively (p value <0.0001). The proportions of depressive or anxiety episodes in the past and the proportion of metastases were higher in GP than in GYP (7.9 vs. 3.6%, and 10.1 vs. 8.6%, p values <0.0001). Within 5 years of follow-up, 36.9% of GP patients and 35.1% of GYP patients had been diagnosed with depression or anxiety. There was a significantly higher risk of depression and/or anxiety in women in the age groups 51-60, 61-70 and >70 years than in women = <50 years (OR between 1.05 and 1.27, all p values lower than 0.0359). Patients with metastases or with previous episodes of depression/anxiety had a higher risk of depression/anxiety (OR = 1.21 and 1.97, p values <0.0001). Finally, women with private health insurance had a lower risk of depression and anxiety (OR = 0.45, p value <0.0001). The present study indicates that levels of depression and anxiety increase in German women after diagnosis of BC and may be predicted on the basis of several demographic and clinical characteristics.

Pregnancy after breast cancer in germany - results of a retrospective database analysis

After the establishment of the FertiPROTEKT network in 2006, an impetus for possibilities of pregnancy during and after breast cancer was introduced. Nowadays, breast cancer survivors are confronted with the question how often women become pregnant after breast cancer and whether there have been significant changes in this respect during the past 10 years. The aim of the study was, therefore, to examine the change in frequency of pregnancies after breast cancer treatment and the time from the first breast cancer diagnosis to pregnancy over one decade, i. e., the period from 2010-2012 compared to the period from 2000-2002. The study is based on data from the IMS Disease Analyzer database, which enables access to anonymous data from registered physicians. Data from 102 gynecological practices were available for the present study. The study included women aged 20-45 with breast cancer. A total of 179 pregnant women were included in this study from 2000-2002 and 2010-2012. 65 pregnancies were recorded in the period from 2000-2002, 114 pregnancies from 2010-2012. The time interval from the breast cancer diagnosis to pregnancy (analysed time period was 10 years) was 896 days (SD: 690) in the period from 2000-2002 and 552 days (SD: 696) in the period from 2010-2012 (p<0.001). There was a significant increase in pregnancies within the first 2 years after the breast cancer diagnosis. These data are consistent with the intensified consultations after the introduction of the FertiPROTEKT network.

Trends and patterns of hormonal contraceptive prescribing for adolescents in primary care in the UK

BackgroundHormonal contraceptives are the most common method used worldwide by teenagers to prevent unwanted pregnancies. To date there are limited data about such use by teenagers in the UK. This...

PWE-178 Impact Of Chronic Constipation On Healthcare Resource Use In The Uk: An Analysis Based On Electronic Medical Records

IntroductionChronic constipation is a common condition with a substantial impact on health-related quality of life. The aim of this study was to assess healthcare resource use and prescription laxative costs...