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Changes in prescribing trends and initial pharmacotherapy of children with nocturnal enuresis in Japan: a large-scale medical claims database analysis

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Abstract

Purpose

We analyzed the annual trends in and initial choice of pharmacotherapy for children with nocturnal enuresis (NE) using a large-scale medical claims database in Japan.

Methods

A retrospective descriptive study performed using data from the Japan Medical Data Center between January 2005 and March 2019 involving 23,814 registrants under 16 years of age. In the first cohort of children with NE, we analyzed the comorbidities and associated annual pharmacotherapy prescribing trends. In the second cohort of only newly diagnosed cases, we analyzed the first prescribed age and initial choice of pharmacotherapy.

Results

A total of 3494 children with NE were identified (mean age, 5.1 ± 3.6 years; male, 66.0%). An incremental increase in the proportion of children administered NE medications was observed. The proportion of children treated with desmopressin significantly increased, whereas the prescription of tricyclic antidepressants significantly decreased and that of anticholinergics did not significantly change. Among the newly diagnosed children, 1897 were treated with approximately 90% of the prescribed monotherapy. Sublingual desmopressin monotherapy accounts for more than half of the initial pharmacotherapy from 2016 onward. Regardless of the drug class, pharmacological therapy was commonly initiated at the age of 8.3 ± 2.1 years.

Conclusions

In Japan, the proportion of children treated with pharmacotherapy has been increasing. Furthermore, since the introduction of desmopressin sublingual formulations in 2012, a paradigm shift has occurred and this form of medication is now the most commonly prescribed, both from the annual perspective and as an initial choice among the newly diagnosed.

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Data availability

The datasets for this study are not publicly available because of the policy of the data vendor (JMDC). Requests to access should be directed to the JMDC.

Code availability

The code that supports the findings of this study is available from the author upon reasonable request.

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Funding

This work was supported by Asahikawa Medical University Fund, Japan.

Author information

Authors and Affiliations

  1. Institutional Research Office, Asahikawa Medical University, Asahikawa, Japan

    Sachiko Kasamo, Seiji Matsumoto & Hiroyasu Inoue

  2. Center for Advanced Research and Education, Asahikawa Medical University, 2-1-1-1, Midorigaoka-Higashi, Asahikawa, Hokkaido, 078-8510, Japan

    Seiji Matsumoto

  3. Clinical Biostatistics Section, Clinical Research Center, Chiba University Hospital, Chiba, Japan

    Yohei Kawasaki

  4. Faculty of Nursing, Japanese Red Cross College of Nursing, Tokyo, Japan

    Yohei Kawasaki

  5. Education Center, Asahikawa Medical University, Asahikawa, Japan

    Hiroyasu Inoue

  6. Department of Hospital Pharmacy and Pharmacology, Asahikawa Medical University, Asahikawa, Japan

    Yoshikazu Tasaki

Authors
  1. Sachiko Kasamo
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  2. Seiji Matsumoto
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  3. Yohei Kawasaki
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  4. Hiroyasu Inoue
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  5. Yoshikazu Tasaki
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Contributions

All authors assisted with interpretation of results, review of the manuscript, tables and figures, and final approval of the manuscript. SK: project development, data collection and management, statistical analysis, manuscript writing, review and critique of the manuscript; SM: project development, data collection and management, statistical analysis, manuscript writing, review and critique of the manuscript; YK: statistical analysis, review and critique of the manuscript; HI: project development, review and critique of the manuscript; YT: project development, review and critique of the manuscript.

Corresponding author

Correspondence to Seiji Matsumoto.

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Ethics approval

This study was approved by the Asahikawa Medical University Research Ethics Committee, Japan (No. 19142-2), and the requirement to obtain informed consent was waived owing to the de-identified and untraceable nature of the present data.

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Kasamo, S., Matsumoto, S., Kawasaki, Y. et al. Changes in prescribing trends and initial pharmacotherapy of children with nocturnal enuresis in Japan: a large-scale medical claims database analysis. World J Urol 39, 3517–3524 (2021). https://doi.org/10.1007/s00345-021-03664-y

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  • DOI: https://doi.org/10.1007/s00345-021-03664-y

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