Epidemiology in Asian Pharmacoepidemiology Network (AsPEN): study in Surveillance of Health Care in Asian Network (SCAN)

Abstract

BACKGROUND: The purpose of SCAN is to gain a better understanding of the health and health care utilization of the population covered in each participating sites from the AsPEN. OBJECTIVES: To investigate the prevalence of clinically recognized disease among the study population in Hong Kong (HK), Taiwan (TW), Japan (JP) and the United States (US). METHODS: We utilized the OMOP common data model in the AsPEN converted from a 1% random sample of Hong Kong Clinical Data Analysis and Reporting System (CDARS), a 5% random sample from Taiwan National Health Insurance Research Database (NHIRD), Japan Medical Data Center Database (JMDC), and 5% sample from the US Medicare database. Prevalence rates (per 100 persons, age-gender adjusted) of 33 clinically recognized diseases were evaluated. RESULTS: 6,476,773 individuals were identified in 4 databases, 47% were male. Hypertension is the most common disease in HK, TW and US and ranked fourth in JP with the prevalence of 2.6, 7.9, 59.6 and 4.6 respectively. Diabetes ranked third in HK (1.3), fourth in TW (3.8), fifth in JP (3.7) and third in US (23.3). Hyperlipidemia is the second most common in TW (5.1), JP (4.9) and US (51.6) and seventh in HK (0.8). Obstructive chronic bronchitis is the third most common disease in TW and JP (4.6 for TW, 4.8 for JP, 0.7 for HK, 9.1 for US). Asthma is the most common disease in JP (7.6) but not in other sites (0.5 for HK, 2.3 for TW, 5 for US). Prevalence of cancers were similar among Asian sites ranging from 0.1-0.5 but were lower than US (0.4-2.2). Similar pattern was observed in psychiatric disorders; Prevalence of depression and schizophrenia were 0.4-1.6 and 0.4 in Asian sites whereas 4.4 and 1 in US. US has the highest prevalence in most of the diseases. CONCLUSIONS: US has the highest age-gender adjusted prevalence across most of the diseases but the discrepancy was much less in non-CV diseases. This may be due to the difference in diet and lifestyle as well as in health care system and coding between Asian countries and US. Understanding the underlying prevalence of disease across standardized database representations is important when undertaking multi-national studies.