16 results on '"P. Motsepe-Ditshego"'
Search Results
2. Increasing Prevalence and Incidence of Atherosclerotic Cardiovascular Disease in Adult Patients in Ontario, Canada From 2002 to 2018
- Author
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Erin S. Mackinnon, PhD, Ron Goeree, BA, MA, Shaun G. Goodman, MD, MSc, Raina M. Rogoza, MSc, Millicent Packalen, BSc(Hons), Louisa Pericleous, PhD, Ponda Motsepe-Ditshego, MD, and Paul Oh, MD, MSc, FRCPC
- Subjects
Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background: Cardiovascular disease is the second-leading cause of death in Canada. However, limited data are available on the prevalence of atherosclerotic cardiovascular disease (ASCVD) in Canada. The study objective was to describe the incidence and prevalence of ASCVD in adult patients in Ontario, Canada, and to evaluate temporal trends for subsequent ASCVD events among those with new-onset ASCVD. Methods: This retrospective, observational study identified ASCVD incidence and prevalence data from the Institute for Clinical Evaluative Sciences Data Repository for adults from Ontario. Overall prevalence was established for the period from 2002 to 2018. Incident cases from April 1, 2005 to March 2016 were then identified, and followed up to 2018. Primary outcomes were date and type of index event/procedure, patient characteristics/baseline demographics, and comorbidities. Secondary outcomes assessed were time from first to second ASCVD event, subsequent event(s) and/or mortality, and type of subsequent event(s) relative to the type of index/primary event. Results: A total of 1,042,621 eligible prevalent ASCVD cases were identified; of these, 743,309 patients (69%) were newly diagnosed with incident ASCVD. The 10-year prevalence rates for all ASCVD subtypes increased over the study period. Overall event incidence rates per 1000 person-years were mostly stable or increased. Among incident cases, 50% experienced subsequent events over the study period. Conclusions: This observational study demonstrated increasing prevalence and high incidence of new ASCVD diagnoses in adults from Ontario, over the study period. These data, together with the substantial number of subsequent events in ASCVD patients, demonstrate significant clinical burden of this disease in Ontario. Résumé: Contexte: Les maladies cardiovasculaires constituent la deuxième cause de décès au Canada. Toutefois, on dispose de peu de données sur la prévalence de la maladie cardiovasculaire athéroscléreuse (MCVAS) au Canada. L’étude avait pour objectifs de décrire l’incidence et la prévalence de la MCVAS chez les patients adultes en Ontario (Canada) et d’évaluer les tendances temporelles des manifestations subséquentes de MCVAS chez les personnes ayant une MCVAS d’apparition récente. Méthodologie: Cette étude observationnelle rétrospective a permis de colliger les données sur l’incidence et la prévalence de la MCVAS chez les adultes ontariens consignées dans le référentiel de l’Institut des sciences cliniques évaluatives. La prévalence globale a été établie pour la période allant de 2002 à 2018. Les cas incidents survenus du 1er avril 2005 à mars 2016 ont ensuite été recensés et suivis jusqu’en 2018. Les paramètres d’évaluation principaux étaient : date et nature de la manifestation index et de l’intervention; caractéristiques des patients et données démographiques initiales; comorbidités. Les éléments suivants constituaient les paramètres d’évaluation secon-daires : temps écoulé entre la première et la deuxième manifestation de MCVAS, la ou les manifestations subséquentes et/ou le décès; nature de la ou des manifestations subséquentes par rapport à celle de la manifestation index ou primaire. Résultats: En tout, 1 042 621 cas de MCVAS prévalents admissibles ont été dénombrés; parmi ceux-ci, il y avait 743 309 (69 %) cas incidents de MCVAS nouvellement diagnostiqués. Les taux de prévalence à 10 ans de tous les sous-types de MCVAS ont augmenté au cours de la période étudiée. Les taux globaux d’incidence des manifestations par 1000 années-personnes étaient généralement stables ou accrus. Cinquante pour cent des cas incidents ont été associés à des manifestations subséquentes au cours de la période étudiée. Conclusions: Cette étude observationnelle a démontré une prévalence croissante et une incidence élevée de nouveaux diagnostics de MCVAS chez les adultes en Ontario au cours de la période étudiée. Les données à cet égard, ainsi que le grand nombre de manifestations subséquentes de la maladie, démontrent que la MCVAS constitue un fardeau clinique considérable en Ontario.
- Published
- 2022
- Full Text
- View/download PDF
3. Fragility fracture identifies patients at imminent risk for subsequent fracture: real-world retrospective database study in Ontario, Canada
- Author
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Jonathan D. Adachi, Jacques P. Brown, Emil Schemitsch, Jean-Eric Tarride, Vivien Brown, Alan D. Bell, Maureen Reiner, Millicent Packalen, Ponda Motsepe-Ditshego, Natasha Burke, and Lubomira Slatkovska
- Subjects
Osteoporosis ,Fragility fracture ,Subsequent fracture ,Real-world data ,Imminent fracture risk ,Post fracture care ,Diseases of the musculoskeletal system ,RC925-935 - Abstract
Abstract Background The secondary fracture prevention gap in the osteoporosis field has been previously described as a ‘crisis’. Closing this gap is increasingly important in the context of accumulating evidence showing that an incident fragility fracture is associated with an increased risk of subsequent fracture within 1–2 years, known as imminent fracture risk. The objective of this study was to use health services data to characterize the time between index fragility fractures occurring at different osteoporotic sites and subsequent fractures. Methods This retrospective observational study used de-identified health services data from the publicly funded healthcare system in Ontario, the largest province of Canada. Patients aged > 65 with an index fragility fracture occurring between 2011 and 2015 were identified from the ICES Data Repository using International Classification of Diseases (ICD)-10 codes. We examined median time to subsequent fragility fractures for osteoporotic fracture sites until the end of follow-up (2017). BMD assessment and use of osteoporosis therapies following index fracture were also characterized. Results Among 115,776 patients with an index fragility fracture, 17.8% incurred a second fragility fracture. Median time between index and second fracture occurring at any site was 555 days (interquartile range: 236–955). For each index fracture site examined, median time from index to second fracture was 3 years post index fracture. Conclusions This cohort of Canadian patients aged > 65 years who experienced a fragility fracture at any site are at imminent risk of experiencing subsequent fracture within the next 2 years and should be proactively assessed and treated.
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- 2021
- Full Text
- View/download PDF
4. Mortality in older adults following a fragility fracture: real-world retrospective matched-cohort study in Ontario
- Author
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Jacques P. Brown, Jonathan D. Adachi, Emil Schemitsch, Jean-Eric Tarride, Vivien Brown, Alan Bell, Maureen Reiner, Thiago Oliveira, Ponda Motsepe-Ditshego, Natasha Burke, and Lubomira Slatkovska
- Subjects
Fracture ,Osteoporosis ,Mortality ,Real-world ,Older adults ,Diseases of the musculoskeletal system ,RC925-935 - Abstract
Abstract Background Recent studies are lacking reports on mortality after non-hip fractures in adults aged > 65. Methods This retrospective, matched-cohort study used de-identified health services data from the publicly funded healthcare system in Ontario, Canada, contained in the ICES Data Repository. Patients aged 66 years and older with an index fragility fracture occurring at any osteoporotic site between 2011 and 2015 were identified from acute hospital admissions, emergency and ambulatory care using International Classification of Diseases (ICD)-10 codes and data were analyzed until 2017. Thus, follow-up ranged from 2 years to 6 years. Patients were excluded if they presented with an index fracture occurring at a non-osteoporotic fracture site, their index fracture was associated with a trauma code, or they experienced a previous fracture within 5 years prior to their index fracture. This fracture cohort was matched 1:1 to controls within a non-fracture cohort by date, sex, age, geography and comorbidities. All-cause mortality risk was assessed. Results The survival probability for up to 6 years post-fracture was significantly reduced for the fracture cohort vs matched non-fracture controls (p 65 years, a fragility fracture occurring at any site was associated with reduced survival for up to 6 years post-fracture. The greatest reduction in survival occurred within the first-year post-fracture, where mortality risk more than doubled and deaths were observed in 1 in 11 women and 1 in 7 men following a non-hip fracture and in 1 in 5 women and 1 in 3 men following a hip fracture.
- Published
- 2021
- Full Text
- View/download PDF
5. Fragility fracture identifies patients at imminent risk for subsequent fracture: real-world retrospective database study in Ontario, Canada
- Author
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Adachi, Jonathan D., Brown, Jacques P., Schemitsch, Emil, Tarride, Jean-Eric, Brown, Vivien, Bell, Alan D., Reiner, Maureen, Packalen, Millicent, Motsepe-Ditshego, Ponda, Burke, Natasha, and Slatkovska, Lubomira
- Published
- 2021
- Full Text
- View/download PDF
6. Mortality in older adults following a fragility fracture: real-world retrospective matched-cohort study in Ontario
- Author
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Brown, Jacques P., Adachi, Jonathan D., Schemitsch, Emil, Tarride, Jean-Eric, Brown, Vivien, Bell, Alan, Reiner, Maureen, Oliveira, Thiago, Motsepe-Ditshego, Ponda, Burke, Natasha, and Slatkovska, Lubomira
- Published
- 2021
- Full Text
- View/download PDF
7. Diversity and Representation Among United States Participants in Amgen Clinical Trials
- Author
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Racadio, E. Racquel, Rai, Angshu, Kizilirmak, Pinar, Agarwal, Sonali, Sosa, Eloy, Desborough, Claire, Adnan, Tatheer, Zhou, Lei, Balasubramanian, Akhila, Sharma, Anushree, and Motsepe-Ditshego, Ponda
- Abstract
Objective: Describe the demographic profile of US participants in Amgen clinical trials over a 10-year period and variations across therapeutic areas, indications, and geographies. Methods: Cross-sectional retrospective study including participants enrolled (2005–2020) in phase 1–3 trials completed between January 1, 2012 and June 30, 2021. Results: Among 31,619 participants enrolled across 258 trials, one-fifth represented racial minority populations (Asian, 3%; Black or African American, 17%; American Indian or Alaska Native, Native Hawaiian or Other Pacific Islander, multiracial, each < 1%); fewer than one-fifth (16%) represented an ethnic minority population (Hispanic or Latino). Compared with census data, representation of racial and ethnic groups varied across US states. Across most therapeutic areas (bone, cardiovascular, hematology/oncology, inflammation, metabolic disorders, neuroscience) except nephrology, participants were predominantly White (72–81%). A similar proportion of males and females were enrolled between 2005 and 2016; male representation was disproportionately higher than female between 2016 and 2020. Across most medical indications, the majority of participants were 18–65 years of age. Conclusions and Relevance: While the clinical research community is striving to achieve diversity and proportional representation across clinical trials, certain populations remain underrepresented. Our data provide a baseline assessment of the diversity and representation of US participants in Amgen-sponsored clinical trials and add to a growing body of evidence on the importance of diversity in clinical research. These data provide a foundation for strategies aimed at supporting more equitable and representative research, and a baseline from which to assess the impact of future strategies to advance health equity.
- Published
- 2024
- Full Text
- View/download PDF
8. Increasing Prevalence and Incidence of Atherosclerotic Cardiovascular Disease in Adult Patients in Ontario, Canada From 2002 to 2018
- Author
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Shaun G. Goodman, Ron Goeree, Erin S Mackinnon, Millicent Packalen, Paul Oh, Raina M. Rogoza, L Pericleous, and P. Motsepe-Ditshego
- Subjects
Pediatrics ,medicine.medical_specialty ,Adult patients ,business.industry ,Atherosclerotic cardiovascular disease ,Incidence (epidemiology) ,Prevalence ,Disease ,RC666-701 ,Diseases of the circulatory (Cardiovascular) system ,Medicine ,Observational study ,Cardiology and Cardiovascular Medicine ,business ,Cause of death ,Ontario canada - Abstract
Background: Cardiovascular disease is the second-leading cause of death in Canada. However, limited data are available on the prevalence of atherosclerotic cardiovascular disease (ASCVD) in Canada. The study objective was to describe the incidence and prevalence of ASCVD in adult patients in Ontario, Canada, and to evaluate temporal trends for subsequent ASCVD events among those with new-onset ASCVD. Methods: This retrospective, observational study identified ASCVD incidence and prevalence data from the Institute for Clinical Evaluative Sciences Data Repository for adults from Ontario. Overall prevalence was established for the period from 2002 to 2018. Incident cases from April 1, 2005 to March 2016 were then identified, and followed up to 2018. Primary outcomes were date and type of index event/procedure, patient characteristics/baseline demographics, and comorbidities. Secondary outcomes assessed were time from first to second ASCVD event, subsequent event(s) and/or mortality, and type of subsequent event(s) relative to the type of index/primary event. Results: A total of 1,042,621 eligible prevalent ASCVD cases were identified; of these, 743,309 patients (69%) were newly diagnosed with incident ASCVD. The 10-year prevalence rates for all ASCVD subtypes increased over the study period. Overall event incidence rates per 1000 person-years were mostly stable or increased. Among incident cases, 50% experienced subsequent events over the study period. Conclusions: This observational study demonstrated increasing prevalence and high incidence of new ASCVD diagnoses in adults from Ontario, over the study period. These data, together with the substantial number of subsequent events in ASCVD patients, demonstrate significant clinical burden of this disease in Ontario. Résumé: Contexte: Les maladies cardiovasculaires constituent la deuxième cause de décès au Canada. Toutefois, on dispose de peu de données sur la prévalence de la maladie cardiovasculaire athéroscléreuse (MCVAS) au Canada. L’étude avait pour objectifs de décrire l’incidence et la prévalence de la MCVAS chez les patients adultes en Ontario (Canada) et d’évaluer les tendances temporelles des manifestations subséquentes de MCVAS chez les personnes ayant une MCVAS d’apparition récente. Méthodologie: Cette étude observationnelle rétrospective a permis de colliger les données sur l’incidence et la prévalence de la MCVAS chez les adultes ontariens consignées dans le référentiel de l’Institut des sciences cliniques évaluatives. La prévalence globale a été établie pour la période allant de 2002 à 2018. Les cas incidents survenus du 1er avril 2005 à mars 2016 ont ensuite été recensés et suivis jusqu’en 2018. Les paramètres d’évaluation principaux étaient : date et nature de la manifestation index et de l’intervention; caractéristiques des patients et données démographiques initiales; comorbidités. Les éléments suivants constituaient les paramètres d’évaluation secon-daires : temps écoulé entre la première et la deuxième manifestation de MCVAS, la ou les manifestations subséquentes et/ou le décès; nature de la ou des manifestations subséquentes par rapport à celle de la manifestation index ou primaire. Résultats: En tout, 1 042 621 cas de MCVAS prévalents admissibles ont été dénombrés; parmi ceux-ci, il y avait 743 309 (69 %) cas incidents de MCVAS nouvellement diagnostiqués. Les taux de prévalence à 10 ans de tous les sous-types de MCVAS ont augmenté au cours de la période étudiée. Les taux globaux d’incidence des manifestations par 1000 années-personnes étaient généralement stables ou accrus. Cinquante pour cent des cas incidents ont été associés à des manifestations subséquentes au cours de la période étudiée. Conclusions: Cette étude observationnelle a démontré une prévalence croissante et une incidence élevée de nouveaux diagnostics de MCVAS chez les adultes en Ontario au cours de la période étudiée. Les données à cet égard, ainsi que le grand nombre de manifestations subséquentes de la maladie, démontrent que la MCVAS constitue un fardeau clinique considérable en Ontario.
- Published
- 2021
9. Fragility fracture identifies patients at imminent risk for subsequent fracture: real-world retrospective database study in Ontario, Canada
- Author
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Jacques P. Brown, Lubomira Slatkovska, Vivien Brown, Maureen Reiner, Millicent Packalen, Emil H. Schemitsch, Alan Bell, Jean-Eric Tarride, Jonathan D. Adachi, P. Motsepe-Ditshego, and Natasha Burke
- Subjects
medicine.medical_specialty ,lcsh:Diseases of the musculoskeletal system ,Osteoporosis ,Secondary fracture prevention ,030209 endocrinology & metabolism ,Context (language use) ,03 medical and health sciences ,0302 clinical medicine ,Fragility ,Rheumatology ,Interquartile range ,Epidemiology ,Secondary Prevention ,Humans ,Medicine ,Orthopedics and Sports Medicine ,030212 general & internal medicine ,Aged ,Retrospective Studies ,Imminent fracture risk ,Ontario ,Bone Density Conservation Agents ,business.industry ,Retrospective cohort study ,Subsequent fracture ,Fragility fracture ,medicine.disease ,Real-world data ,Emergency medicine ,Cohort ,Fracture (geology) ,Post fracture care ,lcsh:RC925-935 ,business ,Osteoporotic Fractures ,Research Article - Abstract
Background The secondary fracture prevention gap in the osteoporosis field has been previously described as a ‘crisis’. Closing this gap is increasingly important in the context of accumulating evidence showing that an incident fragility fracture is associated with an increased risk of subsequent fracture within 1–2 years, known as imminent fracture risk. The objective of this study was to use health services data to characterize the time between index fragility fractures occurring at different osteoporotic sites and subsequent fractures. Methods This retrospective observational study used de-identified health services data from the publicly funded healthcare system in Ontario, the largest province of Canada. Patients aged > 65 with an index fragility fracture occurring between 2011 and 2015 were identified from the ICES Data Repository using International Classification of Diseases (ICD)-10 codes. We examined median time to subsequent fragility fractures for osteoporotic fracture sites until the end of follow-up (2017). BMD assessment and use of osteoporosis therapies following index fracture were also characterized. Results Among 115,776 patients with an index fragility fracture, 17.8% incurred a second fragility fracture. Median time between index and second fracture occurring at any site was 555 days (interquartile range: 236–955). For each index fracture site examined, median time from index to second fracture was 3 years post index fracture. Conclusions This cohort of Canadian patients aged > 65 years who experienced a fragility fracture at any site are at imminent risk of experiencing subsequent fracture within the next 2 years and should be proactively assessed and treated.
- Published
- 2021
10. Low-density lipoprotein cholesterol goal attainment and treatment patterns in a cohort of >143,000 patients with atherosclerotic cardiovascular disease in Ontario, Canada
- Author
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M. Fairbairn, L Pericleous, Raina M. Rogoza, S Colgan, Shaun G. Goodman, Ron Goeree, Millicent Packalen, Paul Oh, and P. Motsepe-Ditshego
- Subjects
medicine.medical_specialty ,business.industry ,Atherosclerotic cardiovascular disease ,Internal medicine ,Cohort ,Medicine ,Low density lipoprotein cholesterol ,Cardiology and Cardiovascular Medicine ,business ,Goal attainment ,Ontario canada - Abstract
Background/Introduction Limited real-world data are available on attainment of low-density lipoprotein cholesterol (LDL-C) treatment goals in patients with atherosclerotic cardiovascular disease (ASCVD) in Canada. Purpose A retrospective observational study was conducted to describe types of ASCVD events/procedures, time between events and use of lipid lowering treatment (LLT) in patients who did not achieve LDL-C goal. Methods Patients in Ontario ≥65 years with a primary ASCVD event/procedure between 1 Apr 2005 and 31 Mar 2016, treated with an LLT and with index and follow up LDL-C values were identified from claims data at the Institute for Clinical Evaluative Sciences data repository. Patients were assessed over a 1-year follow up period for LDL-C goal attainment ( Results Overall, 28% of 143,302 patients ≥65 years on LLT failed to attain LDL-C goal at follow up (Figure). The proportion of patients failing to achieve LDL-C goal decreased from 35% to 22% over the 11-year study period. Mean time between index and follow up LDL-C (based on lowest score >2 weeks and up to 1 year after index LDL-C) was 203±97 days. When analysed by low-, moderate- or high-intensity statin, 57%, 30%, and 22% of patients failed to achieve LDL-C goal at follow up, respectively. Conclusions In this study, more than 1 in 4 patients with ASCVD in Ontario failed to achieve guideline recommended LDL-C goal despite treatment. In particular, ∼1 in 3 patients with cerebral and peripheral arterial disease were not at goal. An opportunity exists to better manage these high risk ASCVD patients with further statin intensification and additional LLTs This study made use of de-identified data from the ICES Data Repository, which is managed by the Institute for Clinical Evaluative Sciences with support from its funders and partners: Canada's Strategy for Patient-Oriented Research (SPOR), the Ontario SPOR Support Unit, the Canadian Institutes of Health Research and the Government of Ontario. The opinions, results and conclusions reported are those of the authors. No endorsement by ICES or any of its funders or partners is intended or should be inferred. Parts of this material are based on data and/or information compiled and provided by CIHI. However, the analyses, conclusions, opinions and statements expressed in the material are those of the author(s), and not necessarily those of CIHI Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Amgen Canada Inc.
- Published
- 2020
11. Differences in lipid treatment patterns in women versus men in a large cohort of patients with atherosclerotic cardiovascular disease in Ontario, Canada
- Author
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M. Fairbairn, Raina M. Rogoza, Shaun G. Goodman, P. Motsepe-Ditshego, Millicent Packalen, Paul Oh, Ron Goeree, and L Pericleous
- Subjects
medicine.medical_specialty ,Myocardial ischemia ,business.industry ,Atherosclerotic cardiovascular disease ,Internal medicine ,Medicine ,LDL Cholesterol Lipoproteins ,Treatment goals ,Cardiology and Cardiovascular Medicine ,business ,Lipid-lowering therapy ,Large cohort ,Ontario canada - Abstract
Background/Introduction The prevalence of ischaemic heart disease is lower in women vs men in Canada. Studies have shown that women are more likely to be underdiagnosed and less likely to receive guideline-recommended treatments than men. Women receiving lipid-lowering therapies (LLTs) are also less likely to attain treatment goals vs men. Purpose We analysed use of LLTs and attainment of low-density lipoprotein cholesterol (LDL-C) treatment goals in a recent longitudinal cohort of patients with ASCVD with public drug coverage in Ontario to describe differences observed between female and male patients. Methods Patients ≥65 years with a primary ASCVD event/procedure between 1 Apr 2005 and 31 Mar 2016, treated with an LLT and with index and follow up LDL-C values were identified from claims data at the Institute for Clinical Evaluative Sciences data repository. Patients were assessed over a 1 year follow up period for LDL-C goal attainment ( Results 143,302 patients with ASCVD ≥65 years on LLTs were identified of which 41% were female. A higher proportion of female vs male patients were prescribed low (3% vs 2%) and medium intensity statins (51% vs 44%) compared with high intensity statins (43% vs 52%). A higher proportion of women failed to attain LDL-C goal compared to men (33% vs 24%) (Figure). When analysed by low, moderate or high intensity statin, 65%, 35%, and 27% of female patients and 49%, 25% and 19% of male patients failed to attain LDL-C goal at follow up. Conclusions In this retrospective study, women with a diagnosis of ASCVD were more frequently treated with low/moderate intensity statins whereas men were more frequently treated with high intensity statins. Approximately 2 of 3 women and 3 of 4 men receiving statin treatment attained LDL-C goal during the 1-year follow up period. Overall, there appear to be treatment differences between female and male patients with ASCVD, with males receiving higher intensity statin therapy and attaining LDL-C goal more frequently. Further research is needed to determine why these discrepancies exist. This study made use of de-identified data from the ICES Data Repository, which is managed by the Institute for Clinical Evaluative Sciences with support from its funders and partners: Canada's Strategy for Patient-Oriented Research (SPOR), the Ontario SPOR Support Unit, the Canadian Institutes of Health Research and the Government of Ontario. The opinions, results and conclusions reported are those of the authors. No endorsement by ICES or any of its funders or partners is intended or should be inferred. Parts of this material are based on data and/or information compiled and provided by CIHI. However, the analyses, conclusions, opinions and statements expressed in the material are those of the author(s), and not necessarily those of CIHI. Figure 1 Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Amgen Canada Inc
- Published
- 2020
12. Mortality in older adults following a fragility fracture: real-world retrospective matched-cohort study in Ontario
- Author
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Maureen Reiner, Lubomira Slatkovska, Emil H. Schemitsch, Jonathan D. Adachi, Jean-Eric Tarride, Alan Bell, Jacques P. Brown, Vivien Brown, Thiago Oliveira, Natasha Burke, and P. Motsepe-Ditshego
- Subjects
Male ,medicine.medical_specialty ,Pediatrics ,lcsh:Diseases of the musculoskeletal system ,Sports medicine ,medicine.medical_treatment ,Osteoporosis ,030209 endocrinology & metabolism ,Comorbidity ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Rheumatology ,Ambulatory care ,Epidemiology ,medicine ,Humans ,Orthopedics and Sports Medicine ,Mortality ,030304 developmental biology ,Aged ,Retrospective Studies ,Ontario ,0303 health sciences ,Hip fracture ,Rehabilitation ,business.industry ,Hip Fractures ,medicine.disease ,Fracture ,Real-world ,Older adults ,Orthopedic surgery ,Cohort ,Female ,lcsh:RC925-935 ,business ,Osteoporotic Fractures ,Research Article - Abstract
Background Recent studies are lacking reports on mortality after non-hip fractures in adults aged > 65. Methods This retrospective, matched-cohort study used de-identified health services data from the publicly funded healthcare system in Ontario, Canada, contained in the ICES Data Repository. Patients aged 66 years and older with an index fragility fracture occurring at any osteoporotic site between 2011 and 2015 were identified from acute hospital admissions, emergency and ambulatory care using International Classification of Diseases (ICD)-10 codes and data were analyzed until 2017. Thus, follow-up ranged from 2 years to 6 years. Patients were excluded if they presented with an index fracture occurring at a non-osteoporotic fracture site, their index fracture was associated with a trauma code, or they experienced a previous fracture within 5 years prior to their index fracture. This fracture cohort was matched 1:1 to controls within a non-fracture cohort by date, sex, age, geography and comorbidities. All-cause mortality risk was assessed. Results The survival probability for up to 6 years post-fracture was significantly reduced for the fracture cohort vs matched non-fracture controls (p n = 101,773 per cohort), with the sharpest decline occurring within the first-year post-fracture. Crude relative risk of mortality (95% confidence interval) within 1-year post-fracture was 2.47 (2.38–2.56) in women and 3.22 (3.06–3.40) in men. In the fracture vs non-fracture cohort, the absolute mortality risk within one year after a fragility fracture occurring at any site was 12.5% vs 5.1% in women and 19.5% vs 6.0% in men. The absolute mortality risk within one year after a fragility fracture occurring at a non-hip vs hip site was 9.4% vs 21.5% in women and 14.4% vs 32.3% in men. Conclusions In this real-world cohort aged > 65 years, a fragility fracture occurring at any site was associated with reduced survival for up to 6 years post-fracture. The greatest reduction in survival occurred within the first-year post-fracture, where mortality risk more than doubled and deaths were observed in 1 in 11 women and 1 in 7 men following a non-hip fracture and in 1 in 5 women and 1 in 3 men following a hip fracture.
- Published
- 2020
13. PATTERNS OF LOW-DENSITY LIPOPROTEIN CHOLESTOEROL MANAGEMENT AND GOAL ATTAINMENT IN PATIENTS WITH ATHEROSCLEROTIC CARDIOVASCULAR DISEASE 65 YEARS AND OLDER FROM ALBERTA AND ONTARIO
- Author
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Shaun G. Goodman, Raina M. Rogoza, Ron Goeree, M. Fairbairn, E. Mackinnon, Todd J. Anderson, Paul Oh, L Pericleous, and P. Motsepe-Ditshego
- Subjects
chemistry.chemical_compound ,medicine.medical_specialty ,chemistry ,business.industry ,Atherosclerotic cardiovascular disease ,Low-density lipoprotein ,Internal medicine ,medicine ,In patient ,Cardiology and Cardiovascular Medicine ,business ,Goal attainment - Published
- 2020
14. PCV32 ECONOMIC BURDEN OF ATHEROSCLEROTIC CARDIOVASCULAR DISEASE AND SPECIFIC EVENTS IN ONTARIO, CANADA
- Author
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Shaun G. Goodman, L Pericleous, M. Fairbairn, Ron Goeree, P. Motsepe-Ditshego, Raina M. Rogoza, Millicent Packalen, and Paul Oh
- Subjects
business.industry ,Atherosclerotic cardiovascular disease ,Health Policy ,Environmental health ,Public Health, Environmental and Occupational Health ,Medicine ,business ,Ontario canada - Published
- 2020
15. PMS52 REAL-WORLD OUTCOMES AND COST OF MANAGEMENT OF OSTEOPOROTIC FRACTURES IN ONTARIO, CANADA
- Author
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Emil H. Schemitsch, P. Motsepe-Ditshego, Jean-Eric Tarride, J.D. Adachi, Jacques P. Brown, S M Colgan, and Natasha Burke
- Subjects
Geography ,Health Policy ,Environmental health ,Public Health, Environmental and Occupational Health ,Real world outcomes ,Ontario canada - Published
- 2019
16. Increasing Prevalence and Incidence of Atherosclerotic Cardiovascular Disease in Adult Patients in Ontario, Canada From 2002 to 2018.
- Author
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Mackinnon ES, Goeree R, Goodman SG, Rogoza RM, Packalen M, Pericleous L, Motsepe-Ditshego P, and Oh P
- Abstract
Background: Cardiovascular disease is the second-leading cause of death in Canada. However, limited data are available on the prevalence of atherosclerotic cardiovascular disease (ASCVD) in Canada. The study objective was to describe the incidence and prevalence of ASCVD in adult patients in Ontario, Canada, and to evaluate temporal trends for subsequent ASCVD events among those with new-onset ASCVD., Methods: This retrospective, observational study identified ASCVD incidence and prevalence data from the Institute for Clinical Evaluative Sciences Data Repository for adults from Ontario. Overall prevalence was established for the period from 2002 to 2018. Incident cases from April 1, 2005 to March 2016 were then identified, and followed up to 2018. Primary outcomes were date and type of index event/procedure, patient characteristics/baseline demographics, and comorbidities. Secondary outcomes assessed were time from first to second ASCVD event, subsequent event(s) and/or mortality, and type of subsequent event(s) relative to the type of index/primary event., Results: A total of 1,042,621 eligible prevalent ASCVD cases were identified; of these, 743,309 patients (69%) were newly diagnosed with incident ASCVD. The 10-year prevalence rates for all ASCVD subtypes increased over the study period. Overall event incidence rates per 1000 person-years were mostly stable or increased. Among incident cases, 50% experienced subsequent events over the study period., Conclusions: This observational study demonstrated increasing prevalence and high incidence of new ASCVD diagnoses in adults from Ontario, over the study period. These data, together with the substantial number of subsequent events in ASCVD patients, demonstrate significant clinical burden of this disease in Ontario., (© 2021 The Authors.)
- Published
- 2021
- Full Text
- View/download PDF
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