Skip header and navigation

Refine By

12 records – page 1 of 2.

3-Hydroxy-3-methylglutaryl coenzyme A reductase inhibitors and the risk of cancer: a nested case-control study.

https://arctichealth.org/en/permalink/ahliterature197667
Source
Arch Intern Med. 2000 Aug 14-28;160(15):2363-8
Publication Type
Article
Author
L. Blais
A. Desgagné
J. LeLorier
Author Affiliation
Centre de Recherche, Hôtel-Dieu du CHUM, Saint-Urbain, Montreal, Quebec, Canada.
Source
Arch Intern Med. 2000 Aug 14-28;160(15):2363-8
Language
English
Publication Type
Article
Keywords
Adverse Drug Reaction Reporting Systems
Aged
Cohort Studies
Female
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - adverse effects - therapeutic use
Hypolipidemic Agents - adverse effects - therapeutic use
Long-Term Care
Male
Neoplasms - chemically induced
Quebec
Risk
Abstract
During the past 15 years there has been an exponential increase in the number of prescriptions for lipid-lowering drugs. Uncertainties remain about the long-term impact of these medications on cancer, which is particularly bothersome given that the duration of these treatments may extend for several decades.
To explore the association between 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors and cancer incidence.
Using the administrative health databases of the Régie de l'Assurance-Maladie du Québec we performed a nested case-control study. We selected a cohort of 6721 beneficiaries of the health care plan of Quebec who were free of cancer for at least 1 year at cohort entry, 65 years and older, and treated with lipid-modifying agents. Cohort members were selected between 1988 and 1994 and were followed up for a median period of 2.7 years. From the cohort, 542 cases of first malignant neoplasm were identified, and 5420 controls were randomly selected. Users of HMG-CoA reductase inhibitors were compared with users of bile acid-binding resins as to their risk of cancer. Specific cancer sites were also considered.
Users of HMG-CoA reductase inhibitors were found to be 28% less likely than users of bile acid-binding resins to be diagnosed as having any cancer (rate ratio, 0.72; 95% confidence interval, 0.57-0.92). All specific cancer sites under study were found to be not or inversely associated with the use of HMG-CoA reductase inhibitors.
The results of our study provide some degree of reassurance about the safety of HMG-CoA reductase inhibitors.
Notes
Comment In: Arch Intern Med. 2001 Jun 11;161(11):146011386902
PubMed ID
10927735 View in PubMed
Less detail

Better adherence to antihypertensive agents and risk reduction of chronic heart failure.

https://arctichealth.org/en/permalink/ahliterature149554
Source
J Intern Med. 2009 Aug;266(2):207 - 18
Publication Type
Article
Date
Aug-2009
Author
S. Perreault
A. Dragomir
M. White
L. Lalonde
L. Blais
A. Bérard
Author Affiliation
Faculty of Pharmacy, University of Montreal, Montréal, QC, Canada. sylvie.perreault@umontreal.ca
Source
J Intern Med. 2009 Aug;266(2):207 - 18
Date
Aug-2009
Language
English
Publication Type
Article
Keywords
Aged
Antihypertensive Agents - therapeutic use
Canada
Case-Control Studies
Coronary Disease - drug therapy - mortality
Databases, Factual
Female
Heart Failure - mortality - prevention & control
Humans
Logistic Models
Male
Medication Adherence - statistics & numerical data
Middle Aged
Public Health - statistics & numerical data
Risk Reduction Behavior
Abstract
Antihypertensive (AH) agents have been shown to reduce the risk of major cardiovascular events including chronic heart failure (CHF). However, the impact of changes in patterns of AH agents use on CHF is unknown. Our objective was to estimate to which different patterns of AH agent use is associated with the occurrence of CHF in a population-based study.
A cohort of 82 320 patients was reconstructed using the Régie de l'assurance maladie du Québec's databases. Patients were eligible if they were between 45 to 85 years of age, had no indication of cardiovascular disease and were newly treated with AH therapy between 1999 and 2004. A nested case-control design was used to study the occurrence of CHF. Every case of CHF was matched for age and duration of follow-up to a maximum of 15 randomly selected controls. Adherence level was reported as a medication possession ratio. Conditional logistic regression models were used to estimate the rate ratio (RR) of CHF adjusting for different covariables. The mean patient age was 65 years, 37% were male, 8% had diabetes, 19% had dyslipidaemia and mean time of follow-up at 2.7 years. High adherence level (95%) to AH therapy compared with lower adherence level (60%) was associated with an additional reduction of CHF events (RR: 0.89; 0.80-0.99). Risk factors for CHF were being on social assistance, diabetes, dyslipidaemia, higher chronic disease score and developing a cardiovascular condition during follow-up.
Our study suggests that a better adherence is associated with a significant risk reduction of CHF. Adherence to AH therapy needs to be improved to optimize benefits.
Notes
Comment In: J Intern Med. 2010 Mar;267(3):335; author reply 33620201922
PubMed ID
19623691 View in PubMed
Less detail

A cohort analysis of excess mortality in asthma and the use of inhaled beta-agonists.

https://arctichealth.org/en/permalink/ahliterature218714
Source
Am J Respir Crit Care Med. 1994 Mar;149(3 Pt 1):604-10
Publication Type
Article
Date
Mar-1994
Author
S. Suissa
P. Ernst
J F Boivin
R I Horwitz
B. Habbick
D. Cockroft
L. Blais
M. McNutt
A S Buist
W O Spitzer
Author Affiliation
Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec.
Source
Am J Respir Crit Care Med. 1994 Mar;149(3 Pt 1):604-10
Date
Mar-1994
Language
English
Publication Type
Article
Keywords
Administration, Inhalation
Administration, Oral
Adolescent
Adrenal Cortex Hormones - administration & dosage
Adult
Albuterol - administration & dosage - adverse effects
Asthma - drug therapy - mortality
Cause of Death
Child
Child, Preschool
Dose-Response Relationship, Drug
Drug Therapy, Combination
Female
Fenoterol - administration & dosage - adverse effects
Follow-Up Studies
Hospitalization - statistics & numerical data
Humans
Linear Models
Male
Middle Aged
Odds Ratio
Population Surveillance
Risk factors
Saskatchewan - epidemiology
Socioeconomic Factors
Survival Analysis
Abstract
The association between the use of inhaled beta-agonists and the risk of death and near-death from asthma has previously been reported. It was based on a nested case-control study of 129 cases and 655 control subjects selected from a cohort of 12,301 users of asthma drugs followed during the period 1980 through 1987. In this paper we examine the question of asthma and non-asthma mortality using data from the entire cohort of 12,301 asthmatics. There were 46 asthma and 134 non-asthma deaths in this cohort, for which there were 47,842 person-years of follow-up. The overall rate of asthma death was 9.6 per 10,000 asthmatics per year. This rate varied significantly according to the use of fenoterol, albuterol, or oral corticosteroids in the prior 12 months and the number of asthma hospitalizations in the prior 2 years. The rate decreased significantly, by 0.6 asthma deaths per 10,000 asthmatics per year over the study period, after controlling for the effect of the four other risk factors. It also increased significantly with the use of all beta-agonists, and more so for fenoterol than for albuterol, although this difference was partly explained by the dose inequivalence of the two drugs. Change-point dose-response curves showed that the risk of asthma death began to escalate drastically at about 1.4 canisters (of 20,000 micrograms each) per month of inhaled beta-agonist, the recommended limit. For non-asthma death, the overall rate of 28 deaths per 10,000 asthmatics per year was not related to the use of inhaled beta-agonists.(ABSTRACT TRUNCATED AT 250 WORDS)
PubMed ID
8118625 View in PubMed
Less detail

Control and severity of asthma during pregnancy are associated with asthma incidence in offspring: two-stage case-control study.

https://arctichealth.org/en/permalink/ahliterature150177
Source
Eur Respir J. 2009 Sep;34(3):579-87
Publication Type
Article
Date
Sep-2009
Author
M-J Martel
E. Rey
M-F Beauchesne
J-L Malo
S. Perreault
A. Forget
L. Blais
Author Affiliation
Université de Montréal, QC, Canada.
Source
Eur Respir J. 2009 Sep;34(3):579-87
Date
Sep-2009
Language
English
Publication Type
Article
Keywords
Anti-Asthmatic Agents - therapeutic use
Asthma - diagnosis - epidemiology - therapy
Canada
Case-Control Studies
Child
Child, Preschool
Cohort Studies
Female
Health status
Humans
Incidence
Male
Pregnancy
Pregnancy Complications - diagnosis - epidemiology - therapy
Risk factors
Severity of Illness Index
Socioeconomic Factors
Abstract
The extent to which childhood asthma incidence is influenced by asthma control and severity during pregnancy is unknown. We have studied this association during the child's first 10 yrs of life. A two-stage, case-control study, nested in a cohort of 8,226 children of asthmatic mothers, was conducted using three interlinked databases of Quebec, Canada, and mailed questionnaires. A total of 2,681 asthmatic children and 30,318 age-matched controls were selected (
Notes
Comment In: Eur Respir J. 2010 Jun;35(6):1423-420513920
PubMed ID
19541714 View in PubMed
Less detail

Impact of a cost-sharing drug insurance plan on drug utilization among older people.

https://arctichealth.org/en/permalink/ahliterature194704
Source
J Am Geriatr Soc. 2001 Apr;49(4):410-4
Publication Type
Article
Date
Apr-2001
Author
L. Blais
J M Boucher
J. Couture
E. Rahme
J. LeLorier
Author Affiliation
Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Quebec, Canada.
Source
J Am Geriatr Soc. 2001 Apr;49(4):410-4
Date
Apr-2001
Language
English
Publication Type
Article
Keywords
Aged
Cost Sharing - economics
Drug Utilization - trends
Female
Humans
Insurance, Pharmaceutical Services - economics
Male
Quebec
Abstract
In August 1996, the Régie de l'assurance-maladie du QuEbec (RAMQ), the government body responsible for medical insurance in the Canadian province of Quebec, introduced a cost-sharing drug insurance plan. Before this plan, individuals age 65 years and older had to pay Canadian (CDN)$2 per prescription, with the remaining cost paid by the RAMQ. With the new plan, beneficiaries may have to pay an amount between CDN$200 and CDN$925 per year, depending on their income. Concerned that this financial constraint imposed on older people might have an impact on the use of medications, we investigated whether the consumption of four classes of medications, antihypertensive agents, anticoagulants, nitrates, and benzodiazepines, was affected by the drug plan implementation.
Time series models with pre/post comparison group.
Administrative computerized databases of the RAMQ.
Random sample of Quebec residents age 65 years and older registered in the provincial drug plan between August 1992 and June 1997: 54,771 users of nitrates, 133,146 users of antihypertensive agents, 45,534 users of anti-coagulants, and 26,165 users of benzodiazepines.
We modeled the monthly consumption of the medications under study between August 1992 and June 1996. Monthly drug consumptions predicted from the models were compared with those observed for the 13 months (August 1996 to August 1997) following the implementation of the new drug plan using 95% confidence intervals. The number of prescriptions dispensed served as an indicator for drug consumption.
During the study period we observed a nonstatistically significant decrease in number of prescriptions of 5.1% for nitrates, 1.1% for antihypertensive agents, and 0.8% for benzodiazepines, and a nonstatistically significant increase of 1.6% for anticoagulants.
Residents of Quebec age 65 years and older were not found to have reduced significantly their consumption of nitrates, antihypertensive agents, anticoagulants, and benzodiazepines during the 13 months that followed the implementation of a cost-sharing drug insurance plan.
PubMed ID
11347784 View in PubMed
Less detail

Impact of a primary care physician workshop on osteoporosis medical practices.

https://arctichealth.org/en/permalink/ahliterature147171
Source
Osteoporos Int. 2010 Sep;21(9):1471-85
Publication Type
Article
Date
Sep-2010
Author
M-C Laliberté
S. Perreault
A. Dragomir
J. Goudreau
I. Rodrigues
L. Blais
N. Damestoy
D. Corbeil
L. Lalonde
Author Affiliation
Faculty of Pharmacy, University of Montreal, Montreal, QC, Canada.
Source
Osteoporos Int. 2010 Sep;21(9):1471-85
Date
Sep-2010
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Bone Density Conservation Agents - therapeutic use
Clinical Competence
Education, Medical, Continuing - methods
Epidemiologic Methods
Female
Humans
Male
Middle Aged
Osteoporosis - diagnosis - drug therapy
Osteoporotic Fractures - prevention & control
Outcome Assessment (Health Care) - methods
Physicians, Primary Care - education - standards
Primary Health Care - standards
Professional Practice - standards - statistics & numerical data
Quebec
Abstract
Attendance at a fragility-fractures-prevention workshop by primary care physicians was associated with higher rates of osteoporosis screening and treatment initiation in elderly female patients and higher rates of treatment initiation in high-risk male and female patients. However, osteoporosis management remained sub-optimal, particularly in men.
Rates of osteoporosis-related medical practices of primary care physicians exposed to a fragility-fractures-prevention workshop were compared with those of unexposed physicians.
In a cluster cohort study, 26 physicians exposed to a workshop were matched with 260 unexposed physicians by sex and year of graduation. For each physician, rates of bone mineral density (BMD) testing and osteoporosis treatment initiation among his/her elderly patients 1 year following the workshop were computed. Rates were compared using multilevel logistic regression models controlling for potential patient- and physician-level confounders.
Twenty-five exposed physicians (1,124 patients) and 209 unexposed physicians (9,663 patients) followed at least one eligible patient. In women, followed by exposed physicians, higher rates of BMD testing [8.5% versus 4.2%, adjusted OR (aOR) = 2.81, 95% CI 1.60-4.94] and treatment initiation with bone-specific drugs (BSDs; 4.8% vs. 2.4%, aOR = 1.95, 1.06-3.60) were observed. In men, no differences were detected. In patients on long-term glucocorticoid therapy or with a previous osteoporotic fracture, higher rates of treatment initiation with BSDs were observed in women (12.0% vs. 1.9%, aOR = 7.38, 1.55-35.26), and men were more likely to initiate calcium/vitamin D (5.3% vs. 0.8%, aOR = 7.14, 1.16-44.06).
Attendance at a primary care physician workshop was associated with higher rates of osteoporosis medical practices for elderly women and high-risk men and women. However, osteoporosis detection and treatment remained sub-optimal, particularly in men.
PubMed ID
19937428 View in PubMed
Less detail

Increased morbidity and mortality related to asthma among asthmatic patients who use major tranquillisers.

https://arctichealth.org/en/permalink/ahliterature212864
Source
BMJ. 1996 Jan 13;312(7023):79-82
Publication Type
Article
Date
Jan-13-1996
Author
K S Joseph
L. Blais
P. Ernst
S. Suissa
Author Affiliation
Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada.
Source
BMJ. 1996 Jan 13;312(7023):79-82
Date
Jan-13-1996
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Antipsychotic Agents - adverse effects
Asthma - complications - mortality
Case-Control Studies
Child
Child, Preschool
Cohort Studies
Humans
Logistic Models
Middle Aged
Psychotic Disorders - complications - drug therapy - mortality
Risk factors
Saskatchewan - epidemiology
Abstract
To assess the potentially increased risk of death or near death from asthma in asthmatic patients with psychosis.
Case-control study.
The computerised health databases of the Canadian province of Saskatchewan.
131 cases of death or near death from asthma identified within a cohort of asthmatic patients; 3930 matched non-cases. EXPOSURE AND OUTCOME MEASURES: The exposure of interest was the use of major tranquillisers in the period before an outcome event. Outcomes included death or near death from asthma.
Crude analyses showed that asthmatic patients who had used major tranquillisers in the previous 12 months were at a 3.2 (95% confidence interval 1.4 to 7.5) times greater risk of death or near death from asthma than asthmatic patients who did not use major tranquillisers. Past users of major tranquillisers who had recently discontinued use were at a particularly high risk (relative risk 6.6; 2.5 to 17.6). Adjustment for use of antiasthma drugs and other confounders abolished this excess risk.
Asthmatic patients who use major tranquillisers seem to be at an increased risk of death or near death from asthma. Physicians treating asthmatic patients with a history of use of major tranquillisers should exercise greater caution with regard to management of such patients.
Notes
Cites: Am J Epidemiol. 1976 Feb;103(2):226-351251836
Cites: Am J Respir Crit Care Med. 1994 Mar;149(3 Pt 1):604-108118625
Cites: Acta Psychiatr Scand. 1979 Apr;59(4):431-47433634
Cites: Drugs. 1980 Oct;20(4):300-86106546
Cites: Arch Intern Med. 1984 Mar;144(3):554-66703827
Cites: Br J Psychiatry. 1984 Oct;145:429-326487916
Cites: JAMA. 1985 Sep 6;254(9):1193-84021061
Cites: Thorax. 1986 Nov;41(11):833-93824270
Cites: Am J Orthopsychiatry. 1987 Apr;57(2):253-73591909
Cites: J Allergy Clin Immunol. 1987 Sep;80(3 Pt 2):481-63624703
Cites: Arch Gen Psychiatry. 1988 Mar;45(3):283-53341883
Cites: J Clin Epidemiol. 1989;42(6):491-6; discussion 497-82661728
Cites: J Epidemiol Community Health. 1989 Mar;43(1):43-72592890
Cites: N Engl J Med. 1992 Feb 20;326(8):501-61346340
Cites: Int J Epidemiol. 1992 Aug;21(4):737-441521979
Cites: Am J Epidemiol. 1993 Jan 1;137(1):1-88434568
Cites: Aust Fam Physician. 1993 Aug;22(8):1467-9, 14718379886
Cites: Am J Epidemiol. 1976 Dec;104(6):609-20998608
Comment In: BMJ. 1996 Jan 13;312(7023):828555933
Comment In: BMJ. 1996 Jan 13;312(7023):82-38555934
PubMed ID
8555932 View in PubMed
Less detail

Inhaled corticosteroids and the prevention of readmission to hospital for asthma.

https://arctichealth.org/en/permalink/ahliterature205187
Source
Am J Respir Crit Care Med. 1998 Jul;158(1):126-32
Publication Type
Article
Date
Jul-1998
Author
L. Blais
P. Ernst
J F Boivin
S. Suissa
Author Affiliation
Division of Clinical Epidemiology, Department of Medicine, Royal Victoria Hospital, Montreal, Canada.
Source
Am J Respir Crit Care Med. 1998 Jul;158(1):126-32
Date
Jul-1998
Language
English
Publication Type
Article
Keywords
Administration, Inhalation
Adolescent
Adult
Anti-Asthmatic Agents - administration & dosage - therapeutic use
Asthma - drug therapy - prevention & control
Child
Child, Preschool
Female
Glucocorticoids - administration & dosage - therapeutic use
Humans
Male
Middle Aged
Patient Readmission
Saskatchewan
Self Administration
Treatment Outcome
Abstract
Despite the proven efficacy of inhaled corticosteroids in reducing airway inflammation and their increasing use for the treatment of asthma since the mid 1980s, hospitalization for asthma has been increasing in frequency in several countries. Only few studies, reporting contradictory results, have investigated the role of inhaled corticosteroids in the prevention of hospitalizations for asthma. Using a cohort of 2,059 hospitalized asthmatic patients between 5 and 54 yr of age, we estimated the effectiveness of inhaled corticosteroids in preventing a readmission to hospital for asthma as a function of the duration of therapy. The cohort was selected from the databases of Saskatchewan Health from 1977 to 1993. The rate ratio (RR) of a readmission for asthma varied with duration of regular therapy with inhaled corticosteroids. During the first 15 d of regular therapy, users of inhaled corticosteroids were as likely as nonusers of these medications to be readmitted for asthma with a RR of 1.2 (95% CI: 0.8-1.8). Subjects treated regularly with inhaled corticosteroids for at least 16 d and as long as 6 mo were 40% less likely to be readmitted for asthma (RR = 0.6; 95% CI: 0.4-0.9), while after 6 mo of regular treatment the protective effect disappeared (RR = 1.3; 95% CI: 0.7-2.4). We conclude that regular therapy with inhaled corticosteroids can substantially reduce the risk of a readmission for asthma after only 15 d of use. Confounding by severity appears as the most likely explanation for the disappearance of the beneficial effect after 6 mo of regular therapy.
PubMed ID
9655718 View in PubMed
Less detail

Patterns of increasing beta-agonist use and the risk of fatal or near-fatal asthma.

https://arctichealth.org/en/permalink/ahliterature217393
Source
Eur Respir J. 1994 Sep;7(9):1602-9
Publication Type
Article
Date
Sep-1994
Author
S. Suissa
L. Blais
P. Ernst
Author Affiliation
Dept of Epidemiology and Biostatistics, Montreal General Hospital, McGill University, Quebec, Canada.
Source
Eur Respir J. 1994 Sep;7(9):1602-9
Date
Sep-1994
Language
English
Publication Type
Article
Keywords
Administration, Inhalation
Adrenergic beta-Agonists - administration & dosage - adverse effects
Adult
Asthma - drug therapy - mortality
Case-Control Studies
Cohort Studies
Female
Humans
Male
Nebulizers and Vaporizers
Risk factors
Saskatchewan - epidemiology
Self Administration - trends
Time Factors
Abstract
The association between the use of inhaled beta-agonists by metered-dose inhaler and the risk of fatal or near-fatal asthma has been demonstrated. It shows that asthmatics who use one canister of beta-agonist per month more than the number used by other similar asthmatics have twice the risk of fatal or near-fatal asthma. The present investigation assesses the magnitude of this excess risk when an asthmatic increases his/her own monthly use of inhaled beta-agonists over time. From a previous nested case-control study of 129 deaths and near-deaths from asthma (cases) and 655 controls from a cohort of 12,301 asthmatics, the subset using at least 12 inhalers during the 12 month study period was identified (97 cases and 258 controls). A profile score, ranging 0-11, was formed to quantify the patterns of beta-agonist use over time for each subject, covering the entire spectrum extending from decreasing to increasing use. The relative risk was 15.2 (95% confidence interval (CI) 2.4-96.2) per unit increase of the profile score in subjects with a pattern of increasing beta-agonist use (profile score of 6.5 or more), but this relative risk was only 1.5 (95% CI 0.8-2.6) per unit when the profile score was less than 6.5 (non-increasing use). This relative risk was independent of the risk associated with the total quantity of beta-agonist use in the 12 month period, which remained around 1.6 (95% CI 1.3-2.0) per inhaler per month.(ABSTRACT TRUNCATED AT 250 WORDS)
PubMed ID
7995388 View in PubMed
Less detail

[Poverty, mental health and survival strategies].

https://arctichealth.org/en/permalink/ahliterature226249
Source
Sante Ment Que. 1991 Jun;16(1):117-38
Publication Type
Article
Date
Jun-1991
Author
L. Blais
L. Guay
Source
Sante Ment Que. 1991 Jun;16(1):117-38
Date
Jun-1991
Language
French
Publication Type
Article
Keywords
Adaptation, Psychological
Ethnic Groups
Female
Humans
Income
Male
Mental health
Poverty
Quebec
Questionnaires
Social Conditions
Social Support
Abstract
The relation between "poverty and mental health" has long been established. However, the dynamic underlying the relation between social and psychic processes has received much less attention. This article presents certain preliminary results of research whose aim is to promote the emergence of the multiple dimensions behind the problematic of mental health in social conditions characterized by extreme poverty. In addition, the authors base their approach on the assumption that human beings, even underprivileged, are very active players, and explore the strategies that are hereby developed in order to maintain or recover their equilibrium.
PubMed ID
1932413 View in PubMed
Less detail

12 records – page 1 of 2.