Faculty Profiles - KAZAWA KANA

Papers - KAZAWA KANA

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Health education improves referral compliance of persons with probable Diabetic Retinopathy: A randomized controlled trial. Reviewed International journal

Zara Khair, Md Moshiur Rahman, Kana Kazawa, Yasmin Jahan, Abu S G Faruque, Mohammod Jobayer Chisti, Michiko Moriyama

PloS one 15 ( 11 ) e0242047 2020

Language：English Publishing type：Research paper (scientific journal)

OBJECTIVE: Lack of awareness about Diabetic Retinopathy (DR) is the most commonly cited reason why many persons with type 2 diabetes are non-compliant with referral instruction to undergo retinal screening. The purpose of this study was to evaluate the efficacy of a culturally, geographically and socially appropriate, locally adapted five-month-long health education on referral compliance of participants. METHOD: A prospective randomized, open-label parallel group study was conducted on persons with type 2 diabetes who underwent basic eye screening at a diabetes hospital between September 2017 and August 2018. Participants who were noncompliant with referral instruction to visit a hospital for advanced DR management were randomly divided into health education intervention group (n = 143) and control group (n = 156). Both groups received information regarding DR and referral instruction at the diabetes hospital. The intervention group was provided personalized education followed by telephonic reminders. The primary endpoint was 'increase in referral compliance' and the secondary endpoint was 'increase in knowledge of DR'. Multivariate logistic regression model was used to identify significant predictors of compliance to referral. RESULTS: A total of nine participants dropped and 290 completed the post intervention survey. The compliance rate in intervention group was found to be significantly higher than the control group (64.3% vs 28.2%; OR 4.73; 95% CI 2.87-7.79; p<0.001). Participants in the intervention group acquired better knowledge on DR (p<0.05). Apart from intervention, referral compliance rate was also found to be significantly associated with participants' self-perception of vision problem (OR 2.02; 95% CI 1.02-4.01; p = 0.045) and participants' income (OR 1.24; 95% CI 1.06-1.44; p = 0.008). DISCUSSION: Our results suggest that intensive health education on DR should be integrated with diabetes education as it may result in significantly improved referral compliance. Outcomes may be sustainable if interventions are institutionalized at referral point. TRIAL REGISTRATION: Clinical Trials.gov (Registration # NCT03658980); https://clinicaltrials.gov/ct2/show/NCT03658980.

DOI： 10.1371/journal.pone.0242047

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Disease perception and experiences among rural Bangladeshi hypertensive women: A qualitative approach. Reviewed International journal

Yasmin Jahan, Michiko Moriyama, Md Moshiur Rahman, Kana Kazawa, Mariko Mizukawa, Atiqur Rahman, Abu Sadat Mohammad Sayeem Bin Shahid, Sumon Kumar Das, Abu Syed Golam Faruque, Mohammod Jobayer Chisti

Health promotion perspectives 10 ( 1 ) 66 - 73 2020

Language：English Publishing type：Research paper (scientific journal)

Background: Hypertension (HTN) is well established as a leading cause of common serious illnesses worldwide. We carried out this qualitative research to understand perception of and experiences related to HTN among rural Bangladeshi hypertensive women. Methods: A total of 74 female hypertensive participants who were diagnosed as HTN were purposively recruited in a rural community in Mirzapur, Bangladesh. A focus group discussion(FGD) was applied to share their perception and experiences. Transcripts were read in an iterative process, and a thematic analysis was performed. This paper is reported followed by COREQ checklist. Results: Three main themes were generated; (i) Perception of HTN based on experiences, (ii)Knowledge of management of HTN, and (iii) Barriers of management of HTN. Under the themes, seven subthemes were identified. The participants only knew about their high blood pressure(HBP) when they had symptoms, and they applied traditional remedies in the rural context to deal with those symptoms. Even though more than half of participants had relevant knowledge of how to manage HTN, but still there were social-cultural and economic barriers and lack of social infrastructure to access healthcare, existed to practice them. Conclusion: Based on our study reports, health education programs at the household and community level could be a potential starting point for any preventive and containment strategy in rural communities of Bangladesh.

DOI： 10.15171/hpp.2020.11

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Characteristics of heart failure patients incurring high medical costs via matching specific health examination results and medical claim data: a cross-sectional study. Reviewed International journal

Yuya Tamaki, Kana Kazawa, Hirohito Watanabe, Tantut Susanto, Michiko Moriyama

BMJ open 9 ( 12 ) e031422 2019.12

Authorship：Corresponding author Language：English Publishing type：Research paper (scientific journal)

OBJECTIVE: We describe the characteristics of patients with high medical costs by matching specific annual medical examination results and medical claim data. Clarifying the relationships between examination items and high medical costs allows the screening of high-risk persons. DESIGN: A cross-sectional study. SUBJECTS: Subjects were persons insured by national health insurance in Hiroshima City, Hiroshima Prefecture, from April 2016 to March 2017. To identify true heart failure (HF) patients, the disease name listed in the medical claim data was compared with drugs prescribed for HF, with extraction of only subjects whose comparative data matched. DATA COLLECTION AND ANALYSIS: The specific health examination includes a questionnaire on areas such as lifestyle habits, anthropometry, blood pressure, blood tests and urine tests. The percentage of the total medical costs related to the medical care of subjects with HF was described using Pareto analysis. For specific health examination items, we compared the high-cost and low-cost groups. The normality and homoscedasticity of each variable was checked and Student's t-tests and χ² tests were applied. Finally, multiple logistic regression analysis was used to detect factors in the health examination items related to high medical costs. RESULTS: Pareto analysis showed that 80% of all medical costs were paid by 30% of the HF patient population. The fees for cardiovascular surgery accounted for 54% of the total surgical cost, 64% of which included preventable diseases. Levels of creatinine (Cr) and γ-glutamyl transpeptidase (γ-GTP) and a history of smoking were found to be related to high medical costs. CONCLUSION: Analysis of specific health examination results for HF patients revealed the association between high medical costs, γ-GTP, Cr, and smoking. These results can thus serve as a reference for screening persons at high risk of HF and help prevent the exacerbation of HF.

DOI： 10.1136/bmjopen-2019-031422

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保健指導による介入効果が高い慢性疾患患者の抽出を支援する重症化リスク予測AIの開発 Reviewed

加澤佳奈, 渡邉拡人, 玉城雄也, 森山美知子, 栗野俊一, 吉開範章, 木原康樹

医療情報学連合大会論文集 39回 462 - 464 2019.11

Disease management for high risk patients with diabetic nephropathy Invited

Precision Medicine 2 ( 5 ) 80 - 84 2019

An Investigation of Factors Influencing High Usage of Medical and Long-Term Care Services in an Aging Society in Japan. Reviewed International journal

Kana Kazawa, Md Moshiur Rahman, Michiko Moriyama

Asia-Pacific journal of public health 30 ( 2 ) 95 - 106 2018.3

Language：English Publishing type：Research paper (scientific journal) Publisher：SAGE PUBLICATIONS INC

Medical and long-term care costs are increasing all over the world. In this study, we investigated the characteristics of groups with high cost of medical and long-term care to define targets for curbing social security costs. As a result, for the population covered by the National Health Insurance, a large portion of medical costs were incurred for mental disorders, malignant neoplasms, and lifestyle-related diseases. For those covered by the Late Elderly Health Insurance System, most medical costs were incurred for lifestyle-related diseases, femoral fractures, neurological diseases, mental disorders, pneumonia, malignant neoplasms, and Alzheimer's disease. From multiple regression analysis, the hospitalization days, use of advanced medical treatment, outpatient days, and high long-term care level influenced the increased costs. On the other hand, disease characteristics had only a very low effect. These findings suggest that the target population has complex medical and long-term care needs because they have multiple diseases.

DOI： 10.1177/1010539517751444

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Quality Primary Care for Disease Prevention and Management Reviewed

Rahman MM, Moriyama M, Kazawa K

Asian Hospital and Healthcare Management 42 30 - 34 2018

フレイル対策における慢性疾患管理の必要性についての実践報告

尾崎果苗, 森山美知子, 加澤佳奈

日本糖尿病教育・看護学会誌 21 ( 特別号 ) 158 - 158 2017.8

Health Resource Utilization and Comorbidities in Patients with Mental Disorders: Analysis Based on Health Insurance Claim Data Reviewed

Health 9 ( 4 ) 763 - 777 2017

糖尿病腎症に対する遠隔面談型セルフマネジメント教育と直接面談型教育の効果の比較:12ヶ月フォローアップ結果 Reviewed

日本糖尿病教育・看護学会誌 21 ( 1 ) 46 - 55 2017

遠隔地居住の慢性疾患患者に対する、モバイル端末を用いた自己管理支援の検討

後藤瑞枝, 尾崎果苗, 原眞理子, 新納栄美子, 加澤佳奈, 森山美知子

日本医療・病院管理学会誌 52 ( Suppl. ) 188 - 188 2015.10

Efficacy of a disease management program focused on acquisition of self-management skills in pre-dialysis patients with diabetic nephropathy: 24 months follow-up. Reviewed International journal

Kana Kazawa, Yae Takeshita, Noriaki Yorioka, Michiko Moriyama

Journal of nephrology 28 ( 3 ) 329 - 38 2015.6

Language：English Publishing type：Research paper (scientific journal)

PURPOSE: We previously performed a preliminary 6-month controlled trial to examine the effect of a disease management education program on prolongation of the time to renal replacement therapy (RRT) and/or avoidance of RRT for patients with diabetic nephropathy. However, its duration was too short to follow the changes of renal function, so we performed the present study for 24 months. METHODS: This was a two-group comparative study. The intervention group received self-management education from disease management nurses and was supported by the nurses in cooperation with their primary physicians for 12 months. Then this group was followed for a further 12 months. The control group received standard care and was followed for 24 months. RESULTS: Of the 31 subjects enrolled in each group, 26 subjects in the intervention group and 27 subjects in the control group were analyzed after excluding drop-outs. During the study period, 0 and 2 subjects in the intervention and the control group started RRT, respectively. In the intervention group, renal function was maintained, while significant worsening was observed in the control group. Hemoglobin A1c (HbA1c) improved in the intervention group, but became significantly worse in the control group. In the intervention group, all process indicators of behavior modification increased significantly after intervention. CONCLUSION: A well-designed disease management program might be useful for maintaining renal function and improving HbA1c in patients with diabetic nephropathy. It is considered that modification of patient behavior contributed to these results.

DOI： 10.1007/s40620-014-0144-2

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保存期慢性腎不全患者の家族における食事療法の協力体制形成過程 Reviewed

広島大学保健学ジャーナル 13 ( 1.2 ) 13 - 21 2015

腹膜透析患者の透析手技とカテーテル管理の実態 Reviewed

日本慢性看護学会誌 9 ( 1 ) 15 - 19 2015

Efficacy and Usability of an E-learning Program for Fostering Qualified Disease Management Nurses Reviewed

Health 7 ( 8 ) 955 - 964 2015

Development and Evaluation of Disease Management Program and Service Framework for Patients with Chronic Diseases Reviewed

Health 7 ( 6 ) 729 - 740 2015

Effects of a Self-Management Skills-Acquisition Program on Pre-Dialysis Patients with Diabetic Nephropathy Reviewed

Kana Kazawa, Michiko Moriyama

NEPHROLOGY NURSING JOURNAL 40 ( 2 ) 141 - 148 2013.3

保存期糖尿病腎症患者に対する教育プログラムの効果(6ヵ月間の介入評価) Reviewed

加澤佳奈, 森山美知子

日本腎不全看護学会誌 2012

行動変容が困難な糖尿病腎症患者へのセルフマネジメント支援 Reviewed

加澤佳奈, 森山美知子

日本慢性看護学会誌 2011

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