Oral antidiabetic drug use and associated health outcomes in cancer patients. (25th July 2016) - Tan, X.
Summary: What is new and objective: To assess oral antidiabetic drug use and associated health outcomes in American non‐elderly adults with cancer Methods: A retrospective study was conducted by analysing the Marketscan ® Commercial Claims and Encounters Database from 2008 to 2009. Individuals 18–64 years with concomitant diagnoses of cancer (breast, prostate, colon or lung) and type 2 diabetes, and treated with oral antidiabetic medications were included. Medication adherence was assessed using the Medication Possession Ratio (MPR); logistic regression was used to analyse factors associated with non‐adherence. Adherence was compared between patients with cancer and non‐cancer controls matched by propensity scores. Negative binomial regression was utilized to examine the effect of antidiabetic drug adherence on all‐cause hospitalizations and emergency room visits. The impact of adherence on total medical costs was then evaluated using the generalized linear model (GLM) with the log‐link function and gamma error distribution. Results and discussion: Of 1918 diabetic, cancer patients who newly initiated oral diabetic drugs, only 37·6% were adherent to oral diabetic medications; a similar proportion of adherence was found in the non‐cancer control population (35·8%, P = 0·24). Younger age, living in the southern region, using combination therapy vs. monotherapy, and using retail pharmacy vs. mail order pharmacy were significantly associated with non‐adherence in patients with cancer. Adherence to oral antidiabetic drugs was associated with 24% fewer all‐cause hospitalizations ( P = 0·02). What is new and conclusion: We identified high prevalence of non‐adherence to oral antidiabetic medications as well as negative consequences associated with non‐adherence, among patients with cancer. These findings may underscore the importance of developing relevant intervention strategies for improving diabetes management and treatment outcomes among cancer patients with diabetes. Abstract : The relationship between adherence to oral antidiabetic drugs among patients with cancer and healthcare utilization and costs. Adherence was associated with 24% fewer all cause hospitalizations than non‐adherence. Moreover, patients with lung cancer had significantly more hospitalizations and ER visits than patients with breast cancer. CCI and DCSI were good predictors of healthcare utilization and costs among our population.