Impact of cancer on adherence to glucose-lowering drug treatment in individuals with diabetes

M.M.J. Zanders, H.R. Raak, M.P.P. van Herk-Sukel, L.V. van de Poll-Franse, J.A. Johnson

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Aims/hypothesis
Adherence to glucose-lowering drug (GLD) treatment regimens is crucial for metabolic control and improving prognosis. Because a diagnosis of cancer might have an impact on adherence to medication, this study explored changes in adherence to GLDs following a cancer diagnosis.
Methods
All new users of GLDs between 1998 and 2011 who lived in the Eindhoven Cancer Registry–PHARMO Database Network catchment area were selected. Those with a primary cancer diagnosis during follow-up were considered cases and matched with eligible controls without cancer during follow-up. Medication possession ratio (MPR) was used as indicator for medication adherence. Segmented linear auto-regression analysis with interrupted time series was used to assess changes in MPR for cases compared with controls (i.e. overall trend) due to (any) cancer diagnosis and specific cancer types.
Results
From the 52,228 GLD users selected, 3,281 cases with cancer and 12,891 controls without cancer during follow-up were included in the study. In our analyses, before cancer diagnosis the MPR increased by 0.10% per month (95% CI 0.10, 0.10). Besides a significant drop in MPR at the time of cancer diagnosis of −6.3% (95% CI −6.5, −6.0), there was an ongoing, yet lower, monthly decline in MPR (−0.20%; 95% CI −0.21, −0.20) after cancer diagnosis. The largest drops in MPR at the time of cancer diagnosis, in the range of 11–15%, were seen among patients with stage IV disease and gastrointestinal or pulmonary cancers.
Conclusions/interpretation
Our findings indicate a clear decline in adherence to GLD treatment regimens following a cancer diagnosis. The reason for the decline in MPR needs to be further elucidated.
Keywords: Adherence, Cancer, Glucose-lowering drugs
Original languageEnglish
Pages (from-to)951-960
JournalDiabetologia
Volume58
Issue number5
DOIs
Publication statusPublished - 2015

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Pharmaceutical Preparations
Neoplasms
Medication Adherence
Gastrointestinal Neoplasms
Drug Users
Linear Models
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Zanders, M.M.J. ; Raak, H.R. ; van Herk-Sukel, M.P.P. ; van de Poll-Franse, L.V. ; Johnson, J.A. / Impact of cancer on adherence to glucose-lowering drug treatment in individuals with diabetes. In: Diabetologia. 2015 ; Vol. 58, No. 5. pp. 951-960.
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title = "Impact of cancer on adherence to glucose-lowering drug treatment in individuals with diabetes",
abstract = "Aims/hypothesisAdherence to glucose-lowering drug (GLD) treatment regimens is crucial for metabolic control and improving prognosis. Because a diagnosis of cancer might have an impact on adherence to medication, this study explored changes in adherence to GLDs following a cancer diagnosis.MethodsAll new users of GLDs between 1998 and 2011 who lived in the Eindhoven Cancer Registry–PHARMO Database Network catchment area were selected. Those with a primary cancer diagnosis during follow-up were considered cases and matched with eligible controls without cancer during follow-up. Medication possession ratio (MPR) was used as indicator for medication adherence. Segmented linear auto-regression analysis with interrupted time series was used to assess changes in MPR for cases compared with controls (i.e. overall trend) due to (any) cancer diagnosis and specific cancer types.ResultsFrom the 52,228 GLD users selected, 3,281 cases with cancer and 12,891 controls without cancer during follow-up were included in the study. In our analyses, before cancer diagnosis the MPR increased by 0.10{\%} per month (95{\%} CI 0.10, 0.10). Besides a significant drop in MPR at the time of cancer diagnosis of −6.3{\%} (95{\%} CI −6.5, −6.0), there was an ongoing, yet lower, monthly decline in MPR (−0.20{\%}; 95{\%} CI −0.21, −0.20) after cancer diagnosis. The largest drops in MPR at the time of cancer diagnosis, in the range of 11–15{\%}, were seen among patients with stage IV disease and gastrointestinal or pulmonary cancers.Conclusions/interpretationOur findings indicate a clear decline in adherence to GLD treatment regimens following a cancer diagnosis. The reason for the decline in MPR needs to be further elucidated.Keywords: Adherence, Cancer, Glucose-lowering drugs",
author = "M.M.J. Zanders and H.R. Raak and {van Herk-Sukel}, M.P.P. and {van de Poll-Franse}, L.V. and J.A. Johnson",
year = "2015",
doi = "10.1007/s00125-015-3497-8",
language = "English",
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pages = "951--960",
journal = "Diabetologia: Clinical and experimental diabetes and metabolism: Organ of the European Association for the Study of Diabetes",
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Impact of cancer on adherence to glucose-lowering drug treatment in individuals with diabetes. / Zanders, M.M.J.; Raak, H.R.; van Herk-Sukel, M.P.P.; van de Poll-Franse, L.V.; Johnson, J.A.

In: Diabetologia, Vol. 58, No. 5, 2015, p. 951-960.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Impact of cancer on adherence to glucose-lowering drug treatment in individuals with diabetes

AU - Zanders, M.M.J.

AU - Raak, H.R.

AU - van Herk-Sukel, M.P.P.

AU - van de Poll-Franse, L.V.

AU - Johnson, J.A.

PY - 2015

Y1 - 2015

N2 - Aims/hypothesisAdherence to glucose-lowering drug (GLD) treatment regimens is crucial for metabolic control and improving prognosis. Because a diagnosis of cancer might have an impact on adherence to medication, this study explored changes in adherence to GLDs following a cancer diagnosis.MethodsAll new users of GLDs between 1998 and 2011 who lived in the Eindhoven Cancer Registry–PHARMO Database Network catchment area were selected. Those with a primary cancer diagnosis during follow-up were considered cases and matched with eligible controls without cancer during follow-up. Medication possession ratio (MPR) was used as indicator for medication adherence. Segmented linear auto-regression analysis with interrupted time series was used to assess changes in MPR for cases compared with controls (i.e. overall trend) due to (any) cancer diagnosis and specific cancer types.ResultsFrom the 52,228 GLD users selected, 3,281 cases with cancer and 12,891 controls without cancer during follow-up were included in the study. In our analyses, before cancer diagnosis the MPR increased by 0.10% per month (95% CI 0.10, 0.10). Besides a significant drop in MPR at the time of cancer diagnosis of −6.3% (95% CI −6.5, −6.0), there was an ongoing, yet lower, monthly decline in MPR (−0.20%; 95% CI −0.21, −0.20) after cancer diagnosis. The largest drops in MPR at the time of cancer diagnosis, in the range of 11–15%, were seen among patients with stage IV disease and gastrointestinal or pulmonary cancers.Conclusions/interpretationOur findings indicate a clear decline in adherence to GLD treatment regimens following a cancer diagnosis. The reason for the decline in MPR needs to be further elucidated.Keywords: Adherence, Cancer, Glucose-lowering drugs

AB - Aims/hypothesisAdherence to glucose-lowering drug (GLD) treatment regimens is crucial for metabolic control and improving prognosis. Because a diagnosis of cancer might have an impact on adherence to medication, this study explored changes in adherence to GLDs following a cancer diagnosis.MethodsAll new users of GLDs between 1998 and 2011 who lived in the Eindhoven Cancer Registry–PHARMO Database Network catchment area were selected. Those with a primary cancer diagnosis during follow-up were considered cases and matched with eligible controls without cancer during follow-up. Medication possession ratio (MPR) was used as indicator for medication adherence. Segmented linear auto-regression analysis with interrupted time series was used to assess changes in MPR for cases compared with controls (i.e. overall trend) due to (any) cancer diagnosis and specific cancer types.ResultsFrom the 52,228 GLD users selected, 3,281 cases with cancer and 12,891 controls without cancer during follow-up were included in the study. In our analyses, before cancer diagnosis the MPR increased by 0.10% per month (95% CI 0.10, 0.10). Besides a significant drop in MPR at the time of cancer diagnosis of −6.3% (95% CI −6.5, −6.0), there was an ongoing, yet lower, monthly decline in MPR (−0.20%; 95% CI −0.21, −0.20) after cancer diagnosis. The largest drops in MPR at the time of cancer diagnosis, in the range of 11–15%, were seen among patients with stage IV disease and gastrointestinal or pulmonary cancers.Conclusions/interpretationOur findings indicate a clear decline in adherence to GLD treatment regimens following a cancer diagnosis. The reason for the decline in MPR needs to be further elucidated.Keywords: Adherence, Cancer, Glucose-lowering drugs

U2 - 10.1007/s00125-015-3497-8

DO - 10.1007/s00125-015-3497-8

M3 - Article

VL - 58

SP - 951

EP - 960

JO - Diabetologia: Clinical and experimental diabetes and metabolism: Organ of the European Association for the Study of Diabetes

JF - Diabetologia: Clinical and experimental diabetes and metabolism: Organ of the European Association for the Study of Diabetes

SN - 0012-186X

IS - 5

ER -