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Tytuł pozycji:

Changes in chronic medication adherence in older adults with cancer versus matched cancer-free cohorts.

Tytuł:
Changes in chronic medication adherence in older adults with cancer versus matched cancer-free cohorts.
Autorzy:
Lund JL; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States of America; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States of America. Electronic address: .
Gupta P; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States of America.
Amin KB; Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States of America.
Meng K; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States of America.
Urick BY; Division of Practice Advancement and Clinical Education, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States of America.
Reeder-Hayes KE; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States of America; Division of Hematology/Oncology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States of America.
Farley JF; Department of Pharmaceutical Care and Health Systems, University of Minnesota, Minneapolis, MN 55455, United States of America.
Wheeler SB; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States of America; Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States of America.
Spees L; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States of America; Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States of America.
Trogdon JG; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States of America; Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States of America.
Źródło:
Journal of geriatric oncology [J Geriatr Oncol] 2021 Jan; Vol. 12 (1), pp. 72-79. Date of Electronic Publication: 2020 May 15.
Typ publikacji:
Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
Język:
English
Imprint Name(s):
Original Publication: Amsterdam : Elsevier
MeSH Terms:
Diabetes Mellitus*
Hypertension*
Neoplasms*/drug therapy
Aged ; Humans ; Hypoglycemic Agents/therapeutic use ; Male ; Medicare ; Medication Adherence ; Retrospective Studies ; United States
References:
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Grant Information:
UL1 TR001111 United States TR NCATS NIH HHS; HHSN261201000035C United States CA NCI NIH HHS; UL1 TR002489 United States TR NCATS NIH HHS; HHSN261201000035I United States CA NCI NIH HHS; HHSN261201000034C United States CA NCI NIH HHS; U58 DP003862 United States DP NCCDPHP CDC HHS; R01 AG050733 United States AG NIA NIH HHS; HHSN261201000140C United States CA NCI NIH HHS
Contributed Indexing:
Keywords: Aging; Cancer; Chronic conditions; Medication adherence
Substance Nomenclature:
0 (Hypoglycemic Agents)
Entry Date(s):
Date Created: 20200520 Date Completed: 20210728 Latest Revision: 20240217
Update Code:
20240217
PubMed Central ID:
PMC7666657
DOI:
10.1016/j.jgo.2020.04.012
PMID:
32423699
Czasopismo naukowe
Objectives: A cancer diagnosis can influence medication adherence for chronic conditions by shifting care priorities or reinforcing disease prevention. This study describes changes in adherence to medications for treating three common chronic conditions - diabetes, hyperlipidemia, and hypertension - among older adults newly diagnosed with non-metastatic breast, colorectal, lung, or prostate cancer.
Methods: We identified Medicare beneficiaries aged ≥66 years newly diagnosed with cancer and using medication for at least one chronic condition, and similar cohorts of matched individuals without cancer. To assess medication adherence, proportion of days covered (PDC) was measured in six-month windows starting six-months before through 24 months following cancer diagnosis or matched index date. Generalized estimating equations were used to estimate difference-in-differences (DID) comparing changes in PDCs across cohorts using the pre-diagnosis window as the referent. Analyses were run separately for each cancer type-chronic condition combination.
Results: Across cancer types and non-cancer cohorts, adherence was highest for anti-hypertensives (90-92%) and lowest for statins (77-79%). In older adults with colorectal and lung cancer, adherence to anti-diabetics and statins declined post-diagnosis compared with the matched non-cancer cohorts, with estimates ranging from a DID of -2 to -4%. In older adults with breast and prostate cancer cohorts, changes in adherence for all medications were similar to non-cancer cohorts.
Conclusion: Our findings highlight variation in medication adherence by cancer type and chronic condition. As many older adults with early stage cancer eventually die from non-cancer causes, it is imperative that cancer survivorship interventions emphasize medication adherence for other chronic conditions.
Competing Interests: Declaration of Competing Interest Dr. Lund's spouse is a full-time, paid employee of GlaxoSmithKline who also holds stock in the amount of approximately $42,000. Dr. Lund also receives unrelated grant funding paid to her institution from AbbVie. Dr. Wheeler receives unrelated grant funding paid to her institution from Pfizer. All other co-authors have no potential conflicts of interest to report.
(Copyright © 2020 Elsevier Ltd. All rights reserved.)

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