Changes in Medication Management After a Diagnosis of Cancer Among Medicare Beneficiaries With Diabetes. - PubMed - NCBI
J Oncol Pract. 2015 Nov;11(6):429-34. doi: 10.1200/JOP.2014.003046. Epub 2015 Jun 23.
Changes in Medication Management After a Diagnosis of Cancer Among Medicare Beneficiaries With Diabetes.
Abstract
PURPOSE:
A new cancer diagnosis commonly initiates a cascade of health care decisions that have potentially important consequences formanagement of other chronic conditions such as diabetes. We sought to determine whether a new cancer diagnosis is associated with changes inmedication adherence among Medicare beneficiaries with diabetes, and whether the relationship is affected by life expectancy and generosity of drug coverage. METHODS:
The study population was drawn from a 5% random sample of Medicare beneficiaries with diabetes enrolled in Medicare Part D in 2007 and 2008. Patients had cancer newly diagnosed between January and December 2007 (n = 4,348) and were compared with a cancer-free control group (N = 28,507) assigned a pseudo-diagnosis date. Adherence (proportion of days covered [PDC]) with oral hypoglycemic agents, renin-angiotensin-aldosterone system inhibitors, and statins was tracked for 6 months before and after the diagnosis date. Multivariable regression models assessed the independent impact of a cancer diagnosis, life expectancy (proxy measure: died 7 to 12 months after index date), and coverage generosity (proxy measure: low-income subsidy recipient) on PDC, controlling for individual characteristics. RESULTS:
Relatively larger declines in medication adherence (3 to 5 percentage points; P < .001) were observed overall for patients with cancerversus controls. Short life expectancy was associated with between 8% and 11% lower PDC (P < .001) in the cancer subgroup relative to controls. Low-income subsidy status had no differential effect on changes in drug adherence. CONCLUSION:
A cancer diagnosis among patients with diabetes reduced adherence with evidence-based medications, particularly if patients' life expectancy was short. Copyright © 2015 by American Society of Clinical Oncology.
- PMID:
- 26105669
- [PubMed - in process]
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