Patterns of medication adherence in a multi-ethnic cohort of prevalent statin users diagnosed with breast, prostate, or colorectal cancer
| Autor: | Marc A. Emerson, Stacey E. Alexeeff, Alyce S. Adams, Ninah S. Achacoso, Neetu Chawla, Laurel A. Habel, Matthew P. Banegas |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Colorectal cancer Hypercholesterolemia Breast Neoplasms California Article Medication Adherence Cohort Studies 03 medical and health sciences Prostate cancer 0302 clinical medicine Breast cancer Internal medicine Ethnicity Prevalence Medicine Humans 030212 general & internal medicine Aged Polypharmacy Aged 80 and over Oncology (nursing) business.industry Racial Groups Cancer Prostatic Neoplasms Odds ratio Middle Aged medicine.disease Comorbidity Oncology 030220 oncology & carcinogenesis Cohort Female Hydroxymethylglutaryl-CoA Reductase Inhibitors business Colorectal Neoplasms |
| Zdroj: | Journal of cancer survivorship : research and practice. 12(6) |
| ISSN: | 1932-2267 |
| Popis: | PURPOSE: To investigate the implications of a cancer diagnosis on medication adherence for pre-existing comorbid conditions, we explored statin adherence patterns prior to and following a new diagnosis of breast, colorectal or prostate cancer among a multi-ethnic cohort. METHODS: We identified adults enrolled at Kaiser Permanente Northern California who were prevalent statin medication users, newly diagnosed with breast, colorectal or prostate cancer between 2000–2012. Statin adherence was measured using the proportion of days covered (PDC) during the two years pre-cancer diagnosis and the two years post-cancer diagnosis. Adherence patterns were assessed using generalized estimating equations, for all cancers combined and stratified by cancer type and race/ethnicity, adjusted for demographic, clinical, and tumor characteristics. RESULTS: Among 10,177 cancer patients, statin adherence decreased from pre- to postcancer diagnosis (Adjusted Odds Ratio (OR(adj)):0.91, 95% Confidence Interval (95% CI):0.88–0.94). Statin adherence decreased from pre- to post-cancer diagnosis among breast (OR(adj):0.94, 95% CI:0.90–0.99) and colorectal (OR(adj):0.79, 95% CI:0.74–0.85) cancer patients. No difference in adherence was observed among prostate cancer patients (OR(adj):1.01, 95% CI:0.97–1.05). Prior to cancer diagnosis, adherence to statins was generally higher among non-Hispanic whites and multi-race patients than other groups. However, statin adherence after diagnosis decreased only among these two populations (OR(adj):0.85, 95% CI:0.85–0.92 and OR(adj):0.86, 95% CI:0.76–0.97), respectively. CONCLUSIONS: We found substantial variation in statin medication adherence following diagnosis by cancer type and race/ethnicity among a large cohort of prevalent statin users in an integrated health care setting. IMPLICATIONS FOR CANCER SURVIVORS: Improving our understanding of comorbidity management and polypharmacy across diverse cancer patient populations is warranted to develop tailored interventions that improve medication adherence and reduce disparities in health outcomes. |
| Databáze: | OpenAIRE |
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