title: Oral antidiabetic drug use and associated health outcomes in cancer patients.
abstract: 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.
  
  
  CONCLUSIONS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: School of Pharmacy, West Virginia University, Morgantown, WV, USA.
authors.forename: X
authors.initials: X
authors.lastname: Tan
authors.affiliation: School of Pharmacy, West Virginia University, Morgantown, WV, USA.
authors.forename: X
authors.initials: X
authors.lastname: Feng
authors.affiliation: School of Pharmacy, University of Texas, El Paso, TX, USA.
authors.forename: J
authors.initials: J
authors.lastname: Chang
authors.affiliation: School of Pharmacy, West Virginia University, Morgantown, WV, USA.
authors.forename: G
authors.initials: G
authors.lastname: Higa
authors.affiliation: Public Health Sciences, Penn State University College of Medicine, Hershey, PA, USA.
authors.forename: L
authors.initials: L
authors.lastname: Wang
authors.affiliation: Public Health Sciences, Penn State University College of Medicine, Hershey, PA, USA.
authors.forename: D
authors.initials: D
authors.lastname: Leslie
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000209:etiology; D010593:Pharmaceutical Services; D010594:Pharmacies; D010595:Pharmacists; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D007004:Hypoglycemic Agents
keywords: antidiabetic drugs; cancer; diabetes; medication adherence