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Diabetes drug adherence drops with cancer diagnoses
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Adherence to glucose-lowering medications among patients with diabetes appears to diminish after they are diagnosed with cancer, according to research published in Diabetologia.
“This study revealed that diabetes patients became less adherent to their prescribed diabetes drugs following a cancer diagnosis,” Marjolein M. J. Zanders, MD, of the department of research at Netherlands Comprehensive Cancer Organization in Eindhoven, the Netherlands, told Endocrine Today.
Marjolein M. J. Zanders
From the 52,228 new users of glucose-lowering drugs between 1998 and 2011 living in the Eindhoven Cancer Registry–PHARMO Database Network area, Zanders and colleagues examined data from 3,281 patients diagnosed with cancer and 12,891 without cancer during follow-up.
The researchers assessed medication possession ratio (MPR) to determine drug adherence; they used segmented linear auto-regression analysis with interrupted time series to identify changes (overall trend) in MPR for patients with cancer — due to any cancer diagnosis and specific cancer types — compared with cancer-free patients.
Before cancer diagnosis, MPR rose 0.1% per month (95% CI, 0.1-0.1). A significant drop in MPR was seen at the time of cancer diagnosis (−6.3%; 95% CI, −6.5 to −6). An ongoing, but lower, monthly decline in MPR was observed after cancer diagnosis (−0.2%; 95% CI, −0.21 to −0.2).
“The decline in adherence observed among diabetes patients was seen for almost all cancer types, but was more pronounced among patients with esophageal, stomach, pancreas or liver cancer and pulmonary cancers,” Zanders said.
The largest decreases in MPR at the time of cancer diagnosis (range, 11% to 15%) were seen among patients with gastrointestinal or pulmonary cancers and those with stage IV disease.
“In cancer patients with more severe or advanced cancers, the adherence to glucose-lowering drug use might be important to prevent recurrent hyperglycemia or ketoacidosis,” Zanders said. Patients and medical professionals must pay attention to use of diabetes medications around a diagnosis of cancer, she added.
Future research needs to further elucidate the reason for the decline in medication adherence among various cancers, Zanders said, to answer the question: “Is it the patient who prioritizes the fight against cancer or the advice of the physician to stop the treatment?” – by Allegra Tiver
For more information:
Marjolein M. J. Zanders, MD, can be reached at the Department of Research, Netherlands Comprehensive Cancer Organization, PO Box 231, 5600 AE Eindhoven, the Netherlands; email: m.zanders@iknl.nl.
Disclosure: Zanders reports employment with the PHARMO Database Network for Drug Outcomes Research.
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