Effects of breast cancer on chronic disease medication adherence among older women
Effects of breast cancer on chronic disease medication adherence among older women
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DOI：
10.1002/pds.3971
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发表时间：
2016-08-01
影响因子：
2.6
通讯作者：
Demissie, Kitaw
中科院分区：
文献类型：
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作者：
Santorelli, Melissa L.;Steinberg, Michael B.;Demissie, Kitaw
目的本研究的目的是确定乳腺癌对老年妇女慢性疾病药物依从性的影响。方法采用监测、流行病学和最终结果(SEER)-医疗保险相关数据和5%的医疗保险登记人随机样本。2008年诊断出的I-III期乳腺癌患者和未患癌症的女性符合条件。使用诊断代码和处方填写记录确定了66岁以上用药人群的三个队列：糖尿病、高血压和脂质紊乱。在每个队列中，乳腺癌患者按年龄和地理区域与对照女性进行频率匹配。药物依从性通过覆盖天数和药物持续时间的比例来衡量。结果基线期后，乳腺癌患者糖尿病药物依从性为26.2%，降脂药物依从性为28.9%，高血压药物依从性为14.2%。乳腺癌患者出现糖尿病药物不依从的几率增加[比值比(OR) = 1.44；95%可信区间(CI) = 1.07至1.95]，与未患癌症的女性相比，她们更有可能不坚持使用糖尿病药物（风险比= 1.31;95% CI: 1.04至1.66）。该研究未能显示乳腺癌患者与对照组女性在不坚持服用高血压药物（OR = 0.87; 95% CI: 0.71 - 1.05）或降脂药物（OR = 0）方面的差异。91年;95% CI: 0.73 ~ 1.13)，覆盖天数比例阈值为80%。结论老年乳腺癌合并糖尿病患者的初级保健协调应引起重视。版权所有：John Wiley & Sons， Ltd。
Purpose The purpose of this study was to determine the effects of breast cancer on chronic disease medication adherence among older women.Methods The Surveillance, Epidemiology, and End Results (SEER)-Medicare-linked data and a 5% random sample of Medicare enrollees were used. Stage I-III breast cancer patients diagnosed in 2008 and women without cancer were eligible. Three cohorts of medication users 66+ years were identified using diagnosis codes and prescription fill records: diabetes, hypertension, and lipid disorders. For each cohort, breast cancer patients were frequency matched to comparison women by age and geographic area. Medication adherence was measured by the proportion of days covered and medication persistence.Results During the post-baseline period, the percentage of breast cancer patients who were non-adherent was 26.2% for diabetes medication, 28.9% for lipid-lowering medication, and 14.2% for hypertension medication. Breast cancer patients experienced an increased odds of diabetes medication non-adherence [odds ratio (OR) = 1.44; 95% confidence interval (CI) = 1.07 to 1.95] and were more likely to be non-persistent with diabetes medication (hazard ratio = 1.31; 95% CI: 1.04 to 1.66) relative to women without cancer. The study failed to show a difference between breast cancer and comparison women in the odds of non-adherence to hypertensive (OR = 0.87; 95% CI: 0.71 to 1.05) or lipid-lowering medication (OR = 0. 91; 95% CI: 0.73 to 1.13) with a proportion of days covered threshold of 80%.Conclusion Special attention should be given to the coordination of primary care for older breast cancer patients with diabetes. Copyright (C) 2016 John Wiley & Sons, Ltd.