Chopra I, et al. - Researchers sought to assess the association between medication adherence and coronary artery disease (CAD)-related hospitalizations immediately following cancer diagnosis. Findings revealed a complex interaction between CAD and cancer. This suggested the importance of routinely monitoring medication adherence in general clinical practice and of providing linkages to support services that can increase medication adherence.

Methods

• Researchers performed a retrospective observational longitudinal study using SEER-Medicare data.
• They searched elderly Medicare fee-for-service beneficiaries with preexisting CAD and incident breast, colorectal, or prostate cancer (N=12,096) for 12 months before and after cancer diagnosis.
• They categorized hospitalizations measured every 120 days into CAD-related hospitalization, other hospitalization, and no hospitalization.
• Into 5 mutually exclusive groups, they categorized medication adherence: adherent to both statins and ACEIs/ARBs/β-blockers (reference group), not adherent to both statins and ACEIs/ARBs/β-blockers, adherent to either statins or ACEIs/ARBs/β-blockers, use of one medication class and adherent to that class, and use of one medication class and not adherent to that class.
• They performed analysis of the association between medication adherence and hospitalization using repeated measures multinomial logistic regressions.
• They used inverse probability treatment weights to control for observed group differences among medication adherence categories.

Results

• During the 120-day period immediately following cancer diagnosis, researchers observed adherence to both statins and ACEIs/ARBs/β-blockers at 31.2%.
• During the same period, 13.7% were not adherent to both medication classes; and 27.4% had CAD-related hospitalizations immediately after cancer diagnosis, which declined to 10.6% during the last 4 months of the postdiagnosis period.
• The adjusted analyses indicated that those not adherent to both statins and ACEIs/ARBs/β-blockers were more likely to have CAD-related hospitalization compared with those adherent to both medication classes (adjusted odds ratio, 1.82; 95% CI, 1.72–1.92; P < .0001).