Providers' mediating role for medication adherence among cancer survivors

Public Deposited
Analytics

Downloadable Content

Download PDF
Request Version for Screen Reader
Creator
  • Trogdon, J.G.
    • Affiliation: Gillings School of Global Public Health, Department of Health Policy and Management
  • Amin, K.
    • Affiliation: Gillings School of Global Public Health, Department of Health Policy and Management
  • Gupta, P.
    • Affiliation: N.C. Cancer Hospital, UNC Lineberger Comprehensive Cancer Center
  • Urick, B.Y.
    • Affiliation: Eshelman School of Pharmacy
  • Reeder-Hayes, K.E.
    • Affiliation: School of Medicine, Division of Hematology/Oncology
  • Farley, J.F.
    • Other Affiliation: University of Minnesota
  • Wheeler, S.B.
    • Affiliation: Gillings School of Global Public Health, Department of Health Policy and Management
  • Spees, L.
    • Affiliation: Gillings School of Global Public Health, Department of Health Policy and Management
  • Lund, J.L.
    • Affiliation: Gillings School of Global Public Health, Department of Epidemiology
Abstract
  • Background We conducted a mediation analysis of the provider team's role in changes to chronic condition medication adherence among cancer survivors. Methods We used a retrospective, longitudinal cohort design following Medicare beneficiaries from 18-months before through 24-months following cancer diagnosis. We included beneficiaries aged ≥66 years newly diagnosed with breast, colorectal, lung or prostate cancer and using medication for non-insulin anti-diabetics, statins, and/or anti-hypertensives and similar individuals without cancer from Surveillance, Epidemiology, and End Results-Medicare data, 2008-2014. Chronic condition medication adherence was defined as a proportion of days covered ≥ 80%. Provider team structure was measured using two factors capturing the number of providers seen and the historical amount of patient sharing among providers. Linear regressions relying on within-survivor variation were run separately for each cancer site, chronic condition, and follow-up period. Results The number of providers and patient sharing among providers increased after cancer diagnosis relative to the non-cancer control group. Changes in provider team complexity explained only small changes in medication adherence. Provider team effects were statistically insignificant in 13 of 17 analytic samples with significant changes in adherence. Statistically significant provider team effects were small in magnitude (<0.5 percentage points). Conclusions Increased complexity in the provider team associated with cancer diagnosis did not lead to meaningful reductions in medication adherence. Interventions aimed at improving chronic condition medication adherence should be targeted based on the type of cancer and chronic condition and focus on other provider, systemic, or patient factors.
Date of publication
Keyword
DOI
Identifier
Resource type
  • Article
License
  • Attribution 4.0 International
Journal title
  • PLoS ONE
Journal volume
  • 16
Journal issue
  • 11-Nov
Language
  • English
Version
  • Publisher
Funder
  • University of North Carolina, UNC
  • National Institute on Aging, NIA: R01AG050733
  • National Center for Advancing Translational Sciences, NCATS: UL1TR001111, UL1TR002489
ISSN
  • 1932-6203
Publisher
  • Public Library of Science

Relations

Parents:

This work has no parents.

In Collection:

Items

Thumbnail Title Date Uploaded Visibility Actions
file details journal.pone.0260358.pdf 2024-01-30 Public Download