Metformin use and hospital attendance‐related resources utilization among diabetic patients with prostate cancer on androgen deprivation therapy: A population‐based cohort study
Abstract Background Androgen deprivation therapy (ADT), used increasingly in the treatment of prostate cancer (PCa), negatively influences glycemic control in diabetes and is associated with an increased risk of diabetes complications where hospitalization commonly ensues. Metformin could decrease t...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-04-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.5651 |
| _version_ | 1797831041913716736 |
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| author | Yan Hiu Athena Lee Jeremy Man Ho Hui Cheuk To Chung Kang Liu Edward Christopher Dee Kenrick Ng Gary Tse Jeffrey Shi Kai Chan Chi Fai Ng |
| author_facet | Yan Hiu Athena Lee Jeremy Man Ho Hui Cheuk To Chung Kang Liu Edward Christopher Dee Kenrick Ng Gary Tse Jeffrey Shi Kai Chan Chi Fai Ng |
| author_sort | Yan Hiu Athena Lee |
| collection | DOAJ |
| description | Abstract Background Androgen deprivation therapy (ADT), used increasingly in the treatment of prostate cancer (PCa), negatively influences glycemic control in diabetes and is associated with an increased risk of diabetes complications where hospitalization commonly ensues. Metformin could decrease the metabolic consequences of ADT and enhance its effect. This study examined the association of metformin use with healthcare resources utilization among diabetic, PCa patients receiving ADT. Methods Diabetic adults with PCa on ADT in Hong Kong between December 1999 and March 2021 were identified. Patients with <6 months of concurrent metformin and ADT use were excluded. All included patients were followed up until September 2021. The outcomes were hospital attendances and related costs. Results In total, 1,284 metformin users and 687 non‐users were studied. Over 8,045 person‐years, 9,049 accident and emergency (A&E), and 21,262 inpatient attendances, with 11,2781 days of hospitalization were observed. Metformin users had significantly fewer A&E attendances (incidence rate ratio (IRR): 0.61 [95% confidence interval 0.54–0.69], p < 0.001), inpatient attendances (IRR: 0.57 [0.48–0.67], p < 0.001), and days of hospitalization (IRR: 0.55 [0.42–0.72], p < 0.001). Annual attendance costs were lower for metformin users than non‐users (cost ratio: 0.28 [0.10–0.80], p = 0.017). Conclusions Metformin use was associated with decreased hospital attendances, days of hospitalization, and associated costs, which could help reduce healthcare resource utilization following ADT in the treatment of PCa. |
| first_indexed | 2024-04-09T13:45:43Z |
| format | Article |
| id | doaj.art-3130fc8fef754b748206de3a79680a5b |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2024-04-09T13:45:43Z |
| publishDate | 2023-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj.art-3130fc8fef754b748206de3a79680a5b2023-05-09T04:04:18ZengWileyCancer Medicine2045-76342023-04-011289128913210.1002/cam4.5651Metformin use and hospital attendance‐related resources utilization among diabetic patients with prostate cancer on androgen deprivation therapy: A population‐based cohort studyYan Hiu Athena Lee0Jeremy Man Ho Hui1Cheuk To Chung2Kang Liu3Edward Christopher Dee4Kenrick Ng5Gary Tse6Jeffrey Shi Kai Chan7Chi Fai Ng8Division of Urology, Department of Surgery, Faculty of Medicine The Chinese University of Hong Kong Hong Kong ChinaCardio‐oncology Research Unit Cardiovascular Analytics Group, China‐UK Collaboration Hong Kong ChinaCardio‐oncology Research Unit Cardiovascular Analytics Group, China‐UK Collaboration Hong Kong ChinaDivision of Urology, Department of Surgery, Faculty of Medicine The Chinese University of Hong Kong Hong Kong ChinaDepartment of Radiation Oncology Memorial Sloan Kettering Cancer Center New York New York United StatesDepartment of Medical Oncology University College London Hospitals NHS Foundation Trust London United KingdomTianjin Key Laboratory of Ionic‐Molecular Function of Cardiovascular Disease, Department of Cardiology Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University Tianjin ChinaCardio‐oncology Research Unit Cardiovascular Analytics Group, China‐UK Collaboration Hong Kong ChinaDivision of Urology, Department of Surgery, Faculty of Medicine The Chinese University of Hong Kong Hong Kong ChinaAbstract Background Androgen deprivation therapy (ADT), used increasingly in the treatment of prostate cancer (PCa), negatively influences glycemic control in diabetes and is associated with an increased risk of diabetes complications where hospitalization commonly ensues. Metformin could decrease the metabolic consequences of ADT and enhance its effect. This study examined the association of metformin use with healthcare resources utilization among diabetic, PCa patients receiving ADT. Methods Diabetic adults with PCa on ADT in Hong Kong between December 1999 and March 2021 were identified. Patients with <6 months of concurrent metformin and ADT use were excluded. All included patients were followed up until September 2021. The outcomes were hospital attendances and related costs. Results In total, 1,284 metformin users and 687 non‐users were studied. Over 8,045 person‐years, 9,049 accident and emergency (A&E), and 21,262 inpatient attendances, with 11,2781 days of hospitalization were observed. Metformin users had significantly fewer A&E attendances (incidence rate ratio (IRR): 0.61 [95% confidence interval 0.54–0.69], p < 0.001), inpatient attendances (IRR: 0.57 [0.48–0.67], p < 0.001), and days of hospitalization (IRR: 0.55 [0.42–0.72], p < 0.001). Annual attendance costs were lower for metformin users than non‐users (cost ratio: 0.28 [0.10–0.80], p = 0.017). Conclusions Metformin use was associated with decreased hospital attendances, days of hospitalization, and associated costs, which could help reduce healthcare resource utilization following ADT in the treatment of PCa.https://doi.org/10.1002/cam4.5651androgen deprivation therapydiabetesmedical costsmetforminprostate cancer |
| spellingShingle | Yan Hiu Athena Lee Jeremy Man Ho Hui Cheuk To Chung Kang Liu Edward Christopher Dee Kenrick Ng Gary Tse Jeffrey Shi Kai Chan Chi Fai Ng Metformin use and hospital attendance‐related resources utilization among diabetic patients with prostate cancer on androgen deprivation therapy: A population‐based cohort study Cancer Medicine androgen deprivation therapy diabetes medical costs metformin prostate cancer |
| title | Metformin use and hospital attendance‐related resources utilization among diabetic patients with prostate cancer on androgen deprivation therapy: A population‐based cohort study |
| title_full | Metformin use and hospital attendance‐related resources utilization among diabetic patients with prostate cancer on androgen deprivation therapy: A population‐based cohort study |
| title_fullStr | Metformin use and hospital attendance‐related resources utilization among diabetic patients with prostate cancer on androgen deprivation therapy: A population‐based cohort study |
| title_full_unstemmed | Metformin use and hospital attendance‐related resources utilization among diabetic patients with prostate cancer on androgen deprivation therapy: A population‐based cohort study |
| title_short | Metformin use and hospital attendance‐related resources utilization among diabetic patients with prostate cancer on androgen deprivation therapy: A population‐based cohort study |
| title_sort | metformin use and hospital attendance related resources utilization among diabetic patients with prostate cancer on androgen deprivation therapy a population based cohort study |
| topic | androgen deprivation therapy diabetes medical costs metformin prostate cancer |
| url | https://doi.org/10.1002/cam4.5651 |
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