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Metformin use and hospital attendance‐related resources utilization among diabetic patients with prostate cancer on androgen deprivation therapy: A population‐based cohort study

Lee, Yan Hiu Athena, Hui, Jeremy Man Ho, Chung, Cheuk To, Liu, Kang, Dee, Edward Christopher, Ng, Kenrick, Tse, Gary, Chan, Jeffrey Shi Kai, Ng, Chi Fai (2023) 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, 12 (8). pp. 9128-9132. ISSN 2045-7634. (doi:10.1002/cam4.5651) (KAR id:100306)

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.

Item Type: Article
DOI/Identification number: 10.1002/cam4.5651
Uncontrolled keywords: androgen deprivation therapy, diabetes, medical costs, metformin, prostate cancer
Subjects: R Medicine
Divisions: Divisions > Division of Natural Sciences > Kent and Medway Medical School
Funders: University of Kent (https://ror.org/00xkeyj56)
Depositing User: Gary Tse
Date Deposited: 03 Mar 2023 11:38 UTC
Last Modified: 18 May 2023 10:26 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/100306 (The current URI for this page, for reference purposes)

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