Use of psychotropic medications by US cancer survivors

Abstract

Objectives To describe national utilization of psychotropic medications by adult cancer survivors in the U.S. To estimate the extra use of psychotropic medications that is attributable to cancer survivorship. Methods Prescription data for 2001 to 2006 from the Medical Expenditure Panel Survey (MEPS) were linked to data identifying cancer survivors from the National Health Interview Survey (NHIS), the MEPS sampling frame. The sample was limited to adults 25 years of age and older. Propensity score matching was used to estimate the effects of cancer survivorship on utilization of psychotropic medications, by comparing cancer survivors and other adults in MEPS. Utilization was measured as any use during a calendar year and the number of prescriptions purchased (including refills). Analyses were stratified by gender and age, distinguishing adults younger than 65 from those 65 and older. Results Nineteen percent of cancer survivors under age 65 and 16% of survivors 65 and older used psychotropic medications. Sixteen percent of younger survivors used antidepressants; 7% used anti-anxiety medications. For older survivors, utilization rates for these two drug types were 11% and 7% respectively. The increase in any use attributable to cancer amounted to 4-5 percentage points for younger survivors (p<.05) and 2-3 percentage points for older survivors (p<.05), depending on gender. Conclusion Increased use of psychotropic medications by cancer survivors, compared to other adults, suggests that survivorship presents ongoing psychological challenges.

Mental health services utilization and expenditures associated with cancer survivorship in the United States

“…As others have suggested, a higher likelihood of mental health services use among survivors may reflect the lasting psychological effects of cancer [21]. Survivors may have more frequent interaction with healthcare providers and therefore may experience more opportunities for detection of and referral for mental health concerns.…”

“…This may suggest higher unmet mental health needs among recently diagnosed younger adult cancer survivors. Punekar et al [21] found significant higher mental health prescription drugs use among younger adult cancer survivors compared to individuals without a cancer history. Our results suggested that mental health services use varied by time since diagnosis.…”

“…Efficacious and cost-effective treatments for psychological comorbidities in cancer survivors have been developed [17–19]. Several studies have found that cancer survivors are more likely to use mental health services than persons without a cancer history [11, 20, 21]. However, very limited research examined the utilization and expenditure among cancer survivors compared to those without a cancer history stratified by age and time since diagnosis.…”

Antidepressants in the treatment of depression/depressive symptoms in cancer patients: a systematic review and meta-analysis

“…Even though these rates appear to be high, a consistent difference to a systematically matched sample from general population data is still controversial. The existing data suggest that “survivorship presents ongoing psychological challenges” [7]. …”

Depression bei onkologischen PatientInnen

“…B. der Zeitpunkt der Diagnose, belastende Therapiesituationen, das Auftreten eines Rezidivs oder einer Tumorprogression, muss betont werden, dass depressive Symptomatik praktisch zu jedem Zeitpunkt im Krankheitsverlauf auftreten kann. Gerade die Beobachtungen der letzten Jahre haben gezeigt, dass bei PatientInnen in der Phase der Tumornachsorge und im Langzeitverlauf wieder depressiv/ängstliche Symptome vermehrt auftreten können [11].…”