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Psychotropic polypharmacy and its association with health-related quality of life among cancer survivors in the USA: a population-level analysis

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Abstract

Purpose

Cancer survivors that use multiple psychotropic medications are at an increased risk of psychotropic polypharmacy. We examined the association between psychotropic polypharmacy and health-related quality of life (HRQoL) among cancer survivors living in the USA.

Methods

We used the Medical Expenditure Panel Survey (MEPS) data for 2010, 2012, and 2014 to identify adult cancer survivors. Psychotropic polypharmacy was defined as use of at least two classes of psychotropic prescription medications. The physical component summary (PCS) and the mental component summary (MCS) were obtained from the 12-item Short Form Health Survey version 2 to measure HRQoL. Adjusted ordinary least square regressions were performed to evaluate the association between psychotropic polypharmacy and HRQoL.

Results

Among 31 million US cancer survivors (weighted from a sample of 2609), 16.3% reported psychotropic polypharmacy. Lung cancer survivors had the highest prevalence of psychotropic polypharmacy (22.5%), followed by survivors of breast cancer (17.8%), colorectal, and other gastrointestinal cancers (16.0%). The unadjusted PCS and MCS scores for those with psychotropic polypharmacy were significantly lower than those without psychotropic polypharmacy, overall, and for each cancer type. In multivariable regressions, cancer survivors with psychotropic polypharmacy had significantly lower PCS scores (β =  − 3.63, p < 0.0001) and MCS scores (β =  − 2.28, p = 0.0138) compared to those without psychotropic polypharmacy.

Conclusion

Cancer survivors requiring multiple psychotropic medications have poorer quality of life.

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References

  1. Bluethmann, S. M., Mariotto, A. B., & Rowland, J. H. (2016). Anticipating the “Silver Tsunami”: Prevalence trajectories and comorbidity burden among older cancer survivors in the United States. Cancer Epidemiology, Biomarkers & Prevention,25, 1029–1036.

    Article  Google Scholar 

  2. Singer, S., Das-Munshi, J., & Brahler, E. (2010). Prevalence of mental health conditions in cancer patients in acute care-a meta-analysis. Annals of Oncology,21, 925–930.

    Article  CAS  Google Scholar 

  3. Mitchell, A. J., Chan, M., Bhatti, H., et al. (2011). Prevalence of depression, anxiety, and adjustment disorders in oncological, haematological, and palliative care settings: A meta-analysis of 94 interview-based studies. Lancet,12(2), 160–174.

    Article  Google Scholar 

  4. Ng, C. G., Boks, M. P., Smeets, H. M., Zainal, N. Z., & de Wit, N. J. (2013). Prescription patterns for psychotropic drugs in cancer patients: A large population study in the Netherlands. Psychooncology,22(4), 762–767.

    Article  Google Scholar 

  5. Farriols, C., Ferrandez, O., Planas, J., Ortiz, P., Mojal, S., & Ruiz, A. I. (2012). Changes in the prescription of psychotropic drugs in the palliative care of advanced cancer patients over a seven-year period. Journal of Pain and Symptom Management,43(5), 945–952.

    Article  Google Scholar 

  6. Punekar, R. S., Short, P. F., & Moran, J. R. (2012). Use of psychotropic medications by US cancer survivors. Psychooncology,21(11), 1237–1243.

    Article  Google Scholar 

  7. Bruera, E., & Neumann, C. (1998). The uses of psychotropics in symptom management in advanced cancer. Psychooncology,7(4), 346–358.

    Article  CAS  Google Scholar 

  8. Thekdi, S. M., Irarrazaval, M. E., & Dunn, L. B. (2012). Psychopharmacological interventions. In L. Grass & M. Riba (Eds.), Clinical psycho-oncology: An international perspective (pp. 109–126). Chichester: Willey-Blackwell.

    Chapter  Google Scholar 

  9. Mojtabai, R., & Olfson, M. (2010). National trends in psychotropic medication polypharmacy in office-based psychiatry. Archives of General Psychiatry,67(1), 26–36.

    Article  Google Scholar 

  10. Correll, C. U., & Gallego, J. A. (2012). Antipsychotic polypharmacy: A comprehensive evaluation of relevant correlates of a long-standing clinical practice. Psychiatric Clinics of North America,35(3), 661–681.

    Article  Google Scholar 

  11. Sandson, N. B., Armstrong, S. C., & Cozza, K. L. (2005). An overview of psychotropic drug-drug interactions. Psychosomatics,46(5), 464–494.

    Article  CAS  Google Scholar 

  12. Yap, K. Y., Tay, W. L., Chui, W. K., & Chan, A. (2011). Clinically relevant drug interactions between anticancer drugs and psychotropic agents. European Journal of Cancer Care (England),20(1), 6–32.

    Article  Google Scholar 

  13. Aroke, H., Vyas, A., Buchanan, A., & Kogut, S. (2019). Prevalence of psychotropic polypharmacy and associated healthcare utilization during initial phase of care among adults with cancer in USA. Drugs Real World Outcomes,6(2), 73–82.

    Article  Google Scholar 

  14. Vyas, A., Kogut, S., & Aroke, H. (2019). Real-world direct healthcare costs associated with psychotropic polypharmacy among adults with common cancer types in the United States. Journal of Managed Care & Specialty Pharmacy,25(5), 555–565.

    Article  Google Scholar 

  15. Harrison, S. L., Bradley, C., Milte, R., et al. (2018). Psychotropic medications in older people in residential care facilities and associations with quality of life: A cross-sectional study. BMC Geriatrics,18, 60.

    Article  Google Scholar 

  16. Thompson Coon, J., Abbott, R., Rogers, M., et al. (2014). Interventions to reduce inappropriate prescribing of antipsychotic medications in people with dementia resident in care homes: A systematic review. Journal of the American Medical Directors Association,15(10), 706–718.

    Article  Google Scholar 

  17. Agency for Healthcare Research and Quality. (2014). Medical expenditure panel survey, HC-171: 2014 Full Year Consolidated Data File. Retrieved July 17, 2019 from https://meps.ahrq.gov/data_stats/download_data/pufs/h171/h171doc.pdf.

  18. Medical Expenditure Panel Survey Clinical Classification Code to ICD-9-CM Code Crosswalk. Retrieved July 17, 2019 from https://meps.ahrq.gov/mepsweb/data_stats/download_data/pufs/h128/h128_icd9codes.shtml.

  19. Ware, J., Jr., Kosinski, M., & Keller, S. D. (1996). A 12-item short-form health survey: Construction of scales and preliminary tests of reliability and validity. Medical Care,34, 220–233.

    Article  Google Scholar 

  20. Ware, J., Jr., Kosinski, M., Turner-Bowker, D. M., & Gandek, B. (2002). SF-12v2: How to score version 2 of the SF-12 health survey (with a supplement documenting version 1). Lincoln, RI: QualityMetric Inc.

    Google Scholar 

  21. Braun, I. M., Rao, S. R., Meyer, F. L., & Fedele, G. (2015). Patterns of psychiatric medication use among nationally representative long-term cancer survivors and controls. Cancer,121, 132–138.

    Article  Google Scholar 

  22. Jones, S. M., Rosenberg, D., Ludman, E., & Arterburn, D. (2015). Medical comorbidity and psychotropic medication fills in older adults with breast or prostate cancer. Supportive Care in Cancer,23(10), 3005–3009.

    Article  Google Scholar 

  23. Bradley, S., Rose, S., Lutgendorf, S., Costanzo, E., & Anderson, B. (2006). Quality of life and mental health in cervical and endometrial cancer survivors. Gynecologic Oncology,100(3), 479–486.

    Article  Google Scholar 

  24. Fleer, J., Hoekstra, H. J., Sleijfer, D. T., Tuinman, M. A., Klip, E. C., & Hoekstra-Weebers, J. E. (2006). Quality of life of testicular cancer survivors and the relationship with socio-demographics, cancer-related variables, and life events. Supportive Care in Cancer,14(3), 251–259.

    Article  CAS  Google Scholar 

  25. Peuckmann, V., Ekholm, O., Rasmussen, N. K., et al. (2007). Health-related quality of life in long-term breast cancer survivors: Nationwide survey in Denmark. Breast Cancer Research and Treatment,104(1), 39–46.

    Article  Google Scholar 

  26. Wang, S., Hsu, S. H., Gross, C. P., et al. (2016). Association between time since cancer diagnosis and health-related quality of life: A population-level analysis. Value Health,19, 631–638.

    Article  Google Scholar 

  27. Hays, R. D., & Morales, L. S. (2001). The RAND-36 measure of health-related quality of life. Annals of Medicine,33, 350–357.

    Article  CAS  Google Scholar 

  28. Paltiel, O., Marzec-Boguslawska, A., Soskolne, V., et al. (2004). Use of tranquilizers and sleeping pills among cancer patients is associated with a poorer quality of life. Quality of Life Research,13(10), 1699–1706.

    Article  CAS  Google Scholar 

  29. Stein, M. B., & Barrett-Connor, E. (2002). Quality of life in older adults receiving medications for anxiety, depression or insomnia: Findings from a community-based study. American Journal of Geriatric Psychiatry,10(5), 568–574.

    Article  Google Scholar 

  30. Liavaag, A. H., Dorum, A., Fossa, S. D., Trope, C., & Dahl, A. A. (2009). Morbidity associated with ‘self-rated health’ in epithelial ovarian cancer survivors. BMC Cancer,9, 2.

    Article  Google Scholar 

  31. Krebber, A. M., Jansen, F., Witte, B. I., et al. (2016). Stepped care targeting psychological distress in head and neck cancer and lung cancer patients: A randomized, controlled trial. Annals of Oncology,27(9), 1754–1760.

    Article  CAS  Google Scholar 

  32. Yabroff, K. R., Warren, J. L., Banthin, J., et al. (2009). Comparison of approaches for estimating prevalence costs of care for cancer patients: What is the impact of data source? Medical Care,47(7 Suppl 1), S64.

    Article  Google Scholar 

  33. Ereshefsky, L., & Sloan, D. M. (2009). Drug–drug interactions with the use of psychotropic medications. CNS Spectrums,14(8), 1–8.

    PubMed  Google Scholar 

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Funding

This study was not funded by any grant.

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Authors and Affiliations

  1. Department of Pharmacy Practice, College of Pharmacy, University of Rhode Island, 7 Greenhouse Road, Kingston, RI, 02881, USA

    Ami Vyas & Ghadah Alghaith

  2. Pharmacy Quality Alliance, Alexandria, VA, USA

    Meghan Hufstader-Gabriel

  3. Department of Pharmaceutics, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia

    Ghadah Alghaith

Authors
  1. Ami Vyas
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  2. Ghadah Alghaith
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  3. Meghan Hufstader-Gabriel
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Correspondence to Ami Vyas.

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All authors declare that they have no conflict of interest.

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This study involved secondary database analysis of a publicly available database, and hence this study was deemed to be exempted from ethical approval by University of Rhode Island.

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Vyas, A., Alghaith, G. & Hufstader-Gabriel, M. Psychotropic polypharmacy and its association with health-related quality of life among cancer survivors in the USA: a population-level analysis. Qual Life Res 29, 2029–2037 (2020). https://doi.org/10.1007/s11136-020-02478-6

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