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Try out PMC Labs and tell us what you think. Learn More. This study investigated the short- and long-term use of medication for psychological distress after the diagnosis Long term use of medications cancer. Longitudinal data from the Taiwan National Health Insurance database were used to follow 35, cancer patients for 2. Among those patients who survived for at least days, Lung cancer, prostate cancer, and oral cancer showed a ificant association with the regular use of medication in the first days. Among patients who survived for at least 2. Lung cancer and prostate cancer were associated with such prolonged use.
This longitudinal study found that the type of cancer was ificantly associated with the use of psychotropic drugs after the diagnosis was made. It provided information about the trajectory of that use and found that a small of patients were still using those medications after 2. The online version of this article doi Cancer is a leading cause of death in developed countries [ 1 ].
Its impact on mental health is also Long term use of medications. Studies of distress in long-term survivors have reported mixed. Several [ 6 — 8 ] have demonstrated persistent symptoms of depression, anxiety, pain, or fatigue, while others have indicated no difference in the frequency of those symptoms from that in the general population [ 910 ]. Pharmacological therapy either alone or in combination with psychosocial intervention has been demonstrated to be beneficial for cancer patients with depression [ 11 — 13 ].
studies have reported the prevalence rates for and the types of psychotropic drugs prescribed for cancer patients; these studies were based on cross-sectional data for prescriptions for sedatives, antidepressants, anxiolytics, and antipsychotics.
The reasons for the use of these drugs included depression, anxiety, insomnia, pain, and treatment-related emesis [ 1415 ]. Little research has investigated the association between type of cancer and the use of psychotropic medication or long-term patterns of use. Braun et al. It is unclear how the level of use might vary from time to time among long-term cancer survivors and what factors might be associated with persistently high use of psychotropic medications by these patients.
We hypothesized that there might be differences in the use of medication among patients with different types of cancer and that the use of such medication would be reduced and stable after a period of time. The aims of this study, therefore, were to investigate the short- and long-term use of medications for psychological distress after the diagnosis of cancer and to determine what factors were associated with such use.
NHI covers almost all Taiwanese Long term use of medications medical services in almost all outpatient settings and hospitals [ 16 ].
Once a patient is diagnosed with a malignancy, the National Health Insurance Administration NHIA issues a catastrophic illness registry card to the patient and then provides that patient with all NHI healthcare services related to treatment of that cancer without copayments. The NHI database includes comprehensive claims and registration data and has detailed information about health services, procedures, and prescriptions provided through NHI.
It also includes data on diagnoses and background information on patients, physicians, and healthcare institutions. The quality Long term use of medications NHI data is considered to be reliable, because the NHIA routinely audits data submitted by healthcare institutions in order to prevent Long term use of medications. The database we acquired contained person-level longitudinal NHI claims and registration data for the entire national population of patients who were newly diagnosed with cancer between January 1, and June 30, We also acquired longitudinal NHI registration data for healthcare institutions.
We used SAS software version 9. Finally, we excluded patients with missing data for the essential variables in our study. We classified the medications for psychological distress as antidepressants, anxiolytics, sedatives, and antipsychotics in accordance with the study of cancer patients by Derogatis et al.
Although several of these medications are used to control chemotherapy-induced nausea and vomiting, The National Comprehensive Cancer Network recommends that they be used only temporarily for this [ 17 ]. Control of emesis would not be a long-term indication. Our outcome variables were binary variables reflecting regular use of psychotropic medication in the five day periods after the diagnosis of cancer.
NHI regulations require that prescriptions be renewed every days. A value of 1 indicated regular use and a value of 0 denoted non-regular use. We used NHI data to establish a set of factors which might potentially influence the use of mediation for psychological distress. Patient characteristics at the time of the diagnosis of cancer included gender, age, and type of cancer; rather than using the more general Charleston Comorbidity Index, we selected comorbid conditions generally associated with use of medications for psychological distress.
We created a binary variable to denote the existence of comorbidity for each of these conditions and also a binary variable to indicate the existence of at least one of these conditions. With regard to socioeconomic status, we included a set of categorical variables showing the position of NHI registration and the salary tertile. All individual identification s were scrambled to protect privacy.
Binary variables indicating use of medication were Long term use of medications as counts and percentages.
The chi-square test was used to assess differences between subgroups of cancer patients. On the basis of the MPR levels in the five day periods after the diagnosis of cancer, we defined patterns of long-term medication use. We regarded the persistent regular use of psychotropic medication as regular use for all the Long term use of medications day periods after the diagnosis.
We used logit regression analysis to identify factors associated with regular medication use in the first days after diagnosis, as well as factors associated with persistent regular medication use over the five day periods after the diagnosis. Among patients with the ten most common types of cancer, The data show that the two groups of patients had ificant differences for each characteristic we investigated. Comparison of the characteristics of patients who survived at least days and those who passed away within days after the diagnosis of cancer.
Among male patients, those with lung cancer and those with liver cancer had the poorest prognosis. Only Among female patients, those with lung cancer and those with liver cancer also had a poor prognosis. Post-diagnosis survival rates among cancer patients, for the ten most common types of cancer.
Supplemental Table S 1 shows the proportions of patients who regularly used medication for psychological distress among those who survived at least days after the diagnosis of cancer. The table reports Long term use of medications proportions for different types of cancer and for all ten common types of cancer combined, as well as the proportions for all types of psychotropic medications combined and separately for antidepressants, anxiolytics, sedatives, and antipsychotics. The overall rate of use during the first day period was Among the four drug classes, sedatives were most commonly prescribed for each type of cancer except prostate cancer; antidepressants were the second most common for each type of cancer except prostate cancer.
Because many patients with prostate cancer used imipramine for enuresis, and imipramine is classified as an antidepressant, antidepressants were the drug class most commonly prescribed for prostate cancer.
Lung cancer patients had the highest overall use of psychotropic mediation in the first days, as Head and neck cancer patients ranked second at The lowest proportion of regular use, The overall use of medication for psychological distress decreased slightly over time during the first 2. Patients with liver cancer showed an increasing trend for the use of medication, while patients with oral cancer showed Long term use of medications decreasing trend.
Both lung cancer and prostate cancer patients had a high use of medication, and both of these groups showed a fluctuating trend in use. Both genders showed similar trends data not shown. Proportions of patients regularly using medication for psychological distress in the five day periods after cancer onset. The region of location of NHI registration was also an influential factor. Factors associated with regular use of psychotropic medications in the first day period after the diagnosis of cancer, for male patients who survived days.
Women with better occupations e. Long-term use of psychotropic medications by patients with different types of cancer, for those who survived at least 2. Comparison among types of cancer indicates that lung and prostate cancer patients were the two groups at higher risk for persistent regular use of psychotropic medication.
Males with oral cancer patients also showed high use in the early periods after the diagnosis. Supplemental Table S 2. No demographic or socioeconomic factors were statistically ificant for male cancer patients with regard to level of drug use. Data about the use of psychotropic medications in the five day periods after the diagnosis by female cancer patients are shown in Supplemental Table S 2. Among cancer patients who survived at least Long term use of medications after the diagnosis, The proportion of patients who used psychotropic mediation regularly remained stable over the 2.
Among patients who survived at least 2. Lung cancer and prostate cancer were associated with such persistent use. Instead of examining the use of psychotropic medication during a specific period of cancer treatment, this study investigated the regular use of these drugs after the diagnosis and focused on patients with newly diagnosed cancer and newly diagnosed psychological distress. In Taiwan, the Distress Thermometer has become a routine screening tool used with cancer patients nationwide, and hospitals provide psychosocial support Long term use of medications [ 24 ].
Some Western studies reported similar findings [ 26 ]. Our study found that Because our study focused on the regular use of psychotropic medication, and controlled for the influences of pre-existent malignancy and mental problems, it is not surprising that we found lower prevalence rates for the use of psychotropic medications than the surveys mentioned above. Major symptoms of psychological distress among cancer patients include sleep disturbance, anxiety, depression, and somatization [ 14 ].
As shown in one prospective study, Our with regard to the distribution of classes of psychotropic medications clearly demonstrated this. Long term use of medications the first day period after the diagnosis, sedatives for insomnia were the most commonly prescribed drugs. Patients with different types of cancer showed different trends in the regular use of medication for psychological distress over time after the diagnosis.
Two types of cancer were particularly noteworthy: liver cancer and oral cancer. Among patients with liver cancer, the proportion of regular use was For patients with oral cancer, the proportion was Determination of the reasons for this difference requires further study. Our data indicated that 4. Without specific data for individual patients, the reasons for persistent distress are unknown. A study showed that the prevalence of psychological distress did not change during the year after curative resection in patients with lung cancer [ 28 ]; however, a recent study by Braun et al.
Epstein et al. Our study provides some indication of the prevalence of distress in the intervening years; however, the determination of which patients may be at risk for psychological distress requires further study. Clinically, Hammerlid et al. Cancer therapy including surgery, radiation, and chemotherapy or combinations of these can be an important factor since treatment is often finished within 6 months. Dinh et al. A survey done in England by Ream et al. Our findings showed a consistent high level of medication use as a result of psychological distress for a long period of time.
Although we were unable to identify the treatment modality for each patient with prostate cancer, the Cancer Registry did show that a majority of our patients had undergone androgen deprivation therapy by surgery, radiation, hormonal therapy, or a combination of these. A strategy to improve long-term health-related quality of life including the need for medication for psychological distress is clearly warranted for men with prostate cancer. In our study, patients with lung cancer showed a trend in medication use similar to that of patients with prostate cancer.
Rauma et al. This suggests that an assessment for psychological distress is important but also depends on the type of cancer and the therapeutic modality [ 35 ]. This study did have several limitations. Neither clinical diagnoses of the psychological disorders nor the stage of cancer at the time of diagnosis was cited. Treatment modalities and treatment outcomes were not noted in the record.
There was no comparison data for the use of psychotropic medications by the general population.Long term use of medications
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