Older patients diagnosed with cancer are at increased risk of physical and emotional distress, however, prescription utilization patterns largely remain to be elucidated. Our objective was to comprehensively assess prescription patterns and predictors in older patients with bladder cancer.
A total of 10,516 older patients diagnosed with clinical stage T1-T4a, N0, M0 bladder urothelial carcinoma from January 1, 2008, to December 31, 2012 from the Surveillance, Epidemiology, and End Results (SEER)-Medicare were analyzed. We used multivariable analysis to determine predictors associated with psychotropic prescription rates (one or more). Medication Possession Ratio (MPR) was used as an index to measure adherence in intervals of 3-months, 6-months, 1-year, and 2-years. Evaluation of psychotropic prescribing patterns and adherence across different drugs and demographic factors.
Of the 10,516 older patients, 5,621 (53%) were prescribed psychotropic drugs following cancer diagnosis. Overall, 3,972 (38%) patients had previous psychotropic prescriptions prior to cancer diagnosis, and these patients were much more likely to receive a post-cancer diagnosis prescription. Prescription rates for psychotropic medications were higher among patients with higher stage BC (P < .001). GABA modulators/stimulators and serotonin reuptake inhibitors/stimulators were the highest prescribed psychotropic drugs in 21% of all patients. Adherence for all drugs was 32% at 3-months and continued to decrease over time.
Over half of patients received psychotropic prescriptions within two years of their cancer diagnosis. Given the chronicity of psychiatric disorders with observed significantly low adherence to medications that warrants an emphasis on prolonged patient monitoring and further investigation. This article is protected by copyright. All rights reserved.
Psycho-oncology. 2021 Jan 28 [Epub ahead of print]
Usama Jazzar, Cristiane D Bergerot, Yong Shan, Christopher Jd Wallis, Stephen J Freedland, Ashish M Kamat, Douglas S Tyler, Jacques Baillargeon, Yong-Fang Kuo, Zachary Klaassen, Stephen B Williams
Division of Urology, The University of Texas Medical Branch at Galveston, Galveston, TX., Department of Medical Oncology, City of Hope Comprehensive Cancer Center, Duarte, CA., Department of Urology, Vanderbilt University Medical Center, Nashville, TN., Department of Urology, Cedars Sinai Medical Center, Los Angeles, CA., Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX., Department of Surgery, The University of Texas Medical Branch at Galveston, Galveston, TX., Department of Preventive Medicine and Community Health, Sealy Center of Aging, The University of Texas Medical Branch, Galveston, TX., Department of Surgery, Section of Urology, Medical College of Georgia - Augusta University, Augusta, GA.