Medication Burden Among Pediatric Cancer Survivors: Analysis of a Population-Wide Electronic Database in Hong Kong

Abstract

Background Few studies have evaluated the medication burden borne by survivors of pediatric cancer. This study aimed to describe the drug utilization pattern of chronic medications in a cohort of young pediatric cancer survivors. Methods This was a population-based study of patients diagnosed with cancer at aged ≤18 years between 2000 and 2013 in Hong Kong, and had survived ≥5 years post-diagnosis. The primary outcome is the use of any chronic medication (medications that were prescribed for ≥30 consecutive days within a 6-month period). Multivariable log-binomial models were used to identify factors associated with chronic medication use. Kaplan-Meier analysis was used to present the cumulative proportion of survivors initiated on a chronic medication across time from cancer diagnosis. Results Of the 2,444 survivors (median age = 22 years, IQR = 16–27 years), 669 (27.4%) required ≥1 chronic medication at ≥ 5 years post-diagnosis. Survivors who developed a chronic health condition (CHC) had a 5.48 (95% CI 4.49–6.71) times higher risk of taking a chronic medication than those without CHC. At 10 years post-diagnosis, the cumulative proportion of survivors being initiated a chronic medication was 33.4% (95% CI 31.1–35.6%) for the overall cohort. Higher cumulative proportions were observed in survivors with endocrine (74.6%, 95% CI 68.4–79.6%), renal (68.8%, 95% CI 54.2–78.7%), neurological (58.6%, 95% CI 46.1–68.1%) and cardiovascular (54.7%, 95% CI 44.0–63.4%) disorders. Conclusion Survivors with certain CHCs had a higher risk of starting a prescription medication early phase of survivorship. Future studies include examining the impact of medication burden on survivors’ functional status.