Psychotropic drug initiation in patients diagnosed with chronic myeloid leukemia: a population‐based study in France

Abstract

Psychotropic drugs (PD) are often used close to a cancer diagnosis and may be considered as a way of coping. We aimed to determine the incidence of anxiolytics, hypnotics, antidepressants, and antipsychotics initiation around a diagnosis of chronic myelogenous leukemia (CML). Population‐based cohort: Data were extracted from Systeme National des données de Santé (SNDS, the French health insurance database) at the regional level (Midi‐Pyrenees area, 2.9 million inhabitants). All newly diagnosed patients treated by a CML tyrosine kinase inhibitor (TKI) between 10/01/2011 and 04/01/2014 were included. Pre‐CML (9 months before to 3 months before first TKI prescription—F‐TKI) and CML (3 months before to 9 months after F‐TKI) phases were defined. The main evaluation criterion was the initiation of PD during CML phase. Determinants associated with this incident PD use were studied through a logistic regression model. We compared pre‐CML and CML healthcare consumption. The cohort included 103 patients (mean age of 60.8 years). PD initiation rate was 35.9%, anxiolytics being the most initiated PD (59.5%). Advanced age was associated with PD initiation (adjusted OR = 1.029, 95% CI = 1.001–1.056). The number of consultations during the pre‐CML phase and female gender tended to be associated with increased risk of PD initiation in univariate analysis. For PD initiators, healthcare consumption was greater in CML but not in pre‐CML phase. PD initiation is a frequent finding around a CML diagnosis. Its risk increases with age. It could be a way to identify a subgroup with higher healthcare consumption.

Use of psychotropic drugs among older patients with bladder cancer in the United States

“…Multiple non‐U.S. cancer studies have also observed this class to be the most frequently prescribed 23–29 . However, we observed remarkably lower rates of prescription compared to available studies.…”

“…A national cohort study in France found a 20% increase in PD prescription rates following a cancer diagnosis 27 . Another French study 28 and a Dutch case–control of multiple cancers 29 reported rates of 32%–33%. A Scottish case–control study found cancer patients to have 10 times more PD prescriptions than that of the general population 30 .…”

“…However, we observed remarkably lower rates of prescription compared to available studies. Two French studies found 47% 27 and 59% 28 of cancer patients had initiated anxiolytics and/or hypnotics within 1 year from diagnosis. Similarly, a rate of 46% was observed in Scottish patients within 6 months from diagnosis 30 .…”

“…Haloperidol, a dopamine antagonist, continues to be the first‐line guideline‐recommended agent in the general population and also the preferred drug in cancer patients 46 . Few studies have published patterns of antipsychotics use in cancer patients, with varying results ranging between 2% and 11% 27–30 . However, a Spanish study among terminally ill patients with advanced cancer revealed rates as high as 40%, with risperidone prescriptions increasing between 2004 and 2009 to match the most commonly prescribed antipsychotic, haloperidol 47 .…”

Patterns of Tyrosine Kinase Inhibitor Utilization in Newly Treated Patients With Chronic Myeloid Leukemia: An Exhaustive Population-Based Study in France

“…We used a specific algorithm to identify incident CML patients who were treated between 1 January 2011 (in order to have at least 12 months before TKI initiation for the identification of comorbidities) and 31 December 2014 (to have at least 12 months of follow-up for the last patients included, to investigate patterns of TKI utilization). The initial algorithm was previously used in a pilot study based on regional data extracted from the SNDS ( 27 ).…”