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Lines LM, Barch DH, Zabala D, Halpern MT, Jacobsen PB, Mollica MA. Associations between Mental Health and Care Experiences among Older Adults with Cancer. Psychooncology 2022; 31:1491-1501. [DOI: 10.1002/pon.5966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 05/02/2022] [Accepted: 05/08/2022] [Indexed: 11/11/2022]
Affiliation(s)
- Lisa M. Lines
- RTI International 3040 E. Cornwallis Rd Research Triangle Park NC27709 United States
- University of Massachusetts Medical School 55 Lake Ave. North Worcester MA01655 United States
| | - Daniel H. Barch
- RTI International 3040 E. Cornwallis Rd Research Triangle Park NC27709 United States
- Tufts University Psychology Department Medford MA United States
| | - Diana Zabala
- RTI International 3040 E. Cornwallis Rd Research Triangle Park NC27709 United States
| | - Michael T. Halpern
- National Cancer Institute Division of Cancer Control and Population Sciences Healthcare Delivery Research Program Bethesda United States
| | - Paul B. Jacobsen
- National Cancer Institute Division of Cancer Control and Population Sciences Healthcare Delivery Research Program Bethesda United States
| | - Michelle A. Mollica
- National Cancer Institute Division of Cancer Control and Population Sciences Healthcare Delivery Research Program Bethesda United States
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Benton JZ, Bergerot CD, Woodruff P, Williams SB, Wallis CJD, Klaassen Z. Mental health screening and diagnosis in cancer patients: Impact on mortality and suggestion of racial bias. Cancer 2021; 128:234-236. [PMID: 34550606 DOI: 10.1002/cncr.33901] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 08/14/2021] [Accepted: 08/18/2021] [Indexed: 11/08/2022]
Affiliation(s)
| | - Cristiane D Bergerot
- Centro de Cancer de Brasilia (CETTRO), Instituto Unity de Ensino e Pesquisa, Brasilia, DF, Brazil
| | - Phillip Woodruff
- St. George's University School of Medicine, St. George's, Grenada
| | - Stephen B Williams
- Division of Urology, The University of Texas Medical Brach at Galveston, Galveston, Texas
| | - Christopher J D Wallis
- Department of Urological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Zachary Klaassen
- Department of Surgery, Section of Urology, Medical College of Georgia-Augusta University, Augusta, Georgia.,Georgia Cancer Center, Augusta, Georgia
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Foley L, Larkin J, Lombard-Vance R, Murphy AW, Hynes L, Galvin E, Molloy GJ. Prevalence and predictors of medication non-adherence among people living with multimorbidity: a systematic review and meta-analysis. BMJ Open 2021; 11:e044987. [PMID: 34475141 PMCID: PMC8413882 DOI: 10.1136/bmjopen-2020-044987] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES This systematic review aimed to describe medication non-adherence among people living with multimorbidity according to the current literature, and synthesise predictors of non-adherence in this population. METHODS A systematic review was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses. PubMed, EMBASE, CINAHL and PsycINFO were searched for relevant articles published in English language between January 2009 and April 2019. Quantitative studies reporting medication non-adherence and/or predictors of non-adherence among people with two or more chronic conditions were included in the review. A meta-analysis was conducted with a subgroup of studies that used an inclusive definition of multimorbidity to recruit participants, rather than seeking people with specific conditions. Remaining studies reporting prevalence and predictors of non-adherence were narratively synthesised. RESULTS The database search produced 10 998 records and a further 75 were identified through other sources. Following full-text screening, 178 studies were included in the review. The range of reported non-adherence differed by measurement method, at 76.5% for self-report, 69.4% for pharmacy data, and 44.1% for electronic monitoring. A meta-analysis was conducted with eight studies (n=8949) that used an inclusive definition of multimorbidity to recruit participants. The pooled prevalence of non-adherence was 42.6% (95% CI: 34.0 - 51.3%, k=8, I2=97%, p<0.01). The overall range of non-adherence was 7.0%-83.5%. Frequently reported correlates of non-adherence included previous non-adherence and treatment-related beliefs. CONCLUSIONS The review identified a heterogeneous literature in terms of conditions studied, and definitions and measures of non-adherence used. Results suggest that future attempts to improve adherence among people with multimorbidity should determine for which conditions individuals require most support. The variable levels of medication non-adherence highlight the need for more attention to be paid by healthcare providers to the impact of multimorbidity on chronic disease self-management. PROSPERO REGISTRATION NUMBER CRD42019133849.
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Affiliation(s)
- Louise Foley
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - James Larkin
- HRB Centre for Primary Care Research, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Richard Lombard-Vance
- Department of Psychology, National University of Ireland Maynooth, Maynooth, Ireland
| | - Andrew W Murphy
- Discipline of General Practice, National University of Ireland Galway, Galway, Ireland
- HRB Primary Care Clinical Trials Network Ireland, National University of Ireland Galway, Galway, Ireland
| | - Lisa Hynes
- Health Programmes, Croí Heart & Stroke Centre, Galway, Ireland
| | - Emer Galvin
- School of Pharmacy & Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Gerard J Molloy
- School of Psychology, National University of Ireland Galway, Galway, Ireland
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Jazzar U, Bergerot CD, Shan Y, Wallis CJD, Freedland SJ, Kamat AM, Tyler DS, Baillargeon J, Kuo YF, Klaassen Z, Williams SB. Use of psychotropic drugs among older patients with bladder cancer in the United States. Psychooncology 2021; 30:832-843. [PMID: 33507622 DOI: 10.1002/pon.5641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/09/2021] [Accepted: 01/24/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVE 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. METHODS A total of 10,516 older patients diagnosed with clinical stage T1-T4a, N0, M0 bladder urothelial carcinoma from 1 January 2008 to 31 December 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 was done. RESULTS Of the 10,516 older patients, 5621 (53%) were prescribed psychotropic drugs following cancer diagnosis. Overall, 3972 (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 < 0.001). Gamma aminobutyric acid 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. CONCLUSION Over half of the patients received psychotropic prescriptions within 2 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.
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Affiliation(s)
- Usama Jazzar
- Division of Urology, The University of Texas Medical Branch at Galveston, Galveston, Texas, USA
| | - Cristiane D Bergerot
- Centro de Câncer de Brasília, Instituto Unity de Ensino e Pesquisa, Brasilia, Distrito Federal, Brazil
| | - Yong Shan
- Division of Urology, The University of Texas Medical Branch at Galveston, Galveston, Texas, USA
| | | | - Stephen J Freedland
- Department of Urology, Cedars Sinai Medical Center, Los Angeles, California, USA
| | - Ashish M Kamat
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Douglas S Tyler
- Department of Surgery, The University of Texas Medical Branch at Galveston, Galveston, Texas, USA
| | - Jacques Baillargeon
- Department of Preventive Medicine and Community Health, Sealy Center of Aging, The University of Texas Medical Branch, Galveston, Texas, USA
| | - Yong-Fang Kuo
- Department of Preventive Medicine and Community Health, Sealy Center of Aging, The University of Texas Medical Branch, Galveston, Texas, USA
| | - Zachary Klaassen
- Department of Surgery, Section of Urology, Medical College of Georgia-Augusta University, Augusta, Georgia, USA
- Georgia Cancer Center, Augusta, Georgia, USA
| | - Stephen B Williams
- Division of Urology, The University of Texas Medical Branch at Galveston, Galveston, Texas, USA
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Shoval G, Balicer RD, Feldman B, Hoshen M, Eger G, Weizman A, Zalsman G, Stubbs B, Golubchik P, Gordon B, Krivoy A. Adherence to antidepressant medications is associated with reduced premature mortality in patients with cancer: A nationwide cohort study. Depress Anxiety 2019; 36:921-929. [PMID: 31332883 DOI: 10.1002/da.22938] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 03/24/2019] [Accepted: 05/25/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Depression and anxiety are common in cancer and antidepressants (AD) are efficacious treatment. The relationship between AD adherence and mortality in cancer is unclear. This study aimed to evaluate the association between adherence to AD and all-cause mortality in a population-based cohort of patients with cancer. MATERIALS AND METHODS We conducted a 4-year historical prospective cohort study including 42,075 patients with cancer who purchased AD at least once during the study period. Adherence to AD was modeled as nonadherence (<20%), poor (20-50%), moderate (50-80%), and good (>80%) adherence. We conducted multivariable survival analyses adjusted for demographic and clinical variables that may affect mortality. RESULTS During 1,051,489 person-years at risk follow-up, the adjusted hazard ratios (HR) for mortality were 0.89 (95% confidence interval [CI]: 0.83-0.95), 0.77 (95% CI: 0.66-0.72), and 0.80 (95% CI: 0.76-0.85) for the poor, moderate, and good adherence groups, respectively, compared to the nonadherent group. Analysis of the entire sample and a subgroup with depression, for cancer subtypes, revealed similar patterns for breast, colon, lung, and prostate cancers, but not for melanoma patients. Multivariate predictors of premature mortality included male gender (HR 1.48 [95% CI: 1.42-1.55]), current/past smoking status (HR 1.1, [95% CI: 1.04-1.15]; P < .0001), low socioeconomic status (HR 1.1, [95% CI: 1.03-1.17]; P < .0001) and more physical comorbidities. CONCLUSIONS The present study is the first to demonstrate that higher adherence to AD is associated with a decrease of all-cause mortality in a large nationwide cohort of cancer patients. Our data add to the pressing need to encourage adherence to AD among cancer patients.
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Affiliation(s)
- Gal Shoval
- Chief Physician Office, Clalit Health Services, Clalit Research Institute, Tel Aviv, Israel.,Child and Adolescent Division, Geha Mental Health Center, Petah Tiqva, Israel.,Department of Psychiatry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ran D Balicer
- Chief Physician Office, Clalit Health Services, Clalit Research Institute, Tel Aviv, Israel.,Public Health Department, Faculty of Health Sciences, Ben-Gurion University, Beer-Sheva, Israel
| | - Becca Feldman
- Chief Physician Office, Clalit Health Services, Clalit Research Institute, Tel Aviv, Israel
| | - Moshe Hoshen
- Chief Physician Office, Clalit Health Services, Clalit Research Institute, Tel Aviv, Israel
| | - Gilad Eger
- Child and Adolescent Division, Geha Mental Health Center, Petah Tiqva, Israel.,Department of Psychiatry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Abraham Weizman
- Child and Adolescent Division, Geha Mental Health Center, Petah Tiqva, Israel.,Department of Psychiatry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Division of Molecular Imaging and Neuropathology, Department of Psychiatry, Columbia University, New York, New York
| | - Gil Zalsman
- Child and Adolescent Division, Geha Mental Health Center, Petah Tiqva, Israel.,Department of Psychiatry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Division of Molecular Imaging and Neuropathology, Department of Psychiatry, Columbia University, New York, New York.,Felsenstein Medical Research Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Brendon Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Pavel Golubchik
- Child and Adolescent Division, Geha Mental Health Center, Petah Tiqva, Israel.,Department of Psychiatry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Barak Gordon
- Medical Corps, Israel Defense Forces, Tel Aviv, Israel.,Department of Family Medicine, Faculty of Medicine, Hebrew University, Jerusalem, Israel
| | - Amir Krivoy
- Chief Physician Office, Clalit Health Services, Clalit Research Institute, Tel Aviv, Israel.,Child and Adolescent Division, Geha Mental Health Center, Petah Tiqva, Israel.,Department of Psychiatry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Banegas MP, Emerson MA, Adams AS, Achacoso NS, Chawla N, Alexeeff S, Habel LA. Patterns of medication adherence in a multi-ethnic cohort of prevalent statin users diagnosed with breast, prostate, or colorectal cancer. J Cancer Surviv 2018; 12:794-802. [PMID: 30338462 DOI: 10.1007/s11764-018-0716-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Accepted: 09/11/2018] [Indexed: 01/16/2023]
Abstract
PURPOSE To investigate the implications of a cancer diagnosis on medication adherence for pre-existing comorbid conditions, we explored statin adherence patterns prior to and following a new diagnosis of breast, colorectal, or prostate cancer among a multi-ethnic cohort. METHODS We identified adults enrolled at Kaiser Permanente Northern California who were prevalent statin medication users, newly diagnosed with breast, colorectal, or prostate cancer between 2000 and 2012. Statin adherence was measured using the proportion of days covered (PDC) during the 2-year pre-cancer diagnosis and the 2-year post-cancer diagnosis. Adherence patterns were assessed using generalized estimating equations, for all cancers combined and stratified by cancer type and race/ethnicity, adjusted for demographic, clinical, and tumor characteristics. RESULTS Among 10,177 cancer patients, statin adherence decreased from pre- to post-cancer diagnosis (adjusted odds ratio (ORadj):0.91, 95% confidence interval (95% CI):0.88-0.94). Statin adherence decreased from pre- to post-cancer diagnosis among breast (ORadj:0.94, 95% CI:0.90-0.99) and colorectal (ORadj:0.79, 95% CI:0.74-0.85) cancer patients. No difference in adherence was observed among prostate cancer patients (ORadj:1.01, 95% CI:0.97-1.05). Prior to cancer diagnosis, adherence to statins was generally higher among non-Hispanic whites and multi-race patients than other groups. However, statin adherence after diagnosis decreased only among these two populations (ORadj:0.85, 95% CI:0.85-0.92 and ORadj:0.86, 95% CI:0.76-0.97), respectively. CONCLUSIONS We found substantial variation in statin medication adherence following diagnosis by cancer type and race/ethnicity among a large cohort of prevalent statin users in an integrated health care setting. IMPLICATIONS FOR CANCER SURVIVORS Improving our understanding of comorbidity management and polypharmacy across diverse cancer patient populations is warranted to develop tailored interventions that improve medication adherence and reduce disparities in health outcomes.
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Affiliation(s)
- Matthew P Banegas
- Center for Health Research, Kaiser Permanente Northwest, 3800 N. Interstate Ave, Portland, OR, 97227-1110, USA.
| | - Marc A Emerson
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Alyce S Adams
- Division of Research, Kaiser Permanente, Oakland, CA, USA
| | | | - Neetu Chawla
- Division of Research, Kaiser Permanente, Oakland, CA, USA
| | | | - Laurel A Habel
- Division of Research, Kaiser Permanente, Oakland, CA, USA
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