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Quality of Life Research

, Volume 13, Issue 10, pp 1699–1706 | Cite as

Use of tranquilizers and sleeping pills among cancer patients is associated with a poorer quality of life

  • O. Paltiel
  • A. Marzec-boguslawska
  • V. Soskolne
  • S. Massalha
  • M. Avitzour
  • R. Pfeffer
  • N. Cherny
  • T. Peretz
Article

Abstract

To evaluate the association between sleeping pill/tranquilizer (SP/T) use and quality of life (QOL) among cancer patients. Patients and methods: Oncology patients (n = 909) in three Israeli hospitals were interviewed in clinics, day centers and in-patient departments regarding SP/T use in the previous week. Crude and adjusted QOL scores, measured using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC QLQ-C30), were compared in users vs. non-users. Results: Sleeping pill/tranquilizer use was self-reported by 234 (25.7%) participants, but rarely documented in medical charts. Factors associated with SP/T use were female gender (adjusted Odds ratio, OR: 1.79; 95% Confidence interval, CI: 1.22–2.62, age (OR: 4.6; 95% CI: 1.66–12.53 for age 70‰+‰), place of birth (OR: 1.97; 95% CI: 1.19–3.26 for Eastern Europe compared with Israel), concomitant use of painkillers (OR: 2.88; 95% CI: 1.97–4.20) and presence of cardiovascular disease (OR: 2.41; 95% CI: 1.48–3.91). Controlling these factors as well as disease status, users had a poorer QOL on all functional scales (P < 0.001) as well as global QOL. Furthermore, users reported increased severity of symptoms, especially fatigue, insomnia, pain, dyspnea and constipation (P < 0.01), compared to non-users. Conclusions: Use of SP/T, reported by one fourth of cancer patients, was associated with substantially poorer QOL and increased severity of symptoms. Causal inference is not possible given the cross-sectional design. Periodic inquiry regarding use of these medications in the Oncology Clinic is recommended since it may identify patients with poor QOL and unmet needs.

Keywords

Cancer Quality of life Sleeping medications 

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References

  1. Hu, D.S., Silberfarb, P.M. 1991Management of sleep problems in cancer patientsRev Oncol (Huntingt.)52327(discussion 28).Google Scholar
  2. Ashbury, F.R., Findlay, H., Reynolds, B.,  et al. 1998A Canadian␣survey of cancer patients’ experiences: Are their needs being met?J Pain Symptom Manage16298306CrossRefGoogle Scholar
  3. Silberfarb, P.M., Hauri, P.J., Oxman, T.E., Schnurr, P. 1993Assessment of sleep in patients with lung cancer and breast cancer.J Clin Oncol119971004Google Scholar
  4. Engstrom, C.A., Strohl, R.A., Rose, L., Lewandowski, L., Stefanek, M.E. 1999Sleep alterations in cancer patients.Cancer Nurs22143148CrossRefGoogle Scholar
  5. Davidson, J.R., MacLean, A.W., Drundage, M.D., Schulze, K. 2002Sleep disturbance in cancer patients.Social Sci Med5413091321CrossRefGoogle Scholar
  6. Savard, J., Morin, C.M. 2001Insomnia in the context of cancer: A review of a neglected problem.J Clin Onc19895908Google Scholar
  7. Morin, C.M., Gibson, D., Wade, J. 1998Self-reported sleep and mood disturbance in chronic pain patients.Clin J Pain14311314CrossRefGoogle Scholar
  8. Gillin, J.C. 1991The long and the short of sleeping pills.N Engl J Med32417351736Google Scholar
  9. Triozzi, P.L., Goldstein, D., Laszlo, J. 1988Contributions of benzodiazepines to cancer therapy.Cancer Invest6103111Google Scholar
  10. King, S.A., Strain, J.J. 1990Benzodiazepine use by chronic pain patients.Clin J Pain6143147Google Scholar
  11. Derogatis, L.R., Feldstein, M., Morrow, G.,  et al. 1979A survey of psychotropic drug prescriptions in an oncology population.Cancer4419191929Google Scholar
  12. Paltiel, O., Avitzour, M., Cherny, N.,  et al. 2001Determinants of the␣use of complementary therapies in patients with cancer.J Clin Oncol1924392448Google Scholar
  13. Aaronson, N.K., Ahmedzai, S., Bergman, B.,  et al. 1993The European Organization for research and treatment of cancer QLQ-C30: A quality-of-life instrument for use in international clinical trials in oncology.J Natl Cancer Inst85365376CrossRefPubMedGoogle Scholar
  14. Graham, K., Vidal-Zeballos, D. 1998Analyses of use of tranquilizers and sleeping pills across five surveys of the same population (1985–1991): The relationship with gender, age and use of other substancesSoc Sci Med46381395CrossRefGoogle Scholar
  15. Wells, K.B., Kamberg, C., Brook, R., Camp, P., Rogers, W. 1985Health status, sociodemographic factors, and the use of prescribed psychotropic drugs.Med Care2312951306Google Scholar
  16. Matalon, A., Yinnon, A.M., Hurwitz, A. 1990Chronic use of hypnotics in a family practice-patients’ reluctance to stop treatment.Fam Pract7258260Google Scholar
  17. Fuchs, Z., Novikov, I., Blumstein, T., Chetrit, A., Ginding, J., Modan, B. 2003Patterns of drug use among the community-dwelling old–old population in Israel.IMAJ5346351Google Scholar
  18. Holbrook, A.M., Crowther, R., Lotter, A., Cheng, C., King, D. 2000Meta-analysis of benzodiazepine use in the treatment of insomnia.CMAJ162225233Google Scholar

Copyright information

© Kluwer Academic Publishers 2004

Authors and Affiliations

  • O. Paltiel
    • 1
    • 2
  • A. Marzec-boguslawska
    • 1
  • V. Soskolne
    • 1
  • S. Massalha
    • 1
  • M. Avitzour
    • 1
  • R. Pfeffer
    • 4
  • N. Cherny
    • 5
  • T. Peretz
    • 3
  1. 1.Braun School of Public Health and Community MedicineHadassah-Hebrew UniversityJerusalemIsrael
  2. 2.Department of HematologyHadassah-Hebrew UniversityIsrael
  3. 3.Department of OncologyHadassah-Hebrew UniversityIsrael
  4. 4.Department of OncologySheba Tel-Hashomer Medical CenterIsrael
  5. 5.Department of OncologyShaare Tzedek Medical CenterIsrael

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