Psychotropic drug dispensing in people with and without cancer in France
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To compare annual and monthly prevalence of psychotropic drug (PD) dispensing and the number and duration of psychotropic treatment episodes among people with and without cancer over a 2-year follow-up.
We studied the following two cohorts of adult patients affiliated with the National Health Insurance Fund (NHIF): cancer patients followed for 2 years after diagnosis and individuals without cancer matched to cancer patients. Using information about anxiolytic, hypnotic, antidepressant, and antipsychotic dispensing in community pharmacies, we applied conditional log-binomial regressions to estimate adjusted relative risks for monthly dispensing of PDs.
Annual prevalence of PD dispensing—all categories included—among cancer patients was significantly higher for almost all the categories we studied than among individuals without cancer. Monthly prevalence of anxiolytic/hypnotic dispensing started to rise several months before diagnosis and peaked immediately after. Among patients with cancer and their matched controls, treatment duration exceeded 1 month for hypnotics in 40 and 35 %, respectively (p < 0.01), and 3 months for anxiolytics in 23 and 23 % (p = 0.8); it was less than 6 months for antidepressants in 76 and 75 % (p = 0.5).
Prevalence of psychotropic treatment was higher among cancer patients than among persons without cancer. Psychotropic treatment duration was not in line with recommendations for significant fractions of cancer patients or their controls.
Implications for cancer survivors
Training of health professionals involved in cancer supportive care should be reinforced and specific guidelines developed to help them address psychological distress of cancer survivors.
KeywordsCancer Survivors Oncology Psychotropic drugs Health insurance reimbursement Quality of health care
All the members of the VICAN Group, Thomas Aparicio, Emmanuel Babin, François Beck, Anne-Deborah Bouhnik, Robert Benamouzig, Cyril Bérenger, Dominique Bessette, Philippe-Jean Bousquet, Marie-Claude Cabanel-Gicquel, Marianick Cavallini-Lambert, Michèle Chantry, Claire Chauvet, Véronique Danguy, Michel Dorval, Jean-Baptiste Herbet, Laetitia Huiart, Xavier Joutard, Anne-Gaëlle Le Corroller-Soriano, Julien Mancini, Mégane Méresse, Jean-François Morere, Herman Nabi, Alain Paraponaris, Marie Préau, Christel Protière, Frédérique Retornaze, Benoit Riandey, Luis Sagaon-Teyssier, Aurélia Tison, Valérie Séror, Archana Singh-Manoux, and Catherine Thieblemont, are acknowledged. We thank Jo Ann Cahn for her help in editing the manuscript.
Compliance with ethical standards
Study design and data collection of the VICAN study were funded by the National Institute of Cancer (Contrat de recherche et développement no. 05-2011; http://www.e-cancer.fr). This study was also partly supported by research fundings from the Paca Cancéropôle (http://canceropole-paca.com) and the French National Agency for Medicines and Health Products Safety (grant number 2014S029; http://ansm.sante.fr). These funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was also approved by the French Commission on Individual Data Protection and Public Liberties (Commission Nationale Informatique et Libertés; study registered under no. 911,290). Patient information was anonymized and de-identified prior to analysis.
Informed consent was obtained from all individual participants included in the VICAN study.
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