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Psychotropic drug initiation during the first diagnosis and the active treatment phase of B cell non-Hodgkin’s lymphoma: a cohort study of the French national health insurance database

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Abstract

Purpose

Patients with B cell non-Hodgkin’s lymphomas (B-NHLs) are known to be at risk of developing psychological disorders. The aims of this study were to measure the incidence of psychotropic drug use during the diagnosis and the active treatment phase in comparison with controls from the general population, and to identify factors associated with this use.

Methods

B-NHL patients were selected through the French national health insurance database in the Midi-Pyrénées region (southwestern France) from January 1, 2011, to April 31, 2013. Patients with a previous history of B-NHL and/or psychotropic drug treatment were excluded.

Results

Among 745 newly diagnosed B-NHL patients, psychotropic treatment was initiated in 31.5 % (95 % CI [28.1–34.9]), compared to 7.6 % (95 % CI [7.57–7.64]) in the general population during the same period. This incidence was comparable in colorectal cancer patients (33.5 %) but higher than that in patients with myocardial infarction (23.5 %) or with a first knee replacement surgery (22.4 %). Anxiolytics and hypnotics were the most frequently used drugs. Median duration of treatment was 37 days for anxiolytics and 58 days for hypnotics, with 20.8 % of patients remaining under treatment at 8 months. Factors associated with psychotropic drug initiation were young age, health care consumption in the year before diagnosis, and initial care at a university hospital.

Conclusion

The high rate of psychotropic drug initiation reflects a high level of anxiety at the initial phase of B-NHL patients’ trajectory. This pharmacoepidemiological study reveals inappropriate use in some patients, which should now be investigated in lymphoma survivorship.

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Acknowledgments

This work received support from the Foundation of France, the Association for Research on Cancer (ARC) and from the National Research Agency (Agence Nationale de la Recherche (ANR)) for the “investissement d’avenir” (“Investment in the Future”) (ANR-11-PHUC-001).

Contributors roles

Conceptualization: Maryse Lapeyre-Mestre, Cécile Conte, Fabien Despas.

Data curation: Cécile Conte, Manuela Rueter.

Formal Analysis: Cécile Conte, Manuela Rueter.

Funding acquisition: Guy Laurent.

Methodology: Maryse Lapeyre-Mestre, Cécile Conte, Fabien Despas.

Resources: Robert Bourrel, Maryse Lapeyre-Mestre, Fabien Despas, Guy Laurent.

Software: Cécile Conte, Manuela Rueter.

Supervision: Maryse Lapeyre-Mestre, Fabien Despas, Guy Laurent.

Validation: All authors.

Writing—original draft: Cécile Conte.

Writing—review and editing: All authors.

Author information

Authors and Affiliations

  1. Laboratoire de Pharmacologie Médicale et Clinique, Faculté de Médecine, Université Paul Sabatier, Toulouse, France

    Cécile Conte, Maryse Lapeyre-Mestre & Fabien Despas

  2. Laboratoire de Pharmacologie Médicale et Clinique, CHU de Toulouse, 37 allées Jules Guesde, 31000, Toulouse, France

    Cécile Conte, Manuela Rueter, Maryse Lapeyre-Mestre & Fabien Despas

  3. UMR1027, Inserm, Université Paul Sabatier, Toulouse, France

    Cécile Conte, Guy Laurent, Maryse Lapeyre-Mestre & Fabien Despas

  4. INSERM CIC 1436 Toulouse, Centre d’Investigation Clinique de Toulouse, Centre Hospitalier Universitaire de Toulouse, Toulouse, France

    Cécile Conte, Maryse Lapeyre-Mestre & Fabien Despas

  5. Departement d’Hématologie et de Médecine Interne, Institut Universitaire du Cancer-Oncopole, 1 Avenue Irène Joliot-Curie, Toulouse, France

    Guy Laurent

  6. Caisse Nationale d’Assurance Maladie Midi-Pyrénées, 3 Boulevard Léopold Escande, 31105, Toulouse, France

    Robert Bourrel

Authors
  1. Cécile Conte
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  2. Manuela Rueter
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  3. Guy Laurent
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Corresponding author

Correspondence to Fabien Despas.

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Conte, C., Rueter, M., Laurent, G. et al. Psychotropic drug initiation during the first diagnosis and the active treatment phase of B cell non-Hodgkin’s lymphoma: a cohort study of the French national health insurance database. Support Care Cancer 24, 4791–4799 (2016). https://doi.org/10.1007/s00520-016-3331-y

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  • DOI: https://doi.org/10.1007/s00520-016-3331-y

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