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The use of psychological supportive care services and psychotropic drugs in patients with early-stage breast cancer: a comparison between two institutions on two continents

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Abstract

The aim of this study was to evaluate the mental health consumption among patients with early-stage breast cancer in two radiation oncology departments in two countries (USA and Italy). Data were extracted from the medical records of consecutive patients treated between 2014 and 2015 in two centers. Extracted data included patient’s demographics, treatment, referral to psychological supportive care programs, and prescribed psychotropic drugs. Data from the two centers were compared using Student’s t, Wilcoxon, Fisher’s exact, and Jonckheere–Terpstra tests. Adjusted relative risks (RR) were estimated using Poisson regression. A total of 231 (Italy = 110, USA = 121) patients were included, with a mean age of 60 years. The crude rate of psychological supportive care visits was similar in the US versus the Italian cohort (28.9 vs. 21.8%, p = 0.23). The crude rate of prescribed psychotropic drug was higher in the US cohort versus Italian cohort (43.8 vs. 18.2%, p < 0.0001). These differences remained significant after adjusting for breast cancer subtype, stage, and treatment (RR 1.8, 95 CI 1.17–2.76). Between 20 and 30% of patients receive psychological supportive care during treatment for breast cancer. The use of psychotropic medication was higher in the US cohort than the cohort from Italy. The reasons for these differences might be related to social and cultural differences and the method of prescribing medication.

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Acknowledgements

We thank Silvia Fabiani and Nicoletta Sclafani, case managers responsible for local CORD at FUH; Silvio Fiorenzoni, MD, and Leonardo Fei, MD, psychiatrists responsible for the supportive care at FUH. We thank Justin Yopp, Ph.D., Elizabeth Sherwood, RN, MS, Mimi Alvarez, RN, MSN, PMHCNS-BC, Pamela Durham, MS, Don Rosenstein, MD, responsible for the supportive care program at UNC.

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Authors and Affiliations

  1. Department of Radiation Oncology, University of North Carolina, 101 Manning Drive, Chapel Hill, NC, USA

    Orit Kaidar-Person, Lauren Terzo, Jayne Camporeale, Lawrence B. Marks & Timothy M. Zagar

  2. UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA

    Orit Kaidar-Person, Allison M. Deal, Jayne Camporeale, Hyman Muss, Lawrence B. Marks, Deborah K. Mayer & Timothy M. Zagar

  3. Radiation Oncology Unit, Oncology Department, Azienda Ospedaliero, Universitaria Careggi – University of Florence, Florence, Italy

    Icro Meattini, Giulio Francolini, Giulio Carta & Lorenzo Livi

  4. Department of Medicine, Division of Medical Oncology, UNC Hospital, Chapel Hill, NC, USA

    Hyman Muss

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  1. Orit Kaidar-Person
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  2. Icro Meattini
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  3. Allison M. Deal
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Correspondence to Orit Kaidar-Person.

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This article does not contain any studies with human participants or animals performed by any of the authors. The study was approved by the institutional ethic review boards at both centers.

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Kaidar-Person, O., Meattini, I., Deal, A.M. et al. The use of psychological supportive care services and psychotropic drugs in patients with early-stage breast cancer: a comparison between two institutions on two continents. Med Oncol 34, 144 (2017). https://doi.org/10.1007/s12032-017-1003-5

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