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Prescription of Psychotropic Drugs in Older Patients With Bladder Cancer

By: Joshua Swore
Posted: Monday, April 5, 2021

Increased use of psychotropic drugs seemed to correlate with worse cancer stages in older patients with bladder cancer, according to an article published in Psycho-Oncology. “This may also stimulate discussion of the patient experience across the disease continuum, promoting effective and efficient treatment planning and, referrals to specialists as needed,” commented Stephen B. Williams, MD, of The University of Texas Medical Branch at Galveston, and colleagues, “thus reducing the risk of emotional symptoms remaining undetected or untreated.”

A total of 10,516 patients with stage I (80%) to IVA bladder cancer were recruited for the study. Patients were aged 66 years or older, diagnosed between January 2008 and December 2012, and had stable source insurance. A breakdown of the study cohort revealed that 40% were older than 80 years, 66% were men, and 90% identified as non-Hispanic White. Before their bladder cancer diagnosis, 37% of patients were prescribed psychotropic drugs.

The authors revealed that 2 years after their cancer diagnosis, 53% of patients were prescribed psychotropic drugs. An increased prescription rate seemed to be associated with an increased cancer stage (stage I, 51%; stage II, 58%; stage III, 59%). However, a reduction in the prescription rate occurred for patients with stage IV bladder cancer (55%). The researchers further showed that previous diagnoses of psychotropic drugs tended to increase the likelihood of prescription of these drugs after a cancer diagnosis and that non-Hispanic Black patients seemed to be less likely to receive a prescription for psychotropic drugs following a cancer diagnosis.

Finally, further analysis revealed that although these drugs' prescription rate increased after diagnosis, adherence after 3 months was just 32%. Between each study period of 6 months, 1 year, and 2 years, compliance decreased by 3% each time. The authors noted that patients seemed to adhere best to norepinephrine antagonists (52.4%) and worst to medications of GABA stimulators and modulators (14%).

Disclosure: The study authors reported no conflicts of interest.



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