TY - JOUR
T1 - Polypharmacy and patterns of prescription medication use among cancer survivors
AU - Murphy, Caitlin C.
AU - Fullington, Hannah M.
AU - Alvarez, Carlos A.
AU - Betts, Andrea C.
AU - Lee, Simon J.Craddock
AU - Haggstrom, David A.
AU - Halm, Ethan A.
N1 - Funding Information:
Supported by the National Cancer Institute (grants P30 CA142543 and R25 CA57712), the Agency for Healthcare Research and Quality (grant R24 HS022418), and the National Center for Advancing Translational Sciences (grant KL2 TR001103) at the National Institutes of Health. Academy Health New Investigator Award to Dr. Murphy. The sponsors had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the article; and decision to submit the article for publication.
Funding Information:
Caitlin C. Murphy has received grants from the National Cancer Institute (NCI), the Agency for Healthcare Research and Quality, and the National Center for Advancing Translational Sciences as well as New Investigator funding from AcademyHealth for work performed as part of the current study. Carlos A. Alvarez has received a grant from the National Institute of Diabetes and Digestive and Kidney Diseases/National Institutes of Health (NIH) (K08DK101602) for work performed as part of the current study. Andrea C. Betts received a grant from the NCI/NIH for work performed as part of the current study. Simon J. Craddock Lee has received a grant from the NCI/NIH (R01 CA203856) for work performed as part of the current study and grants to his institution from the FOCUS Initiative and Gilead Foundation for work performed outside of the current study.
Publisher Copyright:
© 2018 American Cancer Society
PY - 2018/7/1
Y1 - 2018/7/1
N2 - BACKGROUND: The population of cancer survivors is rapidly growing in the United States. Long-term and late effects of cancer, combined with the ongoing management of other chronic conditions, make survivors particularly vulnerable to polypharmacy and its adverse effects. In the current study, the authors examined patterns of prescription medication use and polypharmacy in a population-based sample of cancer survivors. METHODS: Using data from the Medical Expenditure Panel Survey (MEPS), the authors matched cancer survivors (5216 survivors) with noncancer controls (19,588 controls) by age, sex, and survey year. Polypharmacy was defined as ≥5 unique medications. The authors estimated the percentage of respondents prescribed medications within therapeutic classes and total prescription expenditures. RESULTS: A higher percentage of cancer survivors were prescribed ≥5 unique medications (64.0%; 95% confidence interval [95% CI], 62.3%-65.8%) compared with noncancer controls (51.5%; 95% CI, 50.4%-52.6%), including drugs with abuse potential. Across all therapeutic classes, a higher percentage of newly (≤1 year since diagnosis) and previously (>1 years since diagnosis) diagnosed survivors were prescribed medications compared with controls, with large differences observed with regard to central nervous system agents (65.8% [95% CI, 62.3%-69.3%] vs 57.4% [95% CI, 55.3%-59.5%] vs 46.0% [95% CI, 45.0%-46.9%]). Specifically, nearly 10% of survivors were prescribed benzodiazepines and/or opioids compared with approximately 5% of controls. Survivors had more than double the prescription expenditures (median of $1633 vs $784 among controls). Findings persisted across age and comorbidity categories. CONCLUSIONS: Cancer survivors were prescribed a higher number of unique medications, including drugs with abuse potential, thereby increasing their risk of adverse drug events, financial toxicity, poor adherence, and drug-drug interactions. Cancer 2018;124:2850-2857.
AB - BACKGROUND: The population of cancer survivors is rapidly growing in the United States. Long-term and late effects of cancer, combined with the ongoing management of other chronic conditions, make survivors particularly vulnerable to polypharmacy and its adverse effects. In the current study, the authors examined patterns of prescription medication use and polypharmacy in a population-based sample of cancer survivors. METHODS: Using data from the Medical Expenditure Panel Survey (MEPS), the authors matched cancer survivors (5216 survivors) with noncancer controls (19,588 controls) by age, sex, and survey year. Polypharmacy was defined as ≥5 unique medications. The authors estimated the percentage of respondents prescribed medications within therapeutic classes and total prescription expenditures. RESULTS: A higher percentage of cancer survivors were prescribed ≥5 unique medications (64.0%; 95% confidence interval [95% CI], 62.3%-65.8%) compared with noncancer controls (51.5%; 95% CI, 50.4%-52.6%), including drugs with abuse potential. Across all therapeutic classes, a higher percentage of newly (≤1 year since diagnosis) and previously (>1 years since diagnosis) diagnosed survivors were prescribed medications compared with controls, with large differences observed with regard to central nervous system agents (65.8% [95% CI, 62.3%-69.3%] vs 57.4% [95% CI, 55.3%-59.5%] vs 46.0% [95% CI, 45.0%-46.9%]). Specifically, nearly 10% of survivors were prescribed benzodiazepines and/or opioids compared with approximately 5% of controls. Survivors had more than double the prescription expenditures (median of $1633 vs $784 among controls). Findings persisted across age and comorbidity categories. CONCLUSIONS: Cancer survivors were prescribed a higher number of unique medications, including drugs with abuse potential, thereby increasing their risk of adverse drug events, financial toxicity, poor adherence, and drug-drug interactions. Cancer 2018;124:2850-2857.
KW - cancer survivors
KW - comorbid conditions
KW - financial burden
KW - health care use
KW - prescription drugs
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U2 - 10.1002/cncr.31389
DO - 10.1002/cncr.31389
M3 - Article
C2 - 29645083
AN - SCOPUS:85045236268
SN - 0008-543X
VL - 124
SP - 2850
EP - 2857
JO - Cancer
JF - Cancer
IS - 13
ER -