Julius Centre for Health Sciences and Primary Care, University Medical Centre, Utrecht, The Netherlands.
Psychooncology. 2013 Apr;22(4):762-7. doi: 10.1002/pon.3056. Epub 2012 Feb 20.
Psychotropic drugs are commonly prescribed for various psychological complaints in cancer patients. We aim to examine the prescription pattern in cancer patients of three common psychotropic drugs: benzodiazepine, antidepressant and antipsychotic.
This is a retrospective case-control study. Data were extracted from the Agis Health Database. This insurance database contains the healthcare consumption of 1.3 million inhabitants of the Netherlands. We analyzed the use of psychotropics in cancer patients and an equally sized randomly selected control group of noncancer patients from 2006 to 2008. Odds ratio (OR) were adjusted for age, gender, immigrant status, neighborhood socio-economic status, and premorbid medical condition. Additionally, the numbers of new user in the 3 months after cancer was diagnosed and in the 3 months before death were compared.
A total of 113 887 cancer patients and 121 395 control subjects were included. Cancer patients were significantly more often prescribed psychotropic drugs (adjusted OR: benzodiazepines = 1.70, CI = 1.67-1.74; antidepressants = 1.38, CI = 1.34-1.42; and antipsychotics = 1.70, CI = 1.62-1.77). Lower socio-economic status, immigrant, and premorbid chronic medical conditions were significantly associated with higher risk of psychotropic use. Odds for a new prescription for all three psychotropic drugs were significantly less in the first 3 months after cancer diagnosis than the 3 months before death (benzodiazepine, OR = 0.673, CI = 0.647-0.705; antidepressant, OR = 0.592, CI = 0.544-0.644; antipsychotic, OR = 0.177, CI = 0.165-0.190) CONCLUSIONS: Psychotropic drug prescription is common in cancer patients, starts soon after diagnosis, and increases in the terminal stage. Prescription rates were significantly higher in patients from lower socio-economic group, immigrants, or with premorbid chronic medical condition.
在癌症患者中，常开具精神药物来治疗各种心理问题。我们旨在研究三种常见精神药物（苯二氮䓬类、抗抑郁药和抗精神病药）在癌症患者中的处方模式。
这是一项回顾性病例对照研究。数据来自 Agis 健康数据库。该医疗保险数据库包含荷兰 130 万居民的医疗保健消费数据。我们分析了 2006 年至 2008 年间癌症患者和同等数量随机选择的非癌症患者的精神药物使用情况。使用比值比（OR）调整了年龄、性别、移民身份、邻里社会经济地位和发病前的医疗状况。此外，比较了癌症诊断后 3 个月和死亡前 3 个月新用户的数量。
共纳入 113887 例癌症患者和 121395 例对照。癌症患者开具精神药物的比例明显更高（调整后的 OR：苯二氮䓬类=1.70，95%CI=1.67-1.74；抗抑郁药=1.38，95%CI=1.34-1.42；抗精神病药=1.70，95%CI=1.62-1.77）。较低的社会经济地位、移民和发病前的慢性疾病与更高的精神药物使用风险显著相关。与死亡前 3 个月相比，所有三种精神药物在癌症诊断后 3 个月内新处方的可能性显著降低（苯二氮䓬类，OR=0.673，95%CI=0.647-0.705；抗抑郁药，OR=0.592，95%CI=0.544-0.644；抗精神病药，OR=0.177，95%CI=0.165-0.190）。
癌症患者中精神药物的处方很常见，且在诊断后不久开始使用，并在终末期增加。来自社会经济地位较低、移民或有发病前慢性疾病的患者的处方率显著更高。
