Département d'Hématologie, Institut Universitaire du Cancer-Oncopole, 1 Avenue Irène Joliot-Curie, 31059, Toulouse Cedex, France.
Service de Pharmacologie Médicale et Clinique, CHU de Toulouse, 37 allées Jules Guesde, 31000, Toulouse, France.
Fundam Clin Pharmacol. 2020 Oct;34(5):612-622. doi: 10.1111/fcp.12544. Epub 2020 Mar 3.
Psychotropic drugs (PD) are often used close to a cancer diagnosis and may be considered as a way of coping. We aimed to determine the incidence of anxiolytics, hypnotics, antidepressants, and antipsychotics initiation around a diagnosis of chronic myelogenous leukemia (CML). Population-based cohort: Data were extracted from Systeme National des données de Santé (SNDS, the French health insurance database) at the regional level (Midi-Pyrenees area, 2.9 million inhabitants). All newly diagnosed patients treated by a CML tyrosine kinase inhibitor (TKI) between 10/01/2011 and 04/01/2014 were included. Pre-CML (9 months before to 3 months before first TKI prescription-F-TKI) and CML (3 months before to 9 months after F-TKI) phases were defined. The main evaluation criterion was the initiation of PD during CML phase. Determinants associated with this incident PD use were studied through a logistic regression model. We compared pre-CML and CML healthcare consumption. The cohort included 103 patients (mean age of 60.8 years). PD initiation rate was 35.9%, anxiolytics being the most initiated PD (59.5%). Advanced age was associated with PD initiation (adjusted OR = 1.029, 95% CI = 1.001-1.056). The number of consultations during the pre-CML phase and female gender tended to be associated with increased risk of PD initiation in univariate analysis. For PD initiators, healthcare consumption was greater in CML but not in pre-CML phase. PD initiation is a frequent finding around a CML diagnosis. Its risk increases with age. It could be a way to identify a subgroup with higher healthcare consumption.
精神药物（PD）通常在癌症诊断时使用，可被视为一种应对方式。我们旨在确定在慢性髓细胞性白血病（CML）诊断前后开始使用抗焦虑药、催眠药、抗抑郁药和抗精神病药的发生率。基于人群的队列：数据从 Systeme National des données de Santé（SNDS，法国医疗保险数据库）的地区水平（米迪-庇里牛斯地区，290 万居民）中提取。所有在 2011 年 10 月 1 日至 2014 年 4 月 1 日期间接受 CML 酪氨酸激酶抑制剂（TKI）治疗的新诊断患者均被纳入研究。CML 前（首次 TKI 处方前 9 个月至 3 个月-F-TKI）和 CML 期（F-TKI 前 3 个月至 9 个月）定义为。主要评估标准是 CML 期间 PD 的开始使用。通过逻辑回归模型研究与该事件 PD 使用相关的决定因素。我们比较了 CML 前和 CML 期间的医疗保健消费。该队列包括 103 名患者（平均年龄为 60.8 岁）。PD 使用率为 35.9%，抗焦虑药是最常用的 PD（59.5%）。年龄较大与 PD 开始使用相关（调整后的 OR=1.029，95%CI=1.001-1.056）。在单变量分析中，CML 前阶段的就诊次数和女性性别倾向于与 PD 开始使用的风险增加相关。对于 PD 使用者，CML 期的医疗保健消费较高，但 CML 前期没有。PD 开始使用在 CML 诊断前后很常见。其风险随年龄增加而增加。它可能是识别具有更高医疗保健消费的亚组的一种方式。
