Department of Health Promotion and Behavioral Sciences, School of Public Health, University of Texas Health Science Center at Houston (UTHealth), 2777 N. Stemmons Fwy., Ste. 8400, Dallas, TX, 75207, USA.
Department of Health Promotion and Behavioral Sciences, UTHealth School of Public Health, Houston, TX, USA.
J Cancer Surviv. 2023 Aug;17(4):1149-1160. doi: 10.1007/s11764-021-01161-0. Epub 2022 Jan 8.
We examined prescription medication use and identified correlates of polypharmacy-taking multiple medications-in adolescent and young adult cancer survivors (AYAs), who experience early-onset chronic conditions.
Our cross-sectional study pooled data (2008-2017) from the national Medical Expenditure Panel Survey. We estimated prevalence of polypharmacy (≥ 5 unique prescription medications over an approximate 1-year period) in AYAs (age 18-39 years with a history of cancer) and age- and sex-matched controls, overall and by sociodemographics, clinical factors, and health indicators. We compared survivors' and controls' medication use across therapeutic classes. To identify correlates of polypharmacy among AYAs, we included factors with p < 0.20 in bivariable analysis in a multivariable logistic regression model.
AYAs (n = 601) had a higher prevalence of polypharmacy than controls (n = 2,402), overall (31.5% vs. 15.9%, p < .01) and by all sociodemographics, clinical factors, and health indicators. A majority of AYAs with multiple chronic conditions (58.8%, 95% CI 47.3-70.4) or disability (61.3%, 95% CI 52.6-70.0) had polypharmacy. Patterns of AYAs' medication use across therapeutic classes were consistent with their chronic conditions. Nearly one-third used opioid/narcotic analgesics (32.2% vs. 13.7% of controls, p < 0.01). Among AYAs, multiple chronic conditions (aOR 4.68, 95% CI 2.23-9.83) and disability (aOR 3.70, 95% CI 2.23-6.14) were correlated with polypharmacy.
Chronic conditions and disabilities, including aftereffects of cancer treatment, may drive polypharmacy in AYAs. Future research should examine adverse outcomes of polypharmacy and opioid/narcotic use in AYAs.
AYAs with chronic conditions or disabilities should be monitored for polypharmacy.
我们研究了青少年和年轻成年癌症幸存者（AYA）的处方药物使用情况，并确定了其同时服用多种药物（即 1 年内使用 5 种以上处方药）的相关因素，这些 AYA 经历了早发性慢性疾病。
我们对来自全国医疗支出面板调查的 2008 年至 2017 年的数据进行了横断面研究。我们估计了 AYA（18-39 岁，有癌症病史）和年龄、性别匹配的对照组中同时服用多种药物（≥5 种不同处方药，持续约 1 年）的比例，整体和按社会人口统计学、临床因素和健康指标进行分析。我们比较了幸存者和对照组在治疗类别中的药物使用情况。为了确定 AYA 中同时服用多种药物的相关因素，我们在多变量逻辑回归模型中纳入了单变量分析中 p<0.20 的因素。
AYA（n=601）的同时服用多种药物的比例高于对照组（n=2402），总体（31.5%比 15.9%，p<0.01）和所有社会人口统计学、临床因素和健康指标均如此。大多数患有多种慢性疾病（58.8%，95%CI 47.3-70.4）或残疾（61.3%，95%CI 52.6-70.0）的 AYA 都同时服用多种药物。AYA 药物使用的治疗类别模式与其慢性疾病一致。近三分之一的人使用阿片类/麻醉性镇痛药（32.2%比对照组的 13.7%，p<0.01）。在 AYA 中，多种慢性疾病（aOR 4.68，95%CI 2.23-9.83）和残疾（aOR 3.70，95%CI 2.23-6.14）与同时服用多种药物相关。
包括癌症治疗后效在内的慢性疾病和残疾可能导致 AYA 同时服用多种药物。未来的研究应该检查 AYA 同时服用多种药物和使用阿片类/麻醉性镇痛药的不良后果。
患有慢性疾病或残疾的 AYA 应监测其同时服用多种药物的情况。
