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癌症患者的心血管药物使用与医疗服务利用:一项基于人群的回顾性队列研究。

Cardiovascular Medication and Health Service Use in Individuals With Cancer: A Retrospective Population-Based Cohort Study.

作者信息

Tan Jin Quan Eugene, Ng Huah Shin, Woodman Richard, Koczwara Bogda

机构信息

Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.

SA Pharmacy, SA Health, Adelaide, South Australia, Australia.

出版信息

Cancer Med. 2025 May;14(9):e70911. doi: 10.1002/cam4.70911.

Abstract

BACKGROUND

Cancer and cardiovascular disease (CVD) frequently coexist, but little is known about CVD medication use in cancer survivors. The aim of this study was to compare CVD medication and medical service use between individuals with and without cancer.

METHODS

Retrospective cohort study linking Australian National Health Survey 2020-2021 data from participants aged ≥ 25 years to medication dispensing, medical services, and death registry data via the Multi-Agency Data Integration Project. Logistic regression was used to compare patterns of CVD medication use between cancer and non-cancer groups and negative binomial regression to examine patterns of medical service utilisation by cancer and CVD status.

RESULTS

The analysis included 1828 individuals with a history of cancer (cancer survivors) and 7505 people without cancer. Although cancer survivors had a higher prevalence of CVD (31% vs. 13%) compared to people without cancer, there was no difference in the adjusted use of CVD medications (adjusted odds ratios: 1.15; 95% CI = 1.00-1.33) between these two groups. There was, however, an increased rate of health service use in those with cancer alone (adjusted rate ratios (aRR): 1.39; 95% CI = 1.29-1.50), those with CVD alone (aRR: 1.71; 95% CI = 1.63-1.80), and those with both conditions (aRR: 2.10; 95% CI = 1.97-2.25) compared to people without cancer or CVD.

CONCLUSIONS

Despite having a higher prevalence of CVD and higher health service utilisation, the overall use of CVD medication did not differ between people with and without cancer. Cancer survivors with CVD had a higher rate of medical services use compared with persons with either condition alone or neither condition. Further research should explore the underlying reasons behind these data to inform strategies to mitigate the detrimental effects of comorbid CVD in cancer.

摘要

背景

癌症与心血管疾病(CVD)常并存,但对于癌症幸存者使用心血管疾病药物的情况知之甚少。本研究旨在比较患癌个体与未患癌个体之间心血管疾病药物及医疗服务的使用情况。

方法

一项回顾性队列研究,通过多机构数据整合项目将2020 - 2021年澳大利亚国民健康调查中年龄≥25岁参与者的数据与药物配给、医疗服务及死亡登记数据相链接。采用逻辑回归比较癌症组与非癌症组心血管疾病药物的使用模式,采用负二项回归分析癌症和心血管疾病状况对医疗服务利用模式的影响。

结果

分析纳入了1828名有癌症病史的个体(癌症幸存者)和7505名无癌症个体。尽管与无癌症个体相比,癌症幸存者心血管疾病的患病率更高(31%对13%),但两组间心血管疾病药物的调整使用情况无差异(调整比值比:1.15;95%置信区间 = 1.00 - 1.33)。然而,仅患癌症者(调整率比(aRR):1.39;95%置信区间 = 1.29 - 1.50)、仅患心血管疾病者(aRR:1.71;95%置信区间 = 1.63 - 1.80)以及同时患有这两种疾病者(aRR:2.10;95%置信区间 = 1.97 - 2.25)的医疗服务使用率高于无癌症或心血管疾病的个体。

结论

尽管癌症幸存者心血管疾病患病率更高且医疗服务利用率更高,但患癌与未患癌个体之间心血管疾病药物的总体使用情况并无差异。与仅患一种疾病或两种疾病都未患的个体相比,患有心血管疾病的癌症幸存者医疗服务使用率更高。进一步的研究应探究这些数据背后的潜在原因,以便制定策略减轻癌症合并心血管疾病的有害影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce04/12062870/1458edeff403/CAM4-14-e70911-g002.jpg

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