Psychotropic drug dispensing in people with and without cancer in France

Abstract

Purpose: To compare annual and monthly prevalence of psychotropic drug (PD) dispensing and the number and duration of psychotropic treatment episodes among people with and without cancer over a 2-year follow-up.

Methods: We studied the following two cohorts of adult patients affiliated with the National Health Insurance Fund (NHIF): cancer patients followed for 2 years after diagnosis and individuals without cancer matched to cancer patients. Using information about anxiolytic, hypnotic, antidepressant, and antipsychotic dispensing in community pharmacies, we applied conditional log-binomial regressions to estimate adjusted relative risks for monthly dispensing of PDs.

Results: Annual prevalence of PD dispensing-all categories included-among cancer patients was significantly higher for almost all the categories we studied than among individuals without cancer. Monthly prevalence of anxiolytic/hypnotic dispensing started to rise several months before diagnosis and peaked immediately after. Among patients with cancer and their matched controls, treatment duration exceeded 1 month for hypnotics in 40 and 35 %, respectively (p < 0.01), and 3 months for anxiolytics in 23 and 23 % (p = 0.8); it was less than 6 months for antidepressants in 76 and 75 % (p = 0.5).

Conclusions: Prevalence of psychotropic treatment was higher among cancer patients than among persons without cancer. Psychotropic treatment duration was not in line with recommendations for significant fractions of cancer patients or their controls.

Implications for cancer survivors: Training of health professionals involved in cancer supportive care should be reinforced and specific guidelines developed to help them address psychological distress of cancer survivors.

Keywords: Cancer; Health insurance reimbursement; Oncology; Psychotropic drugs; Quality of health care; Survivors.