Currently Viewing:
Newsroom
Currently Reading
Addressing the Psychosocial Needs in Older Breast Cancer Patients
November 17, 2016 – Surabhi Dangi-Garimella, PhD
BLA for Bevacizumab Biosimilar Filed Based on Phase 3 NSCLC Data
November 15, 2016 – Surabhi Dangi-Garimella, PhD
Combining IORT With Chemotherapy Improves Survival in Pancreatic Cancer
November 15, 2016 – Surabhi Dangi-Garimella, PhD
Prospective Trial Confirms Important Role of Vitamin D in Breast Cancer
November 14, 2016 – Surabhi Dangi-Garimella, PhD
Genetic Factors Can Help Tailor Surveillance Programs for Melanoma
November 12, 2016 – Surabhi Dangi-Garimella, PhD
The Fate of Cancer Moonshot in 2017
November 11, 2016 – Surabhi Dangi-Garimella, PhD
What We're Reading: Medicare Premium Increases Will Be Modest
November 11, 2016 – AJMC Staff
Nivolumab Approved in Patients With Recurrent SCCHN
November 10, 2016 – AJMC Staff
US Cigarette Smoking Rate Sees a 5% Decrease Since 2005
November 10, 2016 – Surabhi Dangi-Garimella, PhD

Addressing the Psychosocial Needs in Older Breast Cancer Patients

Surabhi Dangi-Garimella, PhD
A study conducted in Canada to estimate the prevalence of psychotropic and opioid medication use by older women diagnosed with breast cancer found a significant increase in use, especially during the active treatment phase.
A study conducted in Canada to estimate the prevalence of psychotropic and opioid medication use by older women diagnosed with breast cancer found a significant increase in use, especially during the active treatment phase. Antidepressant use, on the other hand, persisted through active treatment and into survivorship. 

Breast cancer diagnosis is more common in older women, who usually present with comorbidities and associated polypharmacy. Further, age-related cognitive decline and greater susceptibility to adverse reactions from cancer-related treatments could be a source of anxiety and distress in this patient population. To complicate matters, studies have shown that antidepressant medications could interfere with the efficacy of breast cancer treatments like tamoxifen. With this in mind, the authors conducted the present study, the results of which have been published in the Journal of the National Comprehensive Cancer Network, to understand pharmacologic management of distress and pain in this high-risk group of patients.

The study followed 19,353 women over age 65 who were diagnosed with incident, nonmetastatic breast cancer in Quebec, Canada. Health data were sourced from provincial, universal health, and drug insurance plans. Psychotropic and opioid medication use was assessed across the care trajectory, from the precancer stage until the first year of survivorship.

A significant increase in medication use was observed from the precancer stage into active treatment, followed by a drop in use during the first year of survivorship. Anxiolytics, the authors write, were more commonly used across the care trajectory by the studied patient population—36.3% at baseline, 50.6% during active treatment, and 44.4% during survivorship. Antipsychotic and opioid medications saw a spike in utilization during the active treatment phase: a 4.5- and 7-fold increase compared with baseline. Antidepressant use, however, peaked during the active phase (22.4%, up from 14.7% at baseline) and then was sustained during survivorship (22.3%).

Accounting for the fact that these older women who were receiving treatment for their cancer experienced distress and pain across their care trajectory, and the risk of drug-drug interactions leading to adverse events, the authors recommend integrating psychological interventions in the treatment plan to address these women’s needs.

Reference

Syrowatka A, Chang SL, Tamblyn R, Mayo NE, Meguerditchian AN. Psychotropic and opioid medication use in older patients with breast cancer across the care trajectory: a population-based cohort study. J Natl Compr Canc Netw. 2016;14(11):1412-1419.

 
Copyright AJMC 2006-2019 Clinical Care Targeted Communications Group, LLC. All Rights Reserved.
x
Welcome the the new and improved AJMC.com, the premier managed market network. Tell us about yourself so that we can serve you better.
Sign Up