Use of Psychotropic Drugs Among Bladder Cancer Patients in the United States

Abstract

Bladder cancer patients are at increased risk of physical and emotional distress, however, prescription utilization patterns largely remain to be elucidated. Our objective was to comprehensively assess prescription patterns and predictors in bladder cancer patients. A total of 10,516 patients diagnosed with clinical stage T1-T4a, N0, M0 bladder urothelial carcinoma from January 1, 2008, to December 31, 2012 from the Surveillance, Epidemiology, and End Results (SEER)-Medicare were analyzed. We used multivariable analysis to determine predictors associated with psychotropic prescription rates. Medication Possession Ratio (MPR) was used as an index to measure adherence in intervals of 3-months, 6-months, 1-year, and 2-years. Evaluation of psychotropic prescribing patterns and adherence across different drugs and demographic factors. Of the 10,516 patients, 5,621 (53%) were prescribed psychotropic drugs following cancer diagnosis. Overall, 3,972 (38%) patients had previous psychotropic prescriptions prior to cancer diagnosis, and these patients were much more likely to receive a post-cancer diagnosis prescription. Prescription rates for psychotropic medications were higher among patients with higher stage bladder cancer (P < .001). GABA modulators/stimulators and serotonin reuptake inhibitors/stimulators were the highest prescribed psychotropic drugs in 21% of all patients. Adherence for all drugs was 32% at 3-months and continued to decrease over time. Over half of bladder cancer patients received psychotropic prescriptions within two years of their cancer diagnosis. Given the chronicity of psychiatric disorders with observed significantly low adherence to medications warrants an emphasis on prolonged patient monitoring and further investigation.