Assessing disruptions in adherence to antidepressant treatments after breast cancer diagnosis

Yi Ting Chou, Aaron N. Winn, Donald L. Rosenstein, Stacie B. Dusetzina

Research output: Contribution to journalArticle

Abstract

Purpose: Long-term treatment with antidepressants can lessen the symptoms of depression, but health-related crises—such as a cancer diagnosis—may disrupt ongoing depression care. The study aims to estimate the effect of receiving a breast cancer diagnosis on antidepressant adherence among women with depression. Methods: Using SEER-Medicare administrative claims, we identified women aged 65+ with newly diagnosed breast cancer between 2008 and 2011, who were diagnosed with depression and used antidepressants during the year before pre-diagnosis year. We compared antidepressant adherence among women with breast cancer to similar women without cancer using generalized estimation equations. Antidepressant adherence was estimated using the proportion of days covered 1 year before and after the index date. Results: We included 1142 women with breast cancer and pre-existing depression and 1142 matched non-cancer patients with pre-existing depression. Mean antidepressant adherence was similar for both groups in the year before and after the index date (all around 0.71); adherence decreased by approximately 0.01 following breast cancer diagnosis in cancer group, with similar reductions among non-cancer group (p = 0.19). However, substantial proportion of patients had inadequate adherence to antidepressants in the post-diagnosis period, and almost 40% of patients in each group discontinued antidepressants over the study period. Conclusions: Antidepressant adherence was not associated with receiving a breast cancer diagnosis beyond what would have been expected in a similar cohort of women without cancer; however, adherence was poor among both groups. Ensuring adequate ongoing depression care is important to improve cancer care and patient quality of life in the long term.

LanguageEnglish (US)
Pages676-684
Number of pages9
JournalPharmacoepidemiology and Drug Safety
Volume26
Issue number6
DOIs
StatePublished - Jun 1 2017

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Antidepressive Agents
Breast Neoplasms
Therapeutics
Neoplasms
Medicare
Patient Care
Quality of Life
Health

Keywords

  • adherence
  • antidepressants
  • breast cancer
  • pharmacoepidemiology
  • psycho-oncology
  • SEER-Medicare
  • supportive care

ASJC Scopus subject areas

  • Epidemiology
  • Pharmacology (medical)

Cite this

Assessing disruptions in adherence to antidepressant treatments after breast cancer diagnosis. / Chou, Yi Ting; Winn, Aaron N.; Rosenstein, Donald L.; Dusetzina, Stacie B.

In: Pharmacoepidemiology and Drug Safety, Vol. 26, No. 6, 01.06.2017, p. 676-684.

Research output: Contribution to journalArticle

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