Antidepressant prescribing in community cancer care.
OBJECTIVE
To describe patterns of antidepressant (ADs) prescribing in community oncology practice.


METHODS
Data were collected using an electronic medical record on all staged breast, colon, and lung cancer patients in three community-based oncology practices. The data were analyzed retrospectively, using descriptive and bivariate analyses and multivariate logistic regression modeling. There were 850 breast, 299 colon, and 473 lung cancer patients identified in this analysis.


RESULTS
Overall, 19.2% of breast, 11% of colon, and 13.7% of lung cancer patients had been prescribed ADs during the 2-year period. The clinic in which cancer treatment was received predicted AD prescribing. The relationship between AD administration and age proved to be nonlinear; the pattern exhibited an "inverted U" shape. Patients with comorbidities and on pain medications were more likely to be administered ADs. Colon cancer patients on pain medications were five times more likely to be administered ADs than those not on pain medications.


CONCLUSIONS
While some predictors of AD prescribing appear to be consistent with other studies, such as being on pain medication, there is still a great amount of variability in prescribing patterns across community practices, age groups, and cancer diagnoses. This study demonstrates that prescriptions of ADs seem to be influenced by parameters other than psychopathology. Given the importance of major depression in oncology care, diagnosis of psychiatric disorders and prescription patterns of psychotropics should be part of the routine monitoring and quality management in oncology patient care.
OpTx Corporation, 304 Inverness Way South, Suite 365, Englewood, CO 80112, USA. fredash@optxcorp.com
Fredrick D
FD
Ashbury
Lisa
L
Madlensky
Peter
P
Raich
Mark
M
Thompson
Geoff
G
Whitney
Ken
K
Hotz
Boris
B
Kralj
William S
WS
Edell
D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000523:psychology; D003110:Colonic Neoplasms / Q000523:psychology; D003151:Community Health Centers / Q000706:statistics & numerical data*; D003863:Depression / Q000188:drug therapy* / Q000209:etiology; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D016015:Logistic Models; D008175:Lung Neoplasms / Q000523:psychology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011785:Quality Assurance, Health Care; D012189:Retrospective Studies; D013997:Time Factors; D014481:United States
D000928:Antidepressive Agents