title: Prevalence and predictors of prescription psychoactive medication use in adult survivors of childhood cancer: a report from the Childhood Cancer Survivor Study.
abstract: OBJECTIVE
  Childhood cancer survivors are at risk for late effects which may be managed pharmacologically. The purposes of this study were to estimate and compare the prevalence of psychoactive medication use of adult survivors of childhood cancer and sibling controls, identify predictors of medication use in survivors, and investigate associations between psychoactive medications and health-related quality of life (HRQOL).
  
  
  METHODS
  Psychoactive medication use from 1994 to 2010 was evaluated in 10,378 adult survivors from the Childhood Cancer Survivor Study. A randomly selected subset of 3,206 siblings served as a comparison group. Multivariable logistic regression models were used to calculate odds ratios (OR) for baseline and new onset of self-reported psychoactive medication use and HRQOL.
  
  
  RESULTS
  Survivors were significantly more likely to report baseline (22 vs. 15 %, p < 0.001) and new onset (31 vs. 25 %, p < 0.001) psychoactive medication use compared to siblings, as well as use of multiple medications (p < 0.001). In multivariable models, controlling for pain and psychological distress, female survivors were significantly more likely to report baseline and new onset use of antidepressants (OR = 2.66, 95 % CI = 2.01-3.52; OR = 2.02, 95 % CI = 1.72-2.38, respectively) and multiple medications (OR = 1.80, 95 % CI = 1.48-2.19; OR = 1.77, 95 % CI = 1.48-2.13, respectively). Non-cranial radiation and amputation predicted incident use of analgesics >15 years following diagnosis. Antidepressants were associated with impairment across all domains of HRQOL, with the exception of physical function.
  
  
  CONCLUSIONS
  Prevalence of psychoactive medication use was higher among survivors for most medication classes, as was the use of multiple medications. Clinicians should be aware of the possible contribution of psychoactive medications to HRQOL.
  
  
  CONCLUSIONS
  Survivors of childhood cancer are more likely to be prescribed psychoactive medication than their sibling counterparts, though use of such medication does not appear to normalize quality of life. Survivors are encouraged to consider additional interventions, including psychosocial support and physical exercise.
authors.affiliation: Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN 38105, USA. tara.brinkman@stjude.org
authors.forename: Tara M
authors.initials: TM
authors.lastname: Brinkman
authors.forename: Nicole J
authors.initials: NJ
authors.lastname: Ullrich
authors.forename: Nan
authors.initials: N
authors.lastname: Zhang
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Green
authors.forename: Lonnie K
authors.initials: LK
authors.lastname: Zeltzer
authors.forename: Karen M
authors.initials: KM
authors.lastname: Lommel
authors.forename: Pim
authors.initials: P
authors.lastname: Brouwers
authors.forename: Deo Kumar
authors.initials: DK
authors.lastname: Srivastava
authors.forename: Neelam
authors.initials: N
authors.lastname: Jain
authors.forename: Leslie L
authors.initials: LL
authors.lastname: Robison
authors.forename: Kevin R
authors.initials: KR
authors.lastname: Krull
mesh_terms: D000293:Adolescent; D000328:Adult; D011307:Drug Prescriptions; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000523:psychology*; D017063:Outcome Assessment, Health Care; D015995:Prevalence; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D011788:Quality of Life; D058028:Research Report; D012307:Risk Factors; D013315:Stress, Psychological / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology; D017741:Survivors / Q000523:psychology*; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D011619:Psychotropic Drugs