TY - JOUR
T1 - Variation and Trends in Antidepressant Prescribing for Men Undergoing Treatment for Nonmetastatic Prostate Cancer
T2 - A Population-based Cohort Study
AU - Matta, Rano
AU - Wallis, Christopher J.D.
AU - Goldenberg, Mitchell G.
AU - Hird, Amanda E.
AU - Klaassen, Zachary
AU - Kulkarni, Girish
AU - Kodama, Ronald T.
AU - Herschorn, Sender
AU - Nam, Robert K.
N1 - Funding Information:
Funding/Support and role of the sponsor : This study was funded by the Ajmera Family Chair in Urologic Oncology awarded to R.K.N. R.M. is supported by a Canadian Institutes of Health Research (CIHR)—Frederick Banting and Charles Best Canada Graduate Scholarship. This study was supported by the Institute for Clinical and Evaluative Sciences, which is funded by the Ontario Ministry of Health and Long-Term Care. The opinions, results, and conclusions reported in this paper are those of the authors and are independent of the funding sources. No endorsement by Institute for Clinical Evaluative Sciences or the Ontario Ministry of Health and Long-Term Care is intended or should be inferred. Parts of this material are based on data and/or information compiled and provided by the Canadian Institution for Health information (CIHI). However, the analyses, conclusions, opinions and statements expressed in the material are those of the author(s), and not necessarily those of CIHI.
Publisher Copyright:
© 2018
PY - 2019/1
Y1 - 2019/1
N2 - Psychological distress is prevalent among men with prostate cancer (PCa). However, the variation in antidepressant use among individuals throughout the survivorship period is unknown. We sought to examine the variation and trends in receipt of antidepressants after PCa treatment, among patients with nonmetastatic PCa. Using population-based linked administrative data, we identified men ≥66 yr old who underwent surgery (n = 4952), radiotherapy (n = 4994), or surveillance (n = 2136), and these men were matched to general population controls (n = 57 127). One year prior to PCa treatment, 7.7% of men received an antidepressant prescription, which increased to 10.5% in the year after treatment. In difference-in-differences analysis, adjusted for demographic and health characteristics, men had increased odds of antidepressant receipt up to 5 yr after surgery (odds ratio [OR] 1.49; 95% confidence interval [CI] 1.35–1.64; p ≤ 0.0001) or radiotherapy (OR 1.33; 95% CI 1.21–1.47; p ≤ 0.0001). Men did not have an increased risk of antidepressant receipt up to 5 yr after surveillance (OR 1.15; 95% CI 0.94–1.41; p = 0.16). Limitations include the potential for selection bias and misclassification due to the retrospective design of the study and the use of administrative databases. Thus, men with nonmetastatic PCa who initially receive surgery or radiotherapy, but not those who initially undergo surveillance, have an increased risk of antidepressant receipt after treatment. Patient summary: In this report, we examined antidepressant prescription for men after treatment of nonmetastatic prostate cancer across the entire population of men ≥66 yr in Ontario, Canada, from 2002 to 2009. For men diagnosed with nonmetastatic prostate cancer, the risk of antidepressant receipt at 5 yr after treatment was significantly increased after surgery or radiotherapy, but not after surveillance. Providers and patients should consider the psychological effects of prostate cancer treatment during the survivorship period. Patients treated for nonmetastatic prostate cancer with surgery or radiation have an increased risk of receiving antidepressant prescriptions for at least 5 yr, whereas patients undergoing surveillance do not. Thus, psychological support after treatment is an important part of prostate cancer care.
AB - Psychological distress is prevalent among men with prostate cancer (PCa). However, the variation in antidepressant use among individuals throughout the survivorship period is unknown. We sought to examine the variation and trends in receipt of antidepressants after PCa treatment, among patients with nonmetastatic PCa. Using population-based linked administrative data, we identified men ≥66 yr old who underwent surgery (n = 4952), radiotherapy (n = 4994), or surveillance (n = 2136), and these men were matched to general population controls (n = 57 127). One year prior to PCa treatment, 7.7% of men received an antidepressant prescription, which increased to 10.5% in the year after treatment. In difference-in-differences analysis, adjusted for demographic and health characteristics, men had increased odds of antidepressant receipt up to 5 yr after surgery (odds ratio [OR] 1.49; 95% confidence interval [CI] 1.35–1.64; p ≤ 0.0001) or radiotherapy (OR 1.33; 95% CI 1.21–1.47; p ≤ 0.0001). Men did not have an increased risk of antidepressant receipt up to 5 yr after surveillance (OR 1.15; 95% CI 0.94–1.41; p = 0.16). Limitations include the potential for selection bias and misclassification due to the retrospective design of the study and the use of administrative databases. Thus, men with nonmetastatic PCa who initially receive surgery or radiotherapy, but not those who initially undergo surveillance, have an increased risk of antidepressant receipt after treatment. Patient summary: In this report, we examined antidepressant prescription for men after treatment of nonmetastatic prostate cancer across the entire population of men ≥66 yr in Ontario, Canada, from 2002 to 2009. For men diagnosed with nonmetastatic prostate cancer, the risk of antidepressant receipt at 5 yr after treatment was significantly increased after surgery or radiotherapy, but not after surveillance. Providers and patients should consider the psychological effects of prostate cancer treatment during the survivorship period. Patients treated for nonmetastatic prostate cancer with surgery or radiation have an increased risk of receiving antidepressant prescriptions for at least 5 yr, whereas patients undergoing surveillance do not. Thus, psychological support after treatment is an important part of prostate cancer care.
KW - Antidepressive agents
KW - Prostatectomy
KW - Prostatic neoplasms
KW - Radiotherapy
KW - Survivorship
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U2 - 10.1016/j.eururo.2018.08.035
DO - 10.1016/j.eururo.2018.08.035
M3 - Article
C2 - 30241972
AN - SCOPUS:85053732936
SN - 0302-2838
VL - 75
SP - 3
EP - 7
JO - European urology
JF - European urology
IS - 1
ER -