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Prevalence and predictors of prescription psychoactive medication use in adult survivors of childhood cancer: a report from the Childhood Cancer Survivor Study

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Abstract

Purpose

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.

Implications for Cancer Survivors

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.

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Author information

Authors and Affiliations

  1. Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, 262 Danny Thomas Place, MS 735, Memphis, TN, 38105, USA

    Tara M. Brinkman, Daniel M. Green, Leslie L. Robison & Kevin R. Krull

  2. Department of Neurology, Children’s Hospital Boston, Boston, MA, USA

    Nicole J. Ullrich

  3. Department of Biostatistics, St. Jude Children’s Research Hospital, Memphis, TN, USA

    Nan Zhang & Deo Kumar Srivastava

  4. Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA

    Lonnie K. Zeltzer

  5. Departments of Psychiatry and Pediatrics, College of Medicine, University of Kentucky, Lexington, KY, USA

    Karen M. Lommel

  6. Division of AIDS Research, National Institute of Mental Health, Rockville, MD, USA

    Pim Brouwers

  7. Germantown Psychological Associates, Germantown, TN, USA

    Neelam Jain

Authors
  1. Tara M. Brinkman
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  2. Nicole J. Ullrich
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  3. Nan Zhang
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  4. Daniel M. Green
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  7. Pim Brouwers
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  9. Neelam Jain
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Correspondence to Tara M. Brinkman.

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Brinkman, T.M., Ullrich, N.J., Zhang, N. et al. Prevalence and predictors of prescription psychoactive medication use in adult survivors of childhood cancer: a report from the Childhood Cancer Survivor Study. J Cancer Surviv 7, 104–114 (2013). https://doi.org/10.1007/s11764-012-0250-x

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  • DOI: https://doi.org/10.1007/s11764-012-0250-x

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