A retrospective case-control study on the prescribing practices of antidepressants administered to cancer patients and non-cancer patients in Australia

Comorbidity of depression risks is common among cancer patients. The pharmacological treatment of depression is antidepressants. However, antidepressants may interact with anticancer drugs or cause adverse reactions. The prescription practice of antidepressants to cancer patients in Australia is not well documented. Our systematic review and meta-analysis identified that the overall prevalence rate of antidepressants was 15.6% varied widely by world-region and gender. A retrospective case-control study was undertaken to determine the recent prescription practice of antidepressants to cancer and non-cancer patients in Australia. Mirtazapine was the highly prescribed antidepressants to cases, whereas Desvenlafaxine was prescribed to controls. Considerable variation in the prescribing patterns of antidepressants was identified. Prospective studies are needed to ascertain whether patients are being treated optimally

Are psychological interventions effective on anxiety in cancer patients? A systematic review and meta-analyses

Objective: The aims of this meta-analysis were to estimate the overall effect size (ES) of psychological interventions on anxiety in patients with cancer and extract sample and intervention characteristics that influence effectiveness. Methods: PubMed, Scopus, PsycINFO, Embase, Medline, and CINAHL were searched using Medical Subject Heading keywords 'cancer' AND 'anxiety' AND 'psychological intervention' AND 'counselling' AND 'psycho*' AND 'psychotherapy' AND 'psychosocial' AND 'therapy' between January 1993 and June 2017. Results: Seventy-one studies were eligible for the systematic review; among them, 51 studies were included in the meta-analysis calculations. The overall ES was -0.21 (95% confidence interval; -0.30 to -0.13) in favour of the intervention. From subgroup analyses, studies conducted in Asia, enrolling inpatients, focussing on relaxation, of < 6-week intervention duration, < 30-minute intervention dose per session, and < 4 hours of total time of intervention showed moderate ESs ranging from -0.40 to -0.55. Only 2 studies restricted enrolment to prescreened patients with clinically elevated level of anxiety and showed moderate ES of -0.58. Conclusions: Low psychological distress at baseline and nonevidence-based interventions were the main factors identified for low effectiveness. Screening and assessment to determine clinical levels of anxiety in patients with cancer should be considered in future trials as an inclusion criterion before providing psychological interventions.SS was funded by Advance Queensland PhD scholarship. SMM (#1090440) and MJ (#11051021) were funded by NHMRC Fellowships

How many patients enter endometrial cancer surgery with psychotropic medication prescriptions, and how many receive a new prescription perioperatively?

Psychotropic medications including antidepressants and anxiolytics are used to treat anxiety and depression in cancer patients; however, little is known about the prescription practices in endometrial cancer. This study aimed to determine the prevalence, type, dose, frequency and timing of psychotropic medications prescribed to endometrial cancer patients. A secondary aim was to study sociodemographic and clinical characteristics associated with receiving a psychotropic medication prescription.Secondary data analysis of an international, multicentre, prospective randomised controlled trial was conducted. Patients aged >18 years diagnosed with Stage I endometrial cancer were included. Logistic regression models were fitted to estimate the association of receiving psychotropic medications with patient's socio-demographic and clinical characteristics.The overall prevalence of patients prescribed one or more psychotropic medications was 16.8% (n = 121/719) comprising antidepressants (12.6%, n = 91/719) and anxiolytics (5.8%, n = 42/719). The majority of patients (78.1%, n = 71/91) were already receiving antidepressants before cancer diagnosis, the remaining medications were newly prescribed perioperatively (21.9%, n = 20/91). Patients of younger age (18-50 years, OR (Odds Ratio): 2.61), who had hypertension (OR: 0.61), history of a previous cancer (OR: 1.96), and ≥2 comorbidities (2-3, OR: 2.97; 4-5, OR: 7.85; ≥6, OR: 9.13) were significantly (p

A systematic review and meta-analysis of prescribing practices of antidepressants in cancer patients

<b>Objective</b>\ud \ud - Antidepressants are commonly used for the pharmacological treatment of depression. We aimed to summarise the prevalence of antidepressant prescription to cancer patients, and differences by study or patient characteristics. \ud \ud <b>Methods</b>\ud \ud - PubMed, Embase, Web of Science, Scopus and psychINFO were searched using keywords ‘psychotropic’, ‘antidepressants’, ‘prescription’ and ‘cancer’. Prevalence of antidepressants, type, dose and follow-up of antidepressants and prescriber details were extracted. \ud \ud <b>Results</b>\ud \ud - Overall, 1537 articles between 1979 and February 2015 were found, 38 met the inclusion criteria and were reviewed according to PRISMA guidelines. The prevalence rate of prescribing antidepressants to cancer patients was 15.6% (95% CI= 13.3-18.3). Prescription was significantly less common in studies from Asia (7.4%; 95% CI= 4.3-12.5), more common in female (22.6%; 95% CI= 16-31) or breast cancer patients (22.6%; 95% CI= 16-30.9). Selective serotonin reuptake inhibitors were the most frequently prescribed antidepressants. General practitioners and psychiatrists, followed by oncologists, were identified as the major providers of antidepressant prescriptions to cancer patients. Few studies reported the exact dose, length of time drugs were prescribed for or follow-up regimens.\ud \ud <b>Conclusions</b>\ud \ud - There is considerable variation in the prescribing patterns of antidepressants across the world, with few studies reporting robust data on exact dose or follow-up regimens. Prospective studies that monitor antidepressant prescribing, including details of reasons for prescribing and the health care providers involved, dose, change in dose or type of medication and follow-up are needed to ascertain whether patients are being treated optimally and if side effects or drug-drug interactions are identified and managed

Are psychological interventions effective on anxiety in cancer patients? A systematic review and meta-analyses

The aim of this meta-analysis was to estimate the overall effect size (ES) of psychological interventions on anxiety in patients with cancer; and extract sample and intervention characteristics that influence effectiveness.PubMed, Scopus, PsycINFO, Embase, Medline and CINAHL were searched using Medical Subject Heading keywords- 'cancer' AND 'anxiety' AND 'psychological intervention' AND 'counselling' AND 'psycho*' AND 'psychotherapy' AND 'psychosocial' AND 'therapy' between January 1993- June 2017.Seventy-one studies were eligible for the systematic review; among them 51 studies were included in the meta-analysis calculations. The overall ES was -0.21 (95% confidence interval; -0.30 to -0.13) in favour the intervention. From sub-group analyses, studies conducted in Asia; enrolling inpatients; focussing on relaxation; o

What type and dose of antidepressants are cancer and non-cancer inpatients being prescribed: a retrospective case-control study at an Australian tertiary hospital

PurposeCancer patients are often prescribed antidepressants, but little data is available about whether the type and dose are similar to prescriptions to patients with other chronic diseases. This study compared the prescription practices of antidepressants to cancer and non-cancer inpatients at a major Australian tertiary hospital and assessed side effects and potential drug-drug interactions.MethodsInpatients diagnosed with cancer within the past 12 months and prescribed antidepressants were age and gender matched to inpatients with other chronic disease conditions. Data from 75 cancer and 75 non-cancer inpatients were extracted.ResultsAntidepressants were prescribed to cancer and non-cancer patients, respectively, for the treatment of depression (n = 50 vs n = 59), other mental health problems (n = 8 vs n = 11, p ConclusionsAntidepressants were prescribed for a range of indications in all patients, but more commonly for unspecified reasons among the cancer patients. Future prospective studies that monitor antidepressant prescribing to cancer patients should ascertain details of the indication, pathways to prescription and differences in type, dose or schedule depending on prescribing medical practitioner

Indigenous Australians&rsquo; Experiences of Cancer Care: A Narrative Literature Review

To provide the latest evidence for future research and practice, this study critically reviewed Indigenous peoples&rsquo; cancer care experiences in the Australian healthcare system from the patient&rsquo;s point of view. After searching PubMed, CINAHL and Scopus databases, twenty-three qualitative studies were included in this review. The inductive approach was used for analysing qualitative data on cancer care experience in primary, tertiary and transitional care between systems. Three main themes were found in healthcare services from Indigenous cancer care experiences: communication, cultural safety, and access to services. Communication was an important theme for all healthcare systems, including language and literacy, understanding of cancer care pathways and hospital environment, and lack of information. Cultural safety was related to trust in the system, privacy, and racism. Access to health services was the main concern in transitional care between healthcare systems. While some challenges will need long-term and collective efforts, such as institutional racism as a downstream effect of colonisation, cultural training for healthcare providers and increasing the volume of the Indigenous workforce, such as Indigenous Liaison Officers or Indigenous Care Coordinators, could effectively address this inequity issue for Indigenous people with cancer in Australia in a timely manner