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Antidepressants to cancer patients during the last year of life—a population-based study

Authors

  • Siri Brelin,

    Corresponding author
    • Oslo University Hospital, Regional Centre for Excellence in Palliative Care, Department of Oncology, Oslo, Norway
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  • Jon Håvard Loge,

    1. Oslo University Hospital, National Resource Centre for Late Effects after Cancer Treatment, Oslo, Norway
    2. University of Oslo, Department of Behavioral Sciences, Oslo, Norway
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  • Svetlana Skurtveit,

    1. Norwegian Institute of Public Health, Department of Pharmacoepidemiology, Division of Epidemiology, Oslo, Norway
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  • Tom Børge Johannesen,

    1. Cancer Registry of Norway, Oslo, Norway
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  • Nina Aass,

    1. Oslo University Hospital, Regional Centre for Excellence in Palliative Care, Department of Oncology, Oslo, Norway
    2. University of Oslo, Faculty of Medicine, Oslo, Norway
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  • Stig Ottesen,

    1. Oslo University Hospital, Regional Centre for Excellence in Palliative Care, Department of Oncology, Oslo, Norway
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  • Marianne Jensen Hjermstad

    1. Oslo University Hospital, Regional Centre for Excellence in Palliative Care, Department of Oncology, Oslo, Norway
    2. European Palliative Care Research Centre, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
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Correspondence to: Regional Centre for Excellence in Palliative Care, Department of Oncology, Oslo University Hospital, Box 4956, Nydalen, Oslo 0424, Norway. E-mail: siri.brelin@gmail.com

Abstract

Objective

Although depression is common among incurable cancer patients, the prescription prevalence of antidepressants (ADs) to these patients is largely unknown. Aims were to examine the prescription prevalence of ADs in the last year of life in a 2-year national cancer death cohort and to examine its associations with sociodemographic and medical variables.

Methods

Nationwide, 20,627 cancer deaths in adults were identified by combining the Norwegian Central Population and Cancer Registries. Individual prescriptions of ADs in the 12 months prior to death were identified in the Norwegian Prescription Database. The study population consisted of 17,753 patients who died from cancer in 2005 and 2006, after excluding patients assumed to be hospitalized whose prescriptions were not registered in the Norwegian Prescription Database.

Results

Twenty-two percent (N = 3836) had at least one prescription of ADs in their last year of life (men 19%/women 25%), compared with 6% in the general population (men 4%/women 8%). Patients who died within 1 year from diagnosis had lower prescription prevalence (20%) than patients with longer disease duration (23%) (p < 0.001). Prescription prevalence increased toward death for both genders, but the prevalence of first-time prescriptions in the last 6 months of life was similar across genders. About 10% of ADs were prescribed for the first time 30 days or less before death.

Conclusion

The prescription prevalence among cancer patients in the last year of life was almost four times higher than in the general population. One of 10 patients was prescribed with ADs so close to death that the clinical effects can be questioned. Copyright © 2012 John Wiley & Sons, Ltd.

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