Use of Chronic Prescription Medications and Prevalence of Polypharmacy in Survivors of Childhood Cancer
BackgroundAs survivors of childhood cancer age, development of cancer treatment-related chronic health conditions often occur. This study aimed to describe the pattern of chronic prescription medication use and identify factors associated with polypharmacy among survivors of childhood cancer.Methods...
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doaj-7b79e57e7cf6463c88ffa34dde45d4dc2021-04-01T08:45:12ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2021-04-011110.3389/fonc.2021.642544642544Use of Chronic Prescription Medications and Prevalence of Polypharmacy in Survivors of Childhood CancerCeleste L. Y. Ewig0Yi Man Cheng1Hoi Shan Li2Jasper Chak Ling Wong3Alex Hong Yu Cho4Freddie Man Hong Poon5Chi Kong Li6Chi Kong Li7Chi Kong Li8Yin Ting Cheung9School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, ChinaSchool of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, ChinaSchool of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, ChinaDepartment of Pharmacy, Hong Kong Children’s Hospital, Hong Kong, ChinaDepartment of Pharmacy, Hong Kong Children’s Hospital, Hong Kong, ChinaDepartment of Pharmacy, Hong Kong Children’s Hospital, Hong Kong, ChinaDepartment of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, ChinaHong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong, ChinaDepartment of Oncology and Hematology, The Hong Kong Children’s Hospital, Hong Kong, ChinaSchool of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, ChinaBackgroundAs survivors of childhood cancer age, development of cancer treatment-related chronic health conditions often occur. This study aimed to describe the pattern of chronic prescription medication use and identify factors associated with polypharmacy among survivors of childhood cancer.MethodsThis was a retrospective study conducted at the pediatric oncology long-term follow-up clinic in Hong Kong. Eligible subjects included survivors who were (1) diagnosed with cancer before 18 years old, (2) were at least 3 years post-cancer diagnosis and had completed treatment for at least 30 days, and (3) receiving long-term follow-up care at the study site between 2015 and 2018. Dispensing records of eligible survivors were reviewed to identify medications taken daily for ≥30 days or used on an “as needed” basis for ≥6 months cumulatively within the past 12-month period. Polypharmacy was defined as the concurrent use of ≥5 chronic medications. Multivariable log-binomial modeling was conducted to identify treatment and clinical factors associated with medication use pattern and polypharmacy.ResultsThis study included 625 survivors (mean current age = 17.9 years, standard deviation [SD] = 7.2 years) who were 9.2 [5.2] years post-treatment. Approximately one-third (n = 219, 35.0%) of survivors were prescribed at least one chronic medication. Frequently prescribed medication classes include systemic antihistamines (26.5%), sex hormones (19.2%), and thyroid replacement therapy (16.0%). Overall prevalence of polypharmacy was 5.3% (n = 33). A higher rate of polypharmacy was found in survivors of CNS tumors (13.6%) than in survivors of hematological malignancies (4.3%) and other solid tumors (5.3%) (P = .0051). Higher medication burden was also observed in survivors who had undergone cranial radiation (RR = 6.31; 95% CI = 2.75–14.49) or hematopoietic stem-cell transplantation (HSCT) (RR = 3.53; 95% CI = 1.59–7.83).ConclusionAlthough polypharmacy was observed in a minority of included survivors of childhood cancer, chronic medication use was common. Special attention should be paid to survivors of CNS tumors and survivors who have undergone HSCT or cranial radiation. These individuals should be monitored closely for drug–drug interactions and adverse health outcomes that may result from multiple chronic medications, particularly during hospitalization in an acute care setting.https://www.frontiersin.org/articles/10.3389/fonc.2021.642544/fullchildhood cancer survivorpediatric oncologychronic medication prescriptionspolypharmacymedication utilization |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Celeste L. Y. Ewig Yi Man Cheng Hoi Shan Li Jasper Chak Ling Wong Alex Hong Yu Cho Freddie Man Hong Poon Chi Kong Li Chi Kong Li Chi Kong Li Yin Ting Cheung |
spellingShingle |
Celeste L. Y. Ewig Yi Man Cheng Hoi Shan Li Jasper Chak Ling Wong Alex Hong Yu Cho Freddie Man Hong Poon Chi Kong Li Chi Kong Li Chi Kong Li Yin Ting Cheung Use of Chronic Prescription Medications and Prevalence of Polypharmacy in Survivors of Childhood Cancer Frontiers in Oncology childhood cancer survivor pediatric oncology chronic medication prescriptions polypharmacy medication utilization |
author_facet |
Celeste L. Y. Ewig Yi Man Cheng Hoi Shan Li Jasper Chak Ling Wong Alex Hong Yu Cho Freddie Man Hong Poon Chi Kong Li Chi Kong Li Chi Kong Li Yin Ting Cheung |
author_sort |
Celeste L. Y. Ewig |
title |
Use of Chronic Prescription Medications and Prevalence of Polypharmacy in Survivors of Childhood Cancer |
title_short |
Use of Chronic Prescription Medications and Prevalence of Polypharmacy in Survivors of Childhood Cancer |
title_full |
Use of Chronic Prescription Medications and Prevalence of Polypharmacy in Survivors of Childhood Cancer |
title_fullStr |
Use of Chronic Prescription Medications and Prevalence of Polypharmacy in Survivors of Childhood Cancer |
title_full_unstemmed |
Use of Chronic Prescription Medications and Prevalence of Polypharmacy in Survivors of Childhood Cancer |
title_sort |
use of chronic prescription medications and prevalence of polypharmacy in survivors of childhood cancer |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Oncology |
issn |
2234-943X |
publishDate |
2021-04-01 |
description |
BackgroundAs survivors of childhood cancer age, development of cancer treatment-related chronic health conditions often occur. This study aimed to describe the pattern of chronic prescription medication use and identify factors associated with polypharmacy among survivors of childhood cancer.MethodsThis was a retrospective study conducted at the pediatric oncology long-term follow-up clinic in Hong Kong. Eligible subjects included survivors who were (1) diagnosed with cancer before 18 years old, (2) were at least 3 years post-cancer diagnosis and had completed treatment for at least 30 days, and (3) receiving long-term follow-up care at the study site between 2015 and 2018. Dispensing records of eligible survivors were reviewed to identify medications taken daily for ≥30 days or used on an “as needed” basis for ≥6 months cumulatively within the past 12-month period. Polypharmacy was defined as the concurrent use of ≥5 chronic medications. Multivariable log-binomial modeling was conducted to identify treatment and clinical factors associated with medication use pattern and polypharmacy.ResultsThis study included 625 survivors (mean current age = 17.9 years, standard deviation [SD] = 7.2 years) who were 9.2 [5.2] years post-treatment. Approximately one-third (n = 219, 35.0%) of survivors were prescribed at least one chronic medication. Frequently prescribed medication classes include systemic antihistamines (26.5%), sex hormones (19.2%), and thyroid replacement therapy (16.0%). Overall prevalence of polypharmacy was 5.3% (n = 33). A higher rate of polypharmacy was found in survivors of CNS tumors (13.6%) than in survivors of hematological malignancies (4.3%) and other solid tumors (5.3%) (P = .0051). Higher medication burden was also observed in survivors who had undergone cranial radiation (RR = 6.31; 95% CI = 2.75–14.49) or hematopoietic stem-cell transplantation (HSCT) (RR = 3.53; 95% CI = 1.59–7.83).ConclusionAlthough polypharmacy was observed in a minority of included survivors of childhood cancer, chronic medication use was common. Special attention should be paid to survivors of CNS tumors and survivors who have undergone HSCT or cranial radiation. These individuals should be monitored closely for drug–drug interactions and adverse health outcomes that may result from multiple chronic medications, particularly during hospitalization in an acute care setting. |
topic |
childhood cancer survivor pediatric oncology chronic medication prescriptions polypharmacy medication utilization |
url |
https://www.frontiersin.org/articles/10.3389/fonc.2021.642544/full |
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