scholarly journals 2163 Polypharmacy and patterns of prescription medication use among cancer survivors

2018 ◽  
Vol 2 (S1) ◽  
pp. 85-86
Author(s):  
Caitlin Murphy ◽  
Hannah Fullington ◽  
Carlos Alvarez ◽  
Simon C. Lee ◽  
Andrea Betts ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Adverse Drug Events ◽  
Medical Expenditure Panel Survey ◽  
Medication Use ◽  
Prescription Medication ◽  
The United States ◽  
Abuse Potential ◽  
Medical Expenditure ◽  
Adolescent And Young Adult ◽  
Increased Risk

OBJECTIVES/SPECIFIC AIMS: The population of cancer survivors is rapidly growing in the United States. Long term and late effects of cancer, combined with ongoing management of other chronic conditions, make cancer survivors particularly vulnerable to polypharmacy and its adverse effects. We examined patterns of prescription medication use and polypharmacy in a population-based sample of cancer survivors. METHODS/STUDY POPULATION: Using data from the Medical Expenditure Panel Survey (MEPS), we matched cancer survivors (n=5216) to noncancer controls (n=19,588) by age, sex, and survey year. We defined polypharmacy as using 5 or more unique medications. We also estimated proportion of respondents prescribed specific medications within therapeutic classes and total prescription expenditures. RESULTS/ANTICIPATED RESULTS: A higher proportion of cancer survivors were prescribed 5 or more unique medications (64.0%, 95% CI 62.3%–65.8%) compared with noncancer controls (51.5%, 95% CI 50.4%–52.6%), including drugs with abuse potential. Across all therapeutic classes, a higher proportion of newly (≤1 year since diagnosis) and previously (>1 years since diagnosis) diagnosed survivors were prescribed medications compared to controls, with large differences in central nervous system agents (65.8% vs. 57.4% vs. 46.2%), psychotherapeutic agents (25.4% vs. 26.8% vs. 18.3%), and gastrointestinal agents (31.9% vs. 29.6% vs. 22.0%). Specifically, nearly 10% of cancer survivors were prescribed benzodiazepines and/or opioids compared to about 5% of controls. Survivors had more than double prescription expenditures (median $1633 vs. $784 among noncancer controls). Findings persisted similarly across categories of age and comorbidity. DISCUSSION/SIGNIFICANCE OF IMPACT: Cancer survivors were frequently prescribed a higher number of unique medications and inappropriate medications or drugs with abuse potential, increasing risk of adverse drug events, financial toxicity, poor adherence, and drug-drug interactions. Adolescent and young adult survivors appear at increased risk of polypharmacy.

scholarly journals Socioeconomic and Demographic Factors for Spousal Resemblance in Obesity Status and Habitual Physical Activity in the United States

2014 ◽  
Vol 2014 ◽  
pp. 1-11 ◽  
Author(s):  
Hsin-Jen Chen ◽  
Yinghui Liu ◽  
Youfa Wang
Keyword(s):  
Physical Activity ◽  
Weight Status ◽  
Medical Expenditure Panel Survey ◽  
Demographic Factors ◽  
Married Couples ◽  
The United States ◽  
Habitual Physical Activity ◽  
Medical Expenditure ◽  
Increased Risk ◽  
Socioeconomic And Demographic Factors

Studies suggested that the married population has an increased risk of obesity and assimilation between spouses’ body weight. We examined what factors may affect married spouses’ resemblance in weight status and habitual physical activity (HPA) and the association of obesity/HPA with spouses’ sociodemoeconomic characteristics and lifestyles. Medical Expenditure Panel Survey data of 11,403 adult married couples in the US during years 2006–2008 were used. Absolute-scale difference and relative-scale resemblance indices (correlation and kappa coefficients) in body mass index (BMI) and HPA were estimated by couples’ socioeconomic and demographic characteristics. We found that spousal difference in BMI was smaller for couples with a lower household income, for who were both unemployed, and for older spouses. Correlation coefficient between spouses’ BMI was 0.24, differing by race/ethnicity and family size. Kappa coefficient for weight status (obesity: BMI ≥ 30, overweight: 30 > BMI ≥ 25) was 0.11 and 0.35 for HPA. Never-working women’s husbands had lower odds of obesity than employed women’s husbands (OR = 0.69 (95% CI = 0.53–0.89)). Men’s unemployment status was associated with wives’ greater odds of obesity (OR = 1.31 (95% CI = 1.01–1.71)). HPA was associated with men’s employment status and income level, but not with women’s. The population representative survey showed that spousal resemblance in weight status and HPA varied with socioeconomic and demographic factors.

scholarly journals Employment Outcomes Among Cancer Survivors in the United States: Implications for Cancer Care Delivery

2020 ◽  
Author(s):  
Janet S de Moor ◽  
Erin E Kent ◽  
Timothy S McNeel ◽  
Katherine S Virgo ◽  
Jennifer Swanberg ◽  
...  
Keyword(s):  
United States ◽  
Cancer Survivors ◽  
Medical Expenditure Panel Survey ◽  
Care Delivery ◽  
The United States ◽  
Medical Expenditure ◽  
Panel Survey ◽  
Part Time ◽  
Patient Provider Communication ◽  
National Prevalence

Abstract The national prevalence of employment changes after a cancer diagnosis has not been fully documented. Cancer survivors who worked for pay at or since diagnosis (n = 1490) were identified from the 2011, 2016, and 2017 Medical Expenditure Panel Survey and Experiences with Cancer supplement. Analyses characterized employment changes due to cancer and identified correlates of those employment changes. Employment changes were made by 41.3% (95% confidence interval [CI] = 38.0% to 44.6%) of cancer survivors, representing more than 3.5 million adults in the United States. Of these, 75.4% (95% CI = 71.3% to 79.2%) took extended paid time off and 46.1% (95% CI = 41.6% to 50.7%) made other changes, including switching to part-time or to a less demanding job. Cancer survivors who were younger, female, non-White, or multiple races and ethnicities, and younger than age 20 years since last cancer treatment were more likely to make employment changes. Findings highlight the need for patient-provider communication about the effects of cancer and its treatment on employment.

National Trends in Diabetes Medication Use in the United States: 2008 to 2015

2018 ◽  
Vol 33 (4) ◽  
pp. 433-442 ◽  
Author(s):  
Amit D. Raval ◽  
Ami Vyas
Keyword(s):  
Glucose Transporter ◽  
Medical Expenditure Panel Survey ◽  
Medication Use ◽  
The United States ◽  
Sglt2 Inhibitors ◽  
Medical Expenditure ◽  
Prescription Data ◽  
Diabetes Medication ◽  
Receptor Agonists ◽  
Glucose Transporter 2

Background Data on trends of diabetes medications use are sparse, outdated, and limited to prescription data. We determined trends in diabetes medication use among US individuals with diabetes during 2008-2015. Methods We used 2008-2015 Medical Expenditure Panel Survey to examine diabetes medication utilization among individuals aged ≥18 years with diabetes. Prescription medications were classified based on therapeutic class and subclass using Multum Lexicon database. Results From 2008 to 2015, use of any diabetes medication (81.4% vs. 87%), metformin (47.8% vs. 59.0%), and insulin (23.0% vs. 31.0%) increased, whereas, use of sulfonylurea (36.0% vs. 29.0%) and thiazolidinedione (21% vs. 9.0%) declined. A linear increase was observed in the uptake of dipeptidyl peptidase-4 (DPP-4) inhibitors from 6.2% in 2008 to 12.4% in 2015; glucagon-like peptide-1 (GLP-1) receptor agonists from 2.5% in 2008 to 4.4% in 2015 and sodium glucose transporter-2 (SGLT2) inhibitors from 0.8% in 2014 (the first SGLT2 inhibitors approval year) to 4.4% in 2015. Monotherapy use increased from 50.6% to 56.4% during 2008-2015, while triple therapy use declined. Conclusions Metformin, insulin and sulfonylureas remained the top-three prescribed classes of diabetes medications. Increased use of DPP-4 inhibitors, GLP-1 receptor agonists and SGLT2 inhibitors was offset by decline in TZDs use.

scholarly journals Financial Hardship Associated With Cancer in the United States: Findings From a Population-Based Sample of Adult Cancer Survivors

2016 ◽  
Vol 34 (3) ◽  
pp. 259-267 ◽  
Author(s):  
K. Robin Yabroff ◽  
Emily C. Dowling ◽  
Gery P. Guy ◽  
Matthew P. Banegas ◽  
Amy Davidoff ◽  
...  
Keyword(s):  
United States ◽  
Cancer Survivors ◽  
Family Income ◽  
Medical Expenditure Panel Survey ◽  
The United States ◽  
Population Based ◽  
Financial Hardship ◽  
Medical Expenditure ◽  
Logistic Regression Models ◽  
Adult Cancer Survivors

Purpose To estimate the prevalence of financial hardship associated with cancer in the United States and identify characteristics of cancer survivors associated with financial hardship. Methods We identified 1,202 adult cancer survivors diagnosed or treated at ≥ 18 years of age from the 2011 Medical Expenditure Panel Survey Experiences With Cancer questionnaire. Material financial hardship was measured by ever (1) borrowing money or going into debt, (2) filing for bankruptcy, (3) being unable to cover one’s share of medical care costs, or (4) making other financial sacrifices because of cancer, its treatment, and lasting effects of treatment. Psychological financial hardship was measured as ever worrying about paying large medical bills. We examined factors associated with any material or psychological financial hardship using separate multivariable logistic regression models stratified by age group (18 to 64 and ≥ 65 years). Results Material financial hardship was more common in cancer survivors age 18 to 64 years than in those ≥ 65 years of age (28.4% v 13.8%; P < .001), as was psychological financial hardship (31.9% v 14.7%, P < .001). In adjusted analyses, cancer survivors age 18 to 64 years who were younger, female, nonwhite, and treated more recently and who had changed employment because of cancer were significantly more likely to report any material financial hardship. Cancer survivors who were uninsured, had lower family income, and were treated more recently were more likely to report psychological financial hardship. Among cancer survivors ≥ 65 years of age, those who were younger were more likely to report any financial hardship. Conclusion Cancer survivors, especially the working-age population, commonly experience material and psychological financial hardship.

scholarly journals Is Cancer History Associated With Assets, Debt, and Net Worth in the United States?

2018 ◽  
Vol 2 (2) ◽  
Author(s):  
Maryam Doroudi ◽  
Diarmuid Coughlan ◽  
Matthew P Banegas ◽  
Xuesong Han ◽  
K Robin Yabroff
Keyword(s):  
United States ◽  
Cancer Survivors ◽  
Medical Expenditure Panel Survey ◽  
Statistical Tests ◽  
The United States ◽  
Financial Hardship ◽  
Medical Expenditure ◽  
Public Health Issue ◽  
Cancer History ◽  
Net Worth

Abstract Background Financial hardships experienced by cancer survivors have become a prominent public health issue in the United States. Few studies of financial hardship have assessed financial holdings, including assets, debts, and their values, associated with a cancer history. Methods Using the 2008–2011 Medical Expenditure Panel Survey, we identified 1603 cancer survivors and 34 915 individuals age 18–64 years without a cancer history to assess associations between self-reported cancer history and assets, debts, and net worth. Distributions of self-reported asset and debt ownership, their values, and net worth were compared for adults with and without a cancer history with chi-square statistics. Multivariable ordered probit regression analysis was conducted to assess the association between cancer history and net worth using a two-sided Wald test. All analyses were stratified by age group (18–34, 35–44, 45–54, and 55–64 years). Statistical tests were two-sided. Results Among those age 45–54 years, cancer survivors had a lower proportion of home ownership than individuals without a cancer history (59.0% vs 67.1%, P = .0014) and were statistically significantly more likely to have negative net worth (≤–$3000) and less likely to have positive net worth (≥$3000). Cancer survivors were more likely to have debt than individuals without a cancer history, especially among those age 18–34 years (41.3% vs 27.1%, P < .001). Conclusions Cancer history is associated with lower asset ownership, more debt, and lower net worth, especially in survivors age 45–54 years. Longitudinal studies of financial holdings will be important to inform development of interventions to reduce financial hardship.

scholarly journals Is Health Insurance Literacy Associated With Financial Hardship Among Cancer Survivors? Findings From a National Sample in the United States

2019 ◽  
Vol 3 (4) ◽  
Author(s):  
Jingxuan Zhao ◽  
Xuesong Han ◽  
Zhiyuan Zheng ◽  
Matthew P Banegas ◽  
Donatus U Ekwueme ◽  
...  
Keyword(s):  
United States ◽  
Health Insurance ◽  
Cancer Survivors ◽  
Medical Expenditure Panel Survey ◽  
Age Groups ◽  
The United States ◽  
Financial Hardship ◽  
Medical Expenditure ◽  
Adult Cancer Survivors ◽  
Health Insurance Literacy

Abstract Little is known about the association between health insurance literacy and financial hardship among cancer survivors. Using the 2016 Medical Expenditure Panel Survey Experiences with Cancer self-administered questionnaire, we evaluated the associations between health insurance literacy and medical financial hardship and nonmedical financial sacrifices among adult cancer survivors in the United States. Of the survivors, 18.9% aged 18–64 years and 14.6% aged 65 years and older reported health insurance literacy problems. In both age groups (18–64 and ≥65 years), from multivariable logistic regressions, survivors with health insurance literacy problems were more likely to report any material (adjusted odds ratio [AOR] = 3.02, 95% confidence interval [CI] = 1.53 to 5.96; AOR = 3.33, 95% CI = 1.69 to 6.57, respectively) or psychological (AOR = 5.53, 95% CI = 2.35 to 13.01; AOR = 8.79, 95% CI = 4.55 to 16.97, respectively) hardship, as well as all types of nonmedical financial sacrifices than those without these problems. Future longitudinal studies are warranted to test causality and assess whether improving health insurance literacy can mitigate financial hardship.

scholarly journals Health Costs of Older Opioid Users with Pain and Comorbid Hypercholesterolemia or Hypertension in the United States

Diseases ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 41
Author(s):  
David R. Axon ◽  
Srujitha Marupuru ◽  
Shannon Vaffis
Keyword(s):  
United States ◽  
Healthcare Expenditure ◽  
Medical Expenditure Panel Survey ◽  
Prescription Medication ◽  
The United States ◽  
Medical Expenditure ◽  
Future Research ◽  
Linear Regression Models ◽  
Healthcare Expenditures ◽  
Opioid Users

This retrospective cross-sectional database study used 2018 Medical Expenditure Panel Survey data to quantify and assess differences in healthcare expenditures between opioid users and non-users among a non-institutionalized sample of older (≥50 years) United States adults with pain in the past four weeks and a diagnosis of comorbid hypercholesterolemia (pain–hypercholesterolemia group) or hypertension (pain–hypertension group). Hierarchical multivariable linear regression models were constructed by using logarithmically transformed positive cost data and adjusting for relevant factors to assess cost differences between groups. Percent difference between opioid users and non-users was calculated by using semi-logarithmic equations. Healthcare costs included inpatient, outpatient, office-based, emergency room, prescription medication, other, and total costs. In adjusted analyses, compared to non-users, opioid users in the pain–hypercholesterolemia and pain–hypertension groups respectively had 66% and 60% greater inpatient expenditure, 46% and 55% greater outpatient expenditure, 67% and 72% greater office-based expenditure, 50% and 60% greater prescription medication expenditure, 24% and 22% greater other healthcare expenditure, and 85% and 93% greater total healthcare expenditure. In conclusion, adjusted total healthcare expenditures were 85–93% greater among opioid users versus non-users in older United States adults with pain and comorbid hypercholesterolemia or hypertension. Future research is needed to identify opioid use predictors among these populations and reduce expenditures.

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