Defense Date

2018

Document Type

Thesis

Degree Name

Master of Science

Department

Pharmaceutical Sciences

First Advisor

Dr. Pramit Nadpara

Abstract

Objective: To determine patterns of use, prescription medicine costs, office-based visit costs and quality of life (QOL) across classes of antidepressants/psychotherapy in elderly cancer patients. Methods: Medical Expenditure Panel Survey data files from 2005-2015 for cancer patients with depression aged 18 years or older were used for the study. Frequencies of patients under specific classes of antidepressants/psychotherapy were identified. Costs and QOL scores were compared using Analysis of Variance (ANOVA). Generalized linear models, linear/multinomial logistic regression were used for analyses adjusted for demographics, overall health status, number and type of comorbidities. Results: The study sample consisted of 17,671 cancer patients with depression. 32.08% patients had an antidepressant prescribed whereas 15.30% reported psychotherapy. SSRI (62.44%) was the most frequently prescribed class. The prescription and office-based visits costs were adjusted for demographics, overall health status, number and type of comorbidities. These adjusted prescription costs were the highest for SNRI (Mean = $112.92), adjusted office-based (psychotherapy) visit costs were the highest for those receiving psychotherapy only without any antidepressant (Mean = $166.39/visit). QOL scores were higher amongst patients who had combinations of antidepressants prescribed, specifically SSRI with either a TCA or SNRI as compared to those who were prescribed an individual class or those who did not receive any treatment at all. Conclusion: Antidepressants were prescribed more often than psychotherapy amongst cancer patients with depression in the United States. The prescription costs and associated QOL scores were higher amongst those with antidepressants prescribed as compared to those receiving psychotherapy with or without an antidepressant for cancer patients with depression in the United States.

Rights

© The Author

Is Part Of

VCU University Archives

Is Part Of

VCU Theses and Dissertations

Date of Submission

8-8-2018

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