Long-Term Pattern of Psychotropic Medication Uses Among Swedish Parents of Children Diagnosed With Cancer
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University Clinic Primary Care Skåne, Region Skåne, Sweden
Center for Community-based Healthcare Research and Education (CoHRE), Department of Functional Pathology, School of Medicine, Shimane University, Matsue, Japan
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University Clinic Primary Care Skåne, Region Skåne, Sweden
Center for Community-based Healthcare Research and Education (CoHRE), Department of Functional Pathology, School of Medicine, Shimane University, Matsue, Japan
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Faculty of Health Sciences, University of Macau, Avenida da Universidade, Taipa, 999078, Macau SAR, China
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Background: Parents experience a range of mental health disorders following their child’s cancer diagnosis. It is thus essential to explore how the child’s cancer diagnosis affects the dosage of psychotropic medication in both short- and long-term use, as well as potential disparities in utilization patterns between mothers and fathers. Patients and Methods: Using Swedish registers, we identified all parents whose children were diagnosed with cancer from July 2009 to December 2015 in Sweden. We randomly matched up to 5 parents of cancer-free children conditional on their baseline characteristics. All parents were followed up from 4 years before to 4 years after their child’s diagnosis. Psychotropic medication cumulative defined daily doses (DDDs) were retrieved from the Swedish Prescribed Drug Register. Using interrupted time series analyses, we sought to investigate how childhood cancer diagnosis influences the evolving pattern of parental psychotropic medication dosage across time with consideration for potential differences compared with matched parents before the child’s cancer diagnosis. We calculated the attributable proportion due to the diagnosis of childhood cancer. Results: Following a child’s cancer diagnosis, mothers experienced a steady increase in psychotropic medication use, averaging 4.9 DDDs per year compared with matched comparisons, with a 46.0% adjusted attributable proportion in the initial year. Fathers had an abrupt increase in psychotropic medication use in the first year after diagnosis, with an adjusted attributable proportion of 72.1%. Parents with lower education attainment tended to use more psychotropic medication. Conclusions: In response to a child’s cancer diagnosis, parents showed increased use of psychotropic medication compared with matched comparisons. Additionally, utilization patterns differed between mothers and fathers. Timely prevention and early support for parents are needed to alleviate their psychological challenges, potentially mitigating the strain on medical resources associated with increased psychotropic medication use.
Submitted September 11, 2023; final revision received June 12, 2024; accepted for publication June 13, 2024.
Author contributions: Conceptualization: Liu, J. Sundquist, K. Sundquist, Ji. Data curation: All authors. Formal analysis: Liu, Jiang, Ji. Funding acquisition: J. Sundquist, K. Sundquist, Ji. Investigation: Liu, Jiang. Methodology: Liu, Jiang. Project administration: Liu, J. Sundquist, K. Sundquist, Ji. Resources: J. Sundquist, K. Sundquist, Ji. Software: J. Sundquist, K. Sundquist, Ji. Supervision: J. Sundquist, K. Sundquist, Ji. Validation: Liu, Jiang, K. Sundquist, Ji. Visualization: Liu, Jiang. Writing—original draft: Liu, Jiang. Writing—review & editing: All authors.
Data availability statement: Due to ethical restrictions, the raw data are not publicly available. However, the integrated data supporting the results of this study can be obtained from the corresponding author upon reasonable request and ethics approval.
Disclosures: The authors have disclosed that they have not received any financial consideration from any person or organization to support the preparation, analysis, results, or discussion of this article.
Funding: This work is supported by the Swedish Research Council to J. Ji (2021-01187), MAS Cancer and 111 project (B21024; J. Ji), and ALF grant to K. Sundquist. Y. Liu is supported by China Scholarship Council (grant 202108310036).
Disclaimer: The funding agencies had no role in the design and conduct of the study; in the collection, analysis, and interpretation of the data; or in the preparation, review, or approval of the manuscript. The researchers were independent of the funding agencies.
Supplementary material: Supplementary material associated with this article is available online at https://doi.org/10.6004/jnccn.2024.7048. The supplementary material has been supplied by the author(s) and appears in its originally submitted form. It has not been edited or vetted by JNCCN. All contents and opinions are solely those of the author. Any comments or questions related to the supplementary materials should be directed to the corresponding author.
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