(325) Utilization of Psychotropic Medications Among Patients Diagnosed with Glioma: A Multinational Drug Utilisation Study

Background: Psychiatric comorbid conditions are well documented in patients with glioma and considerable overlap exists between the symptoms of glioma and psychiatric conditions. However, little is known about the use of psychotropic medications in these patients.

Objectives: We aimed to describe psychotropic drug utilization among patients with glioma, compared to cancer-free individuals in four European countries.

Methods: Data sources included the Secured Anonymised Information Linkage (SAIL) Databank from Wales (2000-2018) and nationwide health registries from Denmark (1999-2018), Sweden (2006- 2020) and Norway (2004-2021). All incident glioma cases were matched to a cancer-free comparison cohort on age and sex. We calculated rates of new psychotropic prescriptions and total psychotropic prescriptions during the two years prior and post glioma diagnosis date. Analyses were stratified by histological subtypes and subclasses of psychotropic medications.

Results: In total, we identified 16,007 glioma patients and 141,301 comparators. The rate of new psychotropic prescriptions increased starting from seven months before diagnosis and peaked at the month of diagnosis in patients with glioma in all datasets with peak incidence rates ranging from 225 prescriptions per 1,000 persons per month in Wales to 753 prescriptions per 1,000 persons per month in Sweden. The rate of new psychotropic prescriptions remained substantially higher among glioma patients than comparators throughout the 2-year follow-up period after glioma diagnosis, though, rates of new use continued to decline throughout. Rates in new and total psychotropic prescriptions varied between drug classes, with the highest new use rates observed for antiepileptics (highest rate observed in Sweden at 391 prescriptions per 1,000 persons per month), which appeared to be the main driver of overall utilization patterns. Although overall patterns were similar when analyses were stratified by histological subtype, patterns were more pronounced for patients with diffuse astrocytoma, with the highest rates of new psychotropic treatment observed in this group (highest rate observed in Sweden at 1,008 prescriptions per 1,000 persons per month).

Conclusions: This multinational study illustrates varying utilization patterns in psychotropic medications during the periods preceding and following a glioma diagnosis. Elevations in psychotropic drug use, largely antiepileptics, were observed from seven months pre-diagnosis, and during the two years following diagnosis and are likely associated with the consequences of disease. These results also have important implications for design considerations for future studies investigating psychotropic drug use and glioma.