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Open AccessArticle

Use of Non-Cancer Medications in New Zealand Women at the Diagnosis of Primary Invasive Breast Cancer: Prevalence, Associated Factors and Effects on Survival

1
Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland 1072, New Zealand
2
Te Aho o Te Kahu, Cancer Control Agency, Wellington 6011, New Zealand
3
Waikato Medical Research Centre, University of Waikato, Hamilton 3240, New Zealand
4
Waikato District Health Board, Hamilton 3240, New Zealand
5
Surgery, School of Medicine, University of Auckland, Auckland 1072, New Zealand
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(21), 7962; https://doi.org/10.3390/ijerph17217962
Received: 28 August 2020 / Revised: 20 October 2020 / Accepted: 26 October 2020 / Published: 29 October 2020
(This article belongs to the Special Issue Co-morbidities, Co-medications and Cancer)
Background: Assessing the use of multiple medications in cancer patients is crucial as such use may affect cancer outcomes. This study reports the prevalence of non-cancer medication use at breast cancer diagnosis, its associated factors, and its effect on survival. Methods: We identified all women diagnosed with primary invasive breast cancer between 1 January 2007 and 31 December 2016, from four population-based breast cancer registries, in Auckland, Waikato, Wellington, and Christchurch, New Zealand. Through linkage to the pharmaceutical records, we obtained information on non-cancer medications that were dispensed for a minimum of 90 days’ supply between one year before cancer diagnosis and first cancer treatment. We performed ordered logistic regressions to identify associated factors and Cox regressions to investigate its effect on patient survival. Results: Of 14,485 patients, 52% were dispensed at least one drug (mean—1.3 drugs; maximum—13 drugs), with a higher prevalence observed in patients who were older, treated at a public facility, more economically deprived, and screen-detected. The use of 2–3 drugs showed a reduced non-breast cancer mortality (HR = 0.75, 95%CI = 0.60–0.92) in previously hospitalised patients, with other groups showing non-significant associations when adjusted for confounding factors. Drug use was not associated with changes in breast cancer-specific mortality. Conclusions: Non-cancer medication use at breast cancer diagnosis was common in New Zealand, more prevalent in older and disadvantaged women, and showed no effect on breast cancer-specific mortality, but a reduction in other cause mortality with the use of 2–3 drugs. View Full-Text
Keywords: breast cancer; medication use; polypharmacy; survival breast cancer; medication use; polypharmacy; survival
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Aye, P.S.; Scott, O.W.; Elwood, J.M.; Sarfati, D.; Lawrenson, R.; Campbell, I.D.; Kuper-Hommel, M.; Tin Tin, S. Use of Non-Cancer Medications in New Zealand Women at the Diagnosis of Primary Invasive Breast Cancer: Prevalence, Associated Factors and Effects on Survival. Int. J. Environ. Res. Public Health 2020, 17, 7962.

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