Reducing Premature Death in Cancer Patients: Adherence to Antidepressants

A study published in Depression & Anxiety found that adherence to antidepressants is associated with a decrease in all‐cause mortality among patients with cancer.

Researchers conducted a four‐year historical prospective cohort study that included 42,075 patients with cancer served by Clalit Health Services, the largest health provider in Israel, who purchased an antidepressant at least once during the study period. Adherence to antidepressants was characterized as non-adherence (<20%), poor (20% to 50%), moderate (50% to 80%), and good (>80%).

Reduced risk of death with moderate antidepressant adherence

The study included 1,051,489 person‐years of follow‐up. During this time, compared with the non-adherent group, the adjusted hazard ratios (HR) for mortality were:

  • 89 (95% CI, 0.83–0.95) for poor adherence
  • 77 (95% CI, 0.66-0.72) for moderate adherence
  • 80 (95% CI, 0.76-0.85) for good adherence

Patients with moderate adherence had a 23% reduction in the risk of death, although adherence above 80% did not appear to confer any additional benefit.

The association between antidepressant adherence and risk of death was observed in patients with breast, colon, lung, and prostate cancers, but not in those with melanoma.

Predictors of premature mortality included male sex (HR=1.48; 95% CI, 1.42-1.55), current or past smoking status (HR=1.1; 95% CI, 1.04-1.15; P<0.0001), low socioeconomic status (HR=1.1; 95% CI, 1.03-1.17; P<0.0001), and more physical comorbidities.

“Our data add to the pressing need to encourage adherence to antidepressants among [patients with] cancer,” the researchers concluded.