Oral Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2023

Patterns of cardiovascular medication utilisation in people with cancer: the Australian National Health Survey linked data analysis (#25)

Jin Quan Eugene Tan 1 2 , Huah Shin Ng 1 2 3 , Bogda Koczwara 1 4
  1. Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
  2. SA Pharmacy, Southern Adelaide Local Health Network, Adelaide, South Australia, Australia
  3. SA Pharmacy, Northern Adelaide Local Health Network, Adelaide, South Australia, Australia
  4. Department of Medical Oncology, Flinders Medical Centre, Adelaide, South Australia, Australia

Abstract

Aims: Cardiovascular disease (CVD) is the leading cause of non-cancer death among cancer survivors, but little is known about CVD medication use in the Australian cancer population. We compared the patterns of CVD medication use between people with and without cancer.

Methods: Data of the participants aged ≥25 years from the Australian National Health Survey 2020-21 were linked to the medication dispensing data (Pharmaceutical Benefits Scheme) through the Multi-Agency Data Integration Project. CVD medications were identified by using the Anatomical Therapeutical Chemical Classification and included cardiac therapy, antihypertensives, lipid-lowering, and antithrombotics. Comparisons were made between cancer and non-cancer population using logistic regression models with the estimates expressed as adjusted odds ratios (aOR) and 95% confidence intervals (CI).

Results: The analysis included 1828 people with cancer and 7505 people without cancer.  People with cancer were more likely to be older (57% vs 21% aged ≥65 years) and have a higher burden of comorbidities (85% vs 72% with ≥1 concurrent conditions) and a higher prevalence of CVD (31% vs 13%) compared to people without cancer. Cancer survivors had a higher odds of receiving any CVD medications (aOR 1.29; 95%CI=1.13-1.46) than those without cancer. These results remained significant across different types of CVD medication groups, including antihypertensives (aOR 1.18; 95%CI=1.04-1.34), and antithrombotics (aOR 1.29; 95%CI=1.06-1.55). Several factors were identified to be associated with higher odds of dispensing any CVD medications, including male sex, older age, unemployment, being overweight/obese, and having ≥1 concurrent health conditions.

Conclusions: Cancer survivors had a higher prevalence of CVD and use of CVD medications than people without cancer.  Our findings support the incorporation of cardiovascular risk assessment and management into cancer care plan. Further research is needed to define best practices of monitoring, prevention and management of CVD in cancer survivors.