Study Shows Inappropriate Medication Use Among Older Patients with Cancer

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A pharmacist-led medication assessment demonstrated high prevalence of polypharmacy and potentially inappropriate medication use in seniors.
A pharmacist-led medication assessment demonstrated high prevalence of polypharmacy and potentially inappropriate medication use in seniors.

A pharmacist-led comprehensive medication assessment demonstrated a high prevalence of polypharmacy, excessive polypharmacy, and potentially inappropriate medication use, a study published in the Journal of Clinical Oncology has shown.1

Polypharmacy and potentially inappropriate medication use are known to be associated with increased risk of falls and/or fractures, cognitive impairment, and delirium, particularly among older adults who are prescribed many medications.

Those with cancer have even more complex medication regimens and undergo various medication changes, putting them at an increased risk for adverse drug events, drug-drug interactions, and nonadherence.

To reduce the risk of polypharmacy and potentially inappropriate medication use, a comprehensive medication review should be included in the geriatric oncology assessment.1

A medication reconciliation performed by pharmacists can reduce the frequency and severity of hospital medication errors that could potentially results in patient harm, according to a statement on the pharmacist's role in medication reconciliation by American Society of Health-System Pharmacists (ASHP); however, previous studies that have evaluated the use of pharmacist-led medication assessment in ambulatory senior adults with cancer are scarce, limited by their outdated criteria and screening tools, and failed to examine polypharmacy.1,2

Therefore, researchers at Thomas Jefferson University Hospital in Philadelphia, PA, sought to assess the effect of a pharmacist-led medication on polypharmacy, excessive polypharmacy, and potentially inappropriate medication use in ambulatory senior adults with cancer.1

RELATED: Many Older Oncology Patients Take Multiple Medications Inappropriately

For the study, researchers identified 248 patients who received a geriatric oncology assessment led by a pharmacist. Patients' mean age was 79.9 years and 87% of patients had solid tumors. The mean number of medications used was 9.23.1

Results showed that the prevalence of polypharmacy, excessive polypharmacy, and potentially inappropriate medication use was 41%, 43%, and 51%, respectively.

Using the 2012 Beers criteria, researchers identified potentially inappropriate medication use occurrences in 40% of patients versus 38% using the STOPP criteria and 21% with the HEDIS criteria.

Researchers found that potentially inappropriate medication use was associated with polypharmacy (P < 0.001) and increased comorbidities (P = 0.005).1

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