Medication optimization in older adults with advanced cancer and a limited life expectancy: A prospective observational study.

Autor: Brokaar EJ; Department of Pharmacy, Haga Teaching Hospital, PO Box 40551, 2504 LN The Hague, the Netherlands. Electronic address: e.brokaar@hagaziekenhuis.nl., Visser LE; Department of Pharmacy, Haga Teaching Hospital, PO Box 40551, 2504 LN The Hague, the Netherlands; Department of Hospital Pharmacy, Erasmus Medical Center, PO Box 2040, 3000 CA Rotterdam, the Netherlands; Department of Epidemiology, Erasmus Medical Center, PO Box 2040, 3000 CA Rotterdam, the Netherlands. Electronic address: l.e.visser@erasmusmc.nl., van den Bos F; Department of Gerontology & Geriatrics, University Medical Center Leiden, PO Box 9600, 2300 RC Leiden, the Netherlands. Electronic address: F.van_den_Bos@lumc.nl., Portielje JEA; Department of Internal Medicine - Medical Oncology, University Medical Center Leiden, PO Box 9600, 2300 RC Leiden, the Netherlands. Electronic address: J.E.A.Portielje@lumc.nl.
Jazyk: angličtina
Zdroj: Journal of geriatric oncology [J Geriatr Oncol] 2023 Nov; Vol. 14 (8), pp. 101606. Date of Electronic Publication: 2023 Aug 19.
DOI: 10.1016/j.jgo.2023.101606
Abstrakt: Introduction: Polypharmacy is common in older adults with cancer and is associated with drug related problems (DRPs) and potentially inappropriate medication (PIM). We introduced a medication optimization care pathway for older adults with advanced cancer and a limited life expectancy and studied the prevalence of DRPs and PIMs as well as the adherence to medication-related recommendations and the patient satisfaction.
Materials and Methods: A medication review was performed in patients aged ≥65 years with polypharmacy and a life expectancy of <24 months. Recommendations on adjustments of medication were discussed in a multidisciplinary team including a pharmacist, an oncologist, and a geriatrician. Implementation of the recommendations was left to the discretion of the oncologist. Four weeks after the implementation, the patient filled a questionnaire to assess satisfaction.
Results: One hundred twenty patients were included. The mean age was 75 years and 39% were female. A mean of 12 medications was used. The median number of DRP was 6.0 per patient and median number of PIMs was 3.0 per patient. Overtreatment accounted for 26% of DRP and the most frequently involved drug classes were antihypertensive medication (22%), non-opioid analgesics (22%), and antilipemics (12%). The multidisciplinary team accepted 78% of the recommendations of the pharmacist and the oncologist implemented 54% of the recommendations. Overall, patients were satisfied or very satisfied with the intervention.
Discussion: DRPs and PIMs are highly prevalent in this population and can be reduced by a multidisciplinary medication optimization intervention. Patients appreciate the medication optimization intervention and are satisfied with the intervention.
Competing Interests: Declaration of Competing Interest The authors have no competing interests to declare.
(Copyright © 2023 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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