Abstract
Objectives
To identify patient characteristics associated with polypharmacy and inappropriate
medication (PIM) use among older patients with newly diagnosed cancer.
Materials and Methods
This is a cross-sectional study conducted in ambulatory oncology clinics at an academic
center. Participants included 117 patients aged ≥65 years with newly diagnosed histologically confirmed stage I–IV cancer and were enrolled
between April 2008 and September 2009. Medication review, included patient self-report
and medical records. Polypharmacy was defined as the concurrent use of ≥five medications, (Yes/No). PIM use was defined as use of ≥one medication included in the 2003 update of Beers Criteria, (Yes/No).
Results
The prevalence of polypharmacy and PIM use was 80% and 41%, respectively. Three independent
correlates of medication use were identified. An increase in comorbidity count by
one, ECOG-PS score by one, and PIM use by one, was associated with an increase in
medication use by 0.48 (P=0.0002), 0.79 (P=0.01) and 1.22 (P=0.006), respectively. Two independent correlates of PIM use were identified. The odds
of using PIMs decreased by 10% for one unit increase in Body Mass Index [Odds Ratio
(OR) 0.90, 95% CI=(0.84, 0.97)], and increased by 18% for each increase in medication count by one [OR
1.18, 95% CI=(1.04, 1.34)].
Conclusion
There was a high prevalence of polypharmacy and PIM use in older patients with newly
diagnosed cancer. Given the co-occurrence of polypharmacy with poor performance status
and multi-morbidity, multi-dimensional interventions are needed in the geriatric-oncology
population to improve health and cancer outcomes.
Keywords
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Article info
Publication history
Published online: March 14, 2012
Accepted:
February 9,
2012
Received in revised form:
January 27,
2012
Received:
September 19,
2011
Identification
Copyright
© 2012 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
