Impact of a pharmacist and geriatrician medication review on drug-related problems in older outpatients with cancer

• Published in: Journal of geriatric oncology 2021-01, Vol.12 (1), p.57-63
• Main Authors: Choukroun, Chloé, Leguelinel-Blache, Géraldine, Roux-Marson, Clarisse, Jamet, Charlotte, Martin-Allier, Amy, Kinowski, Jean-Marie, Le Guillou, Cédric, Richard, Hélène, Antoine, Valéry
• Format: Article
• Language: English
• Subjects: Aged; Cancer; Comorbidity; Drug utilization review; Frailty; Geriatric assessment; Inappropriate prescribing; Life Sciences; Pharmacist; Polypharmacy; Potentially inappropriate medication list
• ISSN: 1879-4068; 1879-4076
• DOI: 10.1016/j.jgo.2020.07.010

Older patients with cancer have increased risk for comorbidity, polypharmacy (PP) and drug related problems (DRP). The aim of this study was to assess the effect of a clinical pharmacist and geriatrician medication review (MR) among older outpatients with cancer to optimize management of comorbidities during comprehensive geriatric assessment (CGA). We conducted a single-center prospective study among older outpatients with cancer (≥75 years). A pharmacist consultation was added into CGA process. The clinical pharmacist detected and assessed PP and DRP such as potentially inappropriate medications (PIM) according to the Laroche French list and STOPP criteria, START criteria and adverse drug events (ADE) risk. After a multidisciplinary MR, the proposals for prescription modification were sent to general practitioners (GPs). Fifty-one consenting patients were recruited between May 2016 and March 2017, with a median age of 83 years. Prevalence of PP was 80.4%. 165 DRP were detected among 86% patients (median number of DRP = 3.0): 19.4% were misuse, 43.6% underuse, and 37.0% overuse. A significant decrease was observed in prevalence of PIM use (Laroche: 31.4% versus 5.9%, p = 0.002), START criteria (66.7% to 5.9%; P