Patient characteristics associated with polypharmacy and inappropriate prescribing of medications among older adults with cancer

• Published in: Journal of geriatric oncology 2012-07, Vol.3 (3), p.228-237
• Main Authors: Prithviraj, Gopi K, Koroukian, Siran, Margevicius, Seunghee, Berger, Nathan A, Bagai, Rakesh, Owusu, Cynthia
• Format: Article
• Language: English
• Subjects: Cancer; Hematology, Oncology and Palliative Medicine; Inappropriate prescribing; Internal Medicine; Older; Polypharmacy
• ISSN: 1879-4068; 1879-4076
• DOI: 10.1016/j.jgo.2012.02.005

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.