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Multiple Drug Use Common in Geriatric Cancer Patients

Health care providers must be vigilant about polypharmacy to curb its negative outcomes

THURSDAY, July 7 (HealthDay News) -- Polypharmacy is a worldwide problem in elderly cancer patients, and health care providers need to take measures to avoid it, according to a review published online July 7 in The Lancet Oncology.

Judith Lees, from the Royal Adelaide Hospital Cancer Centre in Australia, and Alexandre Chan, Pharm.D., from the National University of Singapore, reviewed available literature published between 1996 and 2010 to examine the clinical implications of polypharmacy in elderly people diagnosed with cancer. The investigators gave practical recommendations for drug management of elderly patients with cancer.

The investigators found that polypharmacy in elderly patients with cancer is a recognized issue worldwide. The elderly with concurrent comorbidities who visit several doctors, and have prescriptions dispensed at several pharmacies, are at highest risk from polypharmacy. Its negative outcomes include adverse drug reactions, drug interactions, and increased health care costs. The likelihood of drug interactions increases with the number of prescribed drugs and initiation of oral cytotoxic drugs. Drug histories are often inaccurate with involvement of more than one health care provider, and at various health care levels. Elderly patients often do not disclose use of complementary and alternative medicines, which they believe will improve quality of life and fight cancer, and are safe and natural. Key recommendations include increasing awareness of clinically meaningful drug interactions by health professionals, screening patients for drug interactions, and discontinuation of potentially inappropriate medications with proper planning, communication, and monitoring.

"Health care providers need to be vigilant if they are to curb the negative outcomes of polypharmacy in all elderly patients, but perhaps especially in those diagnosed with cancer," the authors write.

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