Polypharmacy Ups Postchemo Hospitalization Risk in Seniors
Findings seen in older patients with prostate, breast, and lung cancers
WEDNESDAY, April 1, 2020 (HealthDay News) -- Older patients taking five or more medications in the six months before intravenous (IV) chemotherapy are at higher risk for postchemotherapy inpatient hospitalizations, according to a study published online March 18 in the Journal of Geriatric Oncology.
Grace Lu-Yao, Ph.D., from Thomas Jefferson University in Philadelphia, and colleagues used data from the Surveillance, Epidemiology, and End Results-Medicare-linked files to identify patients (≥65 years) who were diagnosed with prostate (1,430 patients), breast (5,490 patients), or lung cancer (7,309 patients) in 1991 to 2013 and received IV chemotherapy in 2011 to 2014. Polypharmacy status was determined by the number of medications during the six-month window pre-IV chemotherapy initiation.
The researchers found a high median number of prescription medications during the six-month window pre-IV chemotherapy initiation: 10 among patients with prostate cancer, nine among patients with breast cancer, and 11 among patients with lung cancer. The postchemotherapy hospitalization rate for patients with prostate cancer was 42 percent among those taking five to nine medications, 75 percent for those taking 10 to 14 medications, and 114 percent among those taking ≥15 medications compared with patients taking fewer than five prescriptions. Patterns were similar for patients with breast and lung cancer.
"The question is whether we can work with patients and their multiple health care providers to de-prescribe medicines that might no longer be essential and may interfere with their cancer care," a coauthor said in a statement. "We are in the process of designing a randomized study to test whether we can improve cancer-patient outcomes by reducing the number of medications in the older population of patients."
One author disclosed financial ties to the pharmaceutical and biotechnology industries.