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

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• 作者：Gopi K. Prithviraj^a ; Siran Koroukian^b ; ^c ; Seunghee Margevicius^c ; Nathan A. Berger^a ; ^b ; ^d ; Rakesh Bagai^e ; Cynthia Owusu^a ; ^b ; ^d ; ^{Cynthia.owusu@case.edu}
• 关键词：Polypharmacy ; Inappropriate prescribing ; Older ; Cancer
• 刊名：Journal of Geriatric Oncology
• 出版年：2012
• 出版时间：July, 2012
• 年：2012
• 卷：3
• 期：3
• 页码：228-237
• 全文大小：277 K

文摘

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 ?#xA0;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 ?#xA0;five medications, (Yes/No). PIM use was defined as use of ?#xA0;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.