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Polypharmacy and Potentially Inappropriate Medications: Predictors of Frailty in Older Patients With Hematologic Malignancies?

By: Jenna Carter, PhD
Posted: Monday, October 24, 2022

Potentially inappropriate medications and polypharmacy are prevalent in older adults with hematologic malignancies, although their impact on frailty remains unclear. Tammy T. Hshieh MD, MPH, of Brigham and Women's Hospital, Boston, and colleagues examined the prevalence of polypharmacy and potentially inappropriate medications in a large cohort of patients with blood cancers and their definitions’ cross-sectional associations with frailty and cognitive impairment. Their findings, which were published in JNCCN–Journal of the National Comprehensive Cancer Network, highlighted that 77% of patients examined were taking five or more medications. They also found that 55% of patients were taking eight or more medications, and this number was significantly associated with frailty. Furthermore, with each additional medication, the odds of being prefrail or frail increased 8%. Based on these findings, the study authors suggested careful medication reconciliation for this population may be helpful.

Data from 785 eligible patients enrolled in the Older Adult Hematologic Malignancies (OHM) Program were used in this study. Frailty was determined via deficit accumulation and phenotypic approaches, and the total number of medications and potentially inappropriate medications were quantified using the Anticholinergic Risk Scale and the Geriatric Oncology Potentially Inappropriate Medications scale. Cross-sectional associations of potentially inappropriate medications with frailty were assessed using multivariable regression models adjusting for age, gender, and comorbidity.

Overall findings revealed that 201 patients (25%) were taking at least one potentially inappropriate medication based on the Anticholinergic Risk Scale, and 343 patients (44%) were taking at least one potentially inappropriate medication based on the other scale assessed. Taking eight or more medications was associated with frailty (adjusted odds ratio [aOR] = 2.82; 95% confidence interval [CI] = 1.92%–4.17%). Additional findings revealed that with each additional medication, the odds of being prefrail or frail increased 8% (aOR = 1.08; 95% CI = 1.04%–1.12%).

Disclosure: For full disclosures of the study authors, visit jnccn.org.


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