Link Between Polypharmacy and Inpatient Hospitalization in Older Patients With Prostate Cancer?
Posted: Tuesday, April 28, 2020
According to research published in the Journal of Geriatric Oncology, patients with prostate, breast, or lung cancer who were at least 65 years old and received at least five concurrent treatments were more likely to undergo inpatient hospitalization than those taking fewer than five medications. Polypharmacy has previously been associated with increased frailty, morbidity, and mortality in this population group.
Grace Lu-Yao, PhD, of Thomas Jefferson University, Philadelphia, and colleagues used the Surveillance, Epidemiology, and End Results–Medicare database to identify 13,959 patients aged 65 and older who had been diagnosed with prostate (n = 1,430), breast (n = 5,490), or lung cancer (n = 7,309) between 1991 and 2013 and who had undergone intravenous chemotherapy between 2011 and 2014. Patients with lung cancer received the highest number of prescription medications in the 6 months prior to chemotherapy (at a count of 11), followed by patients with prostate cancer (at a count of 10) and patients with breast cancer (at a count of 9). The hospitalization rate after chemotherapy appeared to correlate directly with the number of medications taken by patients before chemotherapy. Patients taking between 5 and 9, 10 and 14, and 15 or more medications before chemotherapy experienced hospitalization rates after chemotherapy that were 42%, 75%, and 114% higher, respectively, than those receiving fewer than 5 medications.
“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,” stated study coauthor Ginah Nightingale, PharmD, also of Thomas Jefferson University, in a Jefferson press release. “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.”
Disclosure: For full disclosures of the study authors, visit geriatriconcology.net.