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

ObjectivesTo identify patient characteristics associated with polypharmacy and inappropriate medication (PIM) use among older patients with newly diagnosed cancer.Materials and MethodsThis is a cross-sectional study conducted in ambulatory oncology clinics at an academic center. Participants included 117 patients aged ≥ 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 ≥ five medications, (Yes/No). PIM use was defined as use of ≥ one medication included in the 2003 update of Beers Criteria, (Yes/No).ResultsThe 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)].ConclusionThere 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.