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. 2020 Jan;29(1):e13185.
doi: 10.1111/ecc.13185. Epub 2019 Nov 6.

Optimising pharmacotherapy in older cancer patients with polypharmacy

Elze Vrijkorte  1 , Jennifer de Vries  2 , Ron Schaafsma  2 , Machteld Wymenga  2 , Thijs Oude Munnink  1   3
Affiliations

Optimising pharmacotherapy in older cancer patients with polypharmacy

Elze Vrijkorte et al. Eur J Cancer Care (Engl). 2020 Jan.

Abstract

Objective: Polypharmacy is frequent among older cancer patients and increases the risk of potential drug-related problems (DRPs). DRPs are associated with adverse drug events, drug-drug interactions and hospitalisations. Since no standardised polypharmacy assessment methods for oncology patients exist, we aimed to develop one that can be integrated into routine care.

Methods: Based on the Systematic Tool to Reduce Inappropriate Prescribing (STRIP), we developed OncoSTRIP, which includes a polypharmacy anamnesis, a concise geriatric assessment, a polypharmacy analysis taking life expectancy into account and an optimised treatment plan. Patients ≥65 years with ≥5 chronic drugs visiting our outpatient oncology clinic were eligible for the polypharmacy assessment.

Results: OncoSTRIP was integrated into routine care of our older cancer patients. In 47 of 60 patients (78%), potential DRPs (n = 101) were found. In total, 85 optimisations were recommended, with an acceptance rate of 41%. It was possible to reduce the number of potential DRPs by 41% and the number of patients with at least one potential DRP by 30%. Mean time spent per patient was 71 min.

Conclusions: Polypharmacy assessment of older cancer patients identifies many pharmacotherapeutic optimisations. With OncoSTRIP, polypharmacy assessments can be integrated into routine care.

Keywords: cancer; deprescribing; drug-related problems; geriatrics; medication assessment; polypharmacy.

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Conflict of interest statement

None to declare.

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