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. 2023 Jun 23;23(1):585.
doi: 10.1186/s12885-023-10939-7.

Impact of polypharmacy and comorbidity on survival and systemic parenteral treatment administration in a cohort of hospitalized lung-cancer patients

Hélène Pluchart  1   2   3 , Sébastien Bailly  4 , Sébastien Chanoine  5   6   7 , Denis Moro-Sibilot  6   7   8 , Pierrick Bedouch  5   6   9 , Anne-Claire Toffart  6   7   8
Affiliations

Impact of polypharmacy and comorbidity on survival and systemic parenteral treatment administration in a cohort of hospitalized lung-cancer patients

Hélène Pluchart et al. BMC Cancer. .

Abstract

Background: Although polypharmacy has been described among cancer patients, very few studies have focused on those with lung cancer. We aimed to assess whether polypharmacy and comorbidity have an impact on systemic parenteral treatment administration and survival among lung-cancer patients.

Methods: In this retrospective monocenter cohort study, we included patients hospitalized in thoracic oncology for the first time between 2011 and 2015. The Elixhauser score was used to assess comorbidity and polypharmacy was estimated with a threshold of at least five prescribed medications. The Fine and Gray competitive risk model was used to estimate the impact of polypharmacy and comorbidity on systemic parenteral treatment administration within the first two months of hospitalization. The effect of comorbidity and polypharmacy on overall survival was evaluated by Cox proportional hazards analysis.

Results: In total, 633 patients were included (71% men), with a median age of 66 years. The median Elixhauser score was 6 and median overall survival was four months. Among the patients, 24.3% were considered to be receiving polypharmacy, with a median number of medications of 3, and 49.9% received systemic parenteral treatment within two months after hospitalization. Severe comorbidity (Elixhauser score > 11), but not polypharmacy, was independently associated with a lower rate of systemic parenteral treatment prescription (SdHR = 0.4 [0.3;0.6], p < 0.01) and polypharmacy, but not a high comorbidity score, was independently associated with poorer four-month survival (HR = 1.4 [1.1;1.9], p < 0.01) CONCLUSIONS: This first study to evaluate the consequences of comorbidity and polypharmacy on the care of lung-cancer patients shows that a high comorbidity burden can delay systemic parenteral treatment administration, whereas polypharmacy has a negative impact on four-month survival.

Keywords: Comorbidity; Lung cancer; Polypharmacy; Survival.

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Conflict of interest statement

HP, SB, SC, PB have nothing to disclose. ACT received personal fees and non-financial support from Astra Zeneca, BMS, MSD, Novartis, Boehringer Ingelheim, Roche, Pfizer. DMS received grants from Roche, Astra Zeneca, BMS, Boehringer Ingelheim, Abbvie, Pfizer; received personal fees from Roche, Astra Zeneca, BMS, MSD, Lilly, Takeda, Boehringer Ingelheim, Abbvie, Becton Dickinson, Pfizer, Novartis; received non-financial support from Roche, Astra Zeneca, BMS, MSD, Lilly, Takeda, Boehringer Ingelheim and Pfizer.

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