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Prevalence and factors associated with polypharmacy in older people with cancer

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An Erratum to this article was published on 19 April 2014

Abstract

Purpose

Polypharmacy has been associated with drug–drug interactions, adverse drug events, hospitalisation and increased mortality. The purpose of this study was to investigate the prevalence and factors associated with polypharmacy in older people with cancer.

Patients and methods

Patients aged ≥70 years (n = 385) presenting to the medical oncology outpatient clinic at Royal Adelaide Hospital between January 2009 and July 2010 completed a structured data collection instrument. The instrument included domains related to medications, diagnoses, instrumental activities of daily living (IADLs), Karnofsky Performance Scale (KPS), physical function (SF-36), pain (ten-point visual analogue scale, VAS), weight loss (patient self-reported over previous 6 months), exhaustion (CES-D) and distress (ten-point VAS). Frailty was computed using Fried’s frailty phenotype. Logistic regression was used to compute unadjusted and adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for the association between polypharmacy (defined as five or more self-reported daily medications) and clinical parameters.

Results

Polypharmacy was present in 57 % (n = 221) of patients. When adjusting for age, gender and Charlson Comorbidity Index (CCI), polypharmacy was associated with being pre-frail (OR = 2.35, 95%CI = 1.43–3.86) and frail (OR = 4.48, 95%CI = 1.90–10.54) compared to being robust. When adjusting for age, gender, exhaustion, KPS, IADLs, pain and distress, polypharmacy was associated with higher CCI scores (OR = 1.58, 95%CI = 1.29–1.94) and poorer physical function (OR = 1.13, 95%CI = 1.06–1.20).

Conclusions

Polypharmacy is highly prevalent in older people with cancer and associated with impaired physical function and being pre-frail and frail compared to being robust. Research is needed to identify strategies to minimize patients’ medication regimens.

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Acknowledgments

The authors would like to thank the staff of the medical oncology outpatient clinic and the geriatric oncology multidisciplinary team at the Royal Adelaide Hospital for their enthusiastic support, participation and dedication to data collection.

Funding

Justin Turner was funded through postgraduate research scholarships including an Australian Postgraduate Award, a University of South Australia School of Pharmacy and Medical Science scholarship and a scholarship from the Centre for Medicine Use and Safety at the Faculty of Pharmacy and Medical Sciences at Monash University.

Disclosure

The authors have declared no conflicts of interest.

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Authors and Affiliations

  1. School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, South Australia, Australia

    Justin P. Turner & J. Simon Bell

  2. Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, 381 Royal Parade, Parkville, 3052, Melbourne, Victoria, Australia

    Justin P. Turner & J. Simon Bell

  3. Department of Clinical Pharmacology, Royal Adelaide Hospital, Adelaide, South Australia, Australia

    Sepehr Shakib & Sally Johns

  4. University of Adelaide and Department of Medical Oncology, Royal Adelaide Hospital, Adelaide, South Australia, Australia

    Nimit Singhal & Jonathon Hogan-Doran

  5. Department of Geriatric and Rehabilitation Medicine, Royal Adelaide Hospital, Adelaide, South Australia, Australia

    Robert Prowse

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  1. Justin P. Turner
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Correspondence to Justin P. Turner.

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Turner, J.P., Shakib, S., Singhal, N. et al. Prevalence and factors associated with polypharmacy in older people with cancer. Support Care Cancer 22, 1727–1734 (2014). https://doi.org/10.1007/s00520-014-2171-x

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  • DOI: https://doi.org/10.1007/s00520-014-2171-x

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