Abstract
Background
Older adults (≥ 65 years) with cancer receiving palliative care often have other health conditions requiring multiple medications.
Aim
To describe and assess the appropriateness of prescribing for older adults with cancer in the last seven days of life in an inpatient palliative care setting.
Method
Retrospective observational study of medical records for 180 patients (60.6% male; median age: 74 years; range 65–94 years) over a two-year period. Medication appropriateness was assessed using: STOPPFrail, OncPal deprescribing guideline and criteria for identifying Potentially Inappropriate Prescribing in older adults with Cancer receiving Palliative Care (PIP-CPC).
Results
94.5% of patients had at least one other health condition (median 3, IQR 2–5). The median number of medications increased from five (IQR 3–7) seven days before death, to 11 medications on the day of death (IQR 9–15). The prevalence of PIP varied depending on the tool used: STOPPFrail (version 1: 17.2%, version 2: 19.4%), OncPal (12.8%), PIP-CPC (30%). However, the retrospective nature of the study limited the applicability of the tools. Increasing number of medications had a statistically significant effect on risk of PIP across all tools (STOPPFrail (version 1: 1.29 (1.13–1.37), version 2: 1.30 (1.16–1.48)); OncPal 1.13 (1.01–1.27); PIP-CPC 0.70 (0.61–0.82)).
Conclusion
This study found that the number of medications prescribed to older adults with cancer increased as time to death approached, and the prevalence of PIP varied with the application of different tools. The study also highlights the difficulties of examining PIP in this patient cohort.
Older adults (≥ 65 years) with cancer receiving palliative care often have other health conditions requiring multiple medications.
Aim
To describe and assess the appropriateness of prescribing for older adults with cancer in the last seven days of life in an inpatient palliative care setting.
Method
Retrospective observational study of medical records for 180 patients (60.6% male; median age: 74 years; range 65–94 years) over a two-year period. Medication appropriateness was assessed using: STOPPFrail, OncPal deprescribing guideline and criteria for identifying Potentially Inappropriate Prescribing in older adults with Cancer receiving Palliative Care (PIP-CPC).
Results
94.5% of patients had at least one other health condition (median 3, IQR 2–5). The median number of medications increased from five (IQR 3–7) seven days before death, to 11 medications on the day of death (IQR 9–15). The prevalence of PIP varied depending on the tool used: STOPPFrail (version 1: 17.2%, version 2: 19.4%), OncPal (12.8%), PIP-CPC (30%). However, the retrospective nature of the study limited the applicability of the tools. Increasing number of medications had a statistically significant effect on risk of PIP across all tools (STOPPFrail (version 1: 1.29 (1.13–1.37), version 2: 1.30 (1.16–1.48)); OncPal 1.13 (1.01–1.27); PIP-CPC 0.70 (0.61–0.82)).
Conclusion
This study found that the number of medications prescribed to older adults with cancer increased as time to death approached, and the prevalence of PIP varied with the application of different tools. The study also highlights the difficulties of examining PIP in this patient cohort.
| Original language | English |
|---|---|
| Number of pages | 10 |
| Journal | International Journal of Clinical Pharmacy |
| Early online date | 15 Nov 2022 |
| Publication status | Early online date - 15 Nov 2022 |
Access to Document
- Potentially inappropriate prescribing in older adults with cancer receiving specialist palliative care: A retrospective observational study
Copyright 2022, the Author(s). This work is made available online in accordance with the publisher’s policies. Please refer to any applicable terms of use of the publisher.