Excessive Medication Use in Elderly Cancer Patients May Contribute to Adverse Outcomes
In a significant study conducted by the Wilmot Cancer Institute, the potential side effects and implications of polypharmacy in older adults with cancer have been under the spotlight. This research emphasises the vulnerability of these patients to adverse outcomes, due to age-related changes in drug metabolism and response.
Older adults, including those with cancer, are more susceptible to adverse effects from polypharmacy. This increased risk is attributed to changes in pharmacokinetics and pharmacodynamics, which can lead to medication-related harm. Polypharmacy often triggers prescribing cascades, where side effects of one medication prompt the prescription of additional drugs, escalating complexity and the risk of harmful interactions.
The cumulative burden of medications with sedative and anticholinergic properties is a strong predictor of emergency hospitalisation in older adults. Since many cancer patients take such medications for symptoms or comorbid conditions, this increases hospitalisation risks. Polypharmacy in older cancer patients is associated with increased risks of adverse drug reactions, hospitalisations, decreased quality of life, and mortality.
Last year, a descriptive study by Ramsdale and colleagues highlighted the extent of the polypharmacy problem in a nationwide sample of 718 adults with a mean age of 77, who had stage 3 or 4 cancer and other health conditions. The study found that individuals who had one or more major potential drug interactions had 59-percent-higher odds of having to stop cancer treatment earlier than recommended.
A significant number, 61 percent of the patients, were taking five or more medications before starting chemotherapy. The study also revealed that 67 percent of the patients were taking at least one drug that was potentially inappropriate. The study on cancer treatment at the Wilmot Cancer Institute was published in the journal Cancer.
Both studies suggest that physicians should carefully screen for medication usage and possible drug interactions upon a new patient's cancer diagnosis. The studies underscore the importance of careful medication management in cancer treatment for older adults, to minimise potential drug interactions and inappropriate medication use.
Dr. Erika Ramsdale, a Wilmot oncologist, geriatrics specialist, data scientist, and senior author of the paper, stated that polypharmacy may affect both the experience and effectiveness of chemotherapy. The studies serve as a cautionary note to both patients and physicians regarding the use of multiple medications in cancer treatment.
Researchers at institutions like Bath University have used data-driven and machine learning models to predict short-term hospitalisation risks linked to polypharmacy in older adults, aiming to develop tools (e.g., digital apps) that can proactively identify and reduce medication-related harm in this population.
In conclusion, the implications of polypharmacy in older adults with cancer, as studied at the Wilmot Cancer Institute and other centres, highlight heightened risks of adverse drug effects, complex drug interactions, emergency hospitalisations, and diminished health outcomes. These findings point to the need for careful medication review and personalised management to minimise harm and improve quality of life for this vulnerable group.
- Older adults with cancer, like those studied at the Wilmot Cancer Institute, are at a higher risk of adverse drug effects due to polypharmacy.
- One of the risks associated with polypharmacy in older cancer patients is an increased likelihood of adverse drug reactions, hospitalizations, decreased quality of life, and mortality.
- The study by Ramsdale and colleagues revealed that a significant number of cancer patients, 61 percent, were taking five or more medications before starting chemotherapy, potentially leading to inappropriate medication use.
- To proactively identify and reduce medication-related harm in older adults, researchers at institutions such as Bath University are developing data-driven and machine learning models for predicting short-term hospitalization risks related to polypharmacy.
