Back to Annual Meeting

Back to Annual Meeting

APHA Scientific Session and Event Listing

Denys T. Lau, PhD¹, Mary L. Jarzebowski, BS¹, and Charles Bennett, MD, PhD, MPH². (1) Buehler Center on Aging, Northwestern University, 750 North Lake Shore Drive, Suite 601, Chicago, IL 60611, 3125031231, denystlau@yahoo.com, (2) Feinberg School of Medicine, Northwestern University, 333 East Huron Street, Suite 277, Chicago, IL 60611

Background: Many cancer patients, aged 65 and older, take multi-drug regimens to treat their cancer, side-effects, and comorbid conditions, putting them at high risk for polypharmacy and adverse drug events. This study reviews the epidemiology of the “real-life” suboptimal use of pharmacotherapies and associated problems among older cancer patients. Methods: Sources include PubMed and Ageline. We defined suboptimal medication as under-treatment, non-adherence, adverse drug-drug interactions, and adverse drug events. Only articles published in English and limited to individuals aged 65 and older were included. Results: Seventeen articles were found. (1) Under-treatment (n=3): Chart reviews indicate that many older cancer patients receive inappropriately low doses of anticancer and supportive treatments for fear of potential toxicity. (2) Non-compliance to practice guidelines (n=2): A majority of physicians surveyed have reported that they support published practice guidelines but had problems locating or implementing the guidelines in clinical practice. (3) Medication non-adherence (n=3): Evidence is inconclusive concerning whether elderly cancer patients are less adherent to prescribed medications than younger counterparts. (4) Adverse drug reactions (n=9): Findings are mixed regarding whether age alone predicts greater toxicity among elderly patients than younger patients. Age-related physiological decline may be a stronger predictor of toxicity. No epidemiological studies were found on adverse drug-drug interactions among anticancer therapies. Discussion: The extent of suboptimal medication use among older cancer patients documented in the literature indicates medication safety in this population is of great concern. However, epidemiological studies remain lacking but are needed to further understand these occurrences and their associated factors.

Learning Objectives: