Optimising Medications for Patients With Cancer and Multimorbidity: The Case for Deprescribing. Issue 9 (September 2020)

• Record Type: Journal Article
• Authors: Turner, J.P.; Kantilal, K.; Kantilal, K.; Holmes, H.M.; Koczwara, B.
• Is Part Of: Clinical oncology. Volume 32:Issue 9(2020)
• Page Start: 609
• Page End: 617
• Publication Date: 2020-09
• Subjects: Clinical oncology -- deprescribing -- multimorbidity and cancer -- polypharmacy -- potentially inappropriate medications; Oncology -- Periodicals; Tumors -- Periodicals; Cancer -- Treatment -- Periodicals; Radiotherapy -- Periodicals; Neoplasms -- Periodicals; Cancer -- Radiotherapy; Cancer -- Treatment; Oncology; Medical radiology; Radiotherapy; Tumors; Electronic journals; Periodicals; 616.994
• DOI: 10.1016/j.clon.2020.05.015
• Languages: English
• ISSNs: 0936-6555

Abstract

Abstract: The majority of patients diagnosed with cancer are aged over 65 years and have two or more chronic conditions in addition to cancer and the risk of chronic conditions increases further after cancer. The presence of multimorbidity adds complexity to care, as patients' goals of care and the focus of treatment can change with a diagnosis of cancer. Multimorbidity is frequently associated with polypharmacy, the use of potentially inappropriate medications, the presence of adverse drug reactions and potential drug–drug interactions: all of which impact on health outcomes and the cost of care. Consequently, it is vital that a systematic approach is taken to regularly review cancer patients' medication regimens to ensure that they support an optimal balance of benefits with acceptable levels of harm. Several patient and clinician resources are presented to guide the process of medication review and deprescribing. Highlights: Multimorbidity increases the risk of polypharmacy in older people with cancer. Polypharmacy predisposes to adverse events and poor outcomes. Deprescribing can optimise medications during cancer therapy. Deprescribing may improve outcomes and reduce cost of care. Tools are available to support patient-centred deprescribing.