Cancer patients over 65 and who take anywhere between 5-15 medications per year are at an increased risk of hospitalization, revealed study published in the Journal of Geriatric Oncology. In the largest retrospective population-based study to date, Jefferson researchers showed that hospitalization increase by as much as 114% in patients battling breast, prostate, and lung cancers, when those patients took 15 or more medications prior to chemotherapy treatment.
‘Lung cancer patients taking between 5-9 medications had a 42% higher rate of hospitalization, those taking 10-14 medications had a 75% increase, and those taking over 15 medications prior to chemotherapy had a 114% higher rate compared to patients taking fewer than five medicines.’
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"The comprehensive real-world data we looked at gives us a sense of what's happening today, and offers clues on how we could reduce hospitalizations in older cancer patients," says senior author Grace Lu-Yao, PhD, associate director of Population Science at the Sidney Kimmel Cancer Center (SKCC)--Jefferson Health. The study was published in the Journal of Geriatric Oncology.
"The older patients get, typically the more complex their care becomes - this is especially true when cancer treatment is combined with pre-existing conditions," says co-author Andrew Chapman, DO, co-director of the Senior Adult Oncology Center and chief of Cancer Services at the SKCC. The researchers identified a pool of 13,959 patients with prostate, lung, and breast cancer from a national database of Medicare cancer patients.
They grouped patients by the number of medicines they were on for the 6-months prior to starting intravenous chemotherapy for their cancer. "By looking at hospitalization rates in the 6-months leading up to the start of chemotherapy, we were able to get a baseline, or 'before' data point for these patients, that we could compare against the rates of hospitalization after chemo," said Dr. Lu-Yao.
Drug-drug interactions - where one drug can reduce the effectiveness of another and cause dangerous accumulations of another drug or other effects - are nearly a certainty when people take over eight medicines at once. The researchers saw that the cancer patients studied were starting at a high number of medications already. Lung cancer patients were taking a median of 11 medications, prostate cancer patients were at 10, and those with breast cancer were on a median of 6 therapies.
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"Older patients see multiple specialists, and those specialists rarely coordinate with each other to ensure that the medications are absolutely essential, or weighed against a patient's priorities. So patients end up accumulating more than they absolutely need to take."
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Source-Eurekalert