title: Polypharmacy and potentially inappropriate medication use in geriatric oncology.
abstract: Polypharmacy is a highly prevalent problem in older persons, and is challenging to assess and improve due to variations in definitions of the problem and the heterogeneous methods of medication review and reduction. The purpose of this review is to summarize evidence regarding the prevalence and impact of polypharmacy in geriatric oncology patients and to provide recommendations for assessment and management. Polypharmacy has somewhat variably been incorporated into geriatric assessment studies in geriatric oncology, and polypharmacy has not been consistently evaluated as a predictor of negative outcomes in patients with cancer. Once screened, interventions for polypharmacy are even more uncertain. There is a great need to create standardized interventions to improve polypharmacy in geriatrics, and particularly in geriatric oncology. The process of deprescribing is aimed at reducing medications for which real or potential harm outweighs benefit, and there are numerous methods to determine which medications are candidates for deprescribing. However, deprescribing approaches have not been evaluated in older patients with cancer. Ultimately, methods to identify polypharmacy will need to be clearly defined and validated, and interventions to improve medication use will need to be based on clearly defined and standardized methods.
authors: Department of Pharmaceutical Health Outcomes and Policy, College of Pharmacy, University of Houston, Houston, TX, USA. Electronic address: manvi.uh@gmail.com.
authors: Manvi
authors: M
authors: Sharma
authors: James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA. Electronic address: kahpoh_loh@urmc.rochester.edu.
authors: Kah Poh
authors: KP
authors: Loh
authors: Department of Pharmacy Practice, Jefferson College of Pharmacy, Thomas Jefferson University, Philadelphia, PA, USA. Electronic address: Ginah.Nightingale@jefferson.edu.
authors: Ginah
authors: G
authors: Nightingale
authors: James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA. Electronic address: supriya_mohile@urmc.rochester.edu.
authors: Supriya G
authors: SG
authors: Mohile
authors: Division of Geriatric and Palliative Medicine, University of Texas Health Science Center at Houston, McGovern Medical School, Houston, TX, USA. Electronic address: Holly.M.Holmes@uth.tmc.edu.
authors: Holly M
authors: HM
authors: Holmes
mesh_terms: D000368:Aged; D064420:Drug-Related Side Effects and Adverse Reactions / Q000209:etiology; D015577:Geriatric Assessment; D005853:Geriatrics / Q000379:methods; D006801:Humans; D057970:Inappropriate Prescribing / Q000517:prevention & control*; D008495:Medical Oncology / Q000379:methods; D009369:Neoplasms / Q000188:drug therapy*; D019338:Polypharmacy; D010818:Practice Patterns, Physicians'; D012306:Risk
keywords: Cancer; Deprescribing; Elderly; Geriatric assessment; Geriatric oncology; Geriatrics; Polypharmacy