Prevalence and follow-up of potentially inappropriate medication and potentially omitted medication in older patients with cancer - The PIM POM study

Fianne M. A. M. van Loveren, Inge R. F. van Berlo - van de Laar*, Alex L. T. Imholz, Esther van't Riet, Katja Taxis, Frank G. A. Jansman

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Objectives: To determine the prevalence of Potentially Inappropriate Medication (PIMs) and Potentially Omitted Medication (POMs) in older patients with cancer.

Materials and Methods: In this prospective observational study (hospital) pharmacists conducted comprehensive medication reviews in older patients with cancer (aged >= 65 years) receiving parenteral chemotherapy and/or immunotherapy at the Deventer Hospital. PIMs and POMs were identified using the Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP), the Screening Tool to Alert doctors to the Right Treatment (START), and pharmacists' expert opinion. Recommendations regarding PIMs and POMs were communicated to the patient's oncologist/haematologist and follow-up was measured. Associations between covariates and the prevalence of PIMs and POMs were statistically analysed.

Results: For the 150 patients included, 180 PIMs and 86 POMs were identified with a prevalence of 78%. Using pharmacists' expert opinion in addition to only STOPP/START criteria contributed to 49% of the PIMs and 23% of the POMs. A follow-up action was required in 73% of the 266 PIMs and POMs. Number of medicines and Charlson Comorbidity Index score were both associated with having at least one PIM and/or POM (p = .031 and p = .016, respectively).

Conclusion: The prevalence of PIMs and POMs and subsequent follow-up in older patients with cancer is high. A pharmacist-led comprehensive medication review is a good instrument to identify these PIMs and POMs and to optimize patients' treatment. A complete approach, including pharmacists' expert opinion, is recommended to identify all PIMs and POMs in clinical practice. (C) 2020 The Authors. Published by Elsevier Ltd.

Original languageEnglish
Pages (from-to)80-84
Number of pages5
JournalJournal of Geriatric Oncology
Volume12
Issue number1
DOIs
Publication statusPublished - Jan-2021

Keywords

  • Potentially inappropriate medication
  • Potentially omitted medication
  • Medication review
  • STOPP/START criteria
  • Medical oncology
  • Older patient
  • DRUG-RELATED PROBLEMS
  • ADULTS
  • POLYPHARMACY
  • REDUCE
  • MORBIDITY

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