Pharmacists Could Be Solution to Polypharmacy in Patients With Cancer

The prevalence of polypharmacy is a growing issue in the United States, accounting for more than $50 billion in annual costs from health care plans.¹ Especially when considering complex diseases such as cancer, which include complicated medication regimens, polypharmacy is inevitable.

Taking multiple medications is not the problem, as up to 81% of patients with cancer take medications to treat their other comorbidities. However, due to disjointed health care teams and duplicate therapies, patients pay the steep price of drug-related problems.

A team of researchers from The Netherlands delved deeper into this issue to determine the occurrence of drug-related issues in patients with cancer in a study published in The Journal of Geriatric Oncology.²

The study population was patients over 65 years of age with a life expectancy that exceeded 24 months. The aim was to determine correct use of medications and mitigate any medication-related issues.

The team included a pharmacist, oncologist, and a geriatric specialist. The pharmacist was responsible for conducting an initial interview to determine any medication errors and adherence.

After coming to a shared decision with the rest of the multidisciplinary team, the oncologist made the appropriate changes to the regimen. Four weeks after the improved therapies were implemented, investigators sent a questionnaire to the assess patients’ satisfaction regarding the intervention.

This study revealed several findings that further proved the matter of polypharmacy is pressing and its potential to cause patient harm. First, they identified that each patient had an average of 6 drug-related problems (DRPs) and an average of 3 inappropriately prescribed therapies.

The largest culprit for DRPs remained the overtreatment of hypertension, pain management, and hyperlipidemia, according to the study. After the appropriate interventions were made, patients reported high rates of satisfaction.

Additionally, oncologists accepted the recommendations made by pharmacists more than half of the time. The multidisciplinary team accepted the suggestions more than 75% of the time. The researchers also determined that although using online tracking forums such as OncPal proved useful for catching DRPs, speaking with patients was most effective.

With an average of 34%-47% of all medications taken by cancer patients being eligible for possible discontinuation, a pharmacist is imperative in combating the problem of polypharmacy. The patient responses clearly demonstrate satisfaction, which highlights the additional quality-of-life improvement in these patients. Pharmacists are in a unique position in health care to be able to make these recommendations and interventions before patients bear the consequences of the DRPs.

About the About

Sumoda Achar is a 2024 PharmD candidate at the University of Connecticut.

References

1. Wang X, Liu K, Shirai K, et al. Prevalence and trends of polypharmacy in U.S. adults, 1999-2018. Glob Health Res Policy. 2023;8(1):25. Published 2023 Jul 12. doi:10.1186/s41256-023-00311-4

2. Brokaar EJ, Visser LE, van den Bos F, Portielje JEA. Medication optimization in older adults with advanced cancer and a limited life expectancy: A prospective observational study [published online ahead of print, 2023 Aug 19]. J Geriatr Oncol. 2023;14(8):101606. doi:10.1016/j.jgo.2023.101606