TY - JOUR
T1 - Use of potentially inappropriate medication in older patients with lung cancer at the end of life
AU - Ham, Laurien
AU - Geijteman, Eric C. T.
AU - Aarts, Mieke J.
AU - Kuiper, Josephina G.
AU - Kunst, Peter W. A.
AU - Raijmakers, Natasja J. H.
AU - Visser, Loes E.
AU - van Zuylen, Lia
AU - Brokaar, Edwin J.
AU - Fransen, Heidi P.
N1 - Funding Information: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Publisher Copyright: © 2021 Elsevier Ltd
PY - 2022/1
Y1 - 2022/1
N2 - Objectives: Medications at the end of life should be used for symptom control. Medications which potential adverse effects outweigh their expected benefits are called ‘potentially inappropriate medications’ (PIMs). PIMs are related with adverse drug events and reduced quality of life. In this study, we investigated to what extent PIMs are dispensed to older patients with lung cancer in the last month of life. Methods: We selected patients with lung cancer, aged 65+, diagnosed between 2009 and 2014, and who died before April 1st 2015 from the population-based Netherlands Cancer Registry (NCR). The NCR is linked to the PHARMO Database Network, that includes medications dispensed by community pharmacies in the Netherlands. The eight PIM groups were based on the OncPal Deprescribing Guideline: aspirin, dyslipidaemia medications, antihypertensives, osteoporosis medications, peptic ulcer prophylaxis, oral hypoglycaemics, vitamins and minerals. Results: Data of 7864 patients with lung cancer were analyzed. Median age was 74 year (IQR = 70–79) and 67% was male. 45% of all patients received at least one PIM in their last month of life. Taking into account all dispensed medications, patients receiving PIMs received more different medications compared to those receiving no PIMs, respectively 10 (SD = 5) vs. 3 (SD = 4) different medications (P < 0.001). Conclusion: Almost half of the older patients with lung cancer in the Netherlands received PIMs in their last month of life. Since PIM use is associated with reduced quality of life, it is important that health care professionals continue to critically assess which medication can be discontinued at the end of life.
AB - Objectives: Medications at the end of life should be used for symptom control. Medications which potential adverse effects outweigh their expected benefits are called ‘potentially inappropriate medications’ (PIMs). PIMs are related with adverse drug events and reduced quality of life. In this study, we investigated to what extent PIMs are dispensed to older patients with lung cancer in the last month of life. Methods: We selected patients with lung cancer, aged 65+, diagnosed between 2009 and 2014, and who died before April 1st 2015 from the population-based Netherlands Cancer Registry (NCR). The NCR is linked to the PHARMO Database Network, that includes medications dispensed by community pharmacies in the Netherlands. The eight PIM groups were based on the OncPal Deprescribing Guideline: aspirin, dyslipidaemia medications, antihypertensives, osteoporosis medications, peptic ulcer prophylaxis, oral hypoglycaemics, vitamins and minerals. Results: Data of 7864 patients with lung cancer were analyzed. Median age was 74 year (IQR = 70–79) and 67% was male. 45% of all patients received at least one PIM in their last month of life. Taking into account all dispensed medications, patients receiving PIMs received more different medications compared to those receiving no PIMs, respectively 10 (SD = 5) vs. 3 (SD = 4) different medications (P < 0.001). Conclusion: Almost half of the older patients with lung cancer in the Netherlands received PIMs in their last month of life. Since PIM use is associated with reduced quality of life, it is important that health care professionals continue to critically assess which medication can be discontinued at the end of life.
KW - End of life
KW - Lung cancer - older adults
KW - Palliative care
KW - Potentially inappropriate medications
UR - http://www.scopus.com/inward/record.url?scp=85112652373&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.jgo.2021.07.009
DO - https://doi.org/10.1016/j.jgo.2021.07.009
M3 - Article
C2 - 34366274
SN - 1879-4068
VL - 13
SP - 53
EP - 59
JO - Journal of geriatric oncology
JF - Journal of geriatric oncology
IS - 1
ER -