Patients with advanced lung cancer: is there scope to discontinue inappropriate medication?

Abstract

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Reducing potentially inappropriate medications in palliative cancer patients: evidence to support deprescribing approaches

“…The literature search identified numerous, high-impact publications describing the incidence of polypharmacy and the proportion of geriatric patients prescribed PIMs [10,15,17,[19][20][21]; however, in cancer patients, there are only three retrospective and cross-sectional, small-scale trials [1,13,14]. In these trials, there was a lack of consensus guidelines for assessing PIMs, instead using the authors, or a medical officer's clinical opinion.…”

“…This lack of participants could contribute to the inconsistent results between the cancer trials; for example, Reichelmann et al found 22 % of patients with at least one PIM [13], compared to the 95 % found by Todd et al [14]. The study design may have also contributed to these results, as there was a lack of a clear, standardized algorithm or guideline used for the identification of PIMs.…”

“…Recently, Todd et al [14] retrospectively assessed the prevalence of inappropriate medication in patients taking erlotinib for the treatment of advanced non-small cell lung cancer in a multicenter study across three sites in the North of England. Of the 20 patients assessed, 19 (95 %) were taking medications that were classified as inappropriate by the clinical team.…”

End-of-life prescribing of aspirin in patients with breast or colorectal cancer

“…Much of this decline occurs in the 6–12 months prior to death and is most likely the result of efforts to reduce the treatment burden in patients with terminal cancer 3. However, the possibility that some of this decline may be due to the development of contraindications to aspirin use in patients with metastatic disease should also be considered.…”

“…Prior studies of perimortality medication use in patients with cancer suggest that as many as a third of those who die from their cancer continue to receive medications for long-term cardiovascular disease prevention up to the time of their death 3. However, these studies have focused primarily on statin prescribing and have provided limited information on the prevalence of other cardiovascular medication use in the time close to death.…”