Polypharmacy in elderly cancer patients: Challenges and the way clinical pharmacists can contribute in resource‐limited settings

Shrestha, Sunil; Khanal, Saval

doi:10.1002/agm2.12051

Cited by 52 publications

(41 citation statements)

References 67 publications

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“…14,16 Elderly patients may have reduced bone marrow reserves or declined renal and hepatic function, and are more prone to treatment-related complications. 17,18 Thus, with age, the benefits of cancer chemotherapy may be reduced and the risks may be increased.…”

Section: Discussionmentioning

confidence: 99%

<p>Validation of Risk of Chemotherapy-Induced Neutropenia: Experience from Oncology Hospital of Nepal</p>

Sapkota

Shrestha²,

Chapagai

et al. 2020

CMAR

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Background: The majority of cancer patients undergoing chemotherapy show neutropenic condition which is a common side effect of myelosuppressive chemotherapy diagnosed as the reduced complete blood cell count. Such cancer patients have a higher risk of febrile neutropenia. The present study aimed to validate whether there was a risk of neutropenia in cancer patients receiving chemotherapy at Bhaktapur Cancer Hospital, Nepal. Methods: Cross-sectional study was performed among 203 cancer patients of all age groups who attended Bhaktapur Cancer Hospital from May 2018 to January 2019 and who received a chemotherapy course. Patients receiving at least one cycle of chemotherapy as the first-line treatment were included. Statistical analysis was performed using SPSS 25. Loglinear analysis was used to analyze more than 2×2 categories among the grades and outcome of neutropenia. Multinomial logistic regression was applied to analyze the impact of various predictor variables such as chemotherapy cycles, grades of neutropenia, and gender on the outcome of neutropenia. Variation in the absolute neutrophil count (ANC) level at various days of chemotherapy cycles was assessed with the multivariate analysis of variance (MANOVA). The p-value <0.05 was considered significant at each condition. Results: The main cancer type during the study period was breast cancer (41, 20.2%). Out of 163 neutropenic patients, 149 had severe neutropenia and 14 had mild neutropenia. Most patients were continued up to the 6th cycle of chemotherapy. There was significant association between the grade of neutropenia and the outcome of the condition (p-value 0.017). There were significant relations of the grade of neutropenia and smoking habit with the recovering status (p values 0.033 and 0.001, respectively). The absolute neutrophil count (ANC) level increased and decreased inconsistently (statistically non-significantly) in between treatment period of day 1 to 52. Conclusion: Chemotherapy-induced neutropenia was a common occurrence. Majority (133, 66.5%) grade 4 neutropenic patients were recovering after the chemotherapy cycles. The physicians are warranted that they be ready for any unpredictable situation during chemotherapy treatment.

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Section: Discussionmentioning

confidence: 99%

<p>Validation of Risk of Chemotherapy-Induced Neutropenia: Experience from Oncology Hospital of Nepal</p>

Sapkota

Shrestha²,

Chapagai

et al. 2020

CMAR

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“…• To ensure that these are taken on board and acknowledged by the HCP • Many older people have comorbidities and limitations which affect their cognitive and physical functioning [6,[46][47][48][49][50][51][52].…”

Section: Planning Phase Of Developing the 'Chatandplan' Interventionmentioning

confidence: 99%

Planning and optimising CHAT&PLAN: A conversation-based intervention to promote person-centred care for older people living with multimorbidity

et al. 2020

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Background Older people are more likely to be living with cancer and multiple long-term conditions, but their needs, preferences for treatments, health priorities and lifestyle are often not identified or well-understood. There is a need to move towards a more comprehensive person-centred approach to care that focuses on the cumulative impact of a number of conditions on daily activities and quality of life. This paper describes the intervention planning process for CHAT& PLAN TM , a structured conversation intervention to promote personalised care and support self-management in older adults with complex conditions. Methods A theory-, evidence-and person-based approach to intervention development was undertaken. The intervention planning and development process included reviewing relevant literature and existing guidelines, developing guiding principles, conducting a behavioural analysis and constructing a logic model. Optimisation of the intervention and its implementation involved qualitative interviews with older adults with multimorbidity (n = 8), family

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“…It is predominant when a coexisting medical or psychiatric illness is taken into contemplations. Lifestyle changes associated with retirement, the increased incidence of health problems and the use of multiple medications (polypharmacy), comorbid conditions such as dementia and Alzheimer are at increased risk of disrupted sleep (National Sleep Foundation, ; Shrestha, Shrestha, & Khanal,; Pathy et al, ). If not tended to legitimately, insomnia itself incites numerous different diseases and causes significant morbidity, negative impact on well‐being, as well as degrades the quality of life (Aritake et al, ; National Sleep Foundation, ).…”

Section: Introductionmentioning

confidence: 99%

Insomnia and its associated factors among older people of selected ward of Banepa municipality, Nepal

2019

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Aims The aim of this study was to calculate the prevalence of insomnia and identify the factors associated with it among older people of Banepa Municipality, Province No.3 of Nepal. Design A quantitative descriptive cross‐sectional study was done; data were collected for three months from September–November 2018. Methods One hundred and fourteen older people were recruited. The data were collected through a structured interview questionnaire that included socio‐demographic characteristics and Nepalese version of standard Pittsburgh Insomnia Rating Scale (20‐item version). Information on general health conditions, alcohol intake and personal habits was also collected. Results The mean age of the respondents (N = 114) was 76.04 (SD 7.81), years and 51.8% were females. The prevalence of insomnia was 71.1% in the older population. Significant associations were found between insomnia and advanced age (p = .002), illiteracy (p < .001), not working (p < .001), financially dependent on others (p < .001), presence of comorbid disease (p < .001) and taking regular medicine at present (p < .001).

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Polypharmacy in elderly cancer patients: Challenges and the way clinical pharmacists can contribute in resource‐limited settings

Cited by 52 publications

References 67 publications

<p>Validation of Risk of Chemotherapy-Induced Neutropenia: Experience from Oncology Hospital of Nepal</p>

<p>Validation of Risk of Chemotherapy-Induced Neutropenia: Experience from Oncology Hospital of Nepal</p>

Planning and optimising CHAT&PLAN: A conversation-based intervention to promote person-centred care for older people living with multimorbidity

Insomnia and its associated factors among older people of selected ward of Banepa municipality, Nepal

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