The Association Between Medication Use in Older Women with Early-Stage Operable Primary Breast Cancer and Decision Regarding Primary Treatment
Abstract Background Polypharmacy is one factor contributing to increased mortality, hospitalization, and adverse drug reactions in older adults. The aim of this study was to measure the prevalence of polypharmacy in a cohort of older women with early-stage operable primary breast cancer and the rela...
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| Veröffentlicht in: | The oncologist (Dayton, Ohio) Ohio), 2023-03, Vol.28 (3), p.e128-e135 |
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| container_title | The oncologist (Dayton, Ohio) |
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| creator | Tse, Natalie Parks, Ruth M Holmes, Holly M Cheung, Kwok-Leung |
| description | Abstract
Background
Polypharmacy is one factor contributing to increased mortality, hospitalization, and adverse drug reactions in older adults. The aim of this study was to measure the prevalence of polypharmacy in a cohort of older women with early-stage operable primary breast cancer and the relationship of polypharmacy to primary treatment decision and functional status.
Methods
A total of 139 patients with a new diagnosis of early-stage operable primary breast cancer proven histologically were recruited as part of a prospective study. The average age was 77 years. Assessment using a cancer-specific Comprehensive Geriatric Assessment (CGA) tool was conducted within 6 weeks of diagnosis of breast cancer. Association was determined between number of medications and treatment decision and physical status as measured by the CGA outcomes. Additional analysis was performed to determine the associations above with polypharmacy defined by ≥5 daily medications, and if cardiovascular-related diseases have a role in the treatment decision.
Results
Polypharmacy was present in 48% of patients (n = 139). CGA determined that polypharmacy was associated with greater comorbidity (P < .001), reduced physical status rated by physicians (P = .009) and patients (P = .019), and reduced ability to perform activities of instrumental ADLs (P = .008). Similar findings were present in the analysis of cardiovascular-related diseases.
Conclusions
This work suggests that patients with polypharmacy are more likely to be frail. The number of medications could help us screen patients who should go on to receive full CGA.
This study measured the prevalence of polypharmacy in a cohort of older women with early-stage operable primary breast cancer and the relationship of polypharmacy to primary treatment decision and functional status. |
| doi_str_mv | 10.1093/oncolo/oyac278 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_10020815</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A779838473</galeid><oup_id>10.1093/oncolo/oyac278</oup_id><sourcerecordid>A779838473</sourcerecordid><originalsourceid>FETCH-LOGICAL-c447t-6e1d4a856ae5679617ceeb58d9449c3b90d628676561b065bc7d22349bdf43813</originalsourceid><addsrcrecordid>eNqFkkuLFDEUhQtRnHF061ICbnRRM0mlKo-V9LTjA0ZatAfdhVRyqzpSnfQk1Q79J_zNpqm2URiQLHK59zsnN3CK4jnB5wRLehG8CUO4CDttKi4eFKekqWVZS_z9Ya6xoCUnjTwpnqT0A-Nc0upxcUIZJwILdlr8Wq4AzVIKxunRBY8uYbwD8OgTWGem1k0C5DxaDBYi-hbWeXrnxhW60nHYlV9H3QNabCDqdgD0Obq1jjt0GUGnEc21N1mlvUVvwbi09_sCvY7W-f4ILzM8Zt_xafGo00OCZ4f7rLh5d7WcfyivF-8_zmfXpalrPpYMiK21aJiGhnHJCDcAbSOsrGtpaCuxZZVgnDWMtJg1reG2qmgtW9vVVBB6VryZfDfbdg3W5KejHtRm2kcF7dS_E-9Wqg8_FcG4woI02eHVwSGG2y2kUa1dMjAM2kPYJlVxTiitMGYZfTmhvR5AOd-FbGn2uJpxLgUVNaeZOr-HysfC2pngoXO5f5_AxJBShO64PsFqHw41hUMdwpEFL_7-9BH_k4YMvJ6AsN38z-w3XBnHSg</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2771332006</pqid></control><display><type>article</type><title>The Association Between Medication Use in Older Women with Early-Stage Operable Primary Breast Cancer and Decision Regarding Primary Treatment</title><source>MEDLINE</source><source>DOAJ Directory of Open Access Journals</source><source>Oxford Journals Open Access Collection</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><creator>Tse, Natalie ; Parks, Ruth M ; Holmes, Holly M ; Cheung, Kwok-Leung</creator><creatorcontrib>Tse, Natalie ; Parks, Ruth M ; Holmes, Holly M ; Cheung, Kwok-Leung</creatorcontrib><description>Abstract
Background
Polypharmacy is one factor contributing to increased mortality, hospitalization, and adverse drug reactions in older adults. The aim of this study was to measure the prevalence of polypharmacy in a cohort of older women with early-stage operable primary breast cancer and the relationship of polypharmacy to primary treatment decision and functional status.
Methods
A total of 139 patients with a new diagnosis of early-stage operable primary breast cancer proven histologically were recruited as part of a prospective study. The average age was 77 years. Assessment using a cancer-specific Comprehensive Geriatric Assessment (CGA) tool was conducted within 6 weeks of diagnosis of breast cancer. Association was determined between number of medications and treatment decision and physical status as measured by the CGA outcomes. Additional analysis was performed to determine the associations above with polypharmacy defined by ≥5 daily medications, and if cardiovascular-related diseases have a role in the treatment decision.
Results
Polypharmacy was present in 48% of patients (n = 139). CGA determined that polypharmacy was associated with greater comorbidity (P < .001), reduced physical status rated by physicians (P = .009) and patients (P = .019), and reduced ability to perform activities of instrumental ADLs (P = .008). Similar findings were present in the analysis of cardiovascular-related diseases.
Conclusions
This work suggests that patients with polypharmacy are more likely to be frail. The number of medications could help us screen patients who should go on to receive full CGA.
This study measured the prevalence of polypharmacy in a cohort of older women with early-stage operable primary breast cancer and the relationship of polypharmacy to primary treatment decision and functional status.</description><identifier>ISSN: 1083-7159</identifier><identifier>EISSN: 1549-490X</identifier><identifier>DOI: 10.1093/oncolo/oyac278</identifier><identifier>PMID: 36718086</identifier><language>eng</language><publisher>US: Oxford University Press</publisher><subject>Aged ; Aged women ; Analysis ; Breast Cancer ; Breast Neoplasms - drug therapy ; Breast Neoplasms - surgery ; Cancer ; Comorbidity ; Complications and side effects ; Decision-making ; Demographic aspects ; Diagnosis ; Drug therapy ; Drug-Related Side Effects and Adverse Reactions ; Drugs ; Evidence-based medicine ; Female ; Geriatric Assessment ; Health aspects ; Hospitalization ; Humans ; Medical screening ; Middle aged women ; Mortality ; Oncology, Experimental ; Patient compliance ; Polypharmacy ; Prospective Studies ; Risk factors ; United Kingdom</subject><ispartof>The oncologist (Dayton, Ohio), 2023-03, Vol.28 (3), p.e128-e135</ispartof><rights>The Author(s) 2023. Published by Oxford University Press. 2023</rights><rights>The Author(s) 2023. Published by Oxford University Press.</rights><rights>COPYRIGHT 2023 Oxford University Press</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c447t-6e1d4a856ae5679617ceeb58d9449c3b90d628676561b065bc7d22349bdf43813</cites><orcidid>0000-0003-3832-7431</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10020815/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10020815/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,724,777,781,861,882,1599,27905,27906,53772,53774</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36718086$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tse, Natalie</creatorcontrib><creatorcontrib>Parks, Ruth M</creatorcontrib><creatorcontrib>Holmes, Holly M</creatorcontrib><creatorcontrib>Cheung, Kwok-Leung</creatorcontrib><title>The Association Between Medication Use in Older Women with Early-Stage Operable Primary Breast Cancer and Decision Regarding Primary Treatment</title><title>The oncologist (Dayton, Ohio)</title><addtitle>Oncologist</addtitle><description>Abstract
Background
Polypharmacy is one factor contributing to increased mortality, hospitalization, and adverse drug reactions in older adults. The aim of this study was to measure the prevalence of polypharmacy in a cohort of older women with early-stage operable primary breast cancer and the relationship of polypharmacy to primary treatment decision and functional status.
Methods
A total of 139 patients with a new diagnosis of early-stage operable primary breast cancer proven histologically were recruited as part of a prospective study. The average age was 77 years. Assessment using a cancer-specific Comprehensive Geriatric Assessment (CGA) tool was conducted within 6 weeks of diagnosis of breast cancer. Association was determined between number of medications and treatment decision and physical status as measured by the CGA outcomes. Additional analysis was performed to determine the associations above with polypharmacy defined by ≥5 daily medications, and if cardiovascular-related diseases have a role in the treatment decision.
Results
Polypharmacy was present in 48% of patients (n = 139). CGA determined that polypharmacy was associated with greater comorbidity (P < .001), reduced physical status rated by physicians (P = .009) and patients (P = .019), and reduced ability to perform activities of instrumental ADLs (P = .008). Similar findings were present in the analysis of cardiovascular-related diseases.
Conclusions
This work suggests that patients with polypharmacy are more likely to be frail. The number of medications could help us screen patients who should go on to receive full CGA.
This study measured the prevalence of polypharmacy in a cohort of older women with early-stage operable primary breast cancer and the relationship of polypharmacy to primary treatment decision and functional status.</description><subject>Aged</subject><subject>Aged women</subject><subject>Analysis</subject><subject>Breast Cancer</subject><subject>Breast Neoplasms - drug therapy</subject><subject>Breast Neoplasms - surgery</subject><subject>Cancer</subject><subject>Comorbidity</subject><subject>Complications and side effects</subject><subject>Decision-making</subject><subject>Demographic aspects</subject><subject>Diagnosis</subject><subject>Drug therapy</subject><subject>Drug-Related Side Effects and Adverse Reactions</subject><subject>Drugs</subject><subject>Evidence-based medicine</subject><subject>Female</subject><subject>Geriatric Assessment</subject><subject>Health aspects</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>Medical screening</subject><subject>Middle aged women</subject><subject>Mortality</subject><subject>Oncology, Experimental</subject><subject>Patient compliance</subject><subject>Polypharmacy</subject><subject>Prospective Studies</subject><subject>Risk factors</subject><subject>United Kingdom</subject><issn>1083-7159</issn><issn>1549-490X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>TOX</sourceid><sourceid>EIF</sourceid><recordid>eNqFkkuLFDEUhQtRnHF061ICbnRRM0mlKo-V9LTjA0ZatAfdhVRyqzpSnfQk1Q79J_zNpqm2URiQLHK59zsnN3CK4jnB5wRLehG8CUO4CDttKi4eFKekqWVZS_z9Ya6xoCUnjTwpnqT0A-Nc0upxcUIZJwILdlr8Wq4AzVIKxunRBY8uYbwD8OgTWGem1k0C5DxaDBYi-hbWeXrnxhW60nHYlV9H3QNabCDqdgD0Obq1jjt0GUGnEc21N1mlvUVvwbi09_sCvY7W-f4ILzM8Zt_xafGo00OCZ4f7rLh5d7WcfyivF-8_zmfXpalrPpYMiK21aJiGhnHJCDcAbSOsrGtpaCuxZZVgnDWMtJg1reG2qmgtW9vVVBB6VryZfDfbdg3W5KejHtRm2kcF7dS_E-9Wqg8_FcG4woI02eHVwSGG2y2kUa1dMjAM2kPYJlVxTiitMGYZfTmhvR5AOd-FbGn2uJpxLgUVNaeZOr-HysfC2pngoXO5f5_AxJBShO64PsFqHw41hUMdwpEFL_7-9BH_k4YMvJ6AsN38z-w3XBnHSg</recordid><startdate>20230317</startdate><enddate>20230317</enddate><creator>Tse, Natalie</creator><creator>Parks, Ruth M</creator><creator>Holmes, Holly M</creator><creator>Cheung, Kwok-Leung</creator><general>Oxford University Press</general><scope>TOX</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-3832-7431</orcidid></search><sort><creationdate>20230317</creationdate><title>The Association Between Medication Use in Older Women with Early-Stage Operable Primary Breast Cancer and Decision Regarding Primary Treatment</title><author>Tse, Natalie ; Parks, Ruth M ; Holmes, Holly M ; Cheung, Kwok-Leung</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c447t-6e1d4a856ae5679617ceeb58d9449c3b90d628676561b065bc7d22349bdf43813</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Aged</topic><topic>Aged women</topic><topic>Analysis</topic><topic>Breast Cancer</topic><topic>Breast Neoplasms - drug therapy</topic><topic>Breast Neoplasms - surgery</topic><topic>Cancer</topic><topic>Comorbidity</topic><topic>Complications and side effects</topic><topic>Decision-making</topic><topic>Demographic aspects</topic><topic>Diagnosis</topic><topic>Drug therapy</topic><topic>Drug-Related Side Effects and Adverse Reactions</topic><topic>Drugs</topic><topic>Evidence-based medicine</topic><topic>Female</topic><topic>Geriatric Assessment</topic><topic>Health aspects</topic><topic>Hospitalization</topic><topic>Humans</topic><topic>Medical screening</topic><topic>Middle aged women</topic><topic>Mortality</topic><topic>Oncology, Experimental</topic><topic>Patient compliance</topic><topic>Polypharmacy</topic><topic>Prospective Studies</topic><topic>Risk factors</topic><topic>United Kingdom</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tse, Natalie</creatorcontrib><creatorcontrib>Parks, Ruth M</creatorcontrib><creatorcontrib>Holmes, Holly M</creatorcontrib><creatorcontrib>Cheung, Kwok-Leung</creatorcontrib><collection>Oxford Journals Open Access Collection</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The oncologist (Dayton, Ohio)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tse, Natalie</au><au>Parks, Ruth M</au><au>Holmes, Holly M</au><au>Cheung, Kwok-Leung</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Association Between Medication Use in Older Women with Early-Stage Operable Primary Breast Cancer and Decision Regarding Primary Treatment</atitle><jtitle>The oncologist (Dayton, Ohio)</jtitle><addtitle>Oncologist</addtitle><date>2023-03-17</date><risdate>2023</risdate><volume>28</volume><issue>3</issue><spage>e128</spage><epage>e135</epage><pages>e128-e135</pages><issn>1083-7159</issn><eissn>1549-490X</eissn><abstract>Abstract
Background
Polypharmacy is one factor contributing to increased mortality, hospitalization, and adverse drug reactions in older adults. The aim of this study was to measure the prevalence of polypharmacy in a cohort of older women with early-stage operable primary breast cancer and the relationship of polypharmacy to primary treatment decision and functional status.
Methods
A total of 139 patients with a new diagnosis of early-stage operable primary breast cancer proven histologically were recruited as part of a prospective study. The average age was 77 years. Assessment using a cancer-specific Comprehensive Geriatric Assessment (CGA) tool was conducted within 6 weeks of diagnosis of breast cancer. Association was determined between number of medications and treatment decision and physical status as measured by the CGA outcomes. Additional analysis was performed to determine the associations above with polypharmacy defined by ≥5 daily medications, and if cardiovascular-related diseases have a role in the treatment decision.
Results
Polypharmacy was present in 48% of patients (n = 139). CGA determined that polypharmacy was associated with greater comorbidity (P < .001), reduced physical status rated by physicians (P = .009) and patients (P = .019), and reduced ability to perform activities of instrumental ADLs (P = .008). Similar findings were present in the analysis of cardiovascular-related diseases.
Conclusions
This work suggests that patients with polypharmacy are more likely to be frail. The number of medications could help us screen patients who should go on to receive full CGA.
This study measured the prevalence of polypharmacy in a cohort of older women with early-stage operable primary breast cancer and the relationship of polypharmacy to primary treatment decision and functional status.</abstract><cop>US</cop><pub>Oxford University Press</pub><pmid>36718086</pmid><doi>10.1093/oncolo/oyac278</doi><orcidid>https://orcid.org/0000-0003-3832-7431</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | The oncologist (Dayton, Ohio), 2023-03, Vol.28 (3), p.e128-e135 |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Oxford Journals Open Access Collection; EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Aged Aged women Analysis Breast Cancer Breast Neoplasms - drug therapy Breast Neoplasms - surgery Cancer Comorbidity Complications and side effects Decision-making Demographic aspects Diagnosis Drug therapy Drug-Related Side Effects and Adverse Reactions Drugs Evidence-based medicine Female Geriatric Assessment Health aspects Hospitalization Humans Medical screening Middle aged women Mortality Oncology, Experimental Patient compliance Polypharmacy Prospective Studies Risk factors United Kingdom |
| title | The Association Between Medication Use in Older Women with Early-Stage Operable Primary Breast Cancer and Decision Regarding Primary Treatment |
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