Potential Medication-Related Problems in Older Breast, Colon, and Lung Cancer Patients in the United States
Older adults are often exposed to multiple medications, some of which could be inappropriate or have the potential to interact with each other. Older cancer patients may be at increased risk for medication-related problems due to exposure to cancer-directed treatment. We described patterns of potent...
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| Veröffentlicht in: | Cancer epidemiology, biomarkers & prevention biomarkers & prevention, 2018-01, Vol.27 (1), p.41-49 |
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| creator | Lund, Jennifer L Sanoff, Hanna K Peacock Hinton, Sharon Muss, Hyman B Pate, Virginia Stürmer, Til |
| description | Older adults are often exposed to multiple medications, some of which could be inappropriate or have the potential to interact with each other. Older cancer patients may be at increased risk for medication-related problems due to exposure to cancer-directed treatment.
We described patterns of potentially inappropriate medication (PIM) use and potential drug-chemotherapy interactions among adults age 66+ years diagnosed with stage I-III breast, stage II-III colon, and stage I to II lung cancer. Within the Surveillance, Epidemiology, and End Results-Medicare database, patients had to have Medicare Part D coverage with 1+ prescription in the diagnosis month and Medicare Parts A/B coverage in the prior 12 months. We estimated monthly prevalence of any and cancer-related PIM from 6 months pre- to 23 months postcancer diagnosis and 12-month period prevalence of potential drug-chemotherapy interactions.
Overall, 19,318 breast, 7,283 colon, and 7,237 lung cancer patients were evaluated. Monthly PIM prevalence was stable prediagnosis (37%-40%), but increased in the year following a colon or lung cancer diagnosis, and decreased following a breast cancer diagnosis. Changes in PIM prevalence were driven primarily by cancer-related PIM in patients on chemotherapy. Potential drug-chemotherapy interactions were observed in all cohorts, with prevalent interactions involving hydrochlorothiazide, warfarin, and proton-pump inhibitors.
There was a high burden of potential medication-related problems among older cancer patients; future research to evaluate outcomes of these exposures is warranted.
Older adults diagnosed with cancer have unique medication management needs. Thus, pharmacy specialists should be integrated into multidisciplinary teams caring for these patients.
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| doi_str_mv | 10.1158/1055-9965.EPI-17-0523 |
| format | Article |
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We described patterns of potentially inappropriate medication (PIM) use and potential drug-chemotherapy interactions among adults age 66+ years diagnosed with stage I-III breast, stage II-III colon, and stage I to II lung cancer. Within the Surveillance, Epidemiology, and End Results-Medicare database, patients had to have Medicare Part D coverage with 1+ prescription in the diagnosis month and Medicare Parts A/B coverage in the prior 12 months. We estimated monthly prevalence of any and cancer-related PIM from 6 months pre- to 23 months postcancer diagnosis and 12-month period prevalence of potential drug-chemotherapy interactions.
Overall, 19,318 breast, 7,283 colon, and 7,237 lung cancer patients were evaluated. Monthly PIM prevalence was stable prediagnosis (37%-40%), but increased in the year following a colon or lung cancer diagnosis, and decreased following a breast cancer diagnosis. Changes in PIM prevalence were driven primarily by cancer-related PIM in patients on chemotherapy. Potential drug-chemotherapy interactions were observed in all cohorts, with prevalent interactions involving hydrochlorothiazide, warfarin, and proton-pump inhibitors.
There was a high burden of potential medication-related problems among older cancer patients; future research to evaluate outcomes of these exposures is warranted.
Older adults diagnosed with cancer have unique medication management needs. Thus, pharmacy specialists should be integrated into multidisciplinary teams caring for these patients.
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We described patterns of potentially inappropriate medication (PIM) use and potential drug-chemotherapy interactions among adults age 66+ years diagnosed with stage I-III breast, stage II-III colon, and stage I to II lung cancer. Within the Surveillance, Epidemiology, and End Results-Medicare database, patients had to have Medicare Part D coverage with 1+ prescription in the diagnosis month and Medicare Parts A/B coverage in the prior 12 months. We estimated monthly prevalence of any and cancer-related PIM from 6 months pre- to 23 months postcancer diagnosis and 12-month period prevalence of potential drug-chemotherapy interactions.
Overall, 19,318 breast, 7,283 colon, and 7,237 lung cancer patients were evaluated. Monthly PIM prevalence was stable prediagnosis (37%-40%), but increased in the year following a colon or lung cancer diagnosis, and decreased following a breast cancer diagnosis. Changes in PIM prevalence were driven primarily by cancer-related PIM in patients on chemotherapy. Potential drug-chemotherapy interactions were observed in all cohorts, with prevalent interactions involving hydrochlorothiazide, warfarin, and proton-pump inhibitors.
There was a high burden of potential medication-related problems among older cancer patients; future research to evaluate outcomes of these exposures is warranted.
Older adults diagnosed with cancer have unique medication management needs. Thus, pharmacy specialists should be integrated into multidisciplinary teams caring for these patients.
.</description><subject>Aged</subject><subject>Antineoplastic Agents - adverse effects</subject><subject>Breast cancer</subject><subject>Breast Neoplasms - drug therapy</subject><subject>Chemotherapy</subject><subject>Colon</subject><subject>Colon cancer</subject><subject>Colonic Neoplasms - drug therapy</subject><subject>Colorectal cancer</subject><subject>Cross-Sectional Studies</subject><subject>Diagnosis</subject><subject>Drug-Related Side Effects and Adverse Reactions - prevention & control</subject><subject>Epidemiology</subject><subject>Exposure</subject><subject>Female</subject><subject>Government programs</subject><subject>Health risks</subject><subject>Humans</subject><subject>Hydrochlorothiazide</subject><subject>Inappropriate Prescribing - adverse effects</subject><subject>Inappropriate Prescribing - prevention & control</subject><subject>Inappropriate Prescribing - statistics & numerical data</subject><subject>Lung cancer</subject><subject>Lung Neoplasms - drug therapy</subject><subject>Male</subject><subject>Medical diagnosis</subject><subject>Multiple Chronic Conditions - drug therapy</subject><subject>Neoplasm Staging</subject><subject>Older people</subject><subject>Polypharmacy</subject><subject>Potentially Inappropriate Medication List</subject><subject>Proton pump inhibitors</subject><subject>Risk Factors</subject><subject>United States</subject><subject>Warfarin</subject><issn>1055-9965</issn><issn>1538-7755</issn><issn>1538-7755</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkV1rFDEUhoNUbF39CUrAGy86NZmZfN0IutS6sNJF7XU4M8m2abNJm2QE_72ZflF7lcB534dzeBB6R8kRpUx-ooSxRinOjo43q4aKhrC2e4EOKOtkIwRje_X_kNlHr3O-JIQIxdgrtN9KJSTj3QG62sRiQ3Hg8Q9r3AjFxdD8tB6KNXiT4uDtLmMX8Kk3NuGvyUIuh3gZfQyHGILB6ymc4yWEsY43tV9xt4VyYfFZcDPnV6m4_Aa93ILP9u39u0Bn345_L78369OT1fLLuhn7TpXGjpR2ZqQ9BcONhMEIAdywfqBi23IhOSV0UINVTApQvRykJQQAtoQYZni3QJ_vuNfTsLNmrAsl8Po6uR2kvzqC0_9PgrvQ5_GPZoKTrp0BH-8BKd5MNhe9c3m03kOwccqaql5wKnomavTDs-hlnFKo5-mWEC4lUW1bU-wuNaaYc7Lbx2Uo0bNOPavSsypddWoq9Kyz9t4_veSx9eCv-wfhaJxK</recordid><startdate>20180101</startdate><enddate>20180101</enddate><creator>Lund, Jennifer L</creator><creator>Sanoff, Hanna K</creator><creator>Peacock Hinton, Sharon</creator><creator>Muss, Hyman B</creator><creator>Pate, Virginia</creator><creator>Stürmer, Til</creator><general>American Association for Cancer Research, Inc</general><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>7TM</scope><scope>7TO</scope><scope>H94</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20180101</creationdate><title>Potential Medication-Related Problems in Older Breast, Colon, and Lung Cancer Patients in the United States</title><author>Lund, Jennifer L ; Sanoff, Hanna K ; Peacock Hinton, Sharon ; Muss, Hyman B ; Pate, Virginia ; Stürmer, Til</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c439t-ec113dc141ad6d8abd77a6d54b17f26786101b9be9587a948b8e00aaaf00d5d63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Aged</topic><topic>Antineoplastic Agents - adverse effects</topic><topic>Breast cancer</topic><topic>Breast Neoplasms - drug therapy</topic><topic>Chemotherapy</topic><topic>Colon</topic><topic>Colon cancer</topic><topic>Colonic Neoplasms - drug therapy</topic><topic>Colorectal cancer</topic><topic>Cross-Sectional Studies</topic><topic>Diagnosis</topic><topic>Drug-Related Side Effects and Adverse Reactions - prevention & control</topic><topic>Epidemiology</topic><topic>Exposure</topic><topic>Female</topic><topic>Government programs</topic><topic>Health risks</topic><topic>Humans</topic><topic>Hydrochlorothiazide</topic><topic>Inappropriate Prescribing - adverse effects</topic><topic>Inappropriate Prescribing - prevention & control</topic><topic>Inappropriate Prescribing - statistics & numerical data</topic><topic>Lung cancer</topic><topic>Lung Neoplasms - drug therapy</topic><topic>Male</topic><topic>Medical diagnosis</topic><topic>Multiple Chronic Conditions - drug therapy</topic><topic>Neoplasm Staging</topic><topic>Older people</topic><topic>Polypharmacy</topic><topic>Potentially Inappropriate Medication List</topic><topic>Proton pump inhibitors</topic><topic>Risk Factors</topic><topic>United States</topic><topic>Warfarin</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lund, Jennifer L</creatorcontrib><creatorcontrib>Sanoff, Hanna K</creatorcontrib><creatorcontrib>Peacock Hinton, Sharon</creatorcontrib><creatorcontrib>Muss, Hyman B</creatorcontrib><creatorcontrib>Pate, Virginia</creatorcontrib><creatorcontrib>Stürmer, Til</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Nucleic Acids Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Cancer epidemiology, biomarkers & prevention</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lund, Jennifer L</au><au>Sanoff, Hanna K</au><au>Peacock Hinton, Sharon</au><au>Muss, Hyman B</au><au>Pate, Virginia</au><au>Stürmer, Til</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Potential Medication-Related Problems in Older Breast, Colon, and Lung Cancer Patients in the United States</atitle><jtitle>Cancer epidemiology, biomarkers & prevention</jtitle><addtitle>Cancer Epidemiol Biomarkers Prev</addtitle><date>2018-01-01</date><risdate>2018</risdate><volume>27</volume><issue>1</issue><spage>41</spage><epage>49</epage><pages>41-49</pages><issn>1055-9965</issn><issn>1538-7755</issn><eissn>1538-7755</eissn><abstract>Older adults are often exposed to multiple medications, some of which could be inappropriate or have the potential to interact with each other. Older cancer patients may be at increased risk for medication-related problems due to exposure to cancer-directed treatment.
We described patterns of potentially inappropriate medication (PIM) use and potential drug-chemotherapy interactions among adults age 66+ years diagnosed with stage I-III breast, stage II-III colon, and stage I to II lung cancer. Within the Surveillance, Epidemiology, and End Results-Medicare database, patients had to have Medicare Part D coverage with 1+ prescription in the diagnosis month and Medicare Parts A/B coverage in the prior 12 months. We estimated monthly prevalence of any and cancer-related PIM from 6 months pre- to 23 months postcancer diagnosis and 12-month period prevalence of potential drug-chemotherapy interactions.
Overall, 19,318 breast, 7,283 colon, and 7,237 lung cancer patients were evaluated. Monthly PIM prevalence was stable prediagnosis (37%-40%), but increased in the year following a colon or lung cancer diagnosis, and decreased following a breast cancer diagnosis. Changes in PIM prevalence were driven primarily by cancer-related PIM in patients on chemotherapy. Potential drug-chemotherapy interactions were observed in all cohorts, with prevalent interactions involving hydrochlorothiazide, warfarin, and proton-pump inhibitors.
There was a high burden of potential medication-related problems among older cancer patients; future research to evaluate outcomes of these exposures is warranted.
Older adults diagnosed with cancer have unique medication management needs. Thus, pharmacy specialists should be integrated into multidisciplinary teams caring for these patients.
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| ispartof | Cancer epidemiology, biomarkers & prevention, 2018-01, Vol.27 (1), p.41-49 |
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| source | MEDLINE; American Association for Cancer Research; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Aged Antineoplastic Agents - adverse effects Breast cancer Breast Neoplasms - drug therapy Chemotherapy Colon Colon cancer Colonic Neoplasms - drug therapy Colorectal cancer Cross-Sectional Studies Diagnosis Drug-Related Side Effects and Adverse Reactions - prevention & control Epidemiology Exposure Female Government programs Health risks Humans Hydrochlorothiazide Inappropriate Prescribing - adverse effects Inappropriate Prescribing - prevention & control Inappropriate Prescribing - statistics & numerical data Lung cancer Lung Neoplasms - drug therapy Male Medical diagnosis Multiple Chronic Conditions - drug therapy Neoplasm Staging Older people Polypharmacy Potentially Inappropriate Medication List Proton pump inhibitors Risk Factors United States Warfarin |
| title | Potential Medication-Related Problems in Older Breast, Colon, and Lung Cancer Patients in the United States |
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