Dataset Information

Geriatric assessment-driven polypharmacy discussions between oncologists, older patients, and their caregivers.

ABSTRACT:

Objectives

Polypharmacy (PP) and potentially inappropriate medications (PIM) are common in older adults with cancer, increasing the risk of adverse outcomes. Approaches to identifying and addressing PP/PIM are needed.

Materials and methods

Patients ≥70 years with advanced cancer were enrolled in this cluster-randomized study. All underwent geriatric assessment (GA), and oncologists randomized to the intervention arm received GA-driven recommendations; no information was provided to oncologists at usual care sites. For patients with PP (≥5 medications or ≥1 high-risk medication), clinic visits with treating oncologists were audiorecorded and transcribed, and discussions regarding PP/PIM identified. Quality of provider response was coded as dismissed, mentioned, acknowledged, or addressed.

Results

Forty patient transcripts were analyzed (20 per arm). More discussions occurred in the intervention group (n = 81) versus the usual care group (n = 51). More concerns per patient were brought up in the intervention group (4.1 vs. 2.6, p = 0.07). Physician-initiated discussions were higher in the intervention group (73% vs. 49%, p = 0.006). More PP concerns were "addressed" in the intervention group (59% vs. 45%, p = 0.1). Oncology supportive care medication concerns were more often addressed in the usual care group (58% vs. 18%, p = 0.008), but medication management concerns were addressed more commonly in the intervention group (38% vs. 79%, p = 0.003).

Conclusion

In this secondary analysis, a GA-driven intervention increased PP discussions, particularly about total number of medications and medication management. PP/PIM concerns were more commonly addressed in the intervention group, except for the subset of conversations about supportive care medications.

SUBMITTER: Ramsdale E

PROVIDER: S-EPMC6113101 | biostudies-literature | 2018 Sep

REPOSITORIES: biostudies-literature

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Publications

Geriatric assessment-driven polypharmacy discussions between oncologists, older patients, and their caregivers.

Ramsdale Erika E Lemelman Tatyana T Loh Kah Poh KP Flannery Marie M Kehoe Lee L Mullaney Teraisa T Wells Megan M Gilmore Nikesha N Plumb Sandy S Mohile Supriya S

Journal of geriatric oncology 20180309 5

<h4>Objectives</h4>Polypharmacy (PP) and potentially inappropriate medications (PIM) are common in older adults with cancer, increasing the risk of adverse outcomes. Approaches to identifying and addressing PP/PIM are needed.<h4>Materials and methods</h4>Patients ≥70 years with advanced cancer were enrolled in this cluster-randomized study. All underwent geriatric assessment (GA), and oncologists randomized to the intervention arm received GA-driven recommendations; no information was provided t ...[more]

PMID: 29530495

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Dataset Information

Geriatric assessment-driven polypharmacy discussions between oncologists, older patients, and their caregivers.

Objectives

Materials and methods

Results

Conclusion

Publications

Geriatric assessment-driven polypharmacy discussions between oncologists, older patients, and their caregivers.

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