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Polypharmacy in Older Adults with Cancer: Evaluating Polypharmacy as Part of the Geriatric Assessment

  • Hematology and Oncology (GR Williams, Section Editor)
  • Published:
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Abstract

Purpose of Review

Polypharmacy is a significant public health problem that disproportionally affects older adults who are considered to be the highest consumers of medications. Cancer-related therapy can intensify the prevalence of polypharmacy; however, polypharmacy has inconsistently been included as part of the comprehensive geriatric assessment (CGA). This inconsistency is likely attributed to conflicting study results demonstrating a correlation between polypharmacy and clinical outcomes in older adults with cancer. Despite these inconsistencies, several national and international organization guidelines recommend conducting a polypharmacy evaluation as part of the CGA.

Recent Findings

Some preliminary data suggests a correlation between polypharmacy and negative health outcomes in older adults with cancer including adverse drug events, falls, frailty, hospitalization, postoperative complications, and poorer overall survival.

Summary

This review describes the age-related changes that influence the prescribing of medication for older patients with cancer and some of the most common methods for evaluating polypharmacy as part of the CGA. Changes in the pharmacokinetics and pharmacodynamics of the drugs related to aging and the possibility of end-organ dysfunction must be taken into consideration, particularly the age-related decline of glomerular filtration rate that is not always reflected by an increase in serum creatinine. Interventional studies are still needed to determine how to best evaluate polypharmacy and tailor medication use as part of the CGA in order to reduce the risk of adverse drug reactions when receiving chemotherapy and/or supportive care.

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Funding Information

Manpreet Boparal is an employee of Memorial Sloan Kettering Hospital and is supported by MSK Cancer Center Support/Core Grant (P30 CA008748).

Author information

Authors and Affiliations

  1. Department of Pharmacy Practice, Jefferson College of Pharmacy, Thomas Jefferson University, 901 Walnut Street Suite 946, Philadelphia, PA, 19107, USA

    Ginah Nightingale & Emily Skonecki

  2. Department of Pharmacy, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA

    Manpreet K. Boparai

Authors
  1. Ginah Nightingale
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  2. Emily Skonecki
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  3. Manpreet K. Boparai
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Correspondence to Ginah Nightingale.

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Emily Skoneck and Ginah Nightingale declare no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Hematology and Oncology

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Nightingale, G., Skonecki, E. & Boparai, M.K. Polypharmacy in Older Adults with Cancer: Evaluating Polypharmacy as Part of the Geriatric Assessment. Curr Geri Rep 6, 219–230 (2017). https://doi.org/10.1007/s13670-017-0221-1

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