Understanding Multiple Medications: The Concept of Polypharmacy Explained
In the realm of cancer care, a significant concern for healthcare providers is the potential for harmful drug interactions, particularly among older patients. A clinical trial conducted by Dr. Erika Ramsdale at the Wilmot Cancer Institute is shedding light on this issue.
The study reveals that cholesterol-lowering medications, thyroid therapy, and minerals, including common non-prescription remedies such as vitamins, anti-anemic preparations, and drugs for acid-related disorders and constipation, are most commonly involved in potential drug interactions. Over-the-counter medications are often overlooked as a potential risk in polypharmacy among older adults with cancer.
The trial highlights an opportunity for deprescribing, a planned reduction of medications to avoid harm. This approach considers the risks-versus-benefits of each medication and the patient's life expectancy. The study found that the deprescribing intervention effectively reduced the use of benzodiazepines and opioids among cancer patients.
Approximately 25% of the medications used by patients in the study were non-prescription, accounting for 40% of potentially inappropriate medications. This underscores the need for education and problem-solving, including the practice of deprescribing some drugs.
The study also found that nearly 68 percent of the patients had serious health issues besides cancer, requiring associated medications. Cardiovascular disease was the most common. It's crucial to note that approximately 10 percent of hospital admissions for older adults are associated with hazardous drug interactions. Among older adults with cancer receiving chemotherapy, polypharmacy is associated with dramatic increases in unplanned hospitalizations.
Conversations about deprescribing can be delicate, and Ramsdale's study is testing the best way to intervene in cases of polypharmacy among older people with cancer. The findings could pave the way for improved care and outcomes for this vulnerable patient population.
