David Y Leger1, Stephane Moreau2, Nicolas Signol3, Jean-Baptiste Fargeas3, Marie-Agnès Picat4, Amélie Penot2, Julie Abraham2, Marie-Laure Laroche5, Dominique Bordessoule6. 1. Service d'Hématologie Clinique et Thérapie Cellulaire, CHU Dupuytren, Limoges, France; Laboratoire de Chimie des Substances Naturelles, Faculté de Pharmacie, Université de Limoges, FR 3503, GEIST, EA1069, Limoges, France. 2. Service d'Hématologie Clinique et Thérapie Cellulaire, CHU Dupuytren, Limoges, France. 3. Service d'Hématologie Clinique et Thérapie Cellulaire, CHU Dupuytren, Limoges, France; Unité de Coordination OncoGériatrique HéLim, CHU Dupuytren, Limoges, France. 4. Unité de Coordination OncoGériatrique HéLim, CHU Dupuytren, Limoges, France; Service de Médecine Interne Gériatrique, CHU Dupuytren, Limoges, France. 5. Service de Pharmacologie, Toxicologie et Pharmacovigilance, CHU Dupuytren, Limoges, France. 6. Service d'Hématologie Clinique et Thérapie Cellulaire, CHU Dupuytren, Limoges, France; Unité de Coordination OncoGériatrique HéLim, CHU Dupuytren, Limoges, France. Electronic address: dominique.bordessoule@chu-limoges.fr.
Abstract
OBJECTIVES: Geriatric patients with hematologic malignancies (HMs) are prescribed targeted and supportive care treatments that add to the preexisting polypharmacy (PP). PP is associated with an increased risk of potentially inappropriate medications (PIM) and drug-drug interactions (DDI) resulting in increased hospitalization and mortality in the elderly. As very few data exist on these medication issues in the context of HMs, the objective of this study was to evaluate prevalence of PP, DDI and PIM use at baseline and 3months among elderly patients with HMs who received baseline geriatric assessment. METHODS: PP, DDI and PIM use were assessed by a clinical pharmacist at two time points in patients over 75years with HMs undergoing chemotherapy. PP was defined as the concurrent use of five or more medications. DDIs were evaluated according to the literature and prescription analysis software. PIMs were assessed according to the Laroche list. RESULTS: 122 patients (mean age 81.5; 6.6 medications) were included and after 3months, 86 patients (5.8 medications) were available for a second assessment. Prevalence of PP, PIM and DDI at inclusion was 75.4%, 34.4% and 71.3%, respectively. PP was the only medication risk that was significantly reduced (p<0.05) at 3months (65.1%) compared to admission. CONCLUSION: This observational study highlighted that PP decreased over time but neither DDI nor PIM use were reduced. A pharmacist-led evaluation might help to manage these medication issues.
OBJECTIVES: Geriatric patients with hematologic malignancies (HMs) are prescribed targeted and supportive care treatments that add to the preexisting polypharmacy (PP). PP is associated with an increased risk of potentially inappropriate medications (PIM) and drug-drug interactions (DDI) resulting in increased hospitalization and mortality in the elderly. As very few data exist on these medication issues in the context of HMs, the objective of this study was to evaluate prevalence of PP, DDI and PIM use at baseline and 3months among elderly patients with HMs who received baseline geriatric assessment. METHODS: PP, DDI and PIM use were assessed by a clinical pharmacist at two time points in patients over 75years with HMs undergoing chemotherapy. PP was defined as the concurrent use of five or more medications. DDIs were evaluated according to the literature and prescription analysis software. PIMs were assessed according to the Laroche list. RESULTS: 122 patients (mean age 81.5; 6.6 medications) were included and after 3months, 86 patients (5.8 medications) were available for a second assessment. Prevalence of PP, PIM and DDI at inclusion was 75.4%, 34.4% and 71.3%, respectively. PP was the only medication risk that was significantly reduced (p<0.05) at 3months (65.1%) compared to admission. CONCLUSION: This observational study highlighted that PP decreased over time but neither DDI nor PIM use were reduced. A pharmacist-led evaluation might help to manage these medication issues.