Amy Zhou1, Holly M Holmes2, Arti Hurria3, Tanya M Wildes4. 1. Division of Hematology, Department of Medicine, Washington University School of Medicine, Campus Box 8125, 660 South Euclid Avenue, St. Louis, MO, 63110, USA. a.zhou@wustl.edu. 2. Division of Geriatric and Palliative Medicine, McGovern Medical School, The University of Texas Health Science Center, Houston, TX, USA. 3. City of Hope, Duarte, CA, USA. 4. Division of Oncology, Department of Medicine, Washington University School of Medicine, St Louis, MO, USA.
Abstract
BACKGROUND: There remains a paucity of data regarding the use of potentially inappropriate medications (PIMs) in the supportive management of older adults undergoing chemotherapy. Raising awareness among healthcare providers regarding the frequency of their use and potential toxicities may help to minimize the risks to patients. OBJECTIVE: The aim of this study was to evaluate the frequency of six specific classes of medications considered PIMs by the American Geriatrics Society Beers Criteria that are commonly included in the National Comprehensive Cancer Network (NCCN) chemotherapy order templates for hematologic malignancies. The six PIMs evaluated are first-generation antihistamines, benzodiazepines, corticosteroids, H2-receptor antagonists, metoclopramide, and antipsychotics. METHODS: A total of 311 unique chemotherapy order templates published online by the NCCN for the treatment of hematologic malignancies were reviewed to determine the frequency that these six specific PIMs were recommended for supportive care. RESULTS: Approximately 45% of the NCCN chemotherapy templates for hematologic malignancies specifically recommended the use of at least one of the six PIMs examined. The remainder of the templates evaluated referred exclusively to the NCCN Guidelines® on Oncology for Antiemesis, which also included the use of at least one of the six PIMs evaluated. CONCLUSIONS: These findings demonstrate that PIMs are frequently used as supportive therapy in the treatment of hematologic malignancies. Increasing healthcare provider awareness of their potential side effects may minimize the risks associated with their use in older adults with hematologic malignancies undergoing chemotherapy.
BACKGROUND: There remains a paucity of data regarding the use of potentially inappropriate medications (PIMs) in the supportive management of older adults undergoing chemotherapy. Raising awareness among healthcare providers regarding the frequency of their use and potential toxicities may help to minimize the risks to patients. OBJECTIVE: The aim of this study was to evaluate the frequency of six specific classes of medications considered PIMs by the American Geriatrics Society Beers Criteria that are commonly included in the National Comprehensive Cancer Network (NCCN) chemotherapy order templates for hematologic malignancies. The six PIMs evaluated are first-generation antihistamines, benzodiazepines, corticosteroids, H2-receptor antagonists, metoclopramide, and antipsychotics. METHODS: A total of 311 unique chemotherapy order templates published online by the NCCN for the treatment of hematologic malignancies were reviewed to determine the frequency that these six specific PIMs were recommended for supportive care. RESULTS: Approximately 45% of the NCCN chemotherapy templates for hematologic malignancies specifically recommended the use of at least one of the six PIMs examined. The remainder of the templates evaluated referred exclusively to the NCCN Guidelines® on Oncology for Antiemesis, which also included the use of at least one of the six PIMs evaluated. CONCLUSIONS: These findings demonstrate that PIMs are frequently used as supportive therapy in the treatment of hematologic malignancies. Increasing healthcare provider awareness of their potential side effects may minimize the risks associated with their use in older adults with hematologic malignancies undergoing chemotherapy.
Authors: Arti Hurria; Kayo Togawa; Supriya G Mohile; Cynthia Owusu; Heidi D Klepin; Cary P Gross; Stuart M Lichtman; Ajeet Gajra; Smita Bhatia; Vani Katheria; Shira Klapper; Kurt Hansen; Rupal Ramani; Mark Lachs; F Lennie Wong; William P Tew Journal: J Clin Oncol Date: 2011-08-01 Impact factor: 44.544
Authors: Davy Tawadrous; Stephanie Dixon; Salimah Z Shariff; Jamie Fleet; Sonja Gandhi; Arsh K Jain; Matthew A Weir; Tara Gomes; Amit X Garg Journal: Eur J Intern Med Date: 2014-07-16 Impact factor: 4.487
Authors: Arti Hurria; Laura A Levit; William Dale; Supriya G Mohile; Hyman B Muss; Louis Fehrenbacher; Allison Magnuson; Stuart M Lichtman; Suanna S Bruinooge; Enrique Soto-Perez-de-Celis; William P Tew; Michael A Postow; Harvey J Cohen Journal: J Clin Oncol Date: 2015-07-20 Impact factor: 44.544