Karen Sweiss1,2, Gregory S Calip2,3, Scott Wirth1,2, Damiano Rondelli2,4, Pritesh Patel2,4. 1. Department of Pharmacy Practice, University of Illinois at Chicago, Chicago, IL, USA. 2. Cancer Center, University of Illinois, Chicago, IL, USA. 3. Center for Pharmacoepidemiology and Pharmacoeconomic Research, Chicago IL, USA. 4. Division of Hematology/Oncology, University of Illinois at Chicago, Chicago, IL, USA.
Abstract
OBJECTIVE: To compare polypharmacy and potentially inappropriate medication use in multiple myeloma patients receiving care under a traditional, physician-managed, or collaborative physician-pharmacist clinic. DESIGN: Retrospective chart review. SETTING: Urban academic cancer center. DATA SOURCE: Computerized electronic record. PATIENTS: Forty-four patients in the traditional physician-managed clinic and 57 patients in the collaborative physician-pharmacist clinic. MEASUREMENTS AND MAIN RESULTS: Patients in the collaborative clinic took fewer medications on average (9 vs. 7, p = 0.045). Although the median number of myeloma-related medications was higher (2 vs. 4, p < 0.0001), the number of non-myeloma-related medications was lower (7 vs. 3, p < 0.0001) in the collaborative clinic. Polypharmacy rates were high in both clinics (93% vs. 84%, p = 0.22). However, the collaborative clinic had a lower rate of polypharmacy of non-myeloma medications (71 vs. 33%, p = 0.0003), including both minor (five to nine medications, 48 vs. 28%, p = 0.06) and major (≥10 medications, 23 vs. 5%, p = 0.02) polypharmacy. Minor polypharmacy of myeloma-related medications was higher in the collaborative clinic (32 vs. 2%; p = 0.0002). Multivariate analysis showed a reduced risk of having a higher number of medications (Relative risk (RR) 0.79, 95% confidence interval 0.67-0.93; p = 0.004), a lower risk of having any polypharmacy of non-myeloma-related medications (RR 0.41, 95% confidence interval 0.25-0.67; p < 0.001) and a lower risk of receiving potentially inappropriate medication (RR 0.62, 95% confidence interval 0.41-0.95; p = 0.029) in the collaborative clinic. CONCLUSIONS: Multiple myeloma patients have a high rate of polypharmacy but comanagement with a pharmacist reduced the number of all medications, but in particular the number of non-myeloma-related medications.
OBJECTIVE: To compare polypharmacy and potentially inappropriate medication use in multiple myeloma patients receiving care under a traditional, physician-managed, or collaborative physician-pharmacist clinic. DESIGN: Retrospective chart review. SETTING: Urban academic cancer center. DATA SOURCE: Computerized electronic record. PATIENTS: Forty-four patients in the traditional physician-managed clinic and 57 patients in the collaborative physician-pharmacist clinic. MEASUREMENTS AND MAIN RESULTS: Patients in the collaborative clinic took fewer medications on average (9 vs. 7, p = 0.045). Although the median number of myeloma-related medications was higher (2 vs. 4, p < 0.0001), the number of non-myeloma-related medications was lower (7 vs. 3, p < 0.0001) in the collaborative clinic. Polypharmacy rates were high in both clinics (93% vs. 84%, p = 0.22). However, the collaborative clinic had a lower rate of polypharmacy of non-myeloma medications (71 vs. 33%, p = 0.0003), including both minor (five to nine medications, 48 vs. 28%, p = 0.06) and major (≥10 medications, 23 vs. 5%, p = 0.02) polypharmacy. Minor polypharmacy of myeloma-related medications was higher in the collaborative clinic (32 vs. 2%; p = 0.0002). Multivariate analysis showed a reduced risk of having a higher number of medications (Relative risk (RR) 0.79, 95% confidence interval 0.67-0.93; p = 0.004), a lower risk of having any polypharmacy of non-myeloma-related medications (RR 0.41, 95% confidence interval 0.25-0.67; p < 0.001) and a lower risk of receiving potentially inappropriate medication (RR 0.62, 95% confidence interval 0.41-0.95; p = 0.029) in the collaborative clinic. CONCLUSIONS: Multiple myeloma patients have a high rate of polypharmacy but comanagement with a pharmacist reduced the number of all medications, but in particular the number of non-myeloma-related medications.
Authors: Rahul Banerjee; Ann A Lazar; Lisa Dunn; Jennifer Knoche; Mimi Lo; Shagun Arora; Sandy W Wong; Jeffrey L Wolf; Thomas G Martin; Anand Dhruva; Nina Shah Journal: EJHaem Date: 2021-02-06
Authors: Celeste L Y Ewig; Yi Man Cheng; Hoi Shan Li; Jasper Chak Ling Wong; Alex Hong Yu Cho; Freddie Man Hong Poon; Chi Kong Li; Yin Ting Cheung Journal: Front Oncol Date: 2021-04-01 Impact factor: 6.244