BACKGROUND: Both polypharmacy and potentially inappropriate medication (PIM) intake are highly prevailing in older cancer patients. However, only studies on the association of polypharmacy and postoperative complications have been meta-analyzed previously. METHODS: A systematic review and a meta-analysis of prospective/retrospective observational studies reporting associations of polypharmacy or PIM with at least one out of five predefined adverse health outcomes in a population of older cancer patients (≥60 years) were carried out. PubMed and Web of Science were used to search for relevant studies published between January 1991 and March 2020. Data were pooled by adopting a random-effects model. RESULTS: Overall, 42 publications were included in the systematic review. Meta-analyses could be performed on 39 studies about polypharmacy and 13 studies about PIM. Polypharmacy was found to be statistically significantly associated with all-cause mortality (risk ratio [95% confidence interval]: 1.37 [1.25-1.50]), hospitalization (1.53 [1.37-1.71]), treatment-related toxicity (1.22 [1.01-1.47]), and postoperative complications (1.73 [1.36-2.20]). The association of polypharmacy with prolongation of hospitalization was not statistically significant at the p < .05 significance level (1.62 [0.98-2.66]). With respect to PIM, a statistically significant association with all-cause mortality (1.43 [1.08-1.88]) was observed but not with other adverse outcomes. CONCLUSIONS: Polypharmacy was found to be associated with several adverse outcomes and PIM use with all-cause mortality in older cancer patients. However, these results should be interpreted with caution because about three-quarters of the studies identified did not adjust for comorbidity and are prone to confounding by indication.
BACKGROUND: Both polypharmacy and potentially inappropriate medication (PIM) intake are highly prevailing in older cancerpatients. However, only studies on the association of polypharmacy and postoperative complications have been meta-analyzed previously. METHODS: A systematic review and a meta-analysis of prospective/retrospective observational studies reporting associations of polypharmacy or PIM with at least one out of five predefined adverse health outcomes in a population of older cancerpatients (≥60 years) were carried out. PubMed and Web of Science were used to search for relevant studies published between January 1991 and March 2020. Data were pooled by adopting a random-effects model. RESULTS: Overall, 42 publications were included in the systematic review. Meta-analyses could be performed on 39 studies about polypharmacy and 13 studies about PIM. Polypharmacy was found to be statistically significantly associated with all-cause mortality (risk ratio [95% confidence interval]: 1.37 [1.25-1.50]), hospitalization (1.53 [1.37-1.71]), treatment-related toxicity (1.22 [1.01-1.47]), and postoperative complications (1.73 [1.36-2.20]). The association of polypharmacy with prolongation of hospitalization was not statistically significant at the p < .05 significance level (1.62 [0.98-2.66]). With respect to PIM, a statistically significant association with all-cause mortality (1.43 [1.08-1.88]) was observed but not with other adverse outcomes. CONCLUSIONS: Polypharmacy was found to be associated with several adverse outcomes and PIM use with all-cause mortality in older cancerpatients. However, these results should be interpreted with caution because about three-quarters of the studies identified did not adjust for comorbidity and are prone to confounding by indication.
Authors: Daniel R Dickstein; Eric J Lehrer; Kristin Hsieh; Alexandra Hotca; Brianna M Jones; Ann Powers; Sonam Sharma; Jerry Liu; Vishal Gupta; Loren Mell; Zain Husain; Diana Kirke; Krzysztof Misiukiewicz; Marshall Posner; Eric Genden; Richard L Bakst Journal: Cancers (Basel) Date: 2022-06-05 Impact factor: 6.575
Authors: Lisa Cooper; Aaron R Dezube; Luis E De León; Sam Fox; Carlos E Bravo-Iñiguez; Emanuele Mazzola; Jeffrey Tarascio; Kristin Cardin; Clark DuMontier; Michael T Jaklitsch; Laura N Frain Journal: J Geriatr Oncol Date: 2021-08-06 Impact factor: 3.929
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Authors: Peter M Anderson; Stefanie M Thomas; Shauna Sartoski; Jacob G Scott; Kaitlin Sobilo; Sara Bewley; Laura K Salvador; Maritza Salazar-Abshire Journal: Nutrients Date: 2021-12-08 Impact factor: 5.717