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- Title
Systematic Review and Meta-Analysis on the Associations of Polypharmacy and Potentially Inappropriate Medication With Adverse Outcomes in Older Cancer Patients.
- Authors
Chen, Li-Ju; Trares, Kira; Laetsch, Dana Clarissa; Nguyen, Thi Ngoc Mai; Brenner, Hermann; Schöttker, Ben
- Abstract
<bold>Background: </bold>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.<bold>Methods: </bold>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.<bold>Results: </bold>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.<bold>Conclusions: </bold>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.
- Subjects
INAPPROPRIATE prescribing (Medicine); OLDER patients; POLYPHARMACY; CANCER-related mortality; MORTALITY; CANCER patients; TUMOR treatment; RESEARCH; META-analysis; RESEARCH methodology; SYSTEMATIC reviews; MEDICAL cooperation; EVALUATION research; TREATMENT effectiveness; COMPARATIVE studies; TUMORS
- Publication
Journals of Gerontology Series A: Biological Sciences & Medical Sciences, 2021, Vol 76, Issue 5, p1044
- ISSN
1079-5006
- Publication type
journal article
- DOI
10.1093/gerona/glaa128