Research priorities to address polypharmacy in older adults with cancer.

Affiliation

Nightingale G(1), Mohamed MR(2), Holmes HM(3), Sharma M(4), Ramsdale E(5), Lu-Yao G(6), Chapman A(7).
Author information:
(1)Department of Pharmacy Practice, Jefferson College of Pharmacy, Thomas Jefferson University, Philadelphia, PA, USA. Electronic address: [Email]
(2)James P. Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY, USA; Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA.
(3)McGovern Medical School, University of Texas Health Science Center of Houston, Houston, TX, USA.
(4)Pharmacy Administration, School of Pharmacy, University of Mississippi, University, MS, USA.
(5)James P. Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY, USA.
(6)College of Population Health, Thomas Jefferson University, Philadelphia, PA, USA; Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA, USA; Sidney Kimmel Cancer Center, Jefferson Health, Philadelphia, PA, USA.
(7)Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA, USA; Sidney Kimmel Cancer Center, Jefferson Health, Philadelphia, PA, USA.

Abstract

Polypharmacy poses a significant public health problem that disproportionately affects older adults (≥65 years) since this population represents the largest consumers of medications. Clinicians caring for older adults with cancer must rely on evidence to understand polypharmacy and its implications, not only to communicate with patients and other healthcare providers, but also because of the significant interplay between polypharmacy, cancer, cancer-related treatment, and clinical outcomes. Interest in polypharmacy is rising because of its prevalence, the origins and facilitating factors behind it, and the direct and indirect clinical outcomes associated with it. The growing body of publications focused on polypharmacy in older adults with cancer demonstrates that this is a significant area of research; however, limited evidence exists to guide medication use (e.g., prescribing, administration) in this population. Currently, research priorities aimed at polypharmacy in the field of geriatric oncology lack clarity. We identified current gaps in the literature in order to establish research priorities for polypharmacy in older adults with cancer. The five research priorities-Polypharmacy Methodology and Definitions, Suboptimal Medication Use, Comorbidities and Geriatric Syndromes, Underrepresented Groups, and Polypharmacy Interventions-highlight critical areas for future research to improve outcomes for older adults with cancer.