Polypharmacy in the Older Patient With Cancer

BACKGROUND: Elderly patients -- those aged 65 years and over -- use more medications than their younger counterparts and experience higher risks for polypharmacy, drug interactions, adverse drug reactions, and noncompliance for this age-group. METHODS: The data on polypharmacy in the aged is reviewed, supplemented with preliminary information from studies performed on elderly patients with cancer at our institution. RESULTS: Polypharmacy occurs in ambulatory, extended care, and institutional settings. Over-the-counter medications are underreported. The number of potential drug-related problems is related to the total number of prescriptions. Methods for evaluating the extent of polypharmacy include the "brown-bag" technique and careful medication histories. CONCLUSIONS: The risks of polypharmacy may be reduced with patient and physician education, intervention, and drug monitoring. Further pharmacokinetic investigations of anticancer medications are needed to recognize the potential for harmful drug interactions, to understand their toxicity profiles, and to avoid the clinical implications of drug interactions.