Optimising Medications for Patients With Cancer and Multimorbidity: The Case for Deprescribing

Area of Science:

• Geriatric oncology
• Clinical pharmacology
• Patient safety

Background:

• Most cancer patients are elderly (over 65) and present with pre-existing chronic conditions.
• Cancer diagnosis and treatment can exacerbate existing conditions and increase the risk of developing new ones.
• The presence of multimorbidity complicates care, potentially altering treatment goals and focus.

Purpose of the Study:

• To highlight the challenges of managing cancer patients with multimorbidity.
• To emphasize the link between multimorbidity, polypharmacy, and adverse health outcomes.
• To advocate for systematic medication review and deprescribing in oncology.

Main Methods:

• Review of existing literature on cancer, aging, and multimorbidity.
• Analysis of the impact of polypharmacy and inappropriate medication use in this population.
• Identification of resources for medication management and deprescribing.

Main Results:

• Multimorbidity is common in older cancer patients and increases post-diagnosis.
• Polypharmacy, inappropriate medications, and drug interactions are frequent, impacting outcomes and costs.
• Systematic medication review is crucial for balancing treatment benefits and harms.

Conclusions:

• Effective management of older cancer patients requires addressing multimorbidity and polypharmacy.
• Regular medication review and deprescribing are essential components of optimal cancer care.
• Available resources can guide clinicians and patients in medication management strategies.