Potentially Inappropriate Medications, Frailty, and Outcomes in Patients With Cancer Managed in a National Health...

Area of Science:

• Geriatric Oncology
• Pharmacology
• Cancer Care

Background:

• Geriatric Oncology Potentially Inappropriate Medications (GO-PIMs) scale operationalizes NCCN high-risk medication list for older adults.
• Previous research established the GO-PIMs scale for identifying high-risk medications in elderly cancer patients.

Purpose of the Study:

• Evaluate the GO-PIMs scale's ability to identify high-risk medications.
• Assess the impact of GO-PIMs on patients with solid and liquid tumors within a national healthcare system.

Main Methods:

• Retrospective cohort study using Veterans Affairs (VA) Cancer Registry and electronic health records (2000-2022).
• Assessed GO-PIMs count from prescriptions 90 days before cancer diagnosis.
• Examined associations between GO-PIMs, baseline frailty (VA-FI), unplanned hospitalization, and mortality using multivariable models.

Main Results:

• 388,113 newly diagnosed cancer patients included; 38% received at least one GO-PIM.
• Each additional GO-PIM increased odds of frailty by 66% (aOR, 1.66).
• Each additional GO-PIM was associated with higher hazard of hospitalization (aHR, 1.08) and mortality (aHR, 1.07).

Conclusions:

• Increasing GO-PIMs are independently associated with higher risk of frailty at diagnosis.
• Higher GO-PIMs correlate with increased risk of unplanned hospitalization and mortality in cancer patients.
• The GO-PIMs scale effectively identifies high-risk medications impacting outcomes in a large national healthcare setting.