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Effect of polypharmacy and potentially inappropriate medications on treatment and posttreatment courses in elderly patients with head and neck cancer

  • Jun Woo Park
  • Jong-Lyel RohEmail author
  • Sang-wook Lee
  • Sung-Bae Kim
  • Seung-Ho Choi
  • Soon Yuhl Nam
  • Sang Yoon Kim
Original Article – Clinical Oncology

Abstract

Purpose

The use of excessive and inappropriate medications is a common problem in elderly populations. The use of polypharmacy (PP) and potentially inappropriate medication (PIM) may affect treatment-related morbidities in elderly cancer patients, which has rarely been studied in patients with head and neck cancer (HNC). Here, we evaluate the effects of PP and PIM on treatment and posttreatment courses in elderly HNC patients.

Methods

This study included 229 elderly HNC patients who underwent definitive treatment. Medications were carefully recorded, and the prevalences of PP and PIM are reported. We evaluated the associations between PP, PIM, treatment, and posttreatment course in terms of comorbidities, treatment-related toxicity, prolonged hospitalization, and posttreatment noncancer health events.

Results

The prevalences of PP and PIM in our elderly HNC patients were 29.3 and 24.0 %, respectively, and frequently described PIMs include aspirin (12.2 %), calcium channel blockers (4.8 %), benzodiazepines (4.3 %), and nonsteroidal anti-inflammatory drugs (3.9 %). PP and PIM were not significantly associated with treatment-related toxicity, but were associated with modestly increased prolonged hospitalization [odds ratio [OR] 2.30 (95 % confidence interval 0.89–5.95); P = 0.080] and noncancer health events [OR 1.81 (0.99–3.31); P = 0.052], respectively. Among high-risk medications, benzodiazepine [OR 5.09 (1.21–21.5); P = 0.015] and calcium channel blockers [OR 5.69 (1.07–33.25); P = 0.031) were significantly associated with prolonged hospitalization.

Conclusions

Neither PP nor PIM are significantly associated with treatment-related toxicity in elderly HNC patients, but these are associated with modest increases in prolonged hospitalization and noncancer health events.

Keywords

Head and neck cancer Elderly patients Polypharmacy Potentially inappropriate medication Treatment 

Notes

Acknowledgments

This study was supported by a Grant (2015R1A2A1A15054540) from Basic Science Research Program through the National Research Foundation of Korea (NRF), Ministry of Science, ICT, and Future Planning, and a Grant (HI15C2920) from the Korean Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), Ministry of Health & Welfare, Seoul, Republic of Korea (J.L. Roh).

Compliance with ethical standards

Conflict of interest

The authors have no conflict of interests to disclose.

Supplementary material

432_2015_2108_MOESM1_ESM.doc (36 kb)
Supplementary material 1 (DOC 36 kb)

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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Jun Woo Park
    • 1
  • Jong-Lyel Roh
    • 1
    Email author
  • Sang-wook Lee
    • 2
  • Sung-Bae Kim
    • 3
  • Seung-Ho Choi
    • 1
  • Soon Yuhl Nam
    • 1
  • Sang Yoon Kim
    • 1
  1. 1.Department of Otolaryngology, Asan Medical CentreUniversity of Ulsan College of MedicineSeoulRepublic of Korea
  2. 2.Department of Radiation Oncology, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
  3. 3.Department of Internal Medicine (Oncology), Asan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea

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