Potential Medication Problems in Older Newly Diagnosed Cancer Patients in Canada during Cancer Treatment
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Older cancer patients are possibly at an increased risk of medication-related problems because, typically, they receive many medications during their cancer treatment, both for the cancer itself and for supportive care.
The aim of this study was to describe the number and severity of potential medication problems during treatment of cancer in the first year after diagnosis. We also sought to examine whether patients receiving systemic cancer treatment had more medication-related problems at 3, 6 and 12 months than those not receiving systemic cancer treatment.
This was a prospective pilot cohort study on health and vulnerability in older newly diagnosed cancer patients with 1-year follow-up. The study was conducted at Segal Cancer Centre, Jewish General Hospital, Montreal, Canada. Of 156 eligible patients, 112 agreed to participate (response 71.8%). The patients were aged ≥65 years and were newly diagnosed with breast, colorectal or lung cancer, lymphoma or multiple myeloma. Patients were asked for permission to obtain their list of medications from their pharmacist. The cancer treatment information was abstracted from the medical chart. Vigilance Santé software was used to identify the presence, type and severity of potential medication problems.
The median number of medications was five at baseline, seven at 3 months and six at 6 and 12 months. At baseline, 247 potential medication problems were identified, followed by 273 at 3 months, 229 at 6 months and 188 at 12 months. About half of the patients at each follow-up had one or more moderate or severe potential medication problem. Patients receiving systemic cancer treatment had significantly fewer potential problems at 3 months than patients not receiving systemic cancer treatment, but no differences were observed at 6 and 12 months. The most common warnings were contraindications, interactions and miscellaneous warnings, and the cancer treatment was involved in 12% of all potential problems.
This study showed that the majority of older newly diagnosed cancer patients take prescribed medication and about two-thirds have potential medication problems, of which about half are of at least moderate severity. The cancer treatment was involved in only a small proportion of all potential drug problems.
KeywordsCommunity Pharmacist Tamsulosin Candesartan Cilexetil Pamidronic Acid Medication List
The authors thank all of the patients who gave of their time during a very difficult period in their lives to participate in our study. In addition, the authors very much appreciate the support of the staff and volunteers at the Segal Cancer Centre.
This study was supported through a post-PhD research fellowship of the Canadian Cancer Society/National Cancer Institute of Canada to Dr M.T.E. Puts. The study was sponsored by Solidage McGill University/Université de Montreal Research Group on Frailty and Aging, the McGill Dr Joseph Kaufman Chair in Geriatric Medicine and the Oberlander Fund, Division of Geriatric Medicine, Jewish General Hospital. The sponsors played no role in study design, data collection, data analysis, interpretation of data, writing of the report and the decision to submit the paper for publication.
The authors have no conflicts of interest that are directly relevant to the content of this study.
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