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An Analysis of the Inclusion of Medications Considered Potentially Inappropriate in Older Adults in Chemotherapy Templates for Hematologic Malignancies: One Recommendation for All?

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Abstract

Background

There remains a paucity of data regarding the use of potentially inappropriate medications (PIMs) in the supportive management of older adults undergoing chemotherapy. Raising awareness among healthcare providers regarding the frequency of their use and potential toxicities may help to minimize the risks to patients.

Objective

The aim of this study was to evaluate the frequency of six specific classes of medications considered PIMs by the American Geriatrics Society Beers Criteria that are commonly included in the National Comprehensive Cancer Network (NCCN) chemotherapy order templates for hematologic malignancies. The six PIMs evaluated are first-generation antihistamines, benzodiazepines, corticosteroids, H2-receptor antagonists, metoclopramide, and antipsychotics.

Methods

A total of 311 unique chemotherapy order templates published online by the NCCN for the treatment of hematologic malignancies were reviewed to determine the frequency that these six specific PIMs were recommended for supportive care.

Results

Approximately 45% of the NCCN chemotherapy templates for hematologic malignancies specifically recommended the use of at least one of the six PIMs examined. The remainder of the templates evaluated referred exclusively to the NCCN Guidelines® on Oncology for Antiemesis, which also included the use of at least one of the six PIMs evaluated.

Conclusions

These findings demonstrate that PIMs are frequently used as supportive therapy in the treatment of hematologic malignancies. Increasing healthcare provider awareness of their potential side effects may minimize the risks associated with their use in older adults with hematologic malignancies undergoing chemotherapy.

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Acknowledgements

The contents of this study are solely the responsibility of the authors and do not necessarily represent the official view of the NCI, NCATS or NIH.

Author information

Authors and Affiliations

  1. Division of Hematology, Department of Medicine, Washington University School of Medicine, Campus Box 8125, 660 South Euclid Avenue, St. Louis, MO, 63110, USA

    Amy Zhou

  2. Division of Geriatric and Palliative Medicine, McGovern Medical School, The University of Texas Health Science Center, Houston, TX, USA

    Holly M. Holmes

  3. City of Hope, Duarte, CA, USA

    Arti Hurria

  4. Division of Oncology, Department of Medicine, Washington University School of Medicine, St Louis, MO, USA

    Tanya M. Wildes

Authors
  1. Amy Zhou
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  2. Holly M. Holmes
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  4. Tanya M. Wildes
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Corresponding author

Correspondence to Amy Zhou.

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Funding

This publication was made possible by grant number 1K12CA167540 through the National Cancer Institute (NCI) at the National Institutes of Health (NIH), and grant number UL1TR000448 through the Clinical and Translational Science Award (CTSA) program of the National Center for Advancing Translational Sciences (NCATS) at the NIH.

Conflict of interest

Tanya Wildes receives research funding from Janssen and has consulted for Carevive Systems. Arti Hurria is a principal investigator for Celgene and Novartis, and a consultant for Boehringer Ingelheim Pharmaceuticals and Pieran Biosciences. Amy Zhou, Holly Holmes, Arti Hurria and Tanya Wildes declare that they have no conflicts of interest directly relevant to the content of this study.

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Zhou, A., Holmes, H.M., Hurria, A. et al. An Analysis of the Inclusion of Medications Considered Potentially Inappropriate in Older Adults in Chemotherapy Templates for Hematologic Malignancies: One Recommendation for All?. Drugs Aging 35, 459–465 (2018). https://doi.org/10.1007/s40266-018-0538-2

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  • DOI: https://doi.org/10.1007/s40266-018-0538-2

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