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Lancet Oncol. 2015 Jul;16(7):e333-41. doi: 10.1016/S1470-2045(15)00080-7.

Polypharmacy in patients with advanced cancer and the role of medication discontinuation.

Author information

1
Duke Cancer Institute, Durham, NC, USA; Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Durham, NC, USA; Center for Learning Health Care, Duke Clinical Research Institute, Durham, NC, USA. Electronic address: thomas.leblanc@duke.edu.
2
Duke University School of Medicine, Durham, NC, USA; Center for Learning Health Care, Duke Clinical Research Institute, Durham, NC, USA.
3
Duke Cancer Institute, Durham, NC, USA; Division of Medical Oncology, Department of Medicine, Durham, NC, USA; Center for Learning Health Care, Duke Clinical Research Institute, Durham, NC, USA.
4
Palliative and Supportive Services, Flinders University, Adelaide, SA, Australia.

Abstract

Polypharmacy is a well known problem in elderly patients in general, but its prevalence and effects in patients with cancer are less clear, particularly in end-of-life settings. This Review examines the existing literature on polypharmacy in advanced cancer and end-of-life settings by reviewing evidence-based approaches to reduce polypharmacy, and outlining the potential benefits of decreasing the number of drugs that patients with cancer can take, with emphasis on the need for thoughtful discontinuation initiatives in the context of life-limiting malignant disease. In view of the apparent burden of polypharmacy in patients with advanced cancer, we expect that greater attention to polypharmacy could lead to improvements in adverse drug events, cost, and possibly quality of life. However, few data for specific interventions in the advanced cancer population are available, and thus more research is warranted.

PMID:
26149885
DOI:
10.1016/S1470-2045(15)00080-7
[Indexed for MEDLINE]

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