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Managing Polypharmacy in Older Adults with Cancer Across Different Healthcare Settings

The care of older patients with cancer is becoming increasingly complex. Common challenges for this population include management of comorbidities, safe transitions of care, and appropriate medication use. In particular, polypharmacy—generally defined as the regular use of five or more medications—a...

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Autores principales: Whitman, Andrew, Erdeljac, Paige, Jones, Caroline, Pillarella, Nicole, Nightingale, Ginah
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8092848/
https://www.ncbi.nlm.nih.gov/pubmed/33953612
http://dx.doi.org/10.2147/DHPS.S255893
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author Whitman, Andrew
Erdeljac, Paige
Jones, Caroline
Pillarella, Nicole
Nightingale, Ginah
author_facet Whitman, Andrew
Erdeljac, Paige
Jones, Caroline
Pillarella, Nicole
Nightingale, Ginah
author_sort Whitman, Andrew
collection PubMed
description The care of older patients with cancer is becoming increasingly complex. Common challenges for this population include management of comorbidities, safe transitions of care, and appropriate medication use. In particular, polypharmacy—generally defined as the regular use of five or more medications—and inappropriate medication use can lead to adverse effects and poor outcomes in older adults with cancer, including falls, hospital readmissions, cognitive impairment, poor adherence to essential medications, chemotherapy toxicity, and increased mortality. Managing polypharmacy across different cancer care settings is often challenging. Providers face barriers to safe and successful medication management that may include lack of time, absence of reimbursement, underappreciation of the scale of polypharmacy-related harm, lack of ownership of deprescribing efforts, and poor communication across care settings. Existing literature on managing inappropriate medication use and polypharmacy in older adults with cancer has often focused on ideal state settings in which resources are plentiful and time is purposefully allocated for medication interventions. This paper presents a narrative, rather than a systematic review, of studies published in the past decade that provided detailed information on medication management and polypharmacy across cancer care settings. This review aims to also summarize different healthcare provider roles in taking action against inappropriate medication use and polypharmacy in older adults with cancer.
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spelling pubmed-80928482021-05-04 Managing Polypharmacy in Older Adults with Cancer Across Different Healthcare Settings Whitman, Andrew Erdeljac, Paige Jones, Caroline Pillarella, Nicole Nightingale, Ginah Drug Healthc Patient Saf Review The care of older patients with cancer is becoming increasingly complex. Common challenges for this population include management of comorbidities, safe transitions of care, and appropriate medication use. In particular, polypharmacy—generally defined as the regular use of five or more medications—and inappropriate medication use can lead to adverse effects and poor outcomes in older adults with cancer, including falls, hospital readmissions, cognitive impairment, poor adherence to essential medications, chemotherapy toxicity, and increased mortality. Managing polypharmacy across different cancer care settings is often challenging. Providers face barriers to safe and successful medication management that may include lack of time, absence of reimbursement, underappreciation of the scale of polypharmacy-related harm, lack of ownership of deprescribing efforts, and poor communication across care settings. Existing literature on managing inappropriate medication use and polypharmacy in older adults with cancer has often focused on ideal state settings in which resources are plentiful and time is purposefully allocated for medication interventions. This paper presents a narrative, rather than a systematic review, of studies published in the past decade that provided detailed information on medication management and polypharmacy across cancer care settings. This review aims to also summarize different healthcare provider roles in taking action against inappropriate medication use and polypharmacy in older adults with cancer. Dove 2021-04-29 /pmc/articles/PMC8092848/ /pubmed/33953612 http://dx.doi.org/10.2147/DHPS.S255893 Text en © 2021 Whitman et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Review
Whitman, Andrew
Erdeljac, Paige
Jones, Caroline
Pillarella, Nicole
Nightingale, Ginah
Managing Polypharmacy in Older Adults with Cancer Across Different Healthcare Settings
title Managing Polypharmacy in Older Adults with Cancer Across Different Healthcare Settings
title_full Managing Polypharmacy in Older Adults with Cancer Across Different Healthcare Settings
title_fullStr Managing Polypharmacy in Older Adults with Cancer Across Different Healthcare Settings
title_full_unstemmed Managing Polypharmacy in Older Adults with Cancer Across Different Healthcare Settings
title_short Managing Polypharmacy in Older Adults with Cancer Across Different Healthcare Settings
title_sort managing polypharmacy in older adults with cancer across different healthcare settings
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8092848/
https://www.ncbi.nlm.nih.gov/pubmed/33953612
http://dx.doi.org/10.2147/DHPS.S255893
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