Medication reconciliation (MedRec) including complementary and alternative medicine is considered as an important way to increase the safety of medication use. However, there are few studies in literature showing the impact of an oncogeriatric approach integrating MedRec program in elderly cancer patients (ECP). The objective is to measure the impact of a pharmacogeriatric approach (PGA) on ECP before treatment by chemotherapy.
A monocentric prospective study was implemented to evaluate the overall survival (OS), rate of readmission hospital (RRH) at 1stand 3rdmonth and Early Discontinuation of active treatment (ED). These variables were analyzed according to number of reviewed drugs in MedRec and geriatric tools of Comprehensive Geriatric Assessment (CGA).
144 patients were received in oncogeriatric consultations between 01/2017 and 10/2017 (mean age was 80.9 ± 5.5 years, 52.1 % were men, 48.6 % had metastatic tumors). Main cancers were lung (31.9 %), gastrointestinal (18.1 %), breast and gynecological (16.7 %). At 1st and 3rdmonth, death rates were 3 % and 12 %; RRH were 11.1 % and 16.3 %. Received treatment was analyzed and 62.5% received systemic treatment after oncogeriatric consultations. Concerning ED at 3rd month, 48 % had prematurely stopped it (because of cancer progression in 14.2 % and infections in 7 %) and 23.6 % reduced dose (because of chemotoxicity in 33 % and geriatric conclusions in 20 %). OS prognostic factors were malnutrition (p = 0.03) and metastatic status (p = 0.05), prognosis factors of early death at 1 month were lymphopenia (p = 0.005) and RRH (p = 0.04), and at 3 months: malnutrition (p = 0.01), ADL dependence (p = 0.03), and RRH (p = 0.01).
To our knowledge, this is the first study evaluating and describing the outcomes of PGA with MedRec and CGA in same time for the ECP. First month death rates and RRH are lower compared to literature in our study. RRH, ADL and nutritional disorder are OS prognostic factors. Full analyzes will be presented during the congress to show the real impact of PGA.
Clinical trial identification
Legal entity responsible for the study
Assistance Publique Hôpitaux de Marseille.
Has not received any funding.
All authors have declared no conflicts of interest.