Abstract 5924
Background
Due to their advanced age many cancer patients with unfavorable prognosis suffer from comorbidities, and thus the risk of consuming potentially inappropriate medication (PIM). It is vital to deprescribe drugs with potential harmful effects or no short-term benefit for lowering pill.
Hence, we examined the degree of deprescription of potentially inappropriate medication (PIM) in patients suffering from cancer.
Methods
Retrospective, register-based study of all patients with newly diagnosed breast, prostate, pancreatic, and lung cancer, diagnosed at a hospital in the Capital Region of Denmark (1.8 million inhabitants) from 2012-2014. Patients with insufficient staging information or other malignancy except non-melanoma skin-cancer were excluded. Information about medication, comorbidity and mortality was extracted from the electronic health records.
PIM were defined as: acetylsalicylic acid, calcium channel blockers, statins, thiazides, and bisphosphonates. The study was approved by the Danish Patient Safety Authority (No. 3-3013-1884/1/) and the Danish Data Protection Agency (No. BFH-2016-058).
Results
Table:
1607P
| Breast (n = 3,959)/prostate cancer (n = 3,535) (total n = 7,494) | Lung (n = 2,824)/pancreatic cancer (n = 617) (n = 3,441) | |
|---|---|---|
| Gender (Women) | 52% | 50% |
| Age mean (sd) | 65 (12) | 70 (10) |
| 1-year Survival | 97% | 46% |
| Metastatic disease | 6.7% | 52% |
| Co-morbidities | ||
| Diabetes | 4.0 % | 9.7 % |
| Hypertension | 12 % | 23 % |
| Atrial fibrillation | 4.7 % | 8.7 % |
| Ischemic heart disease | 6.4 % | 11.6 % |
| Heart failure | 2.2 % | 5.6 % |
| Ischemic stroke | 1.5 % | 2.8 % |
| Medication | 1-year deprescription/total treated§ | |
| Acetylsalicylic acid | 250/1,443 (17%) | 398/928 (43%) |
| Calcium channel blockers | 135/1,048 (13%) | 284/659 (43%) |
| Statins | 187/1,769 (11%) | 501/1,066 (47%) |
| Thiazide diuretics | 175/954 (18%) | 259/534 (49%) |
| Bisphosphonates | 26/319 (8.2%) | 64/171 (37%) |
Deprescribed during the first year after cancer-diagnosis/total number of patients treated
(Patients not surviving 1 year and treatment continuing until death does not count towards deprescribed)
Conclusions
Our findings show that oncologists and physicians have a rational approach to deprescription in patients suffering from cancer with short-term (pancreatic and lung cancer) respectively long-term (breast and prostate cancer) survival rates. However, several patients were continuing potential inappropriate medications in the terminal stage of cancer.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
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