1082 - Prevalence and management of Potentially Inappropriate Medication use and Potential Omissions in Medication in older cancer patients - the PIM POM study

Background

Older cancer patients are a vulnerable group of medication users. Pharmacist-led medication reviews may optimize treatment and thereby reduce the risk of harmful effects from medication use. This study aims to determine the prevalence and management of Potentially Inappropriate Medication use (PIM’s) and Potential Omissions in Medication (POM’s) in older cancer patients.

Methods

In this prospective observational study (hospital) pharmacists conducted medication reviews with older cancer patients (aged ≥65 years) treated with parenteral chemo and/or immunotherapy to determine the prevalence of PIM’s and POM’s. PIM’s and POM’s were identified using the Screening Tool of Older Persons’ potentially inappropriate Prescriptions (STOPP), the screening Tool to Alert doctors to the Right Treatment (START) and pharmacists’ expert opinion. Recommendations regarding PIM’s and POM’s were made to the patient’s oncologist/haematologist and follow-up was measured. Associations between covariates and the prevalence of PIM’s and POM’s were statistically analysed.

Results

117 (78%) of the 150 patients included (median age 72 years, 59% male, 68% solid tumours, mean number of medicines 11) had at least one PIM and/or PIM. In total 266 PIM’s and POM’s were identified, and these led to 195 (73%) follow-up actions (table). The number of medicines and Charlson Comorbidity Index score (as a measure of vulnerability) were both independently associated with having at least one PIM and/or POM (p = .031 and p = .002 respectively).Table:

1825P Identification and follow-up of PIM’s and POM’s

Conclusions

PIM’s and POM’s are highly prevalent among older cancer patients. A pharmacist-led medication review using STOPP/START criteria and pharmacists’ expert opinion is an excellent way to identify these PIM’s and POM’s and to optimize patients’ medication use. The majority of recommendations made regarding PIM’s and POM’s leads to a follow-up action.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Deventer Teaching Hospital.

Funding

Has not received any funding.

Disclosure

F.G.A. Jansman: Advisory / Consultancy, 2016: Amgen; Advisory / Consultancy, 2016: Servier. All other authors have declared no conflicts of interest.