Factors associated with potentially inappropriate medications in elderly with multiple myeloma

Taisa R L Machado; Cristiane A M de Pádua; Paula L de Miranda Drummond; Lívia P Silveira; Jéssica S Malta; Roberta M M Dos Santos; Naiane L Costa; Adriano M M Reis

doi:10.1177/10781552231190009

Factors associated with potentially inappropriate medications in elderly with multiple myeloma

J Oncol Pharm Pract. 2023 Aug 1:10781552231190009. doi: 10.1177/10781552231190009. Online ahead of print.

Authors

Taisa R L Machado¹, Cristiane A M de Pádua¹, Paula L de Miranda Drummond^{1

2}, Lívia P Silveira^{1

3}, Jéssica S Malta¹, Roberta M M Dos Santos², Naiane L Costa¹, Adriano M M Reis¹

Affiliations

¹ Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
² Fundação Ezequiel Dias, Belo Horizonte, Minas Gerais, Brazil.
³ Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.

PMID: 37525611
DOI: 10.1177/10781552231190009

Abstract

Introduction: Elderly with cancer often have multimorbidity, which determines a higher risk of polypharmacy. This is related to negative clinical results such as adverse drug reaction and emergence service visits. Furthermore, polypharmacy increases the risk of using potentially inappropriate medications.

Objective: To evaluate the use of potentially inappropriate medication in elderly with multiple myeloma and associated factors.

Methods: The study was conducted with older adults with multiple myeloma treated at outpatient oncology and hematology services in a southeastern Brazilian capital. Potentially inappropriate medications were classified using the American Geriatric Society/Beers 2019 Criteria. Variables were described using frequency and proportions, performing multiple logistic regression to identify factors associated with the use of potentially inappropriate medications.

Results: One hundred fifty-three older adults with multiple myeloma were included, with a median age of 70.9 years. The median number of medications was 8, and 63% of patients used polypharmacy. More than half (54%) of the patients used potentially inappropriate medications, and proton pump inhibitors (46%) and benzodiazepines (8%) were the most employed therapeutic classes. Older adults who used potentially inappropriate medications differed from those who did not use them in the following characteristics: income up to three minimum wages, higher schooling level, private service, multimorbidity, hypertension, cardiovascular disease, chronic kidney disease, depression, adverse event, and polypharmacy. Higher schooling levels and polypharmacy were independently associated with the use of potentially inappropriate medications in the multivariate analysis.

Conclusion: Potentially inappropriate medication use was high in patients with multiple myeloma studied. The use of polypharmacy and higher schooling levels were independently and positively associated with the use of potentially inappropriate medications.

Keywords: Multiple myeloma; aged; elderly; polypharmacy; potentially inappropriate medications.