Interventions to optimise medication prescribing and adherence in older people with cancer: A systematic scoping review

Melanie Murphy; Kathleen Bennett; Carmel M Hughes; Amanda Lavan; Cathal A Cadogan

doi:10.1016/j.sapharm.2020.02.021

Interventions to optimise medication prescribing and adherence in older people with cancer: A systematic scoping review

Res Social Adm Pharm. 2020 Dec;16(12):1627-1631. doi: 10.1016/j.sapharm.2020.02.021. Epub 2020 Mar 5.

Authors

Melanie Murphy¹, Kathleen Bennett², Carmel M Hughes³, Amanda Lavan⁴, Cathal A Cadogan⁵

Affiliations

¹ School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland.
² Population Health Sciences Division, Royal College of Surgeons in Ireland, Dublin, Ireland.
³ School of Pharmacy, Queen's University Belfast, Belfast, United Kingdom.
⁴ Geriatric Medicine, Cork University Hospital, Cork, Ireland; Department of Medicine for the Elderly, St James's Hospital, Dublin, Ireland.
⁵ School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland. Electronic address: cathalcadogan@rcsi.ie.

PMID: 32147463
DOI: 10.1016/j.sapharm.2020.02.021

Abstract

Background: Older adults with cancer often require multiple medications including cancer-specific treatments and supportive care medications (e.g. analgesics), as well as medications for pre-existing medical conditions. Increasing numbers of medications pose risks of potentially inappropriate prescribing, drug-drug interactions and drug-disease interactions. The burden of treatment (i.e. the workload of healthcare and its impact on patient functioning and well-being) may also negatively affect the way patients take their medications. Non-adherence to medication in patients with cancer is associated with treatment failure and increased healthcare costs. Therefore, it is crucial that medicines are optimised for older adults with cancer to enhance appropriate prescribing, reduce the complexity of treatment regimens and minimise the risk of non-adherence.

Objective: To provide an overview of evaluations of interventions aimed at optimising medication prescribing and/or adherence in older adults with cancer.

Methods: A systematic scoping review will be undertaken. Four databases will be searched from inception: PubMed, EMBASE, CINAHL and PsycINFO. In order to meet inclusion criteria, studies must evaluate an intervention seeking to improve medication prescribing and/or adherence in older adults (aged ≥65 years) with an active cancer diagnosis using a comparative evaluation (e.g. inclusion of a control group). Two reviewers will independently screen titles and abstracts for inclusion and extract data relating to study population, intervention characteristics, outcome assessments and key findings. Extracted data will be collated using tables, figures and accompanying descriptive summaries. The review will be reported using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines.

Project impact: The scoping nature of this review will serve to provide an overview of the existing literature on interventions aimed at optimising medication prescribing and adherence in older adults with cancer. The review findings will help to identify research gaps and highlight areas to explore further in future research.

Keywords: Adherence; Cancer; Intervention; Older adults; Oncology; Prescribing.

Publication types

Research Support, Non-U.S. Gov't
Review
Systematic Review

MeSH terms

Aged
Delivery of Health Care
Drug Prescriptions*
Humans
Inappropriate Prescribing
Medication Adherence
Neoplasms* / drug therapy