The potential for deprescribing in a palliative oncology patient population: a cross-sectional study

Eur J Hosp Pharm. 2023 Dec 27;31(1):10-15. doi: 10.1136/ejhpharm-2021-003143.

Abstract

Objectives: The use of preventive medication in palliative oncology patients may be inappropriate due to limited life expectancy. Deprescribing tools are available but time-consuming and not always tailored to this specific population. Our primary goal was to identify potentially inappropriate medications (PIMs) in palliative oncology patients with a life expectancy of up to 2 years using an adapted deprescribing tool. Our secondary aim was to identify patient characteristics associated with the presence of PIMs.

Methods: Oncology patients with a life expectancy of up to 2 years were included cross-sectionally. An adapted deprescribing tool was developed to identify PIMs. Logistic regression was used to identify factors associated with having PIMs.

Results: A total of 218 patients were included in this study of which 56% had at least one PIM with a population mean of 1.1 PIM per patient. Most frequently defined PIMs were antihypertensive drugs and gastric acid inhibitors. Identification of PIMs by review took an estimated 5-10 min per patient. Polypharmacy, age >65 years and inpatient/outpatient status were found to be associated with having at least one PIM.

Conclusions: Deprescribing is possible in more than half of palliative oncology patients with a life expectancy of up to 2 years. The adapted deprescribing tool used is non-time consuming and suitable for palliative oncology patients, regardless of age.

Keywords: drug misuse; medical oncology; palliative care; pharmacy service, hospital; preventive medicine.

MeSH terms

  • Aged
  • Cross-Sectional Studies
  • Deprescriptions*
  • Humans
  • Inappropriate Prescribing / prevention & control
  • Neoplasms* / drug therapy
  • Neoplasms* / epidemiology
  • Potentially Inappropriate Medication List