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The Association Between Medication Use in Older Women with Early-Stage Operable Primary Breast Cancer and Decision Regarding Primary Treatment

Tse, Natalie; Parks, Ruth M.; Holmes, Holly M.; Cheung, Kwok Leung

The Association Between Medication Use in Older Women with Early-Stage Operable Primary Breast Cancer and Decision Regarding Primary Treatment Thumbnail


Authors

Natalie Tse

Ruth M. Parks

Holly M. Holmes



Abstract

Background Polypharmacy is one factor contributing to increased mortality, hospitalization, and adverse drug reactions in older adults. The aim of this study was to measure the prevalence of polypharmacy in a cohort of older women with early-stage operable primary breast cancer and the relationship of polypharmacy to primary treatment decision and functional status. Methods A total of 139 patients with a new diagnosis of early-stage operable primary breast cancer proven histologically were recruited as part of a prospective study. The average age was 77 years. Assessment using a cancer-specific Comprehensive Geriatric Assessment (CGA) tool was conducted within 6 weeks of diagnosis of breast cancer. Association was determined between number of medications and treatment decision and physical status as measured by the CGA outcomes. Additional analysis was performed to determine the associations above with polypharmacy defined by ≥5 daily medications, and if cardiovascular-related diseases have a role in the treatment decision. Results Polypharmacy was present in 48% of patients (n = 139). CGA determined that polypharmacy was associated with greater comorbidity (P < .001), reduced physical status rated by physicians (P = .009) and patients (P = .019), and reduced ability to perform activities of instrumental ADLs (P = .008). Similar findings were present in the analysis of cardiovascular-related diseases. Conclusions This work suggests that patients with polypharmacy are more likely to be frail. The number of medications could help us screen patients who should go on to receive full CGA.

Citation

Tse, N., Parks, R. M., Holmes, H. M., & Cheung, K. L. (2023). The Association Between Medication Use in Older Women with Early-Stage Operable Primary Breast Cancer and Decision Regarding Primary Treatment. Oncologist, 28(3), e128-e135. https://doi.org/10.1093/oncolo/oyac278

Journal Article Type Article
Acceptance Date Nov 14, 2022
Online Publication Date Jan 30, 2023
Publication Date Mar 17, 2023
Deposit Date Feb 1, 2023
Publicly Available Date Mar 29, 2024
Journal Oncologist
Print ISSN 1083-7159
Electronic ISSN 1549-490X
Publisher Oxford University Press (OUP)
Peer Reviewed Peer Reviewed
Volume 28
Issue 3
Pages e128-e135
DOI https://doi.org/10.1093/oncolo/oyac278
Keywords polypharmacy, breast cancer, medications, functional status, treatment, older women
Public URL https://nottingham-repository.worktribe.com/output/16795717
Publisher URL https://academic.oup.com/oncolo/advance-article/doi/10.1093/oncolo/oyac278/7010691?login=false

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