There's a better way to detect high-risk medications in older adults with cancer, according to new study (Change out benzodiazepines, SSRIs, & corticosteroids)

Medical Xpress / Journal of the National Comprehensive Cancer Network ^ | August 10, 2022 | Tammy T. Hshieh et al

[ConservativeMind]

A study suggests a new way for hematologic oncologists to protect older patients from the risks of medication interactions.

Researchers teamed up with hematologic-oncology investigators to look at the association between older patients with blood cancers who were taking multiple medications and their corresponding frailty. They also created a new scale based on a list of Potentially Inappropriate Medications (PIMs) from the NCCN Guidelines for Older Adult Oncology—called the Geriatric Oncology-Potentially Inappropriate Medications (GO-PIMs) Scale—and found it to be more effective at predicting frailty than conventional methods.

"A large portion of research for older adults identifies patients as 'having polypharmacy' (i.e. taking multiple medications at the same time, leading to a higher risk of adverse events) based on a cutoff of five or more medications; but they don't specify which medications," explained Tammy T. Hshieh, MD, MPH.

"The health risks from these specifically identified medications—including falls and fatigue—often outweigh their benefits, especially in older adults whose ability to tolerate side effects is reduced," said Clark DuMontier, MD, MPH. "Our GO-PIMs tool makes it easier for oncology teams to identify these medications and consider deprescribing them."

The researchers examined transplant-ineligible blood cancer patients, age 75 and older. Frailty was defined by combining two approaches well-established in aging research: the "phenotypic approach," based on slow gait speed, weakness measured by grip strength, self-reported exhaustion, low physical activity, and weight loss; and the "cumulative deficit approach," based on the presence of multiple health deficits spanning comorbidity, cognition, and function. Each additional "unspecified" medication in general increased the relative odds of being pre-frail or frail by 8%, while each additional medication on the GO-PIMs scale increased the relative odds by 65%. Compared to robust patients, frail and pre-frail patients were more likely to be taking benzodiazepines, selective serotonin reuptake inhibitors (SSRIs), or corticosteroids.

[ConservativeMind]

Prescription drugs can have a lot of interactions, and the more you have, the worse, to the point that you have induced possibly more problems than you had originally meant to solve.

Please get your medicines reviewed and changed out to better options. Ideally, get healthier outside of your prescriptions, such that you can get off some or all of them.

Medicine is sometimes like using a hammer to fit a square peg into a round hole. Very few medicines are able to only address what they are meant to address.

[ConservativeMind]

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