Consider 'rational discontinuation' to drug burden in elderly cancer patients

GPs should consider 'rational discontinuation' of preventive treatments to ensure elderly cancer patients are not put at risk by rising use of multi-drug regimens, researchers believe.

Writing in The Lancet Oncology, Judith Lees and Alexandre Chan of the Royal Adelaide Hospital in Australia said that more and more elderly patients with cancer are encountering polypharmacy.

‘Rational discontinuation of drugs in older adults is a logical component of management of polypharmacy, and is recommended as part of a comprehensive geriatric assessment in such patients with cancer,’ they said. ‘Discussion with the patient and consideration of overall quality of life is essential.’

Proper planning, communication with patients, families and carers and other clinicians and monitoring of the patient for beneficial or harmful effects should form part of the discontinuation process, Ms Lees and Dr Chan argue.

‘Reasons for the lack of discontinuation can include restricted communication between the primary and specialist care team, and difficulties explaining reasons to patients,’ they said.

They add: ‘In the electronic age where health information technology is integrated to solve drug disorders in clinical practice, clinicians and researchers need to continue to develop new strategies to overcome the challenges of polypharmacy.’

A separate team of researchers warned last month about the cumulative impact on over-65s being prescribed multiple drugs inhibiting acetylcholine.

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