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Medication Reconciliation Associated with Comprehensive Geriatric Assessment in Older Patients with Cancer: ChimioAge Study
- Source :
- Clinical Interventions in Aging, Clinical Interventions in Aging, Dove Medical Press, 2020, 15, pp.1587-1598. ⟨10.2147/CIA.S262209⟩, Clinical Interventions in Aging, 2020, Volume 15, pp.1587-1598. ⟨10.2147/CIA.S262209⟩, Clinical Interventions in Aging, Dove Medical Press, 2020, Volume 15, pp.1587-1598. ⟨10.2147/CIA.S262209⟩, Clinical Interventions in Aging, 2020, 15, pp.1587-1598. ⟨10.2147/CIA.S262209⟩
- Publication Year :
- 2020
- Publisher :
- HAL CCSD, 2020.
-
Abstract
- Anne-Laure Couderc,1,2 Celia Boisseranc,3 Dominique Rey,1 Emilie Nouguerede,1 Laurent Greillier,4,5 Fabrice Barlesi,4,5 Florence Duffaud,4,6 Jean-Laurent Deville,6 Stéphane Honoré,3,4 Patrick Villani,1,2 Florian Correard3,4 1Internal Medicine, Geriatry and Therapeutic Unit, AP-HM, Marseille, France;Coordination Unit for Geriatric Oncology (UCOG), PACA West, Marseille, France; 2Aix-Marseille Université, CNRS, EFS, ADES, Marseille, France; 3Pharmacology Department, AP-HM, Marseille, France; 4Aix-Marseille University, Marseille, France; 5Multidisciplinary Oncology and Therapeutic Innovations Unit, AP-HM, Marseille, France; 6Oncology Unit, AP-HM, Marseille, FranceCorrespondence: Anne-Laure CoudercCoordination Unit for Geriatric Oncology (UCOG), PACA West, University Hospital of Marseille (AP-HM), 270 Boulevard De Sainte Marguerite, Marseille 13009, FranceTel +33 491744530Fax +33 491744833Email anne-laure.couderc@ap-hm.frBackground: Polymorbidity induces polypharmacy in older patients may lead to potential drug–drug interactions (DDI) which can modify the tolerance and safety of oncological treatments and alter the intended therapeutic effect. The objective of our study was to describe the decision-making process for oncological treatment and related outcomes, in a population of older adults undergoing a comprehensive geriatric assessment (CGA) associated to a comprehensive medication reconciliation (CMR) prior to initiating oncological treatment.Methods: ChimioAge is a prospective observational study conducted between 01/2017 and 07/2018 at Marseille University Hospital and approved by the French National Ethics Committee. It comprised all consecutive patients aged 70 years and over who were referred for a CGA as part of CMR, before initiating systemic treatment.Results: One hundred and seventy-one cancer patients were included. Mean age was 79.2 years, over half had metastatic cancers, 75% had an ECOG performance status zero or one, and two-thirds were independent in daily activities. Two-thirds of the patients had polypharmacy and the CMR identified potential DDI with systemic treatment in 43.3% of patients. Following the CGA, the CMR and the hospital oncologists decision, 30% of the patients received adapted systemic treatment with reduced doses at initiation. They presented fewer toxicities – irrespective of grade and type – than patients who received standard treatment (p< 0.001) and had comparable overall survival (Log rank p=0.21).Conclusion: This is one of the first studies to highlight the value in conducting CMR and a CGA simultaneously before initiating systemic treatment in older patients with cancer. These two evaluations could give oncologists decisive information to personalize cancer treatment of older patients and optimize treatment dose to offer the best efficacy and minimize toxicity.Keywords: aged, antineoplastic protocols, geriatric assessment, medication reconciliation, treatment failure
- Subjects :
- Aged, 80 and over
Male
geriatric assessment
[SDV]Life Sciences [q-bio]
[SDV.MHEP.GEG]Life Sciences [q-bio]/Human health and pathology/Geriatry and gerontology
Clinical Decision-Making
antineoplastic protocols
[SDV.CAN]Life Sciences [q-bio]/Cancer
Medical Oncology
Patient Care Planning
[SHS]Humanities and Social Sciences
[SDV.ETH]Life Sciences [q-bio]/Ethics
aged
Neoplasms
Clinical Interventions in Aging
Polypharmacy
medication reconciliation
[SDV.SP.PHARMA]Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology
Humans
Female
Prospective Studies
ComputingMilieux_MISCELLANEOUS
Original Research
treatment failure
Subjects
Details
- Language :
- English
- ISSN :
- 11769092 and 11781998
- Database :
- OpenAIRE
- Journal :
- Clinical Interventions in Aging, Clinical Interventions in Aging, Dove Medical Press, 2020, 15, pp.1587-1598. ⟨10.2147/CIA.S262209⟩, Clinical Interventions in Aging, 2020, Volume 15, pp.1587-1598. ⟨10.2147/CIA.S262209⟩, Clinical Interventions in Aging, Dove Medical Press, 2020, Volume 15, pp.1587-1598. ⟨10.2147/CIA.S262209⟩, Clinical Interventions in Aging, 2020, 15, pp.1587-1598. ⟨10.2147/CIA.S262209⟩
- Accession number :
- edsair.pmid.dedup....2dbd980d84d5c370c46dcfc654ad18dd