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Potential drug-drug interactions and risk of unplanned hospitalization in older patients with cancer: A survey of the prospective ELCAPA (ELderly CAncer PAtients) cohort.

Abstract：

BACKGROUND:Because of comorbidities and polypharmacy, older patients with cancer have a greater risk of iatrogenic events. We aimed to characterize potential drug-drug interactions (PDIs) and the risk of unplanned hospitalization in older patients with cancer treated with antineoplastic agents (ANAs). METHODS:We analyzed all older patients (≥70 years) from the prospective ELCAPA cohort referred for geriatric assessment (2007-2014) prior to treatment with ANA at Henri Mondor Hospital (Créteil, France). PDIs were identified using Lexicomp®, and Theriaque® for French medications. Factors associated with PDIs, and association between PDIs and unplanned hospitalization in the 6 months following geriatric assessment were analyzed using ordered multivariate logistic regression (MLR). RESULTS:We included 442 patients (median [interquartile range] age: 77 years [74-80]); number of medications/patient/day: 6 [3-8]); ECOG-PS ≤ 2: 79%; metastasis: 70%). Most patients had a digestive tract cancer (colorectal: 22%; upper digestive tract: 23%). We identified 1742 PDIs; 76.5% of patients had ≥1 PDI; 13% of the PDIs involved an ANA. In a multivariate analysis, cardiovascular disorders (ischemic heart disease, heart failure, atrial fibrillation and/or arterial hypertension) were independently associated with PDIs (p < .001, after adjustment for polypharmacy and tumor site/stage). A high number of PDIs between two daily medications was independently associated with the risk of unplanned hospitalization (adjusted-odds ratio [95% confidence interval] per PDI: 1.05 [1.00;1.11], p = .05), while polypharmacy was not. CONCLUSION:Patients with cardiovascular comorbidities were more likely to have a PDI. A higher number of PDIs may be an independent risk factor for early unplanned hospitalization.

journal_name

J Geriatr Oncol

journal_title

Journal of geriatric oncology

authors

Beinse G,Reitter D,Segaux L,Carvahlo-Verlinde M,Rousseau B,Tournigand C,Cudennec T,Laurent M,Boudou-Rouquette P,Paillaud E,Canouï-Poitrine F,Caillet P,ELCAPA Study Group.

doi

10.1016/j.jgo.2019.07.023

subject

Has Abstract

pub_date

2020-05-01 00:00:00

pages

586-592

issue

4

eissn

1879-4068

issn

1879-4076

pii

S1879-4068(19)30005-0

journal_volume

11

pub_type

杂志文章

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