Abstract:
:OBJECTIVES: To identify patient characteristics associated with polypharmacy and inappropriate medication (PIM) use among older patients with newly diagnosed cancer. DESIGN: Cross-Sectional Study. SETTING: Ambulatory oncology clinics at an academic medical center. PARTICIPANTS: 117 patients aged ≥ 65 years with newly diagnosed histologically confirmed stage I-IV cancer were enrolled between April 2008 and September 2009. MEASUREMENTS: Medication review, included patient self-report and medical records. Polypharmacy was defined as the concurrent use of ≥ five medications, (Yes/No). PIM use was defined as use of ≥ one medication included in the 2003 update of Beers Criteria, (Yes/No). RESULTS: The prevalence of polypharmacy and PIM use were 80% and 41%, respectively. Three independent correlates of medication use were identified. An increase in comorbidity count by one, ECOG-PS score by one, and PIM use by one, was associated with an increase in medication use by 0.48 (P=0.0002), 0.79 (P=0.01) and 1.22 (P=0.006), respectively. Two independent correlates of PIM use were identified. The odds of using PIMs decreased by 10% for one unit increase in Body Mass Index [Odds Ratio (OR) 0.90, 95% CI = (0.84, 0.97)], and increased by 18% for each increase in medication count by one [OR 1.18, 95% CI = (1.04, 1.34)]. CONCLUSION: There was a high prevalence of polypharmacy and PIM use in older patients with newly diagnosed cancer. Given the co-occurrence of polypharmacy with poor performance status and multi-morbidity, multi-dimensional interventions are needed in the geriatric-oncology population to improve health and cancer outcomes.
journal_name
J Geriatr Oncoljournal_title
Journal of geriatric oncologyauthors
Prithviraj GK,Koroukian S,Margevicius S,Berger NA,Bagai R,Owusu Cdoi
10.1016/j.jgo.2012.02.005subject
Has Abstractpub_date
2012-07-01 00:00:00pages
228-237issue
3eissn
1879-4068issn
1879-4076journal_volume
3pub_type
杂志文章abstract:BACKGROUND:Geriatric assessment (GA) is an appropriate method for identifying frailty in older patients with cancer, but a shorter instrument may be easier to use in clinical practice. Clinical judgment is always available and requires no investments in time or resources. The purpose of this study was to assess correla...
journal_title:Journal of geriatric oncology
pub_type: 杂志文章
doi:10.1016/j.jgo.2020.05.011
更新日期:2020-09-01 00:00:00
abstract:OBJECTIVES:HER2 (human epidermal growth factor receptor 2) is an important biomarker in breast cancer, but its prevalence in elderly women is not well established. Previous studies reported HER2 status based on either immunohistochemistry (IHC) or fluorescent in situ hybridization (FISH) interchangeably. However, the t...
journal_title:Journal of geriatric oncology
pub_type: 杂志文章
doi:10.1016/j.jgo.2013.05.007
更新日期:2013-10-01 00:00:00
abstract:OBJECTIVES:To establish whether clinicopathologic and genomic characteristics may explain the poor prognosis associated with advanced age in ER+/HER2- breast cancer. MATERIALS AND METHODS:The cohort included 271 consecutive post-menopausal patients with ER+/HER2- invasive breast cancer ages 55 years and older. Patient...
journal_title:Journal of geriatric oncology
pub_type: 杂志文章
doi:10.1016/j.jgo.2020.08.007
更新日期:2020-08-25 00:00:00
abstract::With a median age of 70 years at diagnosis, lung cancer is a disease of older persons. As a consequence oncologists are confronted with an increasing older lung cancer population for which treatment decisions are needed. In the past years, the therapeutic landscape of advanced non-small cell lung cancer (NSCLC) has ch...
journal_title:Journal of geriatric oncology
pub_type: 杂志文章,评审
doi:10.1016/j.jgo.2018.09.008
更新日期:2019-07-01 00:00:00
abstract:OBJECTIVE:Suboptimal adherence with endocrine treatment for breast cancer is influenced by a number of factors but remains poorly understood. We sought to describe the prior knowledge about and expectations of breast cancer treatments among older women retrospecting on their diagnosis and treatment. METHODS:Thematic a...
journal_title:Journal of geriatric oncology
pub_type: 杂志文章
doi:10.1016/j.jgo.2019.07.024
更新日期:2020-04-01 00:00:00
abstract::In advising the optimal management for older patients, health care professionals try to balance the risks from frailty, vulnerability, and comorbidity against the patient's ultimate prognosis, potential functional outcomes and quality of life (QOL). At the same time it is important to involve the patient and incorpora...
journal_title:Journal of geriatric oncology
pub_type: 杂志文章,评审
doi:10.1016/j.jgo.2018.08.001
更新日期:2018-11-01 00:00:00
abstract::It is well recognized that the incidence of breast cancer increases significantly with age. Despite this, older people remain under-represented in many clinical trials and their management relies on extrapolation of data from younger patients. Providing an aggressive intervention can be challenging, particularly in le...
journal_title:Journal of geriatric oncology
pub_type: 杂志文章,评审
doi:10.1016/j.jgo.2017.05.004
更新日期:2017-11-01 00:00:00
abstract::Sexual health and sexual minority status are often undiscussed during oncology visits. Yet, these topics should be addressed in older cancer patients in order to help mitigate the sexual side effects of cancer treatment and to acknowledge - and, at times, help provide - the social support older patients need during th...
journal_title:Journal of geriatric oncology
pub_type: 杂志文章,评审
doi:10.1016/j.jgo.2019.08.003
更新日期:2020-05-01 00:00:00
abstract:BACKGROUND:The majority of patients with chronic lymphocytic leukemia (CLL) are older and have multiple comorbidities, including other cancer diagnoses. These patients are routinely excluded from participation in clinical trials. OBJECTIVE:In this phase II study, we determined the activity and toxicity of ofatumumab, ...
journal_title:Journal of geriatric oncology
pub_type: 杂志文章
doi:10.1016/j.jgo.2019.04.002
更新日期:2020-01-01 00:00:00
abstract:PURPOSE:Older patients with brain metastases (BM) are often excluded from clinical trials. The aim of our study was to investigate the outcomes following Gamma Knife radiosurgery (GKRS) in young old (65-74 years) and very old (≥75 years) patients with BM. METHODS:Between October 2012 and October 2018, we treated 89 pa...
journal_title:Journal of geriatric oncology
pub_type: 杂志文章
doi:10.1016/j.jgo.2020.03.009
更新日期:2020-09-01 00:00:00
abstract::Older adults with cancer are quickly becoming the largest group of cancer survivors. Chronological age is a poor predictor of cancer treatment outcomes and of the need for rehabilitation services. While newer symptom management systems and assessments are slowly becoming used in the clinic to improve communication bet...
journal_title:Journal of geriatric oncology
pub_type: 杂志文章,评审
doi:10.1016/j.jgo.2017.11.009
更新日期:2018-11-01 00:00:00
abstract:OBJECTIVE:This study aims to identify Comprehensive Geriatric Assessment (CGA) based risk factors to help predict caregiver burden among elderly patients with cancer. MATERIALS AND METHOD:The study evaluated 249 patients newly diagnosed with cancer, aged 70years and above, who attended the geriatric oncology clinic at...
journal_title:Journal of geriatric oncology
pub_type: 杂志文章
doi:10.1016/j.jgo.2016.03.003
更新日期:2016-05-01 00:00:00
abstract:OBJECTIVE:The G8 is a screening test to identify frail elderly patients with cancer. Objectives were to design and evaluate the performance of alternative tests taking into account other predictive domains for frailty. METHODS:We conducted a literature review to identify predictive factors of frailty. Using a Delphi c...
journal_title:Journal of geriatric oncology
pub_type: 杂志文章
doi:10.1016/j.jgo.2016.01.004
更新日期:2016-03-01 00:00:00
abstract::Older cancer survivors may experience ageing at an accelerated rate when compared to their similar-aged, cancer-free counterparts. Ageing is undoubtedly a significant risk factor for cancer. There is evidence to suggest, however, that this relationship may in fact be bidirectional, with cancer and its treatments contr...
journal_title:Journal of geriatric oncology
pub_type: 杂志文章,评审
doi:10.1016/j.jgo.2020.09.010
更新日期:2020-09-12 00:00:00
abstract::Current research efforts focusing on improving outcomes of older adults with cancer lack the appropriate infrastructure to support this growing need. The Cancer and Aging Group R21/33 National Institute of Health (NIH)/National Institute of Aging (NIA) grant aims to support development of geriatric oncology research t...
journal_title:Journal of geriatric oncology
pub_type: 杂志文章
doi:10.1016/j.jgo.2019.07.019
更新日期:2020-03-01 00:00:00
abstract:BACKGROUND:Regorafenib significantly increases overall survival (OS) in patients with metastatic colorectal cancer previously treated but gives toxicities. OBJECTIVES:to assess the efficacy and safety of regorafenib at it's approved dose in the older population. PATIENTS AND METHODS:This multicenter single-arm phase ...
journal_title:Journal of geriatric oncology
pub_type: 杂志文章
doi:10.1016/j.jgo.2020.04.001
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:An oncogeriatric approach may affect management of elderly patients with breast cancer. However, little is known about oncogeriatric care in the metastatic setting. Therefore, we performed an international comparison of management of elderly patients with primary metastatic disease who were treated in two di...
journal_title:Journal of geriatric oncology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jgo.2014.02.005
更新日期:2014-07-01 00:00:00
abstract:INTRODUCTION:Management of early breast cancer in the elderly population is challenging due to different breast cancer biology and limited tolerance to aggressive treatments. The aim of this study is to evaluate whether the omission of axillary staging impacts breast cancer outcomes in elderly patients. PATIENTS AND M...
journal_title:Journal of geriatric oncology
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jgo.2016.12.003
更新日期:2017-03-01 00:00:00
abstract::Multidisciplinary teams (MDTs) have been incorporated into the practical care of elderly patients with cancer. Several geriatric oncology centres have attempted to determine the best way to implement MDTs by using geriatric assessment (GA). Developing a geriatric oncology service is a feasible work, which requires sig...
journal_title:Journal of geriatric oncology
pub_type: 杂志文章,评审
doi:10.1016/j.jgo.2016.07.001
更新日期:2016-09-01 00:00:00
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journal_title:Journal of geriatric oncology
pub_type: 杂志文章
doi:10.1016/j.jgo.2020.11.009
更新日期:2020-12-03 00:00:00
abstract:INTRODUCTION:Older adults are underrepresented in landmark trials that determine treatment guidelines for pancreatic cancer. We used the National Cancer Database (NCDB) to compare treatment patterns and outcomes in stage I-III pancreatic cancer between older adult patients, defined as age 80 or older, to patients young...
journal_title:Journal of geriatric oncology
pub_type: 杂志文章
doi:10.1016/j.jgo.2019.12.006
更新日期:2020-05-01 00:00:00
abstract::Adjuvant chemotherapy improves overall survival (OS) following stereotactic body radiotherapy (SBRT) in patients with early stage non-small cell lung cancer and tumors ≥four cm. Here, we aim to evaluate its role following SBRT in older patients. Patients >70 years diagnosed with clinical stages I-II NSCLC, (N0 disease...
journal_title:Journal of geriatric oncology
pub_type: 杂志文章
doi:10.1016/j.jgo.2020.04.014
更新日期:2020-09-01 00:00:00
abstract::The incidence of multiple myeloma (MM) increases with age, and with the aging of the population, the number of adults with MM is expected to double in the next 20 years. Novel agents, including the immunomodulatory agents thalidomide and lenalidomide, and the proteosome inhibitor bortezomib have dramatically changed t...
journal_title:Journal of geriatric oncology
pub_type: 杂志文章
doi:10.1016/j.jgo.2012.02.001
更新日期:2012-07-01 00:00:00
abstract:BACKGROUND:A geriatric assessment (GA) is increasingly used to help guide treatment decisions in older patients with cancer. However, there is no consensus regarding which domains should be included in the GA. In addition, the field of geriatric oncology moves very fast and as a result many new studies have been publis...
journal_title:Journal of geriatric oncology
pub_type: 杂志文章
doi:10.1016/j.jgo.2019.02.010
更新日期:2019-11-01 00:00:00
abstract:OBJECTIVE:To date, most comorbidity studies have analyzed either a subgroup of frequent diseases, or used summary instruments such as the Charlson score or the Cumulative Illness Rating Scale-Geriatric (CIRS-G). Yet, comorbidity is a multidimensional construct and impacts function, treatment tolerance, and survival. We...
journal_title:Journal of geriatric oncology
pub_type: 杂志文章
doi:10.1016/j.jgo.2017.07.005
更新日期:2017-09-01 00:00:00
abstract:OBJECTIVE:Assess the utility of the G8 screening tool and CGA for older adults with head and neck cancer. METHODS:Patients 65years or older with a primary malignancy of the head and neck region were presented at the multidisciplinary team (MDT) meeting. The Geriatric 8 (G8) questionnaire was administered prior. Clinic...
journal_title:Journal of geriatric oncology
pub_type: 临床试验,杂志文章
doi:10.1016/j.jgo.2016.05.006
更新日期:2016-11-01 00:00:00
abstract:INTRODUCTION:Older adults with cancer are at increased risk of delirium due to age, comorbidities, medications, cognitive impairment, and possibly cancer treatments. However, there is scant information on the risks of delirium with chemotherapy and approaches to prevent or treat it. We performed a systematic review and...
journal_title:Journal of geriatric oncology
pub_type: 杂志文章
doi:10.1016/j.jgo.2020.08.011
更新日期:2020-09-14 00:00:00
abstract:OBJECTIVES:Increasing evidence suggests that statins may have antitumor effects but their role in rectal cancer appears inconclusive. The aim of this study was to investigate whether statins may have an impact on survival of older and younger patients with rectal cancer. MATERIALS AND METHODS:This study included 238 p...
journal_title:Journal of geriatric oncology
pub_type: 杂志文章
doi:10.1016/j.jgo.2019.01.011
更新日期:2019-09-01 00:00:00
abstract::Median age at bladder cancer (BC) diagnosis is older than for other major tumours. Age should not determine treatment, and patients should be fully involved in decisions. Patients should be screened with Mini-Cog™ for cognitive impairment and the G8 to ascertain need for comprehensive geriatric assessment. In non-musc...
journal_title:Journal of geriatric oncology
pub_type: 杂志文章,评审
doi:10.1016/j.jgo.2020.02.001
更新日期:2020-09-01 00:00:00
abstract::Data regarding management of frail patients with pancreatic ductal adenocarcinoma practice is currently very scarce. Randomized clinical trials usually exclude these subgroup of patients and the majority of the publications only consider chronological age and ECOG performance status for their classification. Therefore...
journal_title:Journal of geriatric oncology
pub_type: 杂志文章,评审
doi:10.1016/j.jgo.2018.06.005
更新日期:2019-05-01 00:00:00