A prospective, observational study of medication use among outpatients with common solid tumors.

Abstract

9055 Background: In addition to treatment for their primary disease, cancer patients (pts) receive medications (meds) for relief of symptoms arising from the disease or its treatment and for prevention and treatment of other concurrent conditions. As part of the ECOG Symptom Outcomes and Practice Patterns study (SOAPP), we explored the number and type of agents pts receive and examined factors associated with taking more than 10 meds. Methods: Eligible pts were seen in outpatient academic or community cancer clinics and agreed to complete a survey at two time points 28 to 35 days apart. Data on current meds were collected through health care providers at both time points. Descriptive statistics, Fisher's exact test, and logistic regression (LR) were used to summarize the findings. Results: In 2,795/3,106 evaluable pts responding to the question at baseline (90% response rate), 32% were taking 0-4 meds, 43% were taking 5-9 meds, and 25% were taking >10 meds. The 5 most frequently prescribed categories of med among 3099 pts with available data were anti-hypertensives (46%), non-opioid pain meds (38%), GI meds other than antiemetics (38%), psychiatric meds (35%), antiemetics (32%). In addition, 48% of pts were taking nutrition supplements. A multivariable LR model showed that Non-Hispanic white pts, older pts, pts with poor ECOG performance status, pts with diagnoses of lung and prostate cancer, and pts with advanced stage of disease were more likely to be taking 10 or more meds. These pts were as prevalent in community practices as in academic settings (p=0.63). Conclusions: Outpatient management of solid tumor patients is complex due to co-morbidities and the need for pharmaceutical intervention of both symptoms of disease and side effects of treatment. The strongest predictor of polypharmacy is race/ethnicity. Factors asssociated with > 10 meds Odds ratio 95% CI P Female 1.13 0.89 – 1.43 0.31 White/non-Hispanic 2.84 2.15 – 3.76 <0.0001 Primary site lung/prostate 1.78 1.40 – 2.25 <0.0001 ECOG PS 2-4 vs PS 0 1.63 1.13 – 2.34 0.001 ECOG PS 2-4 vs. PS 1 1.17 0.83 – 1.64 0.43 Advanced disease 1.41 1.15 – 1.72 0.001 Age > 65 1.72 1.40 – 2.12 <0.0001 Number of moderate to severe symptoms 1.06 1.06 – 1.12 <0.0001