Abstract
e23288 Background: Megestrol Acetate (Megestrol) used for appetite stimulation in cachexic cancer patients is listed as a potentially inappropriate medication to be avoided in patients 65 years and older per the American Geriatrics Society (AGS) Beers Criteria. It is also classified as a high-risk medication for elderly people by the Pharmacy Quality Alliance. However, due to the complexity of medication prescribing in geriatric cancer patients, some medications on the Beers Criteria may be used more often. We aim to review the use, and weight gain benefits of Megestrol in elderly patients with cancer. Methods: We obtained prescription data for Megestrol for episodes with patients 65 years and older for 15 practices in The US Oncology Network (The Network) participating in the Oncology Care Model (July 2016- June 2022). We evaluated the trends and patterns of Megestrol prescribing in The Network. We compared the documented weights before the initial prescription date (Pre-weight) within an episode to the weights immediately after a 12-week period (12-week weight) as documented in the Electronic Health Record (EHR) system. Results: Of 249,944 episodes, 4,957 (2%) episodes had Megestrol prescribed. Of the episodes with Megestrol, 3,464 (70%) had weight documented within the duration of a 6-month episode of care, with a mean weight of 67.3 kgs. The mean difference (0.8 kgs) between Pre-weights (mean = 67.6 kgs, std dev = 16.3 kgs, n = 2,112) and 12-week weights (mean = 66.8 kgs, std dev = 16.0 kgs, n = 2,112) was found to be significant (paired, one tail T-Test, p-value < 0.0001, significance level = 0.01). Patients who received Megestrol showed weight loss instead of weight gain in the 12-week follow-up period. Summary statistics for the two cohorts are provided in Table 1. Table 1: Summary statistics for the two patient cohorts. Conclusions: Oncology providers generally follow Beer’s criteria with limiting Megestrol use in older age patients. Megestrol use did not appear to contribute to weight gain in older age cancer patients. We aim to look at Megestrol use and thromboembolic adverse events in cancer populations in future studies. CMMI Disclaimer: The statements contained in this document are solely those of the authors and do not necessarily reflect the views or policies of CMS. The authors assume responsibility for the accuracy and completeness of the information contained in this document.[Table: see text]
Published Version
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