Polypharmacy and functional status in older patients with breast, colon, and lung cancers.

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9087 Background: To evaluate the prevalence of polypharmacy and the inappropriate prescribing of medications (IPM), and to determine the relation between polypharmacy, IPM, and functional status in older cancer patients. Methods: Between April 2008 and September 2009 patients aged ≥65 years with incident breast, colon, or lung cancer seen at an academic center were enrolled. At study entry patients completed a functional assessment [Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), Karnofsky Performance Scale (KPS), Vulnerable Elderly Survey (VES), and Timed-up and Go (TUG) Test] and a geriatric assessment including review of current medications. Data sources for medication review included patient self-report and medical records. Polypharmacy was defined as current use of ≥7 medications. IPM was defined as use of ≥1 medication included in the Beer's Criteria (Yes/No). Using bivariate analysis with chi-squared testing, associations between polypharmacy, IPM and measures of functional status were examined. Results: Of 91 participants the median age was 74 years. Fifty-two percent and 34% of participants were identified with polypharmacy and IPM, respectively. The median number of medications per patient was 7. Patients with polypharmacy were more likely to have ADL disability at cancer diagnosis (76% vs. 23%, P=0.04), to have KPS scores ≤70 (85% vs. 15%, p = 0.02), to score ≥3 on the VES (64% vs. 36%, p = 0.02), to take >14 seconds to complete the TUG test (78% vs. 22%, p = 0.03), to score ≥2 on the Charlson Comorbidity Index (74% vs. 26%, p = 0.003) and to have ≥1 geriatric syndrome (dementia, depression, falls, visual and hearing impairments) (63% vs. 37%, p = 0.05). Although patients with polypharmacy were more likely to have IPM (77% vs. 23%, p = 0.0005), there was no statistically significant association between IPM and functional outcomes. Conclusions: Polypharmacy and IPM were highly prevalent in this group of older patients with breast, colon, or lung cancer; and polypharmacy was associated with poorer functional status at diagnosis. Interventions for polypharmacy may improve functional status, treatment tolerance and cancer outcomes among older patients and are therefore warranted. No significant financial relationships to disclose.