Evidence map›Paper›PMID 31570516›Full record

SynthesisThe oncologist2020

Associations of Polypharmacy and Inappropriate Medications with Adverse Outcomes in Older Adults with Cancer: A Systematic Review and Meta-Analysis.

Mostafa R Mohamed, Erika Ramsdale, Kah Poh Loh, Asad Arastu, Huiwen Xu, Spencer Obrecht, Daniel Castillo, Manvi Sharma, Holly M Holmes, Ginah Nightingale and 2 more

Open access · bronzeAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The oncologist, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 80 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
80citing papers in PubMed, 4 pooled it
9.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

80 citing papers in PubMed, 4 syntheses or guidelines pooled it, 167 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Trial
  6. Effect of polypharmacy and potentially inappropriate medications on physical functional decline among older adults with advanced cancer receiving systemic treatment.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2024
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  12. Observational
  13. Polypharmacy Thresholds that Best Predict Emergency Room Visits and Mortality in Older Adults: A Population-Based Study in Québec, Canada.Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2026
    Article
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  15. Observational
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  18. Review
  19. Review
  20. Review

20 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 5 institutions in 1 country.

Mostafa R MohamedJames P. Wilmot Cancer Center, University of Rochester Medical Center, Rochester, New York, USA.ORCID 0000-0003-2936-5794
Erika RamsdaleJames P. Wilmot Cancer Center, University of Rochester Medical Center, Rochester, New York, USA.
Kah Poh LohJames P. Wilmot Cancer Center, University of Rochester Medical Center, Rochester, New York, USA.
Asad ArastuJames P. Wilmot Cancer Center, University of Rochester Medical Center, Rochester, New York, USA.
Huiwen XuJames P. Wilmot Cancer Center, University of Rochester Medical Center, Rochester, New York, USA.
Spencer ObrechtJames P. Wilmot Cancer Center, University of Rochester Medical Center, Rochester, New York, USA.
Daniel CastilloMLIS-Miner Library, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA.
Manvi SharmaDepartment of Pharmacy Administration, University of Mississippi School of Pharmacy, University, Mississippi, USA.
Holly M HolmesThe University of Texas Health Science Center at Houston, Houston, Texas, USA.
Ginah NightingaleDepartment of Pharmacy Practice, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Katherine M JubaDepartment of Pharmacy, University of Rochester Medical Center, Rochester, New York, USA.
Supriya G MohileJames P. Wilmot Cancer Center, University of Rochester Medical Center, Rochester, New York, USA.
University of Rochester Medical Center · USUniversity of Rochester · USThe University of Texas Health Science Center at Houston · USThomas Jefferson University · USUniversity of Mississippi · US

Funding

URCC NCORP Research BaseUG1CA189961 · NCI · UNIVERSITY OF ROCHESTER · PI Michelle C Janelsins, KAREN M. MUSTIAN · 2014 to 2026
$67.7M
Reducing Chemotherapy Toxicity in Older AdultsR01CA177592 · NCI · UNIVERSITY OF ROCHESTER · PI MOHILE, SUPRIYA G. · 2013 to 2018
$3.0M
A Patient-Oriented Research Program in Geriatric OncologyK24AG056589 · NIA · UNIVERSITY OF ROCHESTER · PI Supriya G. Mohile · 2018 to 2026
$1.5M
NCI NIH HHS R01 CA177592NCI NIH HHS UG1 CA189961NIA NIH HHS K24 AG056589
6 · The paper itself

Abstract

backgroundPolypharmacy (PP) and potentially inappropriate medications (PIM) are highly prevalent in older adults with cancer. This study systematically reviews the associations of PP and/or PIM with outcomes and, through a meta-analysis, obtains estimates of postoperative outcomes associated with PP in this population. MATERIALS AND

methodsWe searched PubMed, Embase, Web of Science, and Cochrane Register of Clinical Trials using standardized terms for concepts of PP, PIM, and cancer. Eligible studies included cohort studies, cross-sectional studies, meta-analyses, and clinical trials which examined outcomes associated with PP and/or PIM and included older adults with cancer. A random effects model included studies in which definitions of PP were consistent to examine the association of PP with postoperative complications.

resultsForty-seven articles met the inclusion criteria. PP was defined as five or more medications in 57% of the studies. Commonly examined outcomes included chemotherapy toxicities, postoperative complications, functional decline, hospitalization, and overall survival. PP was associated with chemotherapy toxicities (4/9 studies), falls (3/3 studies), functional decline (3/3 studies), and overall survival (2/11 studies). A meta-analysis of four studies indicated an association between PP (≥5 medications) and postoperative complications (overall odds ratio, 1.3; 95% confidence interval [1.3-2.8]). PIM was associated with adverse outcomes in 3 of 11 studies.

conclusionPP is associated with postoperative complications, chemotherapy toxicities, and physical and functional decline. Only three studies showed an association between PIM and outcomes. However, because of inconsistent definitions, heterogeneous populations, and variable study designs, these associations should be further investigated in prospective studies. IMPLICATIONS FOR PRACTICE: Polypharmacy and potentially inappropriate medications (PIM) are prevalent in older adults with cancer. This systematic review summarizes the associations of polypharmacy and PIM with health outcomes in older patients with cancer. Polypharmacy and PIM have been associated with postoperative complications, frailty, falls, medication nonadherence, chemotherapy toxicity, and mortality. These findings emphasize the prognostic importance of careful medication review and identification of PIM by oncology teams. They also underscore the need to develop and test interventions to address polypharmacy and PIM in older patients with cancer, with the goal of improving outcomes in these patients.

Indexed as

PolypharmacyAgedAged, 80 and overFemaleHumansMalePotentially Inappropriate Medication ListRisk FactorsGeriatric oncologyOlder adults with cancerOutcomesPolypharmacyPotentially inappropriate medications

Identifiers

PMID31570516
PMCPMC6964156
OpenAlexW2978533908

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.