Evidence map›Paper›PMID 39294452›Full record

Trial reportSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2024

Effect of polypharmacy and potentially inappropriate medications on physical functional decline among older adults with advanced cancer receiving systemic treatment.

Mostafa R Mohamed, Katherine Juba, Hala Awad, Marie Flannery, Eva Culakova, Megan Wells, Jenna Cacciatore, Marielle Jensen-Battaglia, Supriya Mohile, Erika Ramsdale

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02054741 (A Geriatric Assessment Intervention for Patients Aged 70 and Over Receiving Chemotherapy or Similar Agents for Advanced Cancer), which is not on this map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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.

NCT02054741 nacompletednot on this map

A Geriatric Assessment Intervention for Patients Aged 70 and Over Receiving Chemotherapy or Similar Agents for Advanced Cancer: Reducing Toxicity in Older Adults

TypeinterventionalSponsorSupriya MohileRan2014 to 2021Enrolled733ConditionsAdult Solid Neoplasm, Toxicity, LymphomaArmsComprehensive Geriatric Assessment, Quality-of-Life Assessment, Survey Administration
3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
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

10 authors.

Mostafa R MohamedDepartment of Public Health, University of Rochester, Rochester, NY, USA. mostafa_mohamed@urmc.rochester.edu.
Katherine JubaDepartment of Pharmacy Practice, Wegmans School of Pharmacy, Rochester, NY, USA.
Hala AwadWilmot Cancer Institute, University of Rochester, 601 Elmwood Avenue, Box 704, Rochester, NY, 14642, USA.
Marie FlanneryUniversity of Rochester School of Nursing, Rochester, NY, USA.
Eva CulakovaDepartment of Surgery, School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA.
Megan WellsWilmot Cancer Institute, University of Rochester, 601 Elmwood Avenue, Box 704, Rochester, NY, 14642, USA.
Jenna CacciatoreWilmot Cancer Institute, University of Rochester, 601 Elmwood Avenue, Box 704, Rochester, NY, 14642, USA.
Marielle Jensen-BattagliaDepartment of Public Health, University of Rochester, Rochester, NY, USA.
Supriya MohileWilmot Cancer Institute, University of Rochester, 601 Elmwood Avenue, Box 704, Rochester, NY, 14642, USA.
Erika RamsdaleWilmot Cancer Institute, University of Rochester, 601 Elmwood Avenue, Box 704, Rochester, NY, 14642, USA.

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
Decreasing Polypharmacy in Older Adults with Curable CancersK08CA248721 · NCI · UNIVERSITY OF ROCHESTER · PI RAMSDALE, ERIKA E · 2020 to 2024
$1.2M
Polypharmacy, Potentially Inappropriate Medications, and Adverse Outcomes in Older Adults with Advanced Cancer Receiving ChemotherapyR03AG067977 · NIA · UNIVERSITY OF ROCHESTER · PI RAMSDALE, ERIKA E · 2020 to 2021
$308k
NCI NIH HHS K08 CA248721NCI NIH HHS R01 CA177592NCI NIH HHS UG1 CA189961NIA NIH HHS K24 AG056589NIA NIH HHS R03 AG067977NIH HHS K24 AG056589NIH HHS UG1CA189961Wilmot Cancer Institute, University of Rochester Medical Center GR532432
6 · The paper itself

Abstract

backgroundPolypharmacy and potentially inappropriate medications (PIM) are common among older adults with advanced cancer, but their association with physical functional outcomes is understudied. This study aimed to estimate the risk of physical functional decline associated with medication measures in older adults with advanced cancer starting a new line of systemic treatment.

methodsThis secondary analysis of GAP 70+ Trial (PI: Mohile) enrolled patients aged 70+ with advanced cancer, had ≥ 1 geriatric assessment domain impairment and planned to start a new antineoplastic regimen with a high risk of toxicity. Polypharmacy (concurrent use of ≥ 8 medications (meds)) was assessed before initiation of treatment. PIM were categorized using Screening Tool of Older Person's Prescriptions (STOPP) criteria and 2019 Beers criteria. Physical functional outcomes were assessed within 3 months of treatment initiation: (1) Activity of Daily Living (ADL) decline: 1-point decrease in ADL score between baseline and 3 months; (2) Instrumental ADL (IADL) decline: 1-point decrease in IADL score between baseline and 3 months; (3) Short physical performance battery (SPPB) decline, defined as 1-point decrease on SPPB; (4) ≥ 1 falls within 3 months of treatment. Separate multivariable, cluster-weighted Generalized Estimating Equations models adjusted for relevant covariates (e.g., age, baseline function/comorbidities).

resultsAmong 616 participants, mean number of meds was 6 (range 0-24); 28% received ≥ 8 meds. Polypharmacy was associated with increased risk of ADL decline (adjusted risk ratio [aRR], 1.31; 95% CI, 1.00-1.71). Taking ≥ 1 PIM per STOPP was associated with increased risk of IADL decline (aRR, 1.21; 95% CI, 1.04-1.40) and falls (aRR, 1.93; 95% CI, 1.49-2.51).

conclusionsIn a large cohort of vulnerable older adults with advanced cancer receiving systemic treatment, polypharmacy and PIM were independently associated with an increased risk of physical functional decline. This emphasizes the need to develop interventions to optimize medication use, intending to improve outcomes in these patients.

trial registrationClinicalTrials.gov Identifier: NCT02054741. Registered 01-31-2014.

Indexed as

Activities of Daily LivingGeriatric AssessmentNeoplasmsPolypharmacyPotentially Inappropriate Medication ListAgedAged, 80 and overAntineoplastic AgentsFemaleHumansMaleAntineoplastic AgentsCancerMedicationsOlder adultsPhysical functional declinePolypharmacy

Identifiers

PMID39294452
PMCPMC12093274

What Socratic holds

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Registered trials

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.