Skip to main content
Top
Published in: Breast Cancer 3/2020

01-05-2020 | Breast Cancer | Original Article

Comorbidity and polypharmacy in patients with breast cancer

Authors: Ulaş Serkan Topaloğlu, Ersin Özaslan

Published in: Breast Cancer | Issue 3/2020

Login to get access

Abstract

Background

Cancer sufferers are aged ≥ 65 years, but research has focused infrequently on elderly patients with the majority of cancer. We aimed not only to determine the frequency of comorbidity and polypharmacy, but also to present the discrepiancies in elderly versus non-elderly patients with breast cancer.

Methods

A total of 352 female patients aged over 18 years, 252 non-elderly and 100 elderly, followed-up in the oncology department of a tertiary hospital between January 2016 and September 2019 were retrospectively screened. Demographic data, comorbidity and medications of the patients were recorded hospital data processing system. Polypharmacy was defined as the use of ≥ 5 different medications.

Results

The most common four chronic diseases in both non-elderly and elderly groups were muscle-joint-bone disease, gastrointestinal diseases, diabetes mellitus and hypertension. The most common four prescribed drugs were NSAID, adjuvant endocrine therapy, PPI, and vitamin D or/and calcium in non-elderly group while those were ACEI-ARB, PPI, NSAID, and diuretics in elderly one. The frequency of polypharmacy was 50% (n = 126) in the non-elderly patients and 74% (n = 74) in the elderly ones. These were considered statistically significant (p < 0.001). The mean number of prescription medication categories reported was 5.02 (SD = 2.90; range 0–14) in non-elderly group whereas those was 6.83 (SD = 3.18; range 0–15) in elderly one (p < 0.001). The mean of ages were 47.9 years (without polypharmacy) and 51.3 years (with polypharmacy) in non-elderly patients while those are, respectively, 70.9 years and 74.7 years in elderly ones. These were considered statistically significant (respectively; p = 0.006, p = 0.009).

Conclusions

We first gained to raise awareness in the literature of comorbidity and polypharmacy in patients with breast cancer and to compare between the elderly and non-elderly participants. For the effectiveness of cancer treatment, importance in geriatric population, attention to drug–drug interaction, such studies should be considered during clinical practice.
Literature
1.
go back to reference Pilato B, Martinucci M, Danza K, Pinto R, Petriella D, Lacalamita R, et al. Mutations and polymorphic BRCA variants transmission in breast cancer familial members. Breast Cancer Res Treat. 2011;125(3):651–7.CrossRef Pilato B, Martinucci M, Danza K, Pinto R, Petriella D, Lacalamita R, et al. Mutations and polymorphic BRCA variants transmission in breast cancer familial members. Breast Cancer Res Treat. 2011;125(3):651–7.CrossRef
2.
go back to reference Yang X, Lippman ME. BRCA1 and BRCA2 in breast cancer. Breast Cancer Res Treat. 1999;4:1–10.CrossRef Yang X, Lippman ME. BRCA1 and BRCA2 in breast cancer. Breast Cancer Res Treat. 1999;4:1–10.CrossRef
3.
go back to reference Ritchie CS, Kvale E, Fisch MJ. Multimorbidity: an issue of growing importance for oncologists. J Oncol Pract. 2011;7:371–4.CrossRef Ritchie CS, Kvale E, Fisch MJ. Multimorbidity: an issue of growing importance for oncologists. J Oncol Pract. 2011;7:371–4.CrossRef
4.
go back to reference Neugut AI, Zhong X, Wright JD, Accordino M, Yang J, Hershman DL. Nonadherence to medications for chronic conditions and nonadherence to adjuvant hormonal therapy in women with breast cancer. JAMA Oncol. 2016;2(10):1326–32.CrossRef Neugut AI, Zhong X, Wright JD, Accordino M, Yang J, Hershman DL. Nonadherence to medications for chronic conditions and nonadherence to adjuvant hormonal therapy in women with breast cancer. JAMA Oncol. 2016;2(10):1326–32.CrossRef
5.
go back to reference Turner JP, Shakib S, Singhal N, Hogan-Doran J, Prowse R, Johns S, et al. Prevalence and factors associated with polypharmacy in older people with cancer. Support Care Cancer. 2014;22(7):1727–34.CrossRef Turner JP, Shakib S, Singhal N, Hogan-Doran J, Prowse R, Johns S, et al. Prevalence and factors associated with polypharmacy in older people with cancer. Support Care Cancer. 2014;22(7):1727–34.CrossRef
6.
7.
go back to reference Önal Ö, Durukan E. Frequency of polypharmacy and risk factors in the elderly in Burdur. Turkish J Geriatr. 2018;21(4):550–6.CrossRef Önal Ö, Durukan E. Frequency of polypharmacy and risk factors in the elderly in Burdur. Turkish J Geriatr. 2018;21(4):550–6.CrossRef
8.
go back to reference Azuero A, Benz R, McNees P, Meneses K. Co-morbidity and predictors of health status in older rural breast cancer survivors. Springerplus. 2014;3:102.CrossRef Azuero A, Benz R, McNees P, Meneses K. Co-morbidity and predictors of health status in older rural breast cancer survivors. Springerplus. 2014;3:102.CrossRef
9.
go back to reference Lees J, Chan A. Polypharmacy in elderly patients with cancer: clinical implications and management. Lancet Oncol. 2011;12(13):1249–57.CrossRef Lees J, Chan A. Polypharmacy in elderly patients with cancer: clinical implications and management. Lancet Oncol. 2011;12(13):1249–57.CrossRef
10.
go back to reference Bellury L, Pett MA, Ellington L, Beck SL, Clark JC, Stein KD. The effect of aging and cancer on the symptom experience and physical function of elderly breast cancer survivors. Cancer. 2012;118(24):6171–8.CrossRef Bellury L, Pett MA, Ellington L, Beck SL, Clark JC, Stein KD. The effect of aging and cancer on the symptom experience and physical function of elderly breast cancer survivors. Cancer. 2012;118(24):6171–8.CrossRef
11.
go back to reference Weaver KE, Foraker RE, Alfano CM, Rowland JH, Arora NK, Bellizzi KM, et al. Cardiovascular risk factors among long-term survivors of breast, prostate, colorectal, and gynecologic cancers: a gap in survivorship care? J Cancer Surviv. 2013;7(2):253–61.CrossRef Weaver KE, Foraker RE, Alfano CM, Rowland JH, Arora NK, Bellizzi KM, et al. Cardiovascular risk factors among long-term survivors of breast, prostate, colorectal, and gynecologic cancers: a gap in survivorship care? J Cancer Surviv. 2013;7(2):253–61.CrossRef
12.
go back to reference Williams GR, Deal AM, Lund JL, Chang Y, Muss HB, Pergolotti M, et al. Patient-reported comorbidity and survival in older adults with cancer. Oncologist. 2018;23(4):433–9.CrossRef Williams GR, Deal AM, Lund JL, Chang Y, Muss HB, Pergolotti M, et al. Patient-reported comorbidity and survival in older adults with cancer. Oncologist. 2018;23(4):433–9.CrossRef
13.
go back to reference Arinc S, Ece F, Ertugrul M, Erdal N, Oruc O, Hatabay N, et al. Analysis of young and elderly advanced stage nonsmall-cell lung carcinoma cases. South Med J. 2009;102(10):1019–22.CrossRef Arinc S, Ece F, Ertugrul M, Erdal N, Oruc O, Hatabay N, et al. Analysis of young and elderly advanced stage nonsmall-cell lung carcinoma cases. South Med J. 2009;102(10):1019–22.CrossRef
14.
go back to reference Jorgensen TL, Hallas J, Friis S, Herrstedt J. Comorbidity in elderly cancer patients in relation to overall and cancer-specific mortality. Br J Cancer. 2012;106(7):1353–60.CrossRef Jorgensen TL, Hallas J, Friis S, Herrstedt J. Comorbidity in elderly cancer patients in relation to overall and cancer-specific mortality. Br J Cancer. 2012;106(7):1353–60.CrossRef
15.
go back to reference Williams GR, Mackenzie A, Magnuson A, Olin R, Chapman A, Mohile S, et al. Comorbidity in older adults with cancer. J Geriatr Oncol. 2016;7(4):249–57.CrossRef Williams GR, Mackenzie A, Magnuson A, Olin R, Chapman A, Mohile S, et al. Comorbidity in older adults with cancer. J Geriatr Oncol. 2016;7(4):249–57.CrossRef
16.
go back to reference Menke A, Casagrande S, Geiss L, Cowie CC. Prevalence of and trends in diabetes among adults in the United States, 1988–2012. JAMA. 2015;314(10):1021–9.CrossRef Menke A, Casagrande S, Geiss L, Cowie CC. Prevalence of and trends in diabetes among adults in the United States, 1988–2012. JAMA. 2015;314(10):1021–9.CrossRef
17.
go back to reference Kannel WB, Vokonas PS. Demographics of the prevalence, incidence, and management of coronary heart disease in the elderly and in women. Ann Epidemiol. 1992;2(1–2):5–14.CrossRef Kannel WB, Vokonas PS. Demographics of the prevalence, incidence, and management of coronary heart disease in the elderly and in women. Ann Epidemiol. 1992;2(1–2):5–14.CrossRef
18.
go back to reference Satman I, Omer B, Tutuncu Y, Kalaca S, Gedik S, Dinccag N, TURDEP-II Study Group, et al. Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. Eur J Epidemiol. 2013;28(2):169–80.CrossRef Satman I, Omer B, Tutuncu Y, Kalaca S, Gedik S, Dinccag N, TURDEP-II Study Group, et al. Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. Eur J Epidemiol. 2013;28(2):169–80.CrossRef
19.
go back to reference Lee MH, Seo HJ, Shin EJ, Won YK, Jung YM, Suh SH, et al. The age-related characteristics of adults with asthma who visited emergency departments in Korea from 2007 to 2012. Allergy Asthma Proc. 2018;39(2):136–42.CrossRef Lee MH, Seo HJ, Shin EJ, Won YK, Jung YM, Suh SH, et al. The age-related characteristics of adults with asthma who visited emergency departments in Korea from 2007 to 2012. Allergy Asthma Proc. 2018;39(2):136–42.CrossRef
20.
go back to reference Jonsson H, Olafsdottir S, Sigurdardottir S, Aspelund T, Eiriksdottir G, Sigurdsson S, et al. Incidence and prevalence of total joint replacements due to osteoarthritis in the elderly: risk factors and factors associated with late life prevalence in the AGES-Reykjavik Study. BMC Musculoskelet Disord. 2016;17:14.CrossRef Jonsson H, Olafsdottir S, Sigurdardottir S, Aspelund T, Eiriksdottir G, Sigurdsson S, et al. Incidence and prevalence of total joint replacements due to osteoarthritis in the elderly: risk factors and factors associated with late life prevalence in the AGES-Reykjavik Study. BMC Musculoskelet Disord. 2016;17:14.CrossRef
21.
go back to reference Kaminsky DA, Chapman DG, Holbrook JT, Henderson RJ, Sugar EA, Mastronarde J, et al. Older age and obesity are associated with increased airway closure in response to methacholine in patients with asthma. Respirology. 2019;24(7):638–45.CrossRef Kaminsky DA, Chapman DG, Holbrook JT, Henderson RJ, Sugar EA, Mastronarde J, et al. Older age and obesity are associated with increased airway closure in response to methacholine in patients with asthma. Respirology. 2019;24(7):638–45.CrossRef
22.
go back to reference Rao AV, Demark-Wahnefried W. The older cancer survivor. Crit Rev Oncol Hematol. 2006;60:131–43.CrossRef Rao AV, Demark-Wahnefried W. The older cancer survivor. Crit Rev Oncol Hematol. 2006;60:131–43.CrossRef
23.
go back to reference Hinz A, Krauss O, Hauss JP, Höckel M, Kortmann RD, Stolzenburg JU, et al. Anxiety and depression in cancer patients compared with the general population. Eur J Cancer Care (Engl). 2010;19(4):522–9.CrossRef Hinz A, Krauss O, Hauss JP, Höckel M, Kortmann RD, Stolzenburg JU, et al. Anxiety and depression in cancer patients compared with the general population. Eur J Cancer Care (Engl). 2010;19(4):522–9.CrossRef
24.
go back to reference Hinz A, Herzberg PY, Lordick F, Weis J, Faller H, Brähler E, et al. Age and gender differences in anxiety and depression in cancer patients compared with the general population. Eur J Cancer Care (Engl). 2019;28(5):e13129.CrossRef Hinz A, Herzberg PY, Lordick F, Weis J, Faller H, Brähler E, et al. Age and gender differences in anxiety and depression in cancer patients compared with the general population. Eur J Cancer Care (Engl). 2019;28(5):e13129.CrossRef
25.
go back to reference Hagen KB, Aas T, Kvaløy JT, Søiland H, Lind R. Adherence to adjuvant endocrine therapy in postmenopausal breast cancer patients: A 5-year prospective study. Breast. 2019;44:52–8.CrossRef Hagen KB, Aas T, Kvaløy JT, Søiland H, Lind R. Adherence to adjuvant endocrine therapy in postmenopausal breast cancer patients: A 5-year prospective study. Breast. 2019;44:52–8.CrossRef
26.
go back to reference Temrel T, Şahin S. Polypharmacy and potentially inappropriate medicatıon use in gerıatrıc patients presenting to the emergency department. Turkish J Geriatr. 2019;22(1):25–31.CrossRef Temrel T, Şahin S. Polypharmacy and potentially inappropriate medicatıon use in gerıatrıc patients presenting to the emergency department. Turkish J Geriatr. 2019;22(1):25–31.CrossRef
27.
go back to reference Qato DM, Alexander GC, Conti RM, Johnson M, Schumm P, Lindau ST. Use of prescription and over-the-counter medications and dietary supplements among older adults in the United States. JAMA. 2008;300(24):2867–78.CrossRef Qato DM, Alexander GC, Conti RM, Johnson M, Schumm P, Lindau ST. Use of prescription and over-the-counter medications and dietary supplements among older adults in the United States. JAMA. 2008;300(24):2867–78.CrossRef
28.
go back to reference Lai X, Zhu H, Huo X, Li Z. Polypharmacy in the oldest old (≥80 years of age) patients in China: a cross-sectional study. BMC Geriatr. 2018;18(1):64.CrossRef Lai X, Zhu H, Huo X, Li Z. Polypharmacy in the oldest old (≥80 years of age) patients in China: a cross-sectional study. BMC Geriatr. 2018;18(1):64.CrossRef
29.
go back to reference Öztürk GZ, Ardıç C, Toprak D. Frequency of Polypharmacy and Use of Potentially Inappropriate Medications in the Elderly. Turkish J Geriatr. 2017;20(4):296–305. Öztürk GZ, Ardıç C, Toprak D. Frequency of Polypharmacy and Use of Potentially Inappropriate Medications in the Elderly. Turkish J Geriatr. 2017;20(4):296–305.
30.
go back to reference Jorgensen TL, Herrstedt J, Friis S, Hallas J. Polypharmacy and drug use in elderly Danish cancer patients during 1996 to 2006. J Geriatr Oncol. 2012;3:33–40.CrossRef Jorgensen TL, Herrstedt J, Friis S, Hallas J. Polypharmacy and drug use in elderly Danish cancer patients during 1996 to 2006. J Geriatr Oncol. 2012;3:33–40.CrossRef
31.
go back to reference Jokanovic N, Tan EC, Dooley MJ, Kirkpatrick CM, Bell JS. Prevalence and factors associated with polypharmacy in long-term care facilities: a systematic review. Am Med Dir Assoc. 2015;16(6):535.e1–12.CrossRef Jokanovic N, Tan EC, Dooley MJ, Kirkpatrick CM, Bell JS. Prevalence and factors associated with polypharmacy in long-term care facilities: a systematic review. Am Med Dir Assoc. 2015;16(6):535.e1–12.CrossRef
32.
go back to reference Khaledi AR, Kazemi M, Tahmasebi M. Frequency of polypharmacy in advanced cancer patients consulted with the palliative service of Imam Khomeini Hospital (Tehran), Iran, 2017. Asian Pac J Cancer Prev. 2019;20(1):131–4.CrossRef Khaledi AR, Kazemi M, Tahmasebi M. Frequency of polypharmacy in advanced cancer patients consulted with the palliative service of Imam Khomeini Hospital (Tehran), Iran, 2017. Asian Pac J Cancer Prev. 2019;20(1):131–4.CrossRef
Metadata
Title
Comorbidity and polypharmacy in patients with breast cancer
Authors
Ulaş Serkan Topaloğlu
Ersin Özaslan
Publication date
01-05-2020
Publisher
Springer Japan
Published in
Breast Cancer / Issue 3/2020
Print ISSN: 1340-6868
Electronic ISSN: 1880-4233
DOI
https://doi.org/10.1007/s12282-019-01040-8

Other articles of this Issue 3/2020

Breast Cancer 3/2020 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine