The continuation of preventive drugs among older patients with advanced cancer is examined in a recent publication in the research journal, Cancer. Dr Stephen Barclay (Department Public Health & Primary Care), collaborated with colleagues from the Karolinska Institute and Newcastle University, finding that the use of preventive drugs in the last year of life is common among older adults with cancer, despite these drugs being unlikely to be of clinical benefit during the patients’ remaining months of life.

Led by Dr Lucas Morin in the Karolinska Institute, this Swedish nationwide cohort study of older adults (aged ≥65 years) with solid tumors who died between 2007 and 2013, used routinely collected data with record linkage. Among 151,201 older persons who died with cancer, the average number of drugs increased from 6.9 to 10.1 over the course of the last year before death. Preventive drugs frequently were continued until the final month of life, including antihypertensives, platelet aggregation inhibitors, anticoagulants and statins.

The authors suggest that the use of preventive drugs should be reconsidered in light of the patient’s values and preferences and a reconsideration of the goals of care. Reducing the therapeutic burden in individuals with advanced cancer has the potential to not only reduce unnecessary adverse effects and improve patient quality of life, but also to reduce the financial burden for patients and health services.

Reference

L Morin, A Todd, S Barclay, J Wastesson, J Fastbom, K Johnell: ‘Preventive Drugs in the Last Year of Life of Older Adults With Cancer: Is There Room for Deprescribing?’ Cancer 25 March 2019

Queries: Lucy Lloyd, Communications Manager, Primary Care Unit