PMID- 23229875
OWN - NLM
STAT- MEDLINE
DCOM- 20130923
LR  - 20220408
IS  - 2210-7711 (Electronic)
VI  - 35
IP  - 2
DP  - 2013 Apr
TI  - Patients with advanced lung cancer: is there scope to discontinue inappropriate 
      medication?
PG  - 181-4
LID - 10.1007/s11096-012-9731-2 [doi]
AB  - BACKGROUND: Polypharmacy-taking five or medications per day-is common in lung 
      cancer patients. This patient group is prescribed medication to control acute 
      symptoms associated with cancer and also to prevent or treat other long-term 
      conditions. These medications increase the pill burden for the patient and also 
      the probability of developing a drug-related toxicity. OBJECTIVE: To assess the 
      prevalence of inappropriate medication in patients taking erlotinib for the 
      treatment of advanced non-small cell lung cancer. METHOD: This was a multicentre 
      study across three sites in the North of England. Medication histories for 
      patients receiving erlotinib were retrospectively extracted from medical notes 
      and assessed by the clinical team (a consultant pharmacist, nurse specialist and 
      clinical oncologist) to determine if the medication was appropriate or 
      inappropriate. The clinical team considered the following factors when deciding 
      if the medication was appropriate or inappropriate: remaining life expectancy of 
      the patient, time until benefit of the treatment, goals of care and treatment 
      targets. RESULTS: Among the 20 patients assessed, 19 (95 %) according to the 
      clinical team were taking medications that were inappropriate. The mean number of 
      medications the patients were taking was 8 (range 1-16) and the most common class 
      of medication used were drugs affecting the Central Nervous System. In addition, 
      there were 11 patients (55 %) who were taking erlotinib in combination with a 
      proton pump inhibitor (PPI)-a clinically significant drug interaction that 
      impairs the absorption of erlotinib. CONCLUSIONS: Patients taking erlotinib for 
      the treatment of advanced non-small cell lung cancer take many inappropriate 
      medications for the treatment or prevention of long-term conditions. These 
      patients should have their medications reviewed in the context of their original 
      therapeutic goals.
FAU - Todd, Adam
AU  - Todd A
AD  - Department of Pharmacy, Health and Well-being, Faculty of Applied Sciences, 
      University of Sunderland, Wharncliffe Street, Sunderland, SR1 3SD, UK. 
      adam.todd@durham.ac.uk
FAU - Williamson, Steve
AU  - Williamson S
FAU - Husband, Andy
AU  - Husband A
FAU - Baqir, Wasim
AU  - Baqir W
FAU - Mahony, Mairead
AU  - Mahony M
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20121211
PL  - Netherlands
TA  - Int J Clin Pharm
JT  - International journal of clinical pharmacy
JID - 101554912
RN  - 0 (Antineoplastic Agents)
RN  - 0 (Protein Kinase Inhibitors)
RN  - 0 (Proton Pump Inhibitors)
RN  - 0 (Quinazolines)
RN  - DA87705X9K (Erlotinib Hydrochloride)
SB  - IM
MH  - Antineoplastic Agents/adverse effects/pharmacokinetics/*therapeutic use
MH  - Carcinoma, Non-Small-Cell Lung/*drug therapy/pathology
MH  - Drug Interactions
MH  - England
MH  - Erlotinib Hydrochloride
MH  - Humans
MH  - Inappropriate Prescribing
MH  - Lung Neoplasms/*drug therapy/pathology
MH  - Polypharmacy
MH  - Prevalence
MH  - Protein Kinase Inhibitors/adverse effects/pharmacokinetics/therapeutic use
MH  - Proton Pump Inhibitors/adverse effects/pharmacology
MH  - Quinazolines/adverse effects/pharmacokinetics/*therapeutic use
MH  - Retrospective Studies
EDAT- 2012/12/12 06:00
MHDA- 2013/09/24 06:00
CRDT- 2012/12/12 06:00
PHST- 2012/10/05 00:00 [received]
PHST- 2012/11/27 00:00 [accepted]
PHST- 2012/12/12 06:00 [entrez]
PHST- 2012/12/12 06:00 [pubmed]
PHST- 2013/09/24 06:00 [medline]
AID - 10.1007/s11096-012-9731-2 [doi]
PST - ppublish
SO  - Int J Clin Pharm. 2013 Apr;35(2):181-4. doi: 10.1007/s11096-012-9731-2. Epub 2012 
      Dec 11.