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International Journal of Clinical Pharmacy

, Volume 35, Issue 2, pp 181–184 | Cite as

Patients with advanced lung cancer: is there scope to discontinue inappropriate medication?

  • Adam ToddEmail author
  • Steve Williamson
  • Andy Husband
  • Wasim Baqir
  • Mairead Mahony
Short Research Report

Abstract

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.

Keywords

Erlotinib Inappropriate medication Limited life expectancy Lung cancer Medication review Polypharmacy 

Notes

Funding

None.

Conflicts of interest

None of the authors have any conflicts of interest concerning this work.

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Copyright information

© Springer Science+Business Media Dordrecht 2012

Authors and Affiliations

  • Adam Todd
    • 1
    • 3
    Email author
  • Steve Williamson
    • 2
  • Andy Husband
    • 1
    • 3
  • Wasim Baqir
    • 2
  • Mairead Mahony
    • 1
  1. 1.Department of Pharmacy, Health and Well-being, Faculty of Applied SciencesUniversity of SunderlandSunderlandUK
  2. 2.Pharmacy DepartmentNorthumbria Healthcare NHS Foundation Trust, North Tyneside HospitalTyne and WearUK
  3. 3.Wolfson Research Institute, School of Medicine, Pharmacy and Health, Queen’s CampusDurham UniversityStockton-on-TeesUK

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