| DOI: 10.29090/psa.2025.04.25.4875 | Pharm Sci Asia 2025; 52(4), 584-591 |
Polypharmacy and inappropriate medication use in terminal cancer patients: A retrospective study from a community hospital in ThailandJukapun Yoodee1, Phathaimas Rodsawai1, Pornpattra Fukhammee1, Patinya Suriyong2, Thitichaya Penthinapong1*
1 Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand.
2
Sanpatong Hospital, Chiang Mai, Thailand.
Polypharmacy and the use of potentially inappropriate medications (PIMs) are common among terminal cancer patients with multiple comorbidities. These are associated with increased treatment burden, diminished quality of life, and adverse clinical outcomes. This study investigates the prevalence, patterns, and associated risk factors of polypharmacy and PIMs use among hospice patients at a community hospital in Thailand. A descriptive, retrospective cross-sectional study was conducted among cancer patients aged ≥20 years who attended palliative care clinics at a community hospital between January 2018 and December 2023. Patients receiving active anticancer treatment were excluded. Polypharmacy was defined as the concurrent use of five or more medications. PIMs were identified using the STOPP-Frail, and the OncPal criteria. Logistic regression analysis was performed to identify factors associated with polypharmacy and PIMs use. A total of 65 patients were included (61.5% male; mean age 70.4 years). Polypharmacy was observed in around 40.0% during the last 6 months of life. PIMs use was found in 64.6%- 72.3% in the same periods. Antihypertensives, lipid-lowering agents, and vitamins/minerals were the most prescribed drugs. During the final six months, patients with more than two comorbidities had an increased risk of receiving PIMs when on polypharmacy. Polypharmacy was significantly associated with PIMs use in the final three and one months of life, with multivariate analysis confirming the association during the last three months. Polypharmacy and PIMs use are increasingly prevalent among terminal cancer patients receiving hospice care in Thailand. In the future, implementing systematic deprescribing strategies may help ensure appropriate medication use and improve the quality of end-of-life care.
Keyword:
Polypharmacy; Inappropriate medication use; Hospice care; Palliative; Community hospital
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