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• W4323294481 abstract "Abstract Purpose Polypharmacy is a significant problem in patients with incurable cancer and a method to optimize pharmacotherapy in this patient group is lacking. Therefore, a drug optimization tool was developed and tested in a pilot test. Methods A multidisciplinary team of health professionals developed a “Tool to Optimize Pharmacotherapy in Patients with Incurable Cancer” (TOP-PIC) for patients with a limited life expectancy. The tool consists of five sequential steps to optimize medications, including medication history, screening for medication appropriateness and drug interactions, a benefit–risk assessment using the TOP-PIC Disease-based list, and shared decision-making with the patient. For pilot testing of the tool, 8 patient cases with polypharmacy were analyzed by 11 oncologists before and after training with the TOP-PIC tool. Results TOP-PIC was considered helpful by all oncologists during the pilot test. The median additional time required to administer the tool was 2 min per patient ( P < 0.001). For 17.4% of all medications, different decisions were made by using TOP-PIC. Among possible treatment decisions (discontinuation, reduction, increase, replacement, or addition of a drug), discontinuation of medications was the most common. Without TOP-PIC, physicians were uncertain in 9.3% of medication changes, compared with only 4.8% after using TOP-PIC ( P = 0.001). The TOP-PIC Disease-based list was considered helpful by 94.5% of oncologists. Conclusions TOP-PIC provides a detailed, disease-based benefit–risk assessment with recommendations specific for cancer patients with limited life expectancy. Based on the results of the pilot study, the tool seems practicable for day-to-day clinical decision-making and provides evidence-based facts to optimize pharmacotherapy." @default.
• W4323294481 created "2023-03-07" @default.
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• W4323294481 date "2023-03-06" @default.
• W4323294481 modified "2023-09-25" @default.
• W4323294481 title "TOP-PIC: a new tool to optimize pharmacotherapy and reduce polypharmacy in patients with incurable cancer" @default.
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• W4323294481 doi "https://doi.org/10.1007/s00432-023-04671-9" @default.
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• W4323294481 hasPublicationYear "2023" @default.
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