A concerning issue for many colorectal cancer (CRC) survivors in Australia is the high rate of polypharmacy. This means that a large number of patients are taking multiple medications simultaneously, which can lead to potential health risks.
The Impact of Polypharmacy on CRC Patients
Polypharmacy is a complex issue, and its effects on CRC patients have been the subject of new research. The study reveals that the way patients manage their medication changes throughout their cancer journey, often resulting in the use of multiple drugs at once. This practice has been linked to increased risks of adverse events and even death in other patient populations, such as those undergoing surgery or chemotherapy.
However, the research highlights a knowledge gap regarding polypharmacy in post-treatment CRC survivors. To fill this void, Australian researchers conducted a comprehensive study, examining medication use in CRC patients from the year before their diagnosis, through active treatment, and up to five years post-diagnosis.
The findings are eye-opening: more than 70% of CRC patients experienced polypharmacy at some point during the study, with nearly 50% continuing to do so in the two to five years after their diagnosis.
But here's where it gets controversial...
The Dynamics of Medication Use
The researchers discovered that medication use changes significantly following a CRC diagnosis and primary treatment. Over time, there's an increased reliance on analgesic and psychotropic medications. This trend underscores the unique challenges that CRC survivors face, including ongoing neuropathy, pain, and psychological symptoms.
To ensure quality survivorship, the researchers emphasize the need to prioritize the prevention and management of non-cancer comorbidities.
Uncovering Polypharmacy Patterns
To explore polypharmacy in CRC patients, the researchers utilized the Medicines Intelligence Data Platform, which links electronic health records with various data sources, including dispensing records, hospital admissions, cancer registry data, and death records.
This comprehensive approach identified 19,056 adults diagnosed with CRC over a five-year period. The study population was divided into three groups based on the stage of their disease: localized, regional, and metastatic. Interestingly, the proportion of patients experiencing polypharmacy was similar across these groups, with around 75% of patients in each group taking five or more medications simultaneously for at least one 90-day quarter of the year around their CRC diagnosis.
The number of medications dispensed per patient increased in the first 12 months following a CRC diagnosis, with a significant portion of patients receiving at least 10 unique medications during this timeframe.
Factors associated with an increased likelihood of polypharmacy included female gender, age (75 years and older), the presence of comorbidities, and socioeconomic disadvantage.
And this is the part most people miss...
The Dynamics of Medication Dispensing
The composition of the most commonly dispensed medications changed slightly in the year following a CRC diagnosis, with an increased focus on supportive medicines like antiemetics, painkillers, and antidepressants. Notably, opioids, other analgesics, and antidepressants remained among the most frequently dispensed medications throughout the post-active treatment survivorship period.
For patients treated with curative intent, the high rates of polypharmacy are particularly concerning, as they indicate excess morbidity and a reduced quality of life for survivors who have been cured of cancer but continue to experience poorer health than the general population.
This research highlights the need for a nuanced approach to medication management for CRC patients, taking into account the unique challenges they face post-diagnosis.
What are your thoughts on this issue? Do you think there's enough awareness and support for CRC survivors navigating polypharmacy? We'd love to hear your opinions in the comments!
