Missed opportunities: unnecessary medicine use in patients with lung cancer at the end of life - an international cohort study: Unnecessary medicine use in patients with lung cancer

Adam Todd, Jaafar Al-Khafaji, Nasima Akhter, Adetayo S Kasim, Rachel Quibell, Kelly Merriman, Holly M. Holmes

Research output: Contribution to journalArticlepeer-review

Abstract

Aims
The aims of the current study were: (i) to examine the prescribing of preventative medication in a cohort of people with advanced lung cancer on hospital admission and discharge across different healthcare systems; and (ii) to explore the factors that influence preventative medication prescribing at hospital discharge.

Methods
A retrospective cohort study was conducted across two centres in the UK and the US. The prescribing of preventative medication was examined at hospital admission and discharge for patients who died of lung cancer. A zero-inflated negative binomial regression model was used to examine the association between preventative medications at discharge and patient- and hospital-based factors. The classes of preventative medication prescribed included were: vitamins and minerals, and antidiabetic, antihypertensive, antihyperlipidaemic and antiplatelet medications.

Results
In the UK site (n = 125), the mean number of preventative medications prescribed was 1.9 [standard deviation (SD) 1.7) on admission, and 1.7 (SD 1.7) on discharge, and in the US site (n = 191) the mean was 2.6 (SD 2.2) on admission and 1.9 (SD 2.2) on discharge. The model found a significant association between the number of preventative drugs prescribed on admission and the number on discharge; it also found a significant association between the total number of drugs prescribed on discharge and the number of preventative medications on discharge. Other indicators related to patient and hospital factors were not significantly associated with the number of preventative medications supplied on discharge.

Conclusions
The use of preventative medication was common in lung cancer patients, despite undergoing discharge. Patient- and hospital-based factors did not influence the prescribing of preventative medication.
Original languageEnglish
Pages (from-to)2802-2810
JournalBritish Journal of Clinical Pharmacology
Volume84
Issue number12
DOIs
Publication statusPublished - 5 Sept 2018
Externally publishedYes

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