Medication Reconciliation Associated with Comprehensive Geriatric Assessment in Older Patients with Cancer: ChimioAge Study

Figures & data

Table 1 Socio-Demographic and Medical Characteristics at Baseline According to Systemic Therapy (Standard Doses vs Reduced Doses at Initiation) (n=171)

	Total (n=171)		Treatment Initially Adapted				P value
			Yes (n=51)		No (n=120)
	n	(%)	n	(%)	n	(%)
Gender							0.67
Men	98	(57.3)	28	(54.9)	70	(58.3)
Women	73	(42.7)	23	(45.1)	50	(41.7)
Age (years)							0.11
70–74	37	(21.6)	8	(15.7)	29	(24.2)
75–79	54	(31.6)	16	(31.4)	38	(31.7)
80–84	47	(27.5)	20	(39.2)	27	(22.5)
85 and more	33	(19.3)	7	(13.7)	26	(21.6)
Living alone at home	31	(18.1)	9	(17.6)	22	(18.3)	0.91
Caregiver*	110	(64.7)	35	(68.6)	75	(63.0)	0.48
Cancer localisation							0.19
Lung	53	(31.0)	12	(23.5)	41	(34.2)
Breast or Gynecologic	32	(18.7)	16	(31.4)	16	(13.3)
Gastrointestinal	27	(15.8)	7	(13.7)	20	(16.7)
Head and neck	19	(11.1)	7	(13.7)	12	(10.0)
Prostatic or Urologic	20	(11.7)	4	(7.8)	16	(13.3)
Skin	7	(4.1)	1	(2.0)	6	(5.0)
Hematologic malignancies	10	(5.8)	3	(5.9)	7	(5.8)
Other	3	(1.8)	1	(2.0)	2	(1.7)
Metastasis	91	(53.2)	27	(52.9)	64	(53.3)	0.96
Medical history in the past 3 months
Fall History	32	(18.7)	11	(21.6)	21	(17.5)	0.53
Emergency admission	27	(15.8)	7	(13.7)	20	(16.7)	0.63
Hospitalization**	71	(41.8)	21	(41.2)	50	(42.0)	0.91

Notes: *1 missing value. ** 2 missing value

Table 2 Geriatric and Pharmacological Characteristics at Baseline According to Systemic Therapy (Standard Doses vs Reduced Doses at Initiation) (n=171)

Variables	Total (n=171)		Treatment Initially Adapted				P value
			Yes (n=51)		No (n=120)
	N or Mean± ET	(%) or [min-max]	N or Mean± ET	(%) or [min-max]	N or Mean± ET	(%) or [min-max]
ECOG-PS >2	43	(25.1)	13	(25.5)	30	(25.0)	0.94
G8 ≤14	149	(87.1)	44	(86.3)	105	(87.5)	0.83
ADL<6	58	(33.9)	23	(45.1)	35	(29.2)	0.04
IADL* <4	90	(52.9)	28	(54.9)	62	(52.1)	0.73
Urinary incontinence	18	(10.5)	10	(19.6)	8	(6.7)	0.01
MMSE <24 (n=157)	29	(18.5)	12	(26.1)	17	(15.3)	0.11
GDS ≥1 *	37	(21.8)	15	(30.0)	22	(18.3)	0.09
Nutritional status
Malnutrition ^#	59	(34.5)	19	(37.3)	40	(33.3)	0.62
Mobility
TUG > 20s (n=168)	65	(38.7)	23	(45.1)	42	(35.9)	0.26
OLBT< 5s (n=153)	99	(64.7)	23	(56.1)	76	(67.9)	0.17
Gait speed < 0.8m/s (n=155)	42	(27.1)	15	(34.9)	27	(24.1)	0.17
Impaired handgrip strength^##	66	(38.6)	20	(39.2)	46	(38.3)	0.91
Number of comorbidities **	3.56±2.4	[0–13]	3.1±2.0	[0–8]	3.7±2.6	[0–13]	0.13
Severe comorbidities	73	(42.7)	26	(51.0)	47	(39.2)	0.15
Number of frailties	2.29±1.4	[0–6]	2.6±1.6	[0–6]	2.2±1.4	[0–5]	0.06
Biological status
Renal failure (n=165)	7	(4.2)	2	(4.0)	5	(4.3)	0.91
Thrombopenia (n=166)	21	(12.8)	4	(7.8)	17	(14.8)	0.21
Lymphopenia (n=165)	29	(17.6)	6	(11.8)	23	(20.2)	0.19
Anemia (n=167)	64	(38.3)	20	(39.2)	44	(37.9)	0.87
Polymedication (≥5 drugs)	111	(64.9)	33	(64.7)	78	(65.0)	0.97
Identification of potential drug interaction *	74	(43.3)	24	(47.0)	50	(41.6)	0.54

Notes: Anemia: Hb <11.5 G/dL Thrombopenia (<150 G/L) Lymphopenia: (<1.26G/L). ^#Malnutrition: BMI<21; Albumin <35g/L; MNA<17. ^##Impaired Handgrip strength: < 27 kg for men and < 16 kg for women. *1 missing value - **2 missing values.

Abbreviations: ADL, Activities of Daily Living; IADL, Instrumental Activities of Daily Living; MMSE, Mini Mental State Examination; GDS, Geriatric Depression Scale; TUG, Timed Up and Go Test; OLBT, One-Leg Balance Test.

Table 3 Clinical Follow-Up Data 3 Months After Treatment Initiation According to Systemic Therapy (Standard Doses vs Reduced Doses at Initiation) (n=171)

Variables	Total (n=171)		Treatment Initially Adapted				P value
			Yes (n=51)		No (n=120)
	N	(%)	N	(%)	N	(%)
Systemic treatment (n=168)							0.02
Chemotherapy	117	(74.1)	80	(76.9)	37	(68.5)
Targeted therapy	19	(12.0)	13	(12.5)	6	(11.1)
Immunotherapy	8	(5.1)	1	(1.0)	7	(13.0)
Chemo and targeted therapy	12	(7.6)	8	(5.1)	4	(2.5)
Chemo and immunotherapy	2	(1.3)	2	(1.3)	–	–
Reduction of treatment doses (n=166)							<0.001
None	56	(33.7)	–	–	56	(48.3)
<25%	58	(34.9)	27	(54.0)	31	(26.7)
25–49%	31	(18.7)	14	(28.0)	17	(14.7)
>50%	21	(12.6)	9	(18.0)	12	(10.3)
Type of treatment
Mono-therapy	64	(37.4)	17	(33.3)	47	(39.2)	0.47
Bi-Therapy	89	(52.1)	25	(49.1)	64	(53.3)	0.60
Tri or quadri therapy	18	(10.5)	9	(17.6)	9	(7.5)	0.05
Unplanned hospitalization (n=135)	51	(37.8)	17	(40.5)	34	(36.6)	0.66
Premature TRT discontinuation (n=169)	38	(22.5)	13	(25.5)	25	(21.2)	0.54
Cancer progression	15	(39.5)	6	(16.2)	9	(36.0)
Toxicity	13	(34.2)	2	(15.4)	11	(44.0)
Other reasons	6	(15.8)	3	(23.1)	3	(12.0)
Death	4	(10.5)	2	(15.4)	2	(8.0)
Toxicities
None	101	(59.1)	46	(90.2)	55	(45.8)	<0.001
Grade 1–2	46	(26.9)	3	(5.9)	43	(35.9)
Grade 3–5	24	(14.0)	2	(3.9)	22	(18.3)

Figure 1 Overall survival standard treatment versus adapted treatment.

Table 4 Patient’s Characteristics at Baseline According to Premature Systemic Treatment Discontinuation (n=169)

Variables	Premature Systemic Treatment Discontinuation				P value
	Yes (n=38)		No (n=131)
	N or Mean± ET	(%) or [min-max]	N or Mean± ET	(%) or [min-max]
Gender
Male	27	(71.0)	69	(52.7)	0.04
Female	11	(29.0)	62	(47.3)
Age
70–74	11	(28.9)	25	(19.1)	<0.01
75–79	4	(10.5)	50	(38.2)
80–84	16	(42.2)	30	(22.9)
85 and over	7	(18.4)	26	(19.8)
Cancer site
Lung	15	(39.5)	37	(28.2)	0.02
Breast/Gynecologic	1	(2.6)	30	(22.9)
Gastrointestinal	10	(26.3)	17	(13.0)
Other	12	(31.6)	47	(35.9)
ECOG-PS >2	12	(31.6)	31	(23.7)	0.32
G8 ≤14	34	(89.5)	115	(86.5)	0.68
ADL<6	12	(31.6)	46	(35.1)	0.68
IADL* <4	19	(50.0)	70	(53.8)	0.67
MMSE <24 (n=155)	6	(20.0)	23	(18.4)	0.84
GDS ≥1 *	6	(16.2)	31	(23.6)	0.33
Nutritional status
Malnutrition ^#	16	(42.1)	43	(32.8)	0.29
Impaired handgrip strength^##	16	(42.1)	48	(36.6)	0.54
Mobility
TUG>20s (n=166)	15	(41.7)	50	(38.5)	0.72
OLBT < 5s (n=151)	23	(71.9)	74	(62.2)	0.31
Gait speed <0.8m/s (n=153)	10	(30.3)	31	(25.8)	0.60
Number of comorbidities *	3.1 ±2.0	[0–7]	3.7 ±2.6	[0–13]	0.17
Severe comorbidities**	13	(34.2)	58	(44.3)	0.27
Number of frailties	2.4 ±1.8	[0–5]	2.3 ±2.6	[0–5]	0.62
Biological status
Renal failure (n=163)	3	(8.3)	4	(3.1)	0.17
Thrombopenia (n=164)	2	(5.6)	19	(14.8)	0.14
Lymphopenia (n=163)	6	(16.2)	23	(18.3)	0.77
Anemia (n=165)	13	(35.1)	50	(39.1)	0.66
Polymedication (≥5 drugs)	25	(65.8)	85	(64.9)	0.92
Identification of potential drug interaction *	20	(52.6)	52	(40.0)	0.16
Treatment					0.06
Mono-therapy	12	(31.6)	52	(39.7)
Bi-therapy	25	(65.8)	62	(47.3)
Tri or quadri therapy	1	(2.6)	17	(13.0)
Grade 3–5 toxicities	13	(34.2)	11	(8.4)	<0.001

Notes: Anemia: Hb <11.5 G/dL Thrombopenia (<150 G/L) Lymphopenia: (<1.26G/L). ^#Malnutrition: BMI<21; Albumin <35g/L; MNA<17 - ## Impaired Handgrip strength: < 27 kg for men and < 16 kg for women. *1 missing value - ** 2 missing values.

Abbreviations: ADL, Activities of Daily Living; IADL, Instrumental Activities of Daily Living; MMSE, Mini Mental State Examination; GDS, Geriatric Depression Scale; TUG, Timed Up and Go Test; OLBT, One-Leg Balance Test.

Table 5 Patient’s Characteristics at Baseline According to Presence of Toxicities Grade 3–5 (n=171)

Variables	Toxicities Grade 3–5				P value
	Yes (n=24)		No (n=147)
	N or Mean± ET	(%) or [min-max]	N or Mean± ET	(%) or [min-max]
Gender
Male	15	(62.5)	83	(56.4)	0.58
Female	9	(37.5)	64	(43.6)
Age
70–74	6	(25.0)	31	(21.1)	0.31
75–79	4	(16.6)	50	(34.0)
80–84	7	(29.2)	40	(27.2)
85 and over	7	(29.2)	26	(17.7)
Cancer site
Lung	10	(41.7)	43	(29.3)	0.25
Breast/Gynecologic	1	(4.2)	30	(20.4)
Gastrointestinal	5	(20.8)	22	(15.0)
Other	8	(33.3)	52	(35.3)
ECOG-PS >2	7	(29.2)	36	(24.5)	0.62
G8 ≤14	21	(87.5)	128	(87.0)	0.95
ADL<6	6	(25.0)	52	(35.3)	0.32
IADL* <4	11	(45.8)	79	(54.1)	0.45
MMSE <24 (n=157)	6	(27.3)	23	(17.0)	0.25
GDS ≥1 *	2	(8.3)	35	(24.0)	0.08
Nutritional status
Malnutrition^#	8	(33.3)	51	(34.7)	0.89
Impaired handgrip strength^##	11	(45.8)	55	(37.4)	0.43
Mobility
TUG>20s (n=168)	7	(29.2)	58	(40.3)	0.30
OLBT < 5s (n=153)	11	(52.4)	88	(66.6)	0.20
Gait speed <0.8m/s (n=155)	5	(22.7)	37	(27.8)	0.62
Number of comorbidities*	3.7±2.7	[0–13]	3.5±2.4	[0–11]	0.74
Severe comorbidities**	14	(58.3)	59	(40.1)	0.09
Number of frailties	2.5±1.4	[0–5]	2.3±1.5	[0–6]	0.47
Biological status
Renal failure (n=165)	1	(4.2)	6	(4.2)	0.98
Thrombopenia (n=166)	4	(17.4)	17	(11.9)	0.46
Lymphopenia (n=165)	4	(16.7)	25	(17.7)	0.90
Anemia (n=167)	5	(20.8)	59	(41.3)	0.06
Polymedication (≥5 drugs)	15	(62.5)	96	(65.3)	0.79
Identification of potential drug interaction *	11	(45.8)	63	(43.1)	0.80
Treatment					0.54
Mono-therapy	10	(41.7)	54	(36.7)
Bi-therapy	13	(54.2)	76	(51.7)
Tri or quadri therapy	1	(4.1)	17	(11.6)

Notes: Anemia: Hb <11.5 G/dL Thrombopenia (<150 G/L) Lymphopenia: (<1.26G/L). ^#Malnutrition: BMI<21; Albumin <35g/L; MNA<17 - ^##Impaired Handgrip strength: < 27 kg for men and < 16 kg for women. *1 missing value - ** 2 missing values.

Abbreviations: ADL, Activities of Daily Living; IADL, Instrumental Activities of Daily Living; MMSE, Mini Mental State Examination; GDS, Geriatric Depression Scale; TUG, Timed Up and Go Test; OLBT, One-Leg Balance Test.