The data on
deprescribing in oncology settings has been retrieved from the PubMed, Scopus and Google Scholar. We used "
deprescribing," "potentially inappropriate medication" and "
cancer" as a keyword for the conducting general search. The articles relevant to guidelines or tools used to deprescribe in
cancer care were included.
DATA SUMMARY: The nature of
cancer, its treatment strategies, adverse effects of
therapy and multimorbidity impact negatively on quality of life (QoL). Further, they invite
polypharmacy which puts the patient at higher risk of
drug-related problems like drug interactions,
adverse drug reactions and addition of potentially improper medications, etc. In older adults with
cancer, the incidence of potentially inappropriate medications (PIMs) was between 41% and 52%. Over the decades, multiple strategies have been developed to assess the appropriateness of
therapy. One such approach is
deprescribing. OncPal and oncoSTRIP (Systematic Tool to Reduce
Inappropriate Prescribing) are the
cancer specific guidelines whereas BEERs criteria, Screening Tool to Alert to Right Treatment/Screening Tool of Older Person's Prescriptions criteria (START/STOPP criteria), medication appropriateness index (MAI) are the
cancer nonspecific tools to identify PIM among
cancer patients. Here, we provided an integrative approach and algorithm for
deprescribing in oncology setting which includes patient and caregiver goals, life expectancy (LE), review of medications, determining medication appropriateness, assessment of time to benefit (TTB), symptomatic and asymptomatic care, identifying medications to cease, implementation of the plan, monitoring and reviewing.
CONCLUSION:
Deprescribing in oncology setting is a novel and effective patient-centric approach to counteract the use of PIM, which helps to mitigate
polypharmacy,
drug-drug interactions, and adverse effects.