Complementary and Alternative Medicine Still Popular Among Older Cancer Patients

How complementary and alternative medicine contributes to polypharmacy and potentially inappropriate medication use in older cancer patients is unclear.

Because complementary and alternative medicine may exacerbate pill burden and increase adverse effects, health care providers should assess prescription, nonprescription, and complementary and alternative medicine use at baseline and during each visit.

Previous studies have reported that the prevalence of complementary and alternative medicine ranges from 12.5% to 46%. This broad range can be traced back to the facts that definitions for complementary and alternative medicine vary, and some studies employed unreliable methods to measure its use (eg, self-report).

One study published in the Journal of Geriatric Oncology indicates that patients who have medication regimens qualifying as polypharmacy, vision impairment, and urologic comorbidities are most likely to use complementary and alternative medicine.

The researchers behind this study defined complementary and alternative medicine as the use of herbal medications, minerals, or other dietary supplements. Fish oil and some multivitamins were excluded from that definition because they’re often recommended by health care providers.

Meanwhile, polypharmacy was defined as concurrent use of at least 5 medications.

In the study, pharmacists retrospectively analyzed 234 patients’ electronic medical records during an initial comprehensive geriatric oncology assessment between January 2011 and June 2013. Rather than relying on patients’ self-reports, the pharmacists asked patients to bring in all of their medication bottles.

The researchers found evidence of complementary and alternative medicine use in 26.5% of ambulatory geriatric oncology patients. The total study cohort was mostly aged 80 years or older (57%), and this subpopulation accounted for 68% of complementary and alternative medicine users.

Of note, drug-disease, drug—drug, and/or drug–herb interactions may impact the safety and efficacy of oncology treatments.

Because studies on the use of multivitamins to prevent macular degeneration exclude oncology patients, evidence remains limited in this population.

Nevertheless, pharmacists can help patients better understand complementary and alternative medicine use, as well as its contribution to polypharmacy and potentially inappropriate medication use. The addition of pharmacists to the geriatric oncology team has been shown to reduce morbidity and health care costs.

Therefore, the study authors recommended the incorporation of pharmacists into the medical team, clear documentation of complementary and alternative medicine use in the electronic medical record, and further studies examining the benefits and risks of complementary and alternative medicine use during cancer treatment.