Evidence map›Paper›PMID 26449548›Full record

ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2016

Polypharmacy cut-points in older people with cancer: how many medications are too many?

Justin P Turner, Kris M Jamsen, Sepehr Shakib, Nimit Singhal, Robert Prowse, J Simon Bell

Abstract readEvaluation Study
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In one paragraph

Article in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
53citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

53 citing papers in PubMed, 3 syntheses or guidelines pooled it.

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  5. Polypharmacy Thresholds that Best Predict Emergency Room Visits and Mortality in Older Adults: A Population-Based Study in Québec, Canada.Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Justin P TurnerCentre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, 381 Royal Parade, Parkville, 3052, Melbourne, VIC, Australia. Justin.Turner@unisa.edu.au.
Kris M JamsenCentre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, 381 Royal Parade, Parkville, 3052, Melbourne, VIC, Australia.
Sepehr ShakibDepartment of Clinical Pharmacology, Royal Adelaide Hospital, Adelaide, SA, Australia.
Nimit SinghalDepartment of Medical Oncology, Royal Adelaide Hospital, Adelaide, SA, Australia.
Robert ProwseDepartment of Geriatric and Rehabilitation Medicine, Royal Adelaide Hospital, Adelaide, SA, Australia.
J Simon BellCentre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, 381 Royal Parade, Parkville, 3052, Melbourne, VIC, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposePolypharmacy is often defined as use of 'five-or-more-medications'. However, the optimal polypharmacy cut-point for predicting clinically important adverse events in older people with cancer is unclear. The aim was to determine the sensitivities and specificities of a range of polypharmacy cut-points in relation to a variety of adverse events in older people with cancer.

methodsData on medication use, falls and frailty criteria were collected from 385 patients aged ≥70 years presenting to a medical oncology outpatient clinic. Receiver operating characteristic (ROC) curves were produced to examine sensitivities and specificities for varying definitions of polypharmacy in relation to exhaustion, falls, physical function, Karnofsky Performance Scale (KPS) and frailty. Sub-analyses were performed when stratifying by age, sex, comorbidity status and analgesic use.

resultsPatients had a mean age of 76.7 years. Using Youden's index, the optimal polypharmacy cut-point was 6.5 medications for predicting frailty (specificity 67.0 %, sensitivity 70.0 %), physical function (80.2 %, 49.3 %) and KPS (69.8 %, 52.1 %), 5.5 for falls (59.2 %, 73.0 %) and 3.5 for exhaustion (43.4 %, 74.5 %). For polypharmacy defined as five-or-more-medications, the specificities and sensitivities were frailty (44.9 %, 77.5 %), physical function (58.0 %, 69.7 %), KPS (47.7 %, 69.4 %), falls (44.5 %, 75.7 %) and exhaustion (52.6 %, 64.1 %). The optimal polypharmacy cut-points were similar when the sample was stratified by age, sex, comorbidity status and analgesic use.

conclusionsOur results suggest that no single polypharmacy cut-point is optimal for predicting multiple adverse events in older people with cancer. In this population, the common definition of five-or-more-medications is reasonable for identifying 'at-risk' patients for medication review.

Indexed as

PolypharmacyAccidental FallsAgedAged, 80 and overComorbidityFatigueFemaleGeriatric AssessmentHumansKarnofsky Performance StatusMaleNeoplasmsReference StandardsROC CurveSensitivity and SpecificityAgedCancerDeprescribingPolypharmacy

Identifiers

PMID26449548

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.