Clinical trial · Interventional
Decreasing Polypharmacy in Older Adults With Curable Cancers Trial
Decreasing Polypharmacy in Older Adults With Curable Cancers: a Pilot Cluster-randomized Trial
- Source
- ClinicalTrials.gov
- Retrieved
- Sep 8, 2026
- Layer
- normalized (units and labels harmonized; values unchanged)
- Run
- ING-CLINICALTRIALS-20260908-000001
Summary
Brief summary (as posted)
This is a single-site cluster-randomized trial to assess efficacy and implementation outcomes of deprescribing interventions in 72 older adults with polypharmacy (PP) and curable cancers initiating chemotherapy. Oncologists (as the cluster) will enroll 6 patients each and will be randomized to either a pharmacist-led deprescribing intervention or patient education intervention. Initial focus groups with oncologists, nurses, pharmacists, primary care physicians, and patients will provide data for initial adaptations to the pharmacist-led intervention arm, and 8 patients will be enrolled as a pre-trial cohort to further refine and adapt the pharmacist-led intervention.
Conditions
Conditions (1)
Free-text conditions as registered, with the CancerIndex entity they were reconciled to and the match type.
| Condition (as posted) | Mapped entity | Match | Confidence |
|---|---|---|---|
| Cancer | Malignant Neoplasm | ALIAS | 0.90 |
Interventions
Interventions (2)
| Intervention | Type | Mapped drug | Match |
|---|---|---|---|
| Patient education | Other | — | UNRESOLVED |
| Pharmacist-led deprescribing | Other | — | UNRESOLVED |
Design
Arms and outcomes
Arms (2)
- type
- EXPERIMENTAL
- label
- Arm 1: Pharmacist-led deprescribing intervention
- description
- Pharmacists will complete a comprehensive medication assessment with the participant via telemedicine and discuss tailored recommendations for discontinuations of potentially inappropriate medications. The pharmacist will document the evaluation and recommendations and communicate to the participant and care team members. The pharmacist will telephone each participant at least one time after the initial intervention to assess adherence to instructions and recommendations, and to assess any symptoms potentially related to medication discontinuation.
- interventionNames
- Other: Pharmacist-led deprescribing
- type
- ACTIVE_COMPARATOR
- label
- Arm 2: Patient education brochure
- description
- Participants will receive a brochure discussing medication appropriateness and deprescribing in general terms
- interventionNames
- Other: Patient education
Primary outcomes (1)
Eligibility
Eligibility (as posted)
- Sex
- All
- Minimum age
- 65 Years
Show eligibility criteria text
Inclusion Criteria: * Be age ≥65 years; * Have a diagnosis of malignancy including aggressive lymphoma or cancers of the breast, gastrointestinal system, genitourinary system, or lung; * Be initiating chemotherapy, alone or in combination with other systemic antineoplastic agents, (for a period of at least 3 months) within 4 weeks of enrollment; * Screen positive for polypharmacy (\>10 medications) or potentially inappropriate medications * Be able to read and write English; * Be able to give informed consent, as determined by the primary oncologist, or has a legally authorized representative to sign consent in the case of cognitive impairment. Exclusion Criteria: * Be planned to receive a cancer treatment regimen that does not include standard cytotoxic chemotherapy (e.g., only targeted therapies, hormonal therapies, monoclonal antibody therapies, immunotherapy, etc.), * Have surgery or radiation without concurrent chemotherapy planned within 3 months of consent, * Have a planned referral to the geriatric oncology clinic (SOCARE) within one month of treatment initiation, * Lack decisional capacity, if a legally authorized representative is not available to sign consent and participate in study visits and follow-up phone calls.
References
Publications (2)
- DERIVEDRamsdale E, Mohamed M, Holmes HM, Zubkoff L, Bauer J, Norton SA, Mohile S. Decreasing polypharmacy in older adults with cancer: A pilot cluster-randomized trial protocol. J Geriatr Oncol. 2024 Mar;15(2):101687. doi: 10.1016/j.jgo.2023.101687. Epub 2024 Feb 1. PMID 38302299
- DERIVEDRamsdale E, Malhotra A, Holmes HM, Zubkoff L, Wang J, Mohile S, Norton SA, Duberstein PR. Emotional barriers and facilitators of deprescribing for older adults with cancer and polypharmacy: a qualitative study. Support Care Cancer. 2023 Oct 17;31(12):636. doi: 10.1007/s00520-023-08084-9. PMID 37847423