Table 2.

Outcomes of PIMs in studies applying tools or guidelines

Article	No. cancer patients	Population type	Study type	Criteria for PIM	%n ≥ 1 PIM	% PIMs	Most frequently prescribed PIM
Use of tool developed specific for cancer patients
Marin et al. [20]	266	Cancer patients seen by the palliative care consult team	Retrospective database review	OncPal (not used by palliative team)	82% before consultation, 57% after consultation	21% PIMs before, 14% PIMs after	Vitamin, minerals Antihypertensives Peptic ulcer prophylaxis
Wenedy et al. [21]	6158	Cancer patients in home hospice care	Retrospective study	OncPal to assess appropriateness of discontinuation	NA	NA	Omeprazole, furosemide, simvastatin
Lindsay et al. [10]	61	Palliative cancer in patients with < 6-month prognosis	Prospective, non-interventional cohort study	OncPal	70%	21.4%	Antihypertensive, dyslipidemic agents, CAMs
Todd et al. [22]	125 in the UK 191 in the USA	Patients who died of lung cancer with a hospital admission within the last 6 months of life	Retrospective cohort study	The most common inappropriate preventative medications	At admission: 73% in the UK 80% in the USA At discharge: 63% in the UK 69% in the USA	NA	UK: antihypertensive agents US: vitamin and minerals
Oliveira et al. [13]	448 patients	Patients referred to the palliative care service of an oncology institute	Retrospective analysis	Focus on the prescription of gastric protectants, antihypertensive agents, antidiabetic agents, anticoagulants, antidementia drugs, and statins (criteria modified from Fede et al. [14])	Futility within categories: Statins: 97% Gastric protectors: 50% Antihypertensive agents: 27% Antidiabetic: 1% Bisphosphonates: 26% Antidementia: 100%	NA	Gastric protectants
Garfinkel et al. [16]	202 patients	End-stage cancer patients at the time of admission to homecare hospice	Retrospective chart review	Medications for chronic diseases, excluding oncological treatments Appropriateness of preventative medication was not assessed	NA	NA	2 months before death: 31% patients were treated with statins 23% with aspirin 16% with blood pressure-lowering drugs
Use of tool developed not specific for cancer patients
Karuturi et al. [23]	1595 breast cancer patients 1528 colorectal cancer patients	Patients ≥ 65 years with breast or colorectal cancer receiving adjuvant chemotherapy	Retrospective cohort study	DAE and Beers criteria	NA	At baseline DAE criteria: 22.2% in the breast cohort 15.5% in the colorectal cohort Beers criteria: 27.6% in the breast cohort 24.8% in the colorectal cohort
Karuturi et al. [24]	1595 breast cancer patients 1528 colorectal cancer patients	Patients ≥ 66 years with stage II/III breast or colorectal cancer receiving adjuvant chemotherapy	Retrospective cohort study	STOPP criteria	NA	31.5% in the breast cohort 30.9% in the colorectal cohort	NA
Hong et al. [25]	301	Older adults (≥ 70 years) with histologically diagnosed solid cancer who were candidates for first-line palliative chemotherapy	Secondary analysis of a prospective observational study	2015 Beers criteria with exclusion of medication typically used to alleviate chemotherapy-induced nausea	45.5%	12.4%
Nightingale et al. [26]	172 patients who used no complementary and alternative medications (CAM) 62 patients who used complementary and alternative medications	Ambulatory older adults with cancer who received an initial comprehensive geriatric oncology assessment	Secondary analysis of a retrospective study	Three tools: -STOPP criteria -DAE -Beers criteria	No CAM: 52.3% CAM: 50%	NA	NA
Flood et al. [27]	47	Older adult cancer patients admitted to the oncology-acute care for elderly	Prospective, observational study	Beers criteria	21% on admission	NA	PRN promethazine for nausea Diphenhydramine before blood transfusion
Nightingale et al. [28]	142 of which 41 received iMAP	Patients ≥ 65 years who received an initial geriatric oncology assessment	Prospective, exploratory pilot into pharmacist-led individualized medication assessment and planning (iMAP)	Beers criteria	All patients: 39.4% Patient that received iMAP: 46%	NA	NA
Zhou et al. [29]	311 chemotherapy order templates	No patients were included	Review of order templates	Six medications defined as PIMs by the Beers criteria and frequently prescribed for supportive care: antihistamines, benzodiazepines, corticosteroids, H2-receptor antagonists, metoclopramide, and antipsychotics	45% of the chemotherapy order templates	NA	Antihistamines (39.5% of the templates)
Domingues et al. [19]	71 patients	Cancer patients at the time of transition to the palliative care setting	Prospective observational study	Medication appropriateness index	NA	After first consultation in the palliative care setting: 28.2% drugs were suspended	Most frequently suspended medications: Psychoactive drugs (13.5%) Analgesics (12.4%) Laxatives (9.6%)

NA not available