Comprehensive Evaluation of Health Status and Serious Adverse Drug Events in Elderly Cancer Patients Receiving Chemotherapeutic Agents
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Abstract
This prospective longitudinal descriptive research aimed to assess the comprehensive health status of elderly cancer patients and to identify health status factors associated with serious adverse drug events (SAEs) from chemotherapeutic agents. Method: Newly diagnosed cancer patients at an age of 60 years or older received chemotherapeutic agents at Phrae hospital from March 2015 to July 2016 were recruited. The Comprehensive Geriatric Assessment (CGA) at the before and the end of chemotherapy treatment were evaluated and compared using Wilcoxon Signed Ranks Test. During the chemotherapy treatment, the AEs were recorded. The Chi-Square test was used to identify health status factors associated with the occurrence of SAEs. Result: Seventy-eight elderly cancer patients were enrolled. The mean age was 67.7 ± 6.3 years. 75.6% of patients were women. According to CGA, 93.6% of patients had a good Eastern Cooperative Oncology Group-Performance Status (ECOG-PS < 2). The elderly cancer patients were dependent in activities of daily living (ADL) in 21.8% of patients and dependent in instrumental activities of daily living (IADL) in 59.0% of patients. The prevalence of patients presenting with depression were 1.3%, cognitive function impairment were 3.8% and malnutrition were 75.6 % of patients. There were 36 patients (46.2%) with one or more comorbidities and 20.5 % of patients received at least one inappropriate medication for older adults. At the completed chemotherapy treatment, the median of ECOG-PS was significantly decreased (p <0.001). In all of AEs (515 events), 27.8 % were reported as SAEs. The most common SAEs were anemia, leucopenia, mucositis and nausea/vomiting. Elderly female patients treated with chemotherapeutic agents were significantly associated with a higher risk of SAEs (p=0.002) and malnutrition, which significant related to serious leucopenia (p=0.004). Conclusion: Older cancer patients receiving chemotherapy are at risk for both of serious hematological and other organs adverse events.The comprehensive health status assessment and intensive monitoring of AEs should be performed for prevention or reduction in severity of chemotherapy-related adverse events.
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