| Summary: | Andrew Whitman,1 Paige Erdeljac,2 Caroline Jones,1 Nicole Pillarella,3 Ginah Nightingale3 1Department of Pharmacy, University of Virginia Health, Charlottesville, VA, USA; 2Department of Pharmacy, James Cancer Hospital and Solove Research Institute, Columbus, OH, USA; 3Department of Pharmacy Practice, Jefferson College of Pharmacy, Thomas Jefferson University, Philadelphia, PA, USACorrespondence: Ginah NightingaleJefferson College of Pharmacy, Thomas Jefferson University, Department of Pharmacy Practice, 901 Walnut Street Suite 946, Philadelphia, PA, 19107, USATel +1215-503-3794Fax +1215-503-9052Email ginah.nightingale@jefferson.eduAbstract: The care of older patients with cancer is becoming increasingly complex. Common challenges for this population include management of comorbidities, safe transitions of care, and appropriate medication use. In particular, polypharmacy—generally defined as the regular use of five or more medications—and inappropriate medication use can lead to adverse effects and poor outcomes in older adults with cancer, including falls, hospital readmissions, cognitive impairment, poor adherence to essential medications, chemotherapy toxicity, and increased mortality. Managing polypharmacy across different cancer care settings is often challenging. Providers face barriers to safe and successful medication management that may include lack of time, absence of reimbursement, underappreciation of the scale of polypharmacy-related harm, lack of ownership of deprescribing efforts, and poor communication across care settings. Existing literature on managing inappropriate medication use and polypharmacy in older adults with cancer has often focused on ideal state settings in which resources are plentiful and time is purposefully allocated for medication interventions. This paper presents a narrative, rather than a systematic review, of studies published in the past decade that provided detailed information on medication management and polypharmacy across cancer care settings. This review aims to also summarize different healthcare provider roles in taking action against inappropriate medication use and polypharmacy in older adults with cancer.Keywords: geriatric oncology, polypharmacy, potentially inappropriate medication, medication management, deprescribing, cancer care setting, interprofessional team
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