Medication Management of Patients With Cancer Undergoing Surgery From Preadmission to Discharge: A Mixed-Methods Systematic Review.
Mehrabifar Atefeh, Manias Elizabeth, Nicholson Patricia
PMID 39835655WHAT IT FOUND
Older adults with cancer undergoing surgery who took multiple regular medicines were more likely to be discharged to institutions, stay longer or die in some studies.
Findings conflicted. Patients reported better understanding after preadmission pharmacist review.
Key findings
01Polypharmacy was associated with postdischarge institutionalisation, and excessive polypharmacy was associated with poorer cancer survival, but not with postoperative delirium or 30-day readmission in two studies.
02Potentially inappropriate medications were linked to longer hospital stay, postoperative mortality and postoperative delirium in some studies, while other studies found no mortality or institutionalisation link.
03Preadmission pharmacist services were rated by staff and patients as helping reduce medication errors and improve medication understanding.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only English articles were included, which may miss relevant studies. Four included studies used the same cohort of patients, so findings may overlap. Most participants were aged 65 years and older, so results may not apply to younger cancer patients. Most included studies were retrospective and could not prove that medications caused complications. The pharmacist survey had a low response rate and measured satisfaction and added value. The qualitative study included 9 patients, so it describes experiences rather than proving a treatment effect.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that reducing polypharmacy will prevent complications. The review found associations from observational studies, not randomised evidence, and results were inconsistent. Do not treat the pharmacist survey as proof that patients had better outcomes. It measured satisfaction and had low response.