# Polypharmacy, Potentially Inappropriate Medications, and Adverse Outcomes in Older Adults with Advanced Cancer Receiving Chemotherapy

> **NIH NIH R03** · UNIVERSITY OF ROCHESTER · 2020 · $154,000

## Abstract

PROJECT SUMMARY/ABSTRACT
Polypharmacy (PP), or the concurrent use of multiple medications, affects up to 80% of older adults with
cancer. It is associated with the use of potentially inappropriate medications (PIMs), which have risk greater
than benefit in older adults. In older adults with cancer, PP/PIMs have been associated in some studies with
adverse outcomes, including poor adherence to and tolerance of cancer therapy and decrease in physical
functioning. However, these data have been inconsistent, and studies to date have examined specific
populations (such as disease-specific subgroups enrolled in clinical trials) that may not be representative of the
general population of older adults with cancer. This proposal presents a 2-year research and career
development plan focused on examining a cohort (n=370) of older adults with advanced cancer receiving
chemotherapy in community oncology clinics. This is a secondary analysis of the control arm of the Geriatric
Assessment Intervention for Patients Aged 70 and Over Receiving Chemotherapy or Similar Agents for
Advanced Cancer (“GAP”): Reducing Toxicity in Older Adults study (URCC 13059, principal investigator is
primary mentor Dr. Mohile), describing prevalence and patterns of PP/PIMs as well as the relationship of
PP/PIMs to adverse outcomes including relative dose intensity of chemotherapy (RDI, a ratio of received to
standard doses of chemotherapy), chemotherapy toxicity, and functional trajectory. The candidate, Dr. Erika
Ramsdale, is an Assistant Professor of Medicine at the University of Rochester and is board-certified in both
Oncology and Geriatric Medicine. This proposal builds upon her prior systematic review of PP/PIMs in older
patients with cancer, showing the limited data available in the literature, and her work demonstrating that
PP/PIMs are associated with functional impairments in older adults with advanced cancer prior to initiating
chemotherapy. The aims of the proposed study are: 1/to test the hypotheses that PP/PIMs rates will be higher
than reported in most prior studies, and over-the-counter medications will comprise the majority of PIMs
detected; 2/to examine the association of PP/PIMs and the following adverse outcomes in older adults with
cancer starting chemotherapy: chemotherapy tolerability at 3 months (RDI, grade 3-5 chemotherapy toxicity),
and functional decline over 3 months. An exploratory aim will also compare the performance of regression and
other supervised classification methods to model and predict factors influencing chemotherapy toxicity,
including PP/PIMs and functional status. The proposal describes a comprehensive mentorship and training
plan to develop complementary skills and knowledge in in polypharmacy, quantitative analysis, and data
science. Under the guidance of her primary mentor Dr. Supriya Mohile, co-mentors Dr. Holly Holmes and Dr.
Martin Zand, and advisor Dr. Eva Culakova, she will advance her skills in these areas with the long-term goal
o...

## Key facts

- **NIH application ID:** 10027448
- **Project number:** 1R03AG067977-01
- **Recipient organization:** UNIVERSITY OF ROCHESTER
- **Principal Investigator:** ERIKA E RAMSDALE
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $154,000
- **Award type:** 1
- **Project period:** 2020-09-30 → 2022-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10027448

## Citation

> US National Institutes of Health, RePORTER application 10027448, Polypharmacy, Potentially Inappropriate Medications, and Adverse Outcomes in Older Adults with Advanced Cancer Receiving Chemotherapy (1R03AG067977-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10027448. Licensed CC0.

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