Medication Puts Elderly Lymphoma Patients at Risk for Shortened Survival
There are many medications which are used to combat non-Hodgkin lymphoma. Naturally, as each human being is different, some are more optimal for one person as opposed to another.
Some of the choices are not only lackluster, but can have negative effects on the patient.
We are not just talking about your standard side effect, but rather a reduction in your chance of survival. They are known as Potentially Inappropriate Medications, also called PIMs.
As it turns out, the elderly are at a greater risk of medications being potentially inappropriate. Anecdotally some doctors noticed that certain medications were okay to use on the non-elderly but had a higher chance to harm instead of help the geriatric. There is even a list of medications which may be PIMs.
But with the word ‘potentially,’ there leaves open the shadow of the doubt that it may just be old age coupled with the harshness of non-Hodgkin lymphoma and that the medications themselves are not to blame. This was investigated by several researchers who looked into the potential link between PIMs and elderly people with non-Hodgkin lymphoma.
What makes a potentially inappropriate medication inappropriate?
Nearly every drug contains the potential for adverse reactions. This could be your standard side effect, such as nausea. It could also be an interaction between two medications to cause an unintended effect on the body. Or an existing condition, such as reduced kidney function, could turn a normally beneficial drug into a danger to the patient.
Unfortunately for the elderly, all three of these dangers are increased by old age. The immune system and other normal bodily functions weaken, so normal side effects become stronger and more frequent. What a twenty-year-old may not even feel may take a seventy year old off of their feet.
Also, people generally are prescribed more and more medications as they age, to fight off encroaching health issues. This increases the chance of an adverse drug interaction, especially when prescriptions are not reported between doctors or over-the-counter medication is taken by the patient’s own initiative.
The elderly also tend to have more health issues, such as the reduced kidney function mentioned above. The drugs may be metabolized in the kidney, and if they are not up to the task, potentially unknown and detrimental effects may occur.
A fourth danger to the elderly with non-Hodgkin lymphoma
There is another component of the danger of PIMs, and that is lymphoma doctors are very rarely not geriatricians. This means that they are often unaware of PIMs and the difference being elderly makes in prescribing appropriate medication.
Dr. Diefenbach, assistant professor of medicine and clinical director of lymphoma at the New York University Perlmutter Cancer Center in New York, explained this. She is one of the researchers who took part in the study on this very topic, and mentions her own prior shortcomings on the topic.
She said, “as a non-geriatrician, I really was not aware of PIMs or of the recommendation of the AGS (American Geriatrics Society) regarding them and I don’t think I’m unique in that. Non-geriatricians are really not aware of the significance of PIMs and how pervasive they are in the geriatric population.”
The patients themselves are also often unaware that they are taking a medication that is potentially inappropriate for them.
Specialization helps these doctors treat their patients better most of the time, but it is failing some of their patients in this case. But the information is spreading, partially thanks to Dr. Diefenbach and her fellow researchers.
Resources exist to help reduce the chance of prescribing a PIM to an elderly patient. The Beers Criteria is a lost of such medications that is maintained by the American Geriatric Society.
But if you do not know that there is this danger, why would you seek out the information on how to avoid it? Read on to learn more.