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@ARTICLE{Schttker:275469,
author = {B. Schöttker$^*$ and L.-J. Chen$^*$ and R. Caspari and H.
Brenner$^*$},
title = {{P}rotocol of the optimal study: {O}ptimization of
polypharmacy in geriatric oncology - {A} randomized
controlled trial.},
journal = {BMC cancer},
volume = {23},
number = {1},
issn = {1471-2407},
address = {Heidelberg},
publisher = {Springer},
reportid = {DKFZ-2023-00779},
pages = {357},
year = {2023},
note = {#EA:C070#LA:C070#LA:C120#},
abstract = {Polypharmacy is very common in older cancer patients and
these patients are particularly vulnerable to drug-drug
interactions and adverse drug reactions because they often
receive chemotherapy and symptom-relieving agents.The
primary aim of the randomized, controlled Optimization of
Polypharmacy in Geriatric Oncology (OPTIMAL) trial is to
test whether an advisory letter with the results of a
comprehensive medication review conducted with the Fit fOR
The Aged (FORTA) list to the caring physician in
rehabilitation clinics improves the quality of life (QoL) of
older cancer patients exposed to polypharmacy more than
usual care. The FORTA list detects medication overuse,
underuse, and potentially inappropriate drug use among older
adults. In the oncology departments of approximately 10
German rehabilitation clinics, we aim to recruit 514 cancer
patients (22 common cancers; diagnosis or recurrence
requiring treatment in the last 5 years; all stages) who are
≥ 65 years old, regularly take ≥ 5 drugs, and have ≥ 1
medication-related problem. All necessary information about
the patients will be provided to a pharmacist at the
coordinating center (German Cancer Research Center,
Heidelberg), who will perform randomization (1:1) and
conduct the medication review with the FORTA list. For the
intervention group only, the results are sent by letter to
the treating physician in the rehabilitation clinics, who
shall discuss medication changes with the patient at the
discharge visit, as well as implement them afterwards and
disclose them in the discharge letter to the general
practitioner. The control group gets the usual care provided
in German rehabilitation clinics, which usually does not
include a comprehensive medication review but can include
medication changes. Patients will be blinded, as they cannot
know whether proposed medication changes were part of the
study or part of usual care. Study physicians cannot be
blinded. The primary endpoint will be the EORTC-QLQ-C30
global health status/QoL score, assessed via
self-administered questionnaires 8 months after baseline.If
the planned study shows that a medication review with the
FORTA list improves the QoL of older cancer patients in
oncological rehabilitation more than usual care, it would
provide the necessary evidence to translate the trial's
findings into routine care.German Clinical Trials Register
(DRKS): DRKS00031024.},
keywords = {Cancer (Other) / Polypharmacy (Other) / Potentially
inappropriate medication (Other) / Quality of life (Other) /
Randomized controlled trial (Other) / Rehabilitation
(Other)},
cin = {C070 / C120 / HD01},
ddc = {610},
cid = {I:(DE-He78)C070-20160331 / I:(DE-He78)C120-20160331 /
I:(DE-He78)HD01-20160331},
pnm = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
pid = {G:(DE-HGF)POF4-313},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:37072729},
doi = {10.1186/s12885-023-10812-7},
url = {https://inrepo02.dkfz.de/record/275469},
}