Palliat Care Soc Pract. 2025 Dec 15;19:26323524251403020. doi: 10.1177/26323524251403020. eCollection 2025.
ABSTRACT
BACKGROUND: Potentially inappropriate medications (PIMs) pose a significant burden on patients with advanced cancer approaching the end of life. However, trends in the prescription of PIMs and the factors associated with deprescribing PIMs in these patients remain unclear.
OBJECTIVE: To describe trends in the prescription of PIMs and explore the factors associated with the deprescribing of PIMs in patients with advanced cancer in Japan.
DESIGN: Retrospective cohort study using medical claims data.
METHODS: We analyzed patients aged >65 years who were diagnosed with cancer 6 months before death and died between December 2017 and August 2023 in the city of Mito, Ibaraki prefecture, Japan. Sociodemographic, clinical, and prescription data were collected at 6 months (M6), 3 months (M3), and 1 month (M1) before death. PIMs were assessed according to the OncPal Deprescribing Guidelines.
RESULTS: The mean age of 1269 patients was 80.6 years, and 62.2% were male. PIMs were prescribed to 77.0% at M6, 76.4% at M3, and 70.0% at M1 (p < 0.001, M6 to M1). The factors associated with deprescribing at least one PIM from M6 to M1 included female sex, number of medications at M6, number of comorbidities, admission to a palliative care unit, and admission to a general ward.
CONCLUSION: In patients with advanced cancer, PIM use decreased as they approached death. Deprescribing PIMs was more common in females, patients with polypharmacy and comorbidities, and patients admitted to hospitals, especially palliative care units.
PMID:41415902 | PMC:PMC12708989 | DOI:10.1177/26323524251403020