Medication optimisation in older adults with cancer

Brokaar, E.J. (2026)

Doctoral Thesis

The number of older adults with cancer increases. These patients often use multiple medications, that can influence their quality of life and the cancer treatment. In this thesis is investigated how medication use can be optimized in older adults with cancer.

Many medications have an effect in the long term and may become redundant when life expectancy is reduced due to advanced cancer. We found that on average 6 drug related problems exist in patients with multiple medications and that 3 medications may be inappropriate. We found that these numbers can be reduced by half by a collaborative intervention with oncologists, geriatricians and pharmacists.
Furthermore, we found that use of medication with a strong anticholinergic effect is associated with poorer outcomes of cancer treatment. Patient using such medications have more serious side effects and a higher chance of an emergency care visit or hospital admission.
We found that 12% of patients uses herbal product alongside their cancer treatment. In 4% the herbal product may influence the effect of cancer treatment and in half of these cases, discontinuation of herbal supplement was recommended.

• Geriatric oncology
• Medication optimization
• Limited life expectancy
• Deprescribing

• All authors: Brokaar, E.J.
• Supervisor: Portielje, J.E.A.; Bos, F. van den
• Co-supervisor: Visser, L.E.
• Committee: Gelder, T. van; Gombert-Handoko, K.B.; Marum, R.J. van; Geijteman, E.C.T.
• Qualification: Doctor (dr.)
• Awarding Institution: Faculty of Medicine, Leiden University Medical Center (LUMC), Leiden University
• Date: 2026-09-01
• ISBN (print): 9789465376899
• Sponsorship: KWF Kankerbestrijding