In older patients with cancer, the common definition of polypharmacy of five or more medications is reasonable for identifying at-risk patients to undergo medication review, a recent study published online ahead of print in the journal Supportive Care in Cancer has shown.1

Although polypharmacy is typically defined as use of five or more medications, there are limited data on the optimal polypharmacy cut-point for predicting clinically significant adverse events in older persons with cancer. 

Therefore, researchers in Australia sought to determine the optimal cut-point for polypharmacy in regard to a variety of adverse events commonly experienced by older patients with cancer.

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For the study, researchers collected data on medication use, falls, and frailty from 385 patients age 70 years or older who received treatment at a medical oncology outpatient clinic.

Results showed that the optimal polypharmacy cut-point was 6.5 medications for predicting frailty, Karnofsky Performance Score (KPS), and physical function, while 5.5 and 3.5 medications were the optimal cut-point for falls and exhaustion, respectively.

“Our results suggest that no single polypharmacy cut-point is optimal for predicting multiple adverse events in older people with cancer,” the authors conclude.

However, the researchers suggest that older patients with cancer prescribed five or more medications should reasonably receive medication review to reduce the risk of clinically important adverse events.


1. Turner JP, Jamsen KM, Shakib S, et al. Polypharmacy cut-points in older people with cancer: how many medications are too many? [published online ahead of print October 9, 2015]. Support Care Cancer. doi: 10.1007/s00520-015-2970-8.