Impact of Pharmacist-Led Medication Optimization on Treatment Adherence and Quality of Life in Elderly Cancer Patients

Background: Elderly cancer patients often face challenges related to polypharmacy, Medication-Related Problems (MRPs), and comorbidities, which can compromise treatment adherence and Quality of Life (QoL). Pharmacist-led interventions, such as the Integrated Medication Assessment and Planning (iMAP) program, have shown promise in addressing these issues. To assess the effect of the iMAP program on QoL, MRPs, and medication adherence among elderly cancer patients. Materials and Methods: A randomized controlled trial was carried out at KLES Dr. Prabhakar Kore Hospital and Medical Research Centre in Belagavi, India over the period from January 2022 to December 2023. A total of 238 elderly cancer patients (aged 65 years and above) were randomly assigned to either the intervention (iMAP) group (n=119) or the control group (n=119). The iMAP program involved a pharmacist-led comprehensive medication review, identification of MRPs, and development of a personalized medication plan, with follow-ups at 30 and 60 days. Outcomes included QoL (assessed with the SF-36 questionnaire), medication adherence (measured by the Medication Adherence Rating Scale [MARS]), and the number of MRPs. Statistical analysis utilized paired t-tests and chi-square tests, with p<0.05 considered significant. Results: In our study, SF-36 scores showed significant improvement across all domains over 60 days. Vitality, physical functioning, and mental health notably increased (p<0.001). Age, gender, education, cancer type, and stage were significant predictors of HRQOL. Medication adherence significantly improved in the intervention group, increasing a mean MARS score from 5.52±1.48 at baseline to 6.56.1±1.47 at 60 days (p<0.001). The intervention group also experienced a substantial reduction in MRPs, from 3.8±1.4 to 1.5±1.1 (p<0.001), with high-resolution rates for suboptimal drug use (72%) and non-adherence (85%). Additionally, healthcare utilization decreased, with lower hospital readmission rates (12% vs. 22%, p<0.05) and fewer emergency department visits (18% reduction, p<0.01) in the intervention group. Conclusion: The iMAP program significantly improved medication adherence, reduced MRPs, and enhanced QoL in elderly cancer patients. These findings support the integration of pharmacist-led interventions into oncology care to optimize patient outcomes and reduce healthcare utilization.