{"entity":{"id":"idea-acc-structured-deprescribing-at-diagnosis","kind":"idea","name":"Structured deprescribing review at cancer diagnosis and again at transition to palliative care","aka":[],"tldr":"Older cancer patients often take ten or more medicines, some of which no longer help and may interact with cancer treatment. A pharmacist review to stop unnecessary ones, at diagnosis and when goals change, would reduce harm.","summary":"Polypharmacy is common in older patients with cancer and is associated with toxicity, falls, and hospitalisation. Preventive medicines with long time-to-benefit (statins in limited prognosis, tight glycaemic control, bisphosphonates for osteoporosis in the last year of life) can be stopped. Evidence-based deprescribing algorithms exist for many drug classes. A protocolised pharmacist-led review at two defined points would apply them systematically.","asOf":"2026-09-08","links":[{"label":"Deprescribing.org algorithms","url":"https://deprescribing.org/"}],"tags":[],"related":["idea-acc-oncology-pharmacist-prescribing"],"cancers":[],"sections":["supportive-care"],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":["b-aging-comorbidity","b-toxicity-qol"],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"Structured deprescribing will reduce the mean number of medicines by at least two per patient and reduce adverse drug events and falls by at least 20%, without increasing symptom burden.","rationale":"Deprescribing trials in geriatrics show safety and modest benefit; oncology adds a clear prognostic frame that makes stopping easier to justify.","test":"A randomised trial in 600 patients over 70 with adverse drug events, falls, quality of life, and medicine counts as endpoints.","maturity":"early-clinical","actor":"clinic","cost":"small","horizonYears":2},"route":"/ideas/idea-acc-structured-deprescribing-at-diagnosis/","neighbours":{"idea":[{"id":"idea-acc-oncology-pharmacist-prescribing","kind":"idea","name":"Oncology pharmacists as protocol prescribers for supportive care and dose adjustments","route":"/ideas/idea-acc-oncology-pharmacist-prescribing/"},{"id":"idea-acc-pharmacist-interaction-review-oral-anticancer","kind":"idea","name":"Pharmacist interaction check before every oral cancer-drug prescription","route":"/ideas/idea-acc-pharmacist-interaction-review-oral-anticancer/"}],"section":[{"id":"supportive-care","kind":"section","name":"Supportive Care & Survivorship","route":"/fronts/supportive-care/"}],"bottleneck":[{"id":"b-aging-comorbidity","kind":"bottleneck","name":"Older and multimorbid patients are excluded and undertreated","route":"/bottlenecks/b-aging-comorbidity/"},{"id":"b-toxicity-qol","kind":"bottleneck","name":"Toxicity and quality of life are undervalued","route":"/bottlenecks/b-toxicity-qol/"}]}}