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Assessment of potentially inappropriate medications using STOPPFrail V2 criteria and OncPal guideline in elderly cancer patients with end-stage disease: A cross-sectional study
Wang Y, Li L, Zhe L, Zhang S, Jiao Y, Li F.. Research Square, 2026-06-04
Topic: Drug trials: efficacy and safety
Background This study aimed to evaluate the prevalence, drug classes, and associated factors of potentially inappropriate medications (PIMs) in elderly patients with end-stage cancer using the STOPPFrail V2 criteria and the OncPal guideline, thereby providing evidence for medication optimization in palliative care. Methods This retrospective cross-sectional study included 183 elderly cancer patients (aged ≥ 65 years) from a single hospice care center between January 2023 and December 2024. PIMs were identified using the STOPPFrail V2 criteria and the OncPal guideline. Descriptive statistics and multivariable logistic regression were used to assess PIM prevalence and its independent associated factors. Results The prevalence of PIMs was 32.24% (59/183) using STOPPFrail V2 and 18.58% (34/183) using OncPal. The most common PIMs included lipid-lowering drugs (7.65%), antipsychotics in dementia (7.10%), nutritional supplements (7.10%), and glucose-lowering agents (6.56%). Polypharmacy (≥ 5 drugs) was observed in 85.80% of patients. Under both criteria, the number of medications was the strongest independent risk factor (STOPPFrail V2: ≥10 drugs, OR = 18.488, p < 0.001; OncPal: ≥10 drugs, OR = 6.531, p = 0.023). Notably, severe ADL dependence was a protective factor against PIMs (p < 0.05), possibly reflecting deliberate deprescribing of preventive medications. Age, sex, and comorbidity burden showed no significant association with PIMs. Conclusions Polypharmacy and PIMs are highly prevalent in end-of-life elderly cancer patients. The STOPPFrail V2 and OncPal criteria provide complementary dimensions for identifying PIMs, with the former appearing more sensitive in polypharmacy settings. The number of medications is the strongest modifiable risk factor. These findings support integrating routine medication review and deprescribing into palliative care, particularly targeting preventive drugs such as lipid-lowering agents and nutritional supplements, to reduce medication burden and potentially improve quality of life.
Key findings
- Results The prevalence of PIMs was 32.24% (59/183) using STOPPFrail V2 and 18.58% (34/183) using OncPal.
- Age, sex, and comorbidity burden showed no significant association with PIMs.
- These findings support integrating routine medication review and deprescribing into palliative care, particularly targeting preventive drugs such as lipid-lowering agents and nutritional supplements, to reduce medication burden and potentially improve quality of life.
Study details
- Study designcross-sectional
- Participants183
- Effect size32.24%; 18.58%; 7.65%
- Evidence strengthLow
How this study scored 16/100
Preprint — not yet peer-reviewed. It scored 39 on the same rubric, but non-peer-reviewed sources are capped at 16, so it shows as 16. Scored zero for randomised / blinded because the record does not state it. We have no data on times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multi-centre collaboration, so those were left out: it earned 24 of the 62 points we could judge it on, which is 39 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 2 / 10 | Tier 4 — not a peer-reviewed journal (Research Square) |
| Journal's citation record | 0 / 4 | Not a journal article, so the journal's record does not count |
| Study design | 4 / 12 | A snapshot of people at one point in time |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 4 / 10 | Preprint — not yet peer-reviewed. Hosted on a preprint server. |
| How recent | 5 / 5 | 2026 — within 1 year(s) of the newest study here |
| Sample size | 2 / 4 | 183 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 24 / 62 | Scored on 12 of 20 parts. We have no data for the rest, so they are left out: 24 of the 62 points we could judge it on is 39 out of 100. |
| Total | 39 / 100 | Capped to 16 because this is not a peer-reviewed article. |
What each of these 20 components measures, and what this score is not →
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APA 7th
Wang, Y., Li, L., Zhe, L., Zhang, S., Jiao, Y., & Li, F. (2026). Assessment of potentially inappropriate medications using STOPPFrail V2 criteria and OncPal guideline in elderly cancer patients with end-stage disease: A cross-sectional study. Research Square. https://doi.org/10.21203/rs.3.rs-9733500/v1
Vancouver
Wang Y, Li L, Zhe L, Zhang S, Jiao Y, Li F. Assessment of potentially inappropriate medications using STOPPFrail V2 criteria and OncPal guideline in elderly cancer patients with end-stage disease: A cross-sectional study. Research Square. 2026. doi:10.21203/rs.3.rs-9733500/v1.
BibTeX
@article{wang2026-7bc8dc76,
author = {Wang, Y. and Li, L. and Zhe, L. and Zhang, S. and Jiao, Y. and Li, F.},
title = {{Assessment of potentially inappropriate medications using STOPPFrail V2 criteria and OncPal guideline in elderly cancer patients with end-stage disease: A cross-sectional study}},
journal = {Research Square},
year = {2026},
doi = {10.21203/rs.3.rs-9733500/v1},
url = {https://doi.org/10.21203/rs.3.rs-9733500/v1}
}