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April 15, 2026International Journal of Pharmacy Practice

Taking multiple antithrombotics is linked to ~80% lower odds of deprescribing in advanced cancer hospice patients.

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Why the study?

Older patients with advanced cancer often continue antithrombotic therapy at the end of life despite limited benefit and bleeding risk, but evidence regarding structured deprescribing in real-world hospice populations remains limited.

What are the predictors of antithrombotic deprescribing in older patients with advanced cancer and limited life expectancy in hospice care?

Population

112 patients aged ≥65 years with advanced cancer and life expectancy ≤six months admitted to an inpatient hospice unit

Comparison

Predictors of antithrombotic deprescribing following a palliative care consultation medication review intervention

Design

Retrospective cohort study

Key result

Being prescribed two or more antithrombotic agents was the only significant predictor of non-deprescribing (OR 0.198) among older advanced cancer patients in hospice care.

Authors

TAT AlwidyanOSOmar ShamiehWAWaleed Alrjoub

Discussion

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Member takes

Overview

Additional strategies may be needed for antithrombotic deprescribing in hospice patients on multiple agents; this cohort study generates hypotheses but should not yet change practice.

Key Points

  • The study aims to identify factors that predict the deprescribing of antithrombotic agents in older cancer patients with limited life expectancy in hospice care.
  • Conducted a retrospective cohort study among hospice patients aged 65 and older in Jordan.
  • Reviewed medical records to assess antithrombotic use and clinical factors influencing deprescribing.
  • Performed multivariable binary logistic regression to identify predictors of deprescribing.
  • Among 112 patients, 56.3% had at least one antithrombotic agent deprescribed after intervention.
  • The mean number of antithrombotic agents reduced significantly from 1.30 to 0.62.
  • Being prescribed two or more antithrombotic agents was the only strong predictor against deprescribing.

Structured PICO

What are the predictors of antithrombotic deprescribing in older patients with advanced cancer and limited life expectancy in hospice care?

P
Population
112 older patients (aged ≥65 years, mean age 74.0, 58% female) with advanced cancer and estimated life expectancy ≤6 months, admitted to an inpatient hospice unit in Jordan, prescribed at least one antithrombotic agent at admission.
I
Intervention
Medication review intervention implemented by a palliative care consultation (PCC) team assessing bleeding risk, prognosis, drug-drug interactions, and alignment with goals of care.
O
Outcome
Predictors of antithrombotic deprescribing

In older hospice patients with advanced cancer, medication complexity—specifically the use of multiple antithrombotic agents—significantly hinders deprescribing decisions.

Limitations

  • retrospective design
  • single-centre design

Cite This Study

Alwidyan et al. (2026) studied this question. Being prescribed two or more antithrombotic agents was the only significant predictor of non-deprescribing (OR 0.198) among older advanced cancer patients in hospice care.

synapsesocial.com/papers/69df2c50e4eeef8a2a6b14ffhttps://doi.org/10.1093/ijpp/riag034.079
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