Association of potentially inappropriate medications with prognosis among middle-aged (45-64 years) patients with non-small cell lung cancer

Aims: : Previous studies linked PIMs to reduced overall survival (OS) in elderly NSCLC patients, but data on middle-aged patients remain limited. This study aimed to explore the incidence, types of PIM and the relationship between PIM use and OS in middle-aged NSCLC patients. Methods: This study enrolled 460 NSCLC patients aged 45-64 years, collecting medication data at baseline and 6 months post-systemic therapy. PIMs were identified using PROMPT criteria, with associations analyzed via logistic regression and survival analyses. Results: A total of 460 patients were included. The prevalence of receiving at least one PIM was 13.7% (63/460) at baseline and 20.8% (46/221) after systemic therapy. PIM use was positively correlated with the number of prescribed medications (P<0.001). PIM use did not significantly affect OS in middle-aged patients with NSCLC, either at baseline or after systemic therapy. In multivariable analysis, PIM use after systemic therapy was an independent predictor of poor prognosis in early-stage (I-IIIA) patients (adjusted HR: 5.86 [95% CI 1.61-21.37], P=0.007 for Model 1; 8.60 [95% CI 1.83-40.35], P=0.006 for Model 2). Conclusions: Middle-aged NSCLC patients showed increased PIM incidence and medication quantity post-systemic therapy; while PIMs were not linked to OS in the overall cohort, they independently affected OS in early-stage (I-IIIA) patients at 6 months post-treatment, emphasizing the need for vigilant PIM monitoring in early-stage cases to optimize prognosis.