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Therefore, a drug optimization tool was developed and tested in a pilot test.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A multidisciplinary team of health professionals developed a \u201cTool to Optimize Pharmacotherapy in Patients with Incurable Cancer\u201d (TOP-PIC) for patients with a limited life expectancy. The tool consists of five sequential steps to optimize medications, including medication history, screening for medication appropriateness and drug interactions, a benefit\u2013risk assessment using the TOP-PIC Disease-based list, and shared decision-making with the patient. For pilot testing of the tool, 8 patient cases with polypharmacy were analyzed by 11 oncologists before and after training with the TOP-PIC tool.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>TOP-PIC was considered helpful by all oncologists during the pilot test. The median additional time required to administer the tool was 2\u00a0min per patient (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). For 17.4% of all medications, different decisions were made by using TOP-PIC. Among possible treatment decisions (discontinuation, reduction, increase, replacement, or addition of a drug), discontinuation of medications was the most common. Without TOP-PIC, physicians were uncertain in 9.3% of medication changes, compared with only 4.8% after using TOP-PIC (<jats:italic>P<\/jats:italic>\u2009=\u20090.001). The TOP-PIC Disease-based list was considered helpful by 94.5% of oncologists.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>TOP-PIC provides a detailed, disease-based benefit\u2013risk assessment with recommendations specific for cancer patients with limited life expectancy. Based on the results of the pilot study, the tool seems practicable for day-to-day clinical decision-making and provides evidence-based facts to optimize pharmacotherapy.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00432-023-04671-9","type":"journal-article","created":{"date-parts":[[2023,3,6]],"date-time":"2023-03-06T15:03:13Z","timestamp":1678114993000},"page":"7113-7123","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["TOP-PIC: a new tool to optimize pharmacotherapy and reduce polypharmacy in patients with incurable cancer"],"prefix":"10.1007","volume":"149","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9649-5850","authenticated-orcid":false,"given":"Irene","family":"Strassl","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armin","family":"Windhager","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sigrid","family":"Machherndl-Spandl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronika","family":"Buxhofer-Ausch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga","family":"Stiefel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ansgar","family":"Weltermann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,3,6]]},"reference":[{"issue":"3","key":"4671_CR1","doi-asserted-by":"publisher","first-page":"565","DOI":"10.1007\/s00228-012-1338-y","volume":"69","author":"ML Andersson","year":"2013","unstructured":"Andersson ML, B\u00f6ttiger Y, Lindh JD, Wettermark B, Eiermann B (2013) Impact of the drug-drug interaction database SFINX on prevalence of potentially serious drug-drug interactions in primary health care. 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