Cyclophosphamide is commonly used in the treatment of malignant diseases. Symptomatic severe hyponatremia induced by low-dose cyclophosphamide is very uncommon worldwide. We report a case of severe symptomatic hyponatremia that developed in a female breast cancer patient following the first cycle of chemotherapy containing low-dose cyclophosphamide. Her laboratory test showed serum Na of 112 mmol/L. Her hyponatremia was initially treated with sodium bicarbonate. She completely recovered without neurological deficits after slow correction of the serum Na concentration. Although hyponatremia is a rare toxicity it should always be considered during the usage of cyclophosphamide, even if the dosage is low, especially with concurrent use of other medications that impair water excretion, like chlorthalidone. This report describes the first reported case of cyclophosphamide-induced hyponatremia in Qatar.

Background The economic benefit of the clinical pharmacist's role in ensuring the optimum use of medicines is potentially considerable, particularly when it comes to cancer management. We sought to evaluate the overall economic impact of clinical pharmacist interventions in the main cancer setting in Qatar. Methods The total economic benefit of the clinical pharmacy interventions were analyzed from the public hospital perspective. Patient records in March 2018, July/August 2018, and January 2019 were retrospectively reviewed at the National Center for Cancer Care and Research, Qatar. The total benefit from interventions was the total cost avoidance due to preventable adverse drug events plus any cost savings associated with therapeutic-based resource use. Sensitivity analyses confirmed the results’ robustness and increased generalizability. Results A total of 1352 interventions based on 281 patients were analyzed. The majority of the drug-related problems were related to the appropriateness of therapy, followed by dosing and administration. The total population benefit over the 3-months study period was QAR 4,879,185 (USD 1,336,763), constituting cost avoidance of QAR 4,234,012 (USD 1,160,003) and negative resource-use cost savings of −QAR 645,174 (−USD 176,760). Projected annual overall benefit was QAR 14,355,354 (USD 3,932,974). The increase in resource use with therapies was mostly because of the addition of other medications. Cost avoidance was mostly driven by recommending additional medications and discontinuation of medications. The uncertainty analysis demonstrated the robustness of outcomes. Conclusions The clinical pharmacist intervention increased resource use and its cost. In overall, however, taking avoided cost of adverse drug events in consideration, it is an economically beneficial practice in the National Center for Cancer Care and Research setting, associated with adverse drug events prevention and substantial economic benefits.

Background: Clinical pharmacists play a key role in ensuring the optimum use of cancer medicines. Yet, the economic benefit of this role has never been assessed in Qatar. Aim: To evaluate the overall economic impact of clinical pharmacist interventions in the main cancer care setting in Qatar. Methods: From the public healthcare perspective, this was an analysis of the total economic benefit and a cost-benefit analysis of the clinical pharmacy interventions. As a study sample size, patient records in March 2018, July/August 2018, and January 2019 were retrospectively reviewed at the National Center for Cancer Care & Research (NCCCR), Qatar. The total benefit from interventions was the total of the cost avoidance due to preventable adverse drug events (ADEs) plus the cost savings associated with therapeutic interventions. The interventions cost was based on salary and increased cost due to therapeutic interventions. The cost-benefit analysis results were presented via net benefit and benefit‐to‐cost ratio measures. Results : Total of 1,352 interventions occurred during the 3-month follow-up period. The total benefit was QAR 196,010,360 (USD53,834,206), constituting cost avoidance of QAR 194,764,534 (USD 53,492,040) and cost savings of QAR 1,245,826 (USD 342,166), mostly due to recommending additional medications and the medication dose reduction. The benefit-to-cost ratio was 174:1 and the annual net benefit was QAR 779,539,440 (USD 214,100,351). Sensitivity analyses confirmed the robustness of results. Conclusion: The clinical pharmacist intervention is a cost-beneficial practice in the NCCCR setting, associated with ADEs prevention and substantial economic benefits, including relative to the interventions cost.

Introduction Drug-related problems (DRPs) affect the health outcomes of patients during hospitalization. We sought to analyze the clinical pharmacist-documented interventions among hospitalized patients in the cancer hospital in Qatar. Methods A retrospective analysis of electronically reported clinical pharmacist interventions of patients admitted to cancer units at Hamad Medical Corporation, Qatar was conducted. Extracted data was based on an overall 3-month follow-up period; March 1–31, 2018, July 15–August 15, 2018 and January 1–31, 2019. Categorical variables were expressed as frequencies and percentages, while continuous variables were expressed as mean ± standard deviation (SD). Results A total of 281 cancer patients with 1354 interventions were included. The average age of the study participants was 47 years (SD ± 17.36). The majority of the study population was females ( n = 154, 54.80%). The prevailing pharmacist intervention was the addition of a drug therapy ( n = 305, 22.53%), followed by medication discontinuation ( n = 288, 21.27%) and the addition of a prophylactic agent ( n = 174, 12.85%). This pattern was similar across all subgroups (i.e., gender, age, ward), except for the urgent care unit, where an increase in medication dose was the third highest frequently identified intervention ( n = 3, 0.22%). The two medication groups associated with the majority of interventions were the anti-infective and fluid/electrolyte agents. Most of the interventions documented were in the oncology ward (73.19%), while the urgent care unit had the least documented interventions (1.62%). Conclusions Our analysis showed that clinical pharmacists can effectively identify and prevent DRPs among hospitalized cancer patients.