Assessment of drug therapy problems among patients with cervical cancer at Kenyatta National Hospital, Kenya

Abstract

BackgroundAlthough cervical cancer is preventable, it is still the second leading cause of cancer deaths among women in the world. Further, it is estimated that around 5–10% of hospital admissions are due to drug related problems (DRPs), of which 50% are avoidable. In cancer therapy, there is an immense potential for DRPs due to the high toxicity of most chemotherapeutic regimens. Hence, this study sought to assess DRPs among patients with cervical cancer at Kenyatta National Hospital (KNH).MethodsA cross-sectional study was conducted at the oncology units of KNH. A total of 81 study participants were recruited through simple random sampling. Data were collected from medical records and interviewing patients. The appropriateness of medical therapy was evaluated by comparing with National Compressive Cancer Network and European Society for Medical Oncology practice guideline of cervical cancer treatment protocol. The degree of adherence was determined using eight-item Morisky medication adherence scale. The likelihood of drug interaction was assessed using Medscape, Micromedex and Epocrates drug interaction checkers. The data were entered in Microsoft Excel and analysed using statistical software STATA version 13.0. Descriptive statistics such as mean, percent and frequency were used to summarise patients’ characteristics. Univariable and multivariable binary logistic regression were used to investigate the potential predictors of DRPs.ResultA total of 215 DRPs were identified from 76 patients, translating to a prevalence of 93.8% and a mean of 2.65 ± 1.22 DRPs. The predominant proportion of DRPs (48.2%) was identified in patients who had been treated with chemoradiation regimens. Adverse drug reactions 56(69.1%) and drug interactions 38(46.9%) were the most prevalent DRPs. Majority (67.9%) of the study population were adherent to their treatment regimens. Forgetfulness 18(69.2%), expensive medications 4(15.4%) and side effects of medications 4(15.4%) were the main reasons for medication non-adherence. Patients with advanced stage cervical cancer were 15.4 times (AOR = 15.4, 95% CI = 1.3–185.87, p = 0.031) more likely to have DRPs as compared to patients with early stage disease.ConclusionAdverse drug reactions, drug interactions, and need of additional drug therapy were the most common DRPs identified among cervical cancer patients. Advanced stage cervical cancer was the only predictor of DRPs.

Identification and Resolution of Drug-Related Problems among Childhood Cancer Patients in Ethiopia

“…e prevalence was also higher compared to other studies conducted in the pediatric wards of local (32%) and overseas (21%) hospitals [23,24]. Studies performed in adult cancer patients also reported either a lower (55%) [25] or higher (93.8%) [26] prevalence than the current study. e difference could be attributed to differences in training levels of prescribers, availability of support systems, and composition of the health care team in these hospitals.…”

Magnitude and determinants of drug-related problems among patients admitted to medical wards of southwestern Ethiopian hospitals: A multicenter prospective observational study

“…In this study, 331 DRPs were recorded with 1.057 DRPs per patient. This finding is lower than study conducted among Hiwotfana specialized university hospital [ 27 ], Kenya [ 24 ], but comparable with the study of University of Gondar Teaching Hospital, Northwest Ethiopia [ 7 ]. The large variation seen on the magnitude of DRPs across studies might be due to a different classification system used to classify DRPs, settings in which DRPs were assessed, and differences in sample size of the study participants.…”

“…The prevalence of DRP in the study area was 212 (67.7%), which complies with the study conducted in Gondar (66%) [ 7 ], Northern Sweden (66%) [ 23 ]. However, the magnitude of the DTP was lower than the study done in Dessie referral hospital (75.51%) [ 6 ], Kenya (93.8%) [ 24 ], Tikur Anbesa Specialized hospital (70.4%) [ 18 ], and Jimma University specialized hospital (73.5%) [ 11 ]. The magnitude was also higher than the study conducted in India in which the overall incidence of DRPs was found to be 47.66% [ 4 ].…”

<p>Antimicrobial Drug Therapy Problems Among Patients in the Outpatient Department of Ataye Hospital, Northeast Ethiopia</p>

“…DTPs are usually classified as: unnecessary drug therapy, the need for additional drug therapy, ineffective drug therapy, too low dosage, too high dosage, adverse drug reaction (ADR), and non-compliance. 9 , 10 Antimicrobial drug therapy problems refers to incorrect and inappropriate utilization of antimicrobials which affect patient health outcomes and even result in bacterial resistance. 11 Literature reviews regarding DTPs indicated that a total of 199 DTPs were identified among patients receiving outpatient antimicrobial therapy in the USA.…”