Computerized pediatric oncology prescriptions review by pharmacist: A descriptive analysis and associated risk factors

Hamel, Claire; Tortolano, Lionel; Bermudez, Elisabeth; Desmaris, Romain; Klein, Sébastien; Slimano, Florian; Lemare, François

doi:10.1002/pbc.26897

Cited by 7 publications

(8 citation statements)

References 33 publications

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“…e most frequently encountered DRPs were inappropriate dosing (high and low dose) followed by needs additional drug therapy and nonadherence to the prescribed medications. In line with this, several studies have also reported dosing problems (high and low dose) to be the most frequently (34.9%-61.8%) encountered DRPs in their settings [24,31,32]. e drugs more associated with dosing problems in this study included TMP/SMT, vancomycin, vincristine, metoclopramide, cimetidine, furosemide, and doxorubicin.…”

Section: Discussionsupporting

confidence: 74%

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

Yismaw

Adam

Engidawork

2020

Journal of Oncology

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Background. Even though medications play a major role in the cure, palliation, and inhibition of disease, they also expose patients to drug-related problems. Drug-related problems are frequent and may result in reduced quality of life, morbidity, and mortality.Objectives.e study was aimed to identify, characterize, and resolve drug-related problems in the Pediatric Hematology/ Oncology ward of Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Methods. A prospective observational study was conducted from 25 June to 25 October 2018 to assess DRPs on patients admitted at the pediatric hematology/oncology ward of Tikur Anbessa Specialized Hospital, which is the highest level governmental tertiary care hospital in Ethiopia. Data were obtained from patients' medical charts, physicians, patients/caregivers, pharmacists, and nurses. All the collected data were entered and analyzed using the Statistical Package for the Social Sciences version 25e. Descriptive statistics were used to represent the data. Results. Among the total 156 participants, DRPs were identified in 68.6% of the study subjects. Dosing problems which include dosage too low and high were the top ranking (39.3%) of all DRPs followed by needs additional therapy (27.2%) and nonadherence (14.0%). Systemic anti-infectives were the most common class of drugs involved in DRPs. Trimethoprim-sulfamethoxazole, methotrexate, vincristine, ondansetron, and metoclopramide were frequently involved in DRPs. e addition of drugs and change in drug dose were the two most proposed intervention types. Among the proposed interventions, 223 (92.15%) were fully accepted, 9 (3.72%) partially accepted, and 10 (4.13%) not accepted. Conclusion. DRPs are common among Pediatric Hematology/ Oncology ward patients. e hospital should develop a pediatric dosing chart for the commonly prescribed medications to prevent drug-related morbidity and mortality. e integration of clinical pharmacists can mitigate risks associated with DRPs.

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Section: Discussionsupporting

confidence: 74%

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

Yismaw

Adam

Engidawork

2020

Journal of Oncology

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“…Pharmacist-led intervention was a common practice for hospitalized patients worldwide, such as in Brazil [27] and France [28], but seldom performed for outpatients. Our study showed that pharmacist-led intervention also played an important role in ensuring drug safety for outpatients.…”

Section: Discussionmentioning

confidence: 99%

Prescribing errors in electronic prescriptions for outpatients intercepted by pharmacists and the impact of prescribing workload on error rate in a Chinese tertiary-care women and children’s hospital

Yang

Liao

Lin

et al. 2019

BMC Health Serv Res

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BackgroundPrescribing errors may, influenced by some risk factors, cause adverse drug events. Most studies in this field focus on errors in prescriptions for hospital inpatients, with only a few on those for outpatients. Our study aimed to explore the incidence of prescribing errors in electronic prescriptions and illustrate the trend of prescribing workload and error rate over time.MethodsThe cross-section study was performed between September, 2015 and November, 2015. Prescribing errors were intercepted by pharmacists using a prescription reviewing system under which prescriptions with errors were transferred to a specific computer and recorded by another pharmacist and the incidence of total prescribing errors and severe errors was then calculated. A subgroup analysis was conducted in accordance to the number of drug orders, the age group of patients, the seniority of physicians, the specialty of physicians, the working day when prescriptions were issued, and the prescribing workload of physicians. A time-series analysis was employed to analyze the trend of prescribing workload and error rate, and the correlation between them.ResultsTotally, 65,407 patients were included in this study and 150,611 prescriptions with 294,564 drug orders (including 584 different drugs) were reviewed for identification of errors. A total of 534 prescribing errors (an error rate of 0.34%) were identified. Severe errors accounted for 13.62% of total errors. The subgroup analysis showed prescriptions of multiple drug orders, for pediatric patients aged 29 days to 12 years, from physicians specializing in ophthalmology and otorhinolaryngology, or prescribing on weekdays were more susceptible to errors. A time-series analysis demonstrated no correlation between prescribing workload and error rate which increased at the end of each working shift while prescribing workload decreased.ConclusionLess than 1% of the studied prescriptions came with errors among which one in seven were severe ones. But prescribing errors were in no relation to workloads. What’s more, further studies are needed to investigate pharmacist-led intervention to reduce prescribing errors.

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“…[12][13][14][15] They also outline the potential role of the pharmacist in an oncology setting; however, there was minimal reporting on the nature and incidence of actual or potential drug-related problems (DRPs) where targeted chemotherapy and/or immunotherapy was used to treat patients diagnosed with cancer. 13,14,[16][17][18][19][20][21] The pharmacist as a healthcare professional is actively involved in the identification of patients' treatment-related needs, verification of chemotherapy protocols, drug compounding, detection and prevention of adverse effects, and drug interactions in oncology settings. 22,23 It has been reported that the identification of DRPs by a pharmacist can help to improve patient adherence to drug treatment, treatment outcomes, and maintain or improve quality of life of patients receiving cancer treatment.…”

Section: Introductionmentioning

confidence: 99%

Drug-related problems with targeted/immunotherapies at an oncology outpatient clinic

Kucuk

Bayraktar-Ekincioglu

Erman

et al. 2019

J Oncol Pharm Pract

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Background Some studies in the literature describe drug-related problems in patients with cancer, although few studies focused on patients receiving targeted chemotherapy and/or immunotherapy. To identify the incidence of drug-related problems in patients receiving targeted chemotherapy and/or immunotherapy, and demonstrate the impact of a clinical pharmacist in an outpatient oncology care setting. Methods Prospective study was conducted in a hospital outpatient oncology clinic between October 2015 and March 2016. Patients greater than 18 years old receiving cetuximab, nivolumab, ipilimumab, or pembrolizumab were included in the study and monitored over a three-month period by a clinical pharmacist. Drug-related problems were analyzed using the Pharmaceutical Care Network Europe classification system. The main outcome measures were the frequency and causes of drug-related problems and the degree of resolution achieved through the involvement of a clinical pharmacist. Results A total of 54 patients (mean age: 57 ± 12 years) were included. There were 105 drug-related problems and 159 associated causes. Among the planned interventions (n = 149), 92 interventions were at the patient-level with 88 (96%) being accepted by the doctors. This resulted in 68 (65%) drug-related problems being completely resolved and 9 (8.6%) being partially resolved. The most common drug-related problem identified was “adverse drug event” (n = 38, 36%). Of the 105 drug-related problems, 63 (60%) related to targeted chemotherapy and/or immunotherapy with 34 (54%) classified as an “adverse drug event.” Conclusion Adverse drug events were the most common drug-related problems in patients with cancer. The involvement of a clinical pharmacist improved the identification of drug-related problems and helped optimize treatment outcomes in patients receiving targeted chemotherapy/immunotherapy.

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Computerized pediatric oncology prescriptions review by pharmacist: A descriptive analysis and associated risk factors

Cited by 7 publications

References 33 publications

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

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

Prescribing errors in electronic prescriptions for outpatients intercepted by pharmacists and the impact of prescribing workload on error rate in a Chinese tertiary-care women and children’s hospital

Drug-related problems with targeted/immunotherapies at an oncology outpatient clinic

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