Polypharmacy and comorbidities among ambulatory cancer patients: A cross-sectional retrospective study

Abstract

<jats:sec><jats:title>Introduction</jats:title><jats:p> Polypharmacy is prevalent among cancer patients; however, its relationship with comorbidities as well as its other potential factors has not been well studied among this segment of the patient population. Although several studies have described the prevalence of polypharmacy in cancer patients, its prevalence among Middle Eastern cancer patients is largely unknown. Therefore, the aim of this study is to assess the prevalence of polypharmacy among ambulatory cancer patients as well as its association with comorbidities. </jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p> A cross-sectional study using patients’ electronic health records was conducted among ambulatory cancer patients aged ≥ 18 years in a tertiary care hospital. Polypharmacy was defined as the cumulative use of five or more medications. The main outcome was to assess the factors related to polypharmacy among ambulatory cancer patients which was evaluated using a multivariable binary logistic regression model. </jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p> A total of 383 ambulatory cancer patients were included. Of these, approximately 79% had polypharmacy. Polypharmacy was more likely among patients with hypertension (AOR = 3.24; 95% CI: 1.41–7.42), diabetes (AOR = 3.33; 95% CI: 1.39–7.98), asthma (AOR = 8.64; 95% CI: 1.64–45.54), and anxiety (AOR = 3.61; 95% CI: 1.72–7.57). </jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p> Polypharmacy is highly prevalent in the Saudi Arabian oncology patients, especially in those with comorbidities like hypertension, diabetes, anxiety and asthma. Because polypharmacy mostly goes hand in hand with comorbidities, therefore, a multidisciplinary team approach of oncology pharmacist working with other healthcare providers to manage polypharmacy and simplify drug regimens for cancer patients is warranted to optimize the healthcare quality and improve drug safety. </jats:p></jats:sec>

Polimedicação em Idosos Submetidos a Tratamento Oncológico

“…A polifarmácia pode ser considerada um grande problema em todas as faixas etárias, contudo, representa maior perigo em pacientes idosos pela quantidade elevada de comorbidades, riscos de interações medicamentosas e de efeitos colaterais 15,16 . Somado a isso, o idoso apresenta alterações fisiológicas, como por exemplo, redução de acidez gástrica, água corporal e albumina sérica, aumento na percentagem de gordura corporal, diminuição de encontrada neste estudo é semelhante ao descrito na literatura (40% a 84%) [19][20][21][22] . A prescrição de múltiplos medicamentos pode ser necessária em algumas situações clínicas, contudo, a farmacoterapia deve ser revisada principalmente em pacientes em tratamento oncológico, podendo ser indicada antes do início do tratamento, ou na mudança no manejo da comorbidade ou em condição clínica, determinada pela equipe multidisciplinar durante a assistência ao paciente, para prevenir e detectar eventos adversos como problemas relacionados a medicamentos e interações medicamentosas 13 .…”

Potential Drug Interactions Between Psychotropics and Intravenous Chemotherapeutics Used by Patients With Cancer

“…20,21 Similarly, data from studies conducted in other countries show DDI rates ranging from 27% to 58% of the patients assessed. 14,22,24 The presence of comorbidities increases the tendency to use a greater number of medications, [25][26][27] increasing their susceptibility to drug interactions, 20,26,27 notably among antineoplastic and psychotropic drugs. 24,[28][29][30] An expressive DDI between chemotherapeutic and psychotropic drugs has been observed in patients undergoing cancer treatment, 14,31 and the psychotropics most commonly cited in these interactions are antiepileptics, antipsychotics, barbiturates, and benzodiazepines, 24,28,31 more specifically carbamazepine, phenobarbital, primidone, 31 haloperidol, alprazolam, 28 sodium valproate, 28,31 and phenytoin.…”

“…20,21 Similarly, data from studies conducted in other countries show DDI rates ranging from 27% to 58% of the patients assessed. 14,22,24 The presence of comorbidities increases the tendency to use a greater number of medications, 25-27 increasing their susceptibility to drug interactions, 20,26,27 notably among antineoplastic and psychotropic drugs. 24,28-30…”

Prevalence of Potential Pharmacological Interactions in Patients Undergoing Systemic Chemotherapy in a Tertiary Hospital

“…Patients diagnosed with cancer often have comorbidities, 8,9 such as diabetes mellitus, dyslipidemia, and cardiovascular diseases which are the most common chronic diseases. 8 This fact contributes to the increased prevalence of polypharmacy among cancer patients, 10,11 favoring DDI occurrence both due to the increased number of drugs used to treat cancer and comorbidities and also to the support drugs prescribed, thus increasing the susceptibility of those patients to DDI. 12-14…”