Potential drug-drug interactions and risk of unplanned hospitalization in older patients with cancer: A survey of the prospective ELCAPA (ELderly CAncer PAtients) cohort

Beinse, Guillaume; Reitter, Delphine; Segaux, Lauriane; Carvahlo-Verlinde, Muriel; Rousseau, Benoît; Tournigand, Christophe; Cudennec, Tristan; Laurent, Marie; Boudou‐Rouquette, Pascaline; Paillaud, Éléna; Canouï‐Poitrine, Florence; Caillet, Philippe

doi:10.1016/j.jgo.2019.07.023

Cited by 25 publications

(25 citation statements)

References 26 publications

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“…In a previous work, we observed a potential DDI with abiraterone in 52 % of 95 prostate cancer patients, but their median age was 77 years [68-82] with a median number of 7 drugs (28). In the present study, sarcoma patients had a median age of 50 years with a median of 3 drugs per patient, which together could contribute to a lower risk of DDI than in elderly cancer patients (29) As far as we know, we identi ed for the rst time baseline factors associated with DDI in sarcoma patients. The type of antitumor protocol seems primordial since patients treated with TKI were at higher risk to present a major DDI (p < 0.001).…”

Section: Discussionsupporting

confidence: 42%

Prevalence of drug–drug interactions in sarcoma patients: key role of the pharmacist integration for toxicity risk management

Bellesœur

Gataa

Jouinot

et al. 2021

Cancer Chemother Pharmacol

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Background: The risk of drug drug interactions (DDI) has become a major issue in cancer patient care. However, data in sarcoma patients are scarce. We aimed to evaluate the frequency of DDI with antitumor treatments, identify the risk factors for DDI and evaluate the impact of a pharmacist evaluation before anticancer treatment.Patients and Methods: We performed a retrospective review of consecutive sarcoma patients starting chemotherapy (CT) or Tyrosine kinase inhibitor (TKI). A pharmacist performed medication reconciliation and established an early toxicity risk assessment. Potential DDI with antitumor drugs were identi ed using Micromedex electronic software.Results: One hundred twenty-two soft-tissue and 80 bone sarcoma patients (103 males, median age 50 years,) were included before chemotherapy (86%) or tyrosine kinase inhibitor (14%). The median number of medications was 3; 34 patients (22% of patients with medication reconciliation) reported complementary medicine use. 37 potential DDI classi ed as major, were identi ed (12% of the 243 pretherapeutic assessments). In multivariate analysis, TKI (p<0.0001), proton pump inhibitor (p=0.026) and antidepressant (p<0.001) were identi ed as risk factors of DDI (p<0.02). Marital status (p=0.003) was the single factor associated with complementary medicine use. A pharmacist performed 157 medication reconciliation and made 71 interventions among 59 patients (37%). In multivariate analysis, factors associated with pharmacist intervention were: complementary medicines (p= 0.004), drugs number (p=0.005) and treatment with TKI (p=0.0002) Conclusions:Clinical interventions on DDI are more frequently required among sarcoma patients treated with TKI than CT. Multidisciplinary risk assessment including a medication reconciliation by a pharmacist could be crucial to prevent DDI with TKI.

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Section: Discussionsupporting

confidence: 42%

Prevalence of drug–drug interactions in sarcoma patients: key role of the pharmacist integration for toxicity risk management

Bellesœur

Gataa

Jouinot

et al. 2021

Cancer Chemother Pharmacol

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“…This exploratory study is one of the first to examine the risk of medication interactions with HS by using 3 different medication interaction software programs over 3 distinct time periods among patients with cancer treated with chemotherapy. The high risk for a PMI during this study, which was identified in 94% of the patients, is higher than previously reported in this population (19%‐78%) 1,2,26‐40 . Ten of the prior studies also included the use of HS by patients as part of their analysis 1,26‐32,35,37 ; however, only 2 included interaction software specific for HS medication interactions 26,32 .…”

Section: Discussionmentioning

confidence: 75%

“…The high risk for a PMI during this study, which was identified in 94% of the patients, is higher than previously reported in this population (19%-78%). 1,2,[26][27][28][29][30][31][32][33][34][35][36][37][38][39][40] Ten of the prior studies also included the use of HS by patients as part of their analysis 1,[26][27][28][29][30][31][32]35,37 ; however, only 2 included interaction software specific for HS medication interactions. 26,32 Ramos-Esquivel et al, 32 using the NMCD, found that 50.3% of patients surveyed were at risk for an HS PMI; this was slightly lower than the 66% rate identified in this study.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of potential interactions of medications, including herbs and supplements, before, during, and after chemotherapy in patients with breast and prostate cancer

Lee

Kwon

et al. 2021

Cancer

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Background The use of herbs and supplements (HS) is common among patients with cancer, yet limited information exists about potential medication interactions (PMIs) with HS use around chemotherapy. Methods Patients with breast or prostate cancer who had recently finished chemotherapy at 2 academic medical centers were surveyed by telephone. Interviewers inquired about all medications, including HS, before, during, and after chemotherapy. Micromedex, Lexicomp, and Natural Medicines Comprehensive Database interaction software programs were used to determine PMIs. Results A total of 67 subjects (age range, 39‐77 years) were evaluated in this study. Participants were primarily White patients (73%) with breast cancer (87%). The median number of medications was 11 (range, 2‐28) during the entire study and was highest during chemotherapy (7; range, 2‐22). Approximately four‐fifths (84%) used HS. A total of 1747 PMIs were identified, and they represented 635 unique PMIs across all 3 timeframes, with most occurring during chemotherapy. Prescription‐related PMIs (70%) were the most common type, and they were followed by HS‐related (56%) and anticancer treatment–related PMIs (22%). Approximately half of the PMIs (54%) were categorized as moderate interactions, and more than one‐third (38%) were categorized as major interactions. Patient use of HS increased from 51% during chemotherapy to 66% after chemotherapy, and this correlated with an increased prevalence of HS PMIs (46% to 60%). HS users were more likely to be at risk for a major PMI than non‐HS users (92% vs 70%; P = .038). Conclusions The use of HS remains prevalent among patients with cancer and may place them at risk for PMIs both during chemotherapy and after the completion of treatment. Lay Summary This study evaluates the risk of potential medication interactions for patients with breast or prostate cancer undergoing chemotherapy. The results show that patients often use herbs and supplements during treatment. Prescription medications are most often associated with medication interactions, which are followed by herb and supplement–related interactions. More than one‐third of potential medication interactions are considered major. Patients should be educated about the risk of herb and supplement–related medication interactions during treatment.

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“…In a previous work, we observed a potential DDI with abiraterone in 52 % of 95 prostate cancer patients, but their median age was 77 years [68-82] with a median number of 7 drugs(28). In the present study, sarcoma patients had a median age of 50 years with a median of 3 drugs per patient, which together could contribute to a lower risk of DDI than in elderly cancer patients (29) As far as we know, we identi ed for the rst time baseline factors associated with DDI in sarcoma patients. The type of antitumor protocol seems primordial since patients treated with TKI were at higher risk to present a major DDI (p < 0.001).…”

Section: Discussionmentioning

confidence: 89%

Prevalence of Drug-Drug Interactions in Sarcoma Patients: Key Role of the Pharmacist Integration for Toxicity Risk Management

Bellesœur

Gataa

Jouinot

et al. 2021

Preprint

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Background: The risk of drug drug interactions (DDI) has become a major issue in cancer patient care. However, data in sarcoma patients are scarce. We aimed to evaluate the frequency of DDI with antitumor treatments, identify the risk factors for DDI and evaluate the impact of a pharmacist evaluation before anticancer treatment. Patients and Methods: We performed a retrospective review of consecutive sarcoma patients starting chemotherapy (CT) or Tyrosine kinase inhibitor (TKI). A pharmacist performed medication reconciliation and established an early toxicity risk assessment. Potential DDI with antitumor drugs were identified using Micromedex electronic software. Results: One hundred twenty-two soft-tissue and 80 bone sarcoma patients (103 males, median age 50 years,) were included before chemotherapy (86%) or tyrosine kinase inhibitor (14%). The median number of medications was 3; 34 patients (22% of patients with medication reconciliation) reported complementary medicine use. 37 potential DDI classified as major, were identified (12% of the 243 pre-therapeutic assessments). In multivariate analysis, TKI (p<0.0001), proton pump inhibitor (p=0.026) and antidepressant (p<0.001) were identified as risk factors of DDI (p<0.02). Marital status (p=0.003) was the single factor associated with complementary medicine use. A pharmacist performed 157 medication reconciliation and made 71 interventions among 59 patients (37%). In multivariate analysis, factors associated with pharmacist intervention were: complementary medicines (p= 0.004), drugs number (p=0.005) and treatment with TKI (p=0.0002)Conclusions: Clinical interventions on DDI are more frequently required among sarcoma patients treated with TKI than CT. Multidisciplinary risk assessment including a medication reconciliation by a pharmacist could be crucial to prevent DDI with TKI.

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Potential drug-drug interactions and risk of unplanned hospitalization in older patients with cancer: A survey of the prospective ELCAPA (ELderly CAncer PAtients) cohort

Cited by 25 publications

References 26 publications

Prevalence of drug–drug interactions in sarcoma patients: key role of the pharmacist integration for toxicity risk management

Prevalence of drug–drug interactions in sarcoma patients: key role of the pharmacist integration for toxicity risk management

Prevalence of potential interactions of medications, including herbs and supplements, before, during, and after chemotherapy in patients with breast and prostate cancer

Prevalence of Drug-Drug Interactions in Sarcoma Patients: Key Role of the Pharmacist Integration for Toxicity Risk Management

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