Potential drug interactions and duplicate prescriptions among ambulatory cancer patients: a prevalence study using an advanced screening method

Leeuwen, Roelof W F van; Swart, Eleonora L.; Boom, F. A.; Schuitenmaker, Martin S; Hugtenburg, Jacqueline G.

doi:10.1186/1471-2407-10-679

Cited by 40 publications

(24 citation statements)

References 21 publications

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“…Another study that focused on pharmacokinetic interactions affecting the activity of the anticancer agent found a 5% prevalence rate [20]. Other studies found similar [10,16,17] or higher [19,21] rates of DIs, but the interactions considered were not limited to DIs with anticancer agents.…”

Section: Discussionmentioning

confidence: 96%

See 1 more Smart Citation

Potential Interactions with Anticancer Agents: A Cross-Sectional Study

Mouzon¹,

Kerger²,

D’Hondt³

et al. 2013

Chemotherapy

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Background: Patients with cancer are particularly susceptible to drug interactions (DIs), but the extent of the problem has received limited attention. We aimed to evaluate the frequency of interactions with anticancer agents in a group of cancer patients. Methods: The study was performed in a Belgian teaching hospital. One hundred and twenty-two patients with solid malignancies were included. A comprehensive drug history was performed by a clinical pharmacist. Three renowned DI compendia were used to identify DIs. Results: Forty-one potential interactions involving an anticancer agent and considered to be clinically significant were identified among 25% of patients. The anticancer drugs mostly involved were cisplatin and methotrexate, and the most frequent co-medications involved were vitamin K antagonists, proton pump inhibitors and diuretics. In the majority of cases, the potential adverse consequence was increased toxicity of the anticancer agent and/or of the co-medication. Less than 10% of DIs were identified by the three compendia. Conclusions: Preventive measures should be taken to avoid increased toxicity or decreased efficacy of the drugs. Most of the time, this simply involves surveillance of biological or clinical parameters. Collaboration with a clinical pharmacist may be useful for the prescribing physician.

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Section: Discussionmentioning

confidence: 96%

“…Therefore, the risk of DIs in cancer patients is important to consider and has been the object of several studies [16,17,18,19,20,21,22]. A recent systematic review found that approximately one third of ambulatory cancer patients had potential DIs, but only limited data were found on the clinical consequences of DIs [10].…”

Section: Introductionmentioning

confidence: 99%

Potential Interactions with Anticancer Agents: A Cross-Sectional Study

Mouzon¹,

Kerger²,

D’Hondt³

et al. 2013

Chemotherapy

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“…Literature showed that drug interactions occur in approximately 30% of patients in an oncology outpatient clinic; therefore, with an accuracy of 5% and 95% CI, a total of 300 patients is considered appropriate 4 12 13…”

Section: Methodsmentioning

confidence: 99%

Potential drug interactions and side effects in an outpatient oncology clinic: a retrospective descriptive study

et al. 2014

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Objective To identify potential drug interactions and side effects in an oncology outpatient clinic. Method The study was undertaken at an oncology outpatient clinic during November 2012 in Turkey. The information regarding patient demographics, drug treatments and side effects were collected retrospectively through the patient care records and potential drug interactions were identified. Side effects due to chemotherapy were assessed by using determined criteria of the National Cancer Institute Common Toxicity Criteria version 2. Results A total number of side effects assessed in 347 patients was 9080, of those 1526 (16.96%) were graded as ‘≥1’, which accounts for 4.4 side effects per patient. The top three categories of side effects were gastrointestinal (32.30%), neurological (23.91%) and fatigue (16.12%). Men experienced more side effects than women, and there was a correlation between the number of side effects and patient's age. There were 229 drug–drug interactions identified in 126 patients (1.8 interactions per patient). There was no correlation between the number side effects and drug interactions. An estimated prevalence (36%; in 126 out of 347 patients) of drug interactions found in this study was similar to the previous studies. Conclusions Identification of potential drug-related problems in the clinic may improve the patient monitoring process and maintain effective drug treatment in oncology settings. There is a potential role for a clinical pharmacist to be integrated into the outpatient clinic.

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“…Second, many css are elderly, and altered drug metabolism in this age group might make them more susceptible to adverse drug interactions 10,19,20 . Third, css frequently take concomitant prescription and overthe-counter (otc) medications for the management of either other comorbidities or late toxicities from anticancer therapies 9,17,19,21,22 . For instance, one U.S. study of css found that 96% consumed at least 1 prescription drug, and 71%, at least 1 otc drug, 3 days before their chemotherapy 23 .…”

Section: Discussionmentioning

confidence: 99%

Potential Drug Interactions in Patients with a History of Cancer

Chen

Cheung

2014

Current Oncology

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Background: Cancer survivors (css) are frequently exposed to polypharmacy, which might increase their risk of drug interactions. Our study aimed to determine the relative prevalence of potential drug interactions (pdis) among css compared with non-cancer respondents (ncrs). Methods: Self-reported prescription data from 4975 patients were extracted from the U.S. National Health and Nutrition Examination Survey and screened for pdis using iFacts: Drug Interaction Facts (Facts and Comparisons, St. Louis, MO, U.S.A.). The clinical significance of each pdi was graded on a 5-point scale based on the severity of the interaction and the level of evidence documenting the interaction. Summary statistics and logistic regression models were used to assess the impact of cancer history on the risk of pdis. Results: Of patients eligible for the analyses, the css (n = 302) indicated using 4.4 ± 0.22 prescriptions on average, and the ncrs (n = 908), 3.8 ± 0.09. Nearly half of both cohorts (40% of css, 43% of ncrs) had at least 1 pdi. In both cohorts, 12% were at risk for fatal or permanently debilitating effects. In multivariate analyses, css were significantly less likely than ncrs to be at risk for any pdis (odds ratio: 0.65; 95% confidence interval: 0.46 to 0.92; p = 0.02). Advanced age and low household income were associated with pdis among css. Medications most commonly prescribed to css with a pdi included metoprolol (15.6%), levothyroxine (13.6%), and furosemide (11.9%). Conclusions: Although css appear to be less susceptible than ncrs to pdis, the prevalence of pdis among css remains suboptimal. Specific subgroups of css may be particularly prone to pdis, underscoring the importance of increased vigilance.

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Potential drug interactions and duplicate prescriptions among ambulatory cancer patients: a prevalence study using an advanced screening method

Cited by 40 publications

References 21 publications

Potential Interactions with Anticancer Agents: A Cross-Sectional Study

Potential Interactions with Anticancer Agents: A Cross-Sectional Study

Potential drug interactions and side effects in an outpatient oncology clinic: a retrospective descriptive study

Potential Drug Interactions in Patients with a History of Cancer

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