Potential Drug Interactions in Patients with a History of Cancer

Abstract

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.

Prevalence and significance of potential drug-drug interactions among cancer patients receiving chemotherapy

“…Another study from Netherland reported a prevalence rate of 46% among patients using oral anticancer drugs [41]. Whereas, a study from the United States of America reported 40% prevalence rate of pDDIs [29]. Similarly, the prevalence rate of present study is higher in comparison with studies from other specialties such as internal medicine (52.8%) [25], psychiatry (64.8%) [42], pediatrics (25.8%) [43] and pulmonology (45%) [44].…”

“…DDIs among cancer patients have been well studied in developed countries [20,24,[26][27][28][29]. However, such studies have been poorly addressed in developing countries like Pakistan.…”

Prevalence and significance of potential drug-drug interactions among cancer patients receiving chemotherapy

“…Another study from Netherland reported a prevalence rate of 46% among patients using oral anticancer drugs [34]. Whereas, a study from the United States of America reported 40% prevalence rate of pDDIs [35]. Similarly, the prevalence rate of present study is higher in comparison with studies from other specialties such as internal medicine (52.8%) [25], psychiatry (64.8%) [36], pediatrics (25.8%) [37] and pulmonology (45%) [38].…”

Achieving sequential therapy in advanced gastric cancer: the importance of appropriate patient management for the elderly and/or those with ascites

“…However, it should be noted that the studies differed in trial design, methodology, and, importantly, definitions of DDIs. To avoid harmful DDIs, the following are strongly recommended: a routine reassessment of all prescription and over-the-counter medications and herbal supplements; communication of a complete list of medications between healthcare providers on every referral, hospital admission, hospital transfer, and hospital discharge; and monitoring for signs of DDIs [46,49,50]. However, the optimal approach for screening for DDIs (e.g., comprehensive medication review by a clinical pharmacist, consultation with a clinical pharmacologist, use of clinical decision support software) remains to be determined [43].…”