Drug therapy problems and health related quality of life among patients with colorectal cancer in a Kenyan tertiary health facility

Abstract

Background Colorectal cancer is the third most common form of cancer in males and the second in females globally. The ill-health due to cancer and use of multiple therapies may result in drug related problems and also affect the health-related quality of life of the patients. Objective To characterize drug therapy problems and health-related quality of life among patients with colorectal cancer at Kenyatta National Hospital. Methodology: A descriptive prospective cross-sectional study design was used and simple random sampling utilized to select seventy- one participants. The participants were interviewed and their responses captured using World Health Organisation Quality of Life-BREF and a structured questionnaire. The data were analysed using STATA version 15.0. Data was summarized using descriptive statistic such as mean, range and standard deviation. Association between variables was determined using linear regression model at 0.05% level of significance. Ethical approval was granted by the relevant authorities to conduct the study. Results Patients were predominantly females (52.1%), had a mean age of 55.9± 14.4 years. The main drug therapy problems were adverse drug reactions (45.1%). Approximately two thirds (67.6%) of the participants complained of gastrointestinal problems followed by cardiovascular diseases (29.6%). Quality of life assessment indicated that psychological health had the highest score at 60.5%. On linear regression analysis, the presence of anemia ( p = 0.021), coverage ( p = 0.038), and cardiovascular problems ( p = 0.034) were significantly associated with the overall health-related quality of life. Conclusion The health-related quality of life was is dependent on several patient related factors. Interventions regarding prevention of drug therapy problems should be considered alongside other measures used to manage colorectal cancer.

Clinical pattern and drug-related problems among colorectal cancer patients at oncology center in Ethiopia: A hospital-based study

“…DDIs, ADRs, and the need for additional drug therapy were the most prevalent DRPs, which accounted for 32.7%, 32%, and 17%, respectively, in FHCSH. Similarly, a study in Kenya on CRC 21 and cervical cancer 30 patients reported that ADRs and DDIs were the most prevalent DRPs. In terms of severity, 58% of the DDIs were significant, necessitating modification or close monitoring of the drug interactions’ outcomes.…”

“… 38 In the same manner, a study conducted among CRC patients at a Kenyan tertiary care facility reported that cardiovascular disease (39.4%) is the leading co-morbid medical illness. 21 About 22% of patients had co-existing complications, with anemia (30.3%) being the most common. Likewise, anemia is seen in approximately 30%–75% of CRC patients, 47 , 48 and is a predictor of prognosis for CRC patients.…”

“…In agreement with our findings, a study at a Kenyan tertiary health facility found that FOLFOX/leucovorin, 5-FU, and oxaliplatin (54.9%) were the most commonly used regimens for CRC treatment, followed by XELOX/capecitabine and oxaliplatin and FOLFIRI/leucovorin, 5-FU, and irinotecan. 21 The FOLFOX regimen is widely used for CRC treatment. The FOLFOX regimen was recommended by the MOSAIC trial study for patients with stage III and above CRC because it slowed the growth and spread of cancer in stage III CRC patients and reduced symptoms and improved quality of life in stage IV CRC patients.…”

“… 25 ADR (45.1%), non-compliance (25.4%), and need for additional therapy (23.9%) were the three most typical types of DRPs, according to a study among CRC patients in a Kenyan tertiary health facility. 21 Other studies in Ethiopia showed that ADRs and DRPs were observed in 52.86% and 74.7% of patients, respectively. 26 , 27 Various studies have shown that sex, age, length of hospital stay, histopathological grading and stages of cancer, number of medications, co-morbidity, and complications are determinants of DRP development.…”

“…Other studies showed that adverse drug reaction (ADR), the need for additional drug therapy, and drug–drug interaction (DDI) are the most prevalent DRPs. 21,22 DDIs are common since the agents used in the management of cancer and associated co-morbidities may have pharmacokinetic and pharmacodynamic effects on each other. 23,24 A previous study in Singapore demonstrated that potential DDIs (36.4%), ADRs (31.7%), and non-adherence (8.9%) were the most prevalent DRPs among cancer patients.…”