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

Abstract

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.

Pharmacotherapy follow-up of key points in the safety of oral antineoplastic agents

“…As for severity, a significant percentage of drug interactions was relevant, since 23% were classified as ‘high‐risk’ (Bayraktar‐Ekincioglu et al . ). This finding is similar to the 16% major interactions observed by Van Leeuwen et al .…”

“…; Bayraktar‐Ekincioglu et al . ), which in turn lead to safety problems. In addition, since OAA are administered at home without direct supervision by a health professional, greater responsibility is placed on the patient.…”

“…Nevertheless, OAA are considered highrisk medications by the Institute for Safe Medication Practices and by the Joint Commission (Institute for Safe Medications Practices 2007). Unregistered adverse events (AE) and administration problems are more likely to result from a lack of coordinated care and monitoring (Ruddy et al 2009;Bayraktar-Ekincioglu et al 2014), which in turn lead to safety problems. In addition, since OAA are administered at home without direct supervision by a health professional, greater responsibility is placed on the patient.…”

Oncology nurses awareness of drug interactions

“…[12] In an another study performed by Riechelmann et al .,[13] 276 potential drug interactions were observed in 405 cancer patients, and they also identified at least one drug interaction in 109 cancer patients in Canada. Considering the result of studies, drug interactions are a common problem in cancer patients.…”

“…[19] In another study, drug combinations involving antihypertensive and long-term corticosteroids raised the risks for potential drug-drug interactions among patients with cancer. [7] Bayraktar-Ekincioglu[12] identified 229 drug-drug interactions in 126 cancer patients. Riechelmann et al .…”