Prevalence of potential drug–drug interactions in outpatients on treatment with parenteral antineoplastic drugs

Castro-Manzanares, M.; Pazo-Oubiña, Fernando do; Rodríguez-Rincón, Raquel María

doi:10.1007/s11096-019-00910-7

Cited by 8 publications

(7 citation statements)

References 10 publications

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“…The prevalence of PDDIs identified by three databases was 72.1%, which was in line with the studies conducted in Spain (71.8%)20 and China (72.9%),27 but higher than other studies conducted in the oncology setting in Iran at 62.88%,39 the Netherlands at 46%2 and the USA 40. Similarly, the prevalence rate of the present study is higher in comparison with studies from other specialties such as psychiatry (68.9%),41 internal medicine (43.7%)42 and paediatrics (45.8%) 43.…”

Section: Discussionsupporting

confidence: 89%

“…9 As various recent studies reported, the rate of PDDIs varies from approximately 19.3% to 78%. 2 10-12 A study conducted in Brazil 13 and Spain 14 showed that patients with cancer are predisposed to clinically relevant drug interactions because of polypharmacy, which may alter the therapeutic effects and expose patients to drug toxicity. This might be increased mortality, especially in the elderly and patients with cancer.…”

Section: Open Accessmentioning

confidence: 99%

“…Most previous studies related to PDDIs among patients with cancer were limited to other African countries and Western countries 20–26. Furthermore, these studies were limited to single DDI screening tools, retrospective methods and small sample sizes.…”

Section: Introductionmentioning

confidence: 99%

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Potential drug–drug interaction and its determinants among patients with cancer receiving chemotherapy in oncology centres of Northwest Ethiopia: an institutional-based cross-sectional study

Wondm,

Tamene,

Gubae

et al. 2023

BMJ Open

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ObjectiveThe study was conducted to assess potential drug–drug interactions (PDDIs) and its determinants among patients with cancer receiving chemotherapy.Design and settingAn institutional-based cross-sectional study was used. This study was conducted from 1 June 2021 to 15 December 2021, in Northwest Ethiopia oncology centres.ParticipantsAll eligible patients with cancer received a combination of chemotherapy.OutcomesThe prevalence and severity of PDDIs were evaluated using three drug interaction databases. Characteristics of participants were presented, arranged and summarised using descriptive statistics. The predictors and outcome variables were examined using logistic regression. The cut-off point was a p value of 0.05.ResultsOf 422 patients included in the study, 304 patients were exposed to at least one PDDI with a prevalence of 72.1% (95 % CI: 68% to 76%) using three drug interaction databases. There were varied reports of the severity of PDDI among databases, but the test agreement using the kappa index was 0.57 (95% CI: 0.52 to 0.62, p=0.0001) which is interpreted as a moderate agreement among three databases. Patients aged ≥50 years old had the risk to be exposed to PDDI by odds of 3.1 times (adjusted OR (AOR)=3.1, 95% CI (1.8 to 5.3); p=0.001) as compared with patients <50 years old. Similarly, patients with polypharmacy and comorbidity were more likely to be exposed to PDDI than their counterparts (AOR=2.4, 95% CI (1.4 to 4.1); p=0.002 and AOR=1.9, 95% CI (1.1 to 3.4); p=0.02, respectively).ConclusionThe main finding of this study is the high prevalence of PDDI, signifying the need for strict patient monitoring for PDDIs among patients with cancer receiving chemotherapy. We suggest the use of at least three drug databases for quality screening. Patients with an age ≥50 years old, polypharmacy and comorbidity were significantly associated with PDDIs. The establishment of oncology clinical pharmacists and computerised reminder mechanisms for PDDIs through drug utilisation review is suggested.

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Section: Discussionsupporting

confidence: 89%

Section: Open Accessmentioning

confidence: 99%

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Potential drug–drug interaction and its determinants among patients with cancer receiving chemotherapy in oncology centres of Northwest Ethiopia: an institutional-based cross-sectional study

Wondm,

Tamene,

Gubae

et al. 2023

BMJ Open

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“…Schaefer et al (2018) discovered that 47% of 202 hematological cancer patients had at least one potentially interacting drug combination, which is more than discovered in other studies (e.g. Castro-Manzanares et al 2019;Hoemme et al 2019). Two hundred two patients with 1929 drugs were included in the study (Schaefer et al 2018) while our study includes 115 patients with 1191 active ingredients in medical treatment.…”

Section: Discussionmentioning

confidence: 92%

“…The high proportion of 92% of all patients with drug interactions of any kind and 62% of all patients with drug–drug interactions classified as major could not be found in literature so far. Hoemme et al ( 2019 ) report a number of 24% of cancer patients affected by severe drug–drug interactions and Castro-Manzanares et al ( 2019 ) report a number of 27% of outpatients affected by at least one clinically relevant drug–drug interaction. The differences to our study might partly result from considering all patients’ medications including on-demand medication and the use of a different drug interaction checking software.…”

Section: Discussionmentioning

confidence: 99%

Interactions in cancer treatment considering cancer therapy, concomitant medications, food, herbal medicine and other supplements

Wolf

Rachow

Ernst

et al. 2021

J Cancer Res Clin Oncol

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Purpose The aim of our study was to analyse the frequency and severity of different types of potential interactions in oncological outpatients’ therapy. Therefore, medications, food and substances in terms of complementary and alternative medicine (CAM) like dietary supplements, herbs and other processed ingredients were considered. Methods We obtained data from questionnaires and from analysing the patient records of 115 cancer outpatients treated at a German university hospital. Drug–drug interactions were identified using a drug interaction checking software. Potential CAM-drug interactions and food–drug interactions were identified based on literature research. Results 92.2% of all patients were at risk of one or more interaction of any kind and 61.7% of at least one major drug–drug interaction. On average, physicians prescribed 10.4 drugs to each patient and 6.9 interactions were found, 2.5 of which were classified as major. The most prevalent types of drug–drug interactions were a combination of QT prolonging drugs (32.3%) and drugs with a potential for myelotoxicity (13.4%) or hepatotoxicity (10.1%). In 37.2% of all patients using CAM supplements the likelihood of interactions with medications was rated as likely. Food-drug interactions were likely in 28.7% of all patients. Conclusion The high amount of interactions could not be found in literature so far. We recommend running interaction checks when prescribing any new drug and capturing CAM supplements in medication lists too. If not advised explicitly in another way drugs should be taken separately from meals and by using nonmineralized water to minimize the risk for food–drug interactions.

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TOP-PIC: a new tool to optimize pharmacotherapy and reduce polypharmacy in patients with incurable cancer

Straßl

Windhager

Machherndl‐Spandl

et al. 2023

J Cancer Res Clin Oncol

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Purpose Polypharmacy is a significant problem in patients with incurable cancer and a method to optimize pharmacotherapy in this patient group is lacking. Therefore, a drug optimization tool was developed and tested in a pilot test. Methods A multidisciplinary team of health professionals developed a “Tool to Optimize Pharmacotherapy in Patients with Incurable Cancer” (TOP-PIC) for patients with a limited life expectancy. The tool consists of five sequential steps to optimize medications, including medication history, screening for medication appropriateness and drug interactions, a benefit–risk assessment using the TOP-PIC Disease-based list, and shared decision-making with the patient. For pilot testing of the tool, 8 patient cases with polypharmacy were analyzed by 11 oncologists before and after training with the TOP-PIC tool. Results TOP-PIC was considered helpful by all oncologists during the pilot test. The median additional time required to administer the tool was 2 min per patient (P < 0.001). For 17.4% of all medications, different decisions were made by using TOP-PIC. Among possible treatment decisions (discontinuation, reduction, increase, replacement, or addition of a drug), discontinuation of medications was the most common. Without TOP-PIC, physicians were uncertain in 9.3% of medication changes, compared with only 4.8% after using TOP-PIC (P = 0.001). The TOP-PIC Disease-based list was considered helpful by 94.5% of oncologists. Conclusions TOP-PIC provides a detailed, disease-based benefit–risk assessment with recommendations specific for cancer patients with limited life expectancy. Based on the results of the pilot study, the tool seems practicable for day-to-day clinical decision-making and provides evidence-based facts to optimize pharmacotherapy.

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Prevalence of potential drug–drug interactions in outpatients on treatment with parenteral antineoplastic drugs

Cited by 8 publications

References 10 publications

Potential drug–drug interaction and its determinants among patients with cancer receiving chemotherapy in oncology centres of Northwest Ethiopia: an institutional-based cross-sectional study

Potential drug–drug interaction and its determinants among patients with cancer receiving chemotherapy in oncology centres of Northwest Ethiopia: an institutional-based cross-sectional study

Interactions in cancer treatment considering cancer therapy, concomitant medications, food, herbal medicine and other supplements

TOP-PIC: a new tool to optimize pharmacotherapy and reduce polypharmacy in patients with incurable cancer

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