Drug-drug interactions in patients treated for cancer

Autor: T. van Gelder, P.M.L.A. van den Bemt, F. de Man, Agnes Jager, J. D. Brugma, F. Piran, I. Vincenten, A. W. Rijneveld, Frank G A Jansman, Ron H.J. Mathijssen, van Robert Leeuwen
Přispěvatelé: Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Pharmacy, Medical Oncology, Hematology
Jazyk: angličtina
Rok vydání: 2015
Předmět:
Male
drug-drug interactions
Psychological intervention
Administration
Oral
Comorbidity
Pharmacology
law.invention
Risk Factors
law
Neoplasms
Ambulatory Care
Odds Ratio
Drug Interactions
Prospective Studies
Prospective cohort study
Netherlands
Aged
80 and over
Clinical pharmacology
Hematology
Middle Aged
PREVALENCE
Oncology
Administration
Intravenous
Female
Pharmacy Service
Hospital
pharmacokinetics
Adult
medicine.medical_specialty
Medication Therapy Management
Antineoplastic Agents
Nonprescription Drugs
Risk Assessment
EVENTS
Young Adult
SDG 3 - Good Health and Well-being
Intervention (counseling)
medicine
pharmacodynamics
Humans
cancer
medication review
Intensive care medicine
Aged
business.industry
Retrospective cohort study
Drug interaction
medicine.disease
Clinical trial
Logistic Models
Multivariate Analysis
Polypharmacy
pharmacology
business
Software
Zdroj: Annals of Oncology, 26(5), 992-997. Oxford University Press
Annals of Oncology, 26(5), 992-997. Elsevier Ltd.
ISSN: 0923-7534
Popis: Drug interactions are of major concern, since cancer patients take many medications and may have serious consequences. Therefore, a study was designed to identify interactions leading to interventions. It was revealed that the consultancy of the clinical pharmacologist led to a doubling in interventions. To improve the safe use of drugs in oncology, an assessment of prescribed drugs is needed. Background Drug–drug interactions (DDIs) are of major concern in oncology, since cancer patients typically take many concomitant medications. Retrospective studies have been conducted to determine the prevalence of DDIs. However, prospective studies on DDIs needing interventions in cancer patients have not yet been carried out. Therefore, a prospective study was designed to identify DDIs leading to interventions among ambulatory cancer patients receiving anticancer treatment. Patients and methods Patients starting with a new treatment regimen with i.v. or oral anticancer medication were asked to participate. The patients' medication was checked for DDIs by using drug interaction software. An expert team of clinical pharmacologists evaluated the relevance of these identified DDIs. If a DDI was qualified as potentially clinically relevant, an intervention was proposed to the treating (hemato)oncologist. Several variables were studied as determinants for performing an intervention. Descriptive statistics and uni- and multivariate logistic regression analyses were carried out. Results In this study, 302 patients were included. A total of 603 DDIs were identified by the drug interaction software and judged by the expert team. Of all 603 DDIs, 120 DDIs were considered potentially clinically relevant. These 120 DDIs, present in a total of 81 patients, resulted in a clinical intervention already executed by the (hemato)oncologist in 39 patients (13%), while an additional intervention was proposed by a clinical pharmacologist in 42 patients (14%). The number of comorbidities and the number of ‘over-the-counter' drugs were identified as determinants. Conclusions Clinical interventions on DDIs are frequently required among patients starting with anticancer therapy. Structured screening for these potentially clinically relevant DDIs, by (hemato)oncologists in close collaborations with clinical pharmacologists, should take place before the start and during anticancer treatment. Clinical Trials number This study was registered at the Dutch Trial Registry under number NTR3760.
Databáze: OpenAIRE
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