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

An assessment of the prevalence of drug therapy problems and its associated factors among ovarian cancer patients at Kenyatta National Hospital

IntroductionDespite several studies in various cancers reporting a high prevalence of drug therapy problems (DTPs), there is a notable scarcity of comprehensive data addressing DTPs among patients with an ovarian cancer diagnosis. This study aimed to assess DTPs among those patients at Kenyatta National Hospital.MethodsA retrospective cohort study was used to assess the prevalence of DTPs among all 100 eligible patients with an ovarian cancer diagnosis. This research used a data abstraction tool to gather ovarian patients' data on drug therapy problems. The statistical package for Social Science version 20.0 software was used for data entry and analysis. The findings were presented using frequency tables, percentages and figures.ResultsThe mean age of the study population was 51.2 ± 15.1 with a bigger population being above 50 years (57.0%). The prevalent histological type of ovarian cancer was epithelial ovarian cancer (79.0%) followed by sex cord-stromal ovarian cancer (13%) and germ cell ovarian cancer (8%) which was least prevalent. A total of 175 DTPs were identified with the most prevalent being adverse drug reactions (40.6%) and drug non-adherence (17.1%). The number of medications used and stage of ovarian cancer as statistically significant predictors of DTP.ConclusionThe prevalence of DTPs was high and the most prevalent DTP was adverse drug reactions. The number of medications used and the stage of ovarian cancer were statistically significant predictors of DTP. Hence, regular medication reviews and robust pharmacovigilance systems should be implemented to detect and manage DTPs effectively.

Management pattern and medication-related harms and its predictors in colorectal cancer patients: an institutional-based retrospective study

Introduction

Data on colorectal cancer (CRC) patients' thorough management practices and medication-related harms (MRH) are scarce. This study's aim was to investigate the MRHs in patients receiving CRC chemotherapy at the comprehensive specialized hospital of the University of Gondar (UoGCSH).

Methods

A registry-based retrospective cohort study was conducted on CRC patients at the UoGCSH during 2017-2021. From February to May 2022, medical records were reviewed using a pretested data collection tool to collect socio-demographic and disease-related characteristics, MRHs, and medication regimens. MRHs occurrence and adverse drug reactions (ADRs) severity were assessed using standard guidelines and protocols. Version 16/MP of STATA for Windows was used for the analysis. Independent predictors of MRHs were investigated using logistic regression analysis. A p-value ≤0.05 was used to determine an independent variable's statistical significance.

Results

One hundred forty three CRC patients were included, with a mean age of 49.9 ± 14.5 years. About 32.9% and 33.6% had stage II and III cancer, respectively. Significant patients had co-morbidities (15.4%) and complications (13.3%). Fluorouracil (5-FU)-based regimens were given to more than half (56%) of the patients. MRHs were found in 53.1% of the patients, with a mean of 2.45 ± 1.37 MRHs. The most common MRHs were the need for additional drug therapy, sub-therapeutic dose, DDIs, and ADRs. Being on stage IV (AOR = 27.7, 95% CI = 3.85-199.38, p = 0.001), having co-morbidity (AOR = 7.42, 95% CI = 1.80-30.59, p = 0.018) and having complication (AOR = 11.04, 95% CI = 1.72-70.95, p = 0.011) and treated with five or more drugs (AOR = 2.54, 95% CI = 1.07-6.07, p = 0.035) were independent predictors of MRHs.

Conclusion

A fluorouracil-based treatment regimen was most frequently used. MRHs were found in nearly half of CRC patients. Furthermore, MRHs were significantly associated with cancer stage, comorbidity and complication status, and the number of medications used. Because MRHs are common, improving clinical pharmacy services is critical for optimizing drug therapy in CRC patients.

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

Objective:

Despite the fact that cancer patients are highly susceptible to drug-related problems due to the effects of cytotoxic agents, data are limited due to a lack of studies on those patients. Hence, we aimed to investigate drug-related problems among patients diagnosed with colorectal cancer.

Method:

A registry-based cross-sectional study was conducted on colorectal cancer patients at the Felege Hiwot Comprehensive Specialized Hospital. Socio-demographic and disease-related characteristics, treatment regimens, and drug-related problems were recorded by reviewing medical records. Standard guidelines, protocols, and databases were used to evaluate the occurrence of drug-related problems and the severity of adverse drug reactions. For the analysis, Stata version 16/MP for Windows was used. Logistic regression analysis was employed to investigate the potential-associated factors of drug-related problems. A p-value ⩽ 0.05 was used to declare the statistical significance of each independent variable.

Results:

A total of 150 colorectal cancer patients were included, with a mean age of 51.4 ± 13.8 years. About 30% and 41.3% had stage II and stage III cancers, respectively. About three-quarters (73.8%) of the patients were given 5-fluorouracil-based combination regimens. The prevalence of drug-related problems was found to be 48.7%, with a mean of 2.12 ± 0.93 drug-related problems. In the Felege Hiwot Comprehensive Specialized Hospital, drug–drug interactions and adverse drug reactions were the most prevalent drug-related problems, which accounted for 50 (32.7%) and 49 (32%) cases, respectively. Being elderly (>50 years old) (p = 0.013), having co-morbidity (p = 0.001), and being on five or more medications (p = 0.002) were independent predictors of drug-related problems.

Conclusion:

Fluorouracil-based chemotherapy was the most frequently used treatment regimen. Almost, half of the colorectal cancer patients had one or more drug-related problems. About one-third of patients had adverse drug reactions and drug–drug interactions. Furthermore, age, co-morbidity status, and the number of medications used were significantly associated with drug-related problems. Clinical pharmacy services should be implemented to optimize drug therapy because the majority of colorectal cancer patients have one or more drug-related problems.