Prevalence and significance of potential drug-drug interactions among cancer patients receiving chemotherapy
Prevalence and significance of potential drug-drug interactions among cancer patients receiving chemotherapy
复制标题
DOI：
10.1186/s12885-020-06855-9
复制
发表时间：
2020-04-19
期刊：
影响因子：
3.8
通讯作者：
Rasheed, Irum
中科院分区：
文献类型：
--
作者：
Ismail, Mohammad;Khan, Sehrash;Rasheed, Irum
癌症患者经常接受多种药物治疗，以最大限度地提高治疗效益，治疗合并症和对抗化疗的不良反应。同时使用多种药物会增加药物相互作用的风险，从而降低治疗效果或治疗安全性。本研究的目的是确定癌症患者中潜在药物-药物相互作用（pddi）的患病率、水平和预测因素。方法对两所三级医院的678例化疗患者进行横断面研究。使用Micromedex (R)数据库筛选患者用药概况以筛选pddi。采用Logistic回归分析确定pddi的预测因素。结果pddi总体患病率为78%，以1 ~ 2位pddi为主（39.2%）。共检测到1843个pddi。主要- pddi最为常见（67.3%），而>= 7种所有处方药物（p < 0.001）与>= 3种抗癌药物（p < 0.001）之间的pddi有显著相关性。这些相互作用的潜在不良后果包括治疗效果降低、QT间期延长、肌腱断裂、骨髓抑制和神经毒性。结论本研究的主要发现是pddi的高患病率，这表明需要严格监测癌症患者的pddi。pddi风险较高的患者包括那些处方>= 7的任何类型的药物或>= 3的抗癌药物。此外，最常见的主要和中度相互作用清单将有助于卫生保健专业人员及时识别和预防pddi。
Background Cancer patients often receive multiple drugs to maximize their therapeutic benefit, treat co-morbidities and counter the adverse effects of chemotherapy. Concomitant administration of multiple drugs increases the risk of drug interactions leading to compromised therapeutic efficacy or safety of therapy. The purpose of this study was to identify the prevalence, levels and predictors of potential drug-drug interactions (pDDIs) among cancer patients. Methods Six hundred and 78 patients receiving chemotherapy from two tertiary care hospitals were included in this cross-sectional study. Patient medication profiles were screened for pDDIs using the Micromedex (R) database. Logistic regression analysis was performed to identify the predictors of pDDIs. Results The overall prevalence of pDDIs was 78%, majority of patients had 1-2 pDDIs (39.2%). A total of 1843 pDDIs were detected. Major-pDDIs were most frequent (67.3%) whereas, a significant association of pDDIs was found between > 7 all prescribed drugs (p < 0.001) and >= 3 anti-cancer drugs (p < 0.001). Potential adverse outcomes of these interactions include reduced therapeutic effectiveness, QT interval prolongation, tendon rupture, bone marrow suppression and neurotoxicity. Conclusions Major finding of this study is the high prevalence of pDDIs signifying the need of strict patient monitoring for pDDIs among cancer patients. Patients at higher risk to pDDIs include those prescribed with > 7 any types of drugs or >= 3 anticancer drugs. Moreover, list of most frequently identified major and moderate interactions will aid health care professional in timely identification and prevention of pDDIs.