A prospective study on assessment of clinically potential drug-drug interactions in hospital and community pharmacy prescriptions

Purpose: Patients with cancer frequently use herbal supplements and concomitant medications along with antineoplastic agents. These patients are at high risk of herb-drug interactions (HDIs) and drug-drug interactions (DDIs). We aimed to determine clinically relevant DDIs and HDIs leading to pharmaceutical intervention. Methods: Patients starting a new anticancer therapy were asked to complete a questionnaire to identify concomitant use of any over-the-counter drug or herbal supplement. Potential DDIs and HDIs were identified using two different databases. If a potentially clinically relevant DDI was recognized by the clinical pharmacist, a notification was sent to the prescribing oncologist, who decided whether to carry out a suggested intervention. Regression analyses were performed to identify variables associated with clinically relevant DDIs. Results: A total of 149 patients were included in this study, with 36 potentially clinically relevant DDIs identified in 26 patients (17.4%; 95% CI, 11.3% to 23.5%), all of them leading to therapy modifications. In total, four patients (2.7%; 95% CI, 0.1% to 5.3%) had experienced clinical consequences from DDIs at the time of pharmacist notification. Additionally, 84 patients (56.4%; 95% CI, 48.4% to 64.4%) reported using concurrent herbal supplements, and 122 possible HDIs were detected. Concomitant use of two or more drugs was independently associated with high risk of a clinically significant DDI (odds ratio, 2.53; 95% CI, 1.08 to 5.91; P = .03). Conclusion: Potentially clinically relevant DDIs and possible HDIs were frequently detected in this prospective study. A multidisciplinary approach is required to identify and avoid potentially harmful combinations with anticancer therapy.

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Determination of Potential Drug–Drug Interactions Using Various Software Programs in a Community Pharmacy Setting

Turkish Journal of Pharmaceutical Sciences ◽

10.4274/tjps.30932 ◽

2019 ◽

Vol 16 (1) ◽

pp. 14-19

Author(s):

Mesut SANCAR ◽

Aksa KAŞIK ◽

Betul OKUYAN ◽

Sevda BATUHAN ◽

Fikret Vehbi İZZETTİN

Keyword(s):

Drug Interactions ◽

Community Pharmacy ◽

Potential Drug ◽

Software Programs ◽

Pharmacy Setting

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A PROSPECTIVE STUDY OF DRUG–DRUG INTERACTIONS AND ADVERSE DRUG REACTIONS AMONG STROKE PATIENTS IN A TERTIARY CARE HOSPITAL

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2016.v9s3.13651 ◽

2016 ◽

Vol 9 (9) ◽

pp. 100

Author(s):

Kavitha Samy P ◽

Athira Jith ◽

Chaithanya T Kumar ◽

Joffey Sara Joy ◽

Sambath Kumar R

Keyword(s):

Prospective Study ◽

Drug Interactions ◽

Adverse Drug Reactions ◽

Clinical Pharmacist ◽

Prescription Data ◽

Care Hospital ◽

Care Providers ◽

Drug Reactions ◽

Stroke Patients ◽

A Prospective Study

ABSTRACTObjective: Our study attempts to get an insight into the drug–drug interactions (DDIs) and adverse drug reactions (ADRs) among stroke patients fromthe Neurology Department in a private hospital.Methods: In a prospective study spanning 6 months (May to October 2015), we have analyzed the prescription data of 221 patients with bothischemic and hemorrhagic stroke. Gender, age, social habits, length of stay, drug utilization pattern, DDIs reported from the database and clinicallyobserved, and ADRs of individual drugs were observed among the patients. Of 221 cases, 208 (94.11%) were ischemic, 12 (5.43%) were hemorrhagic,and 1 (0.45%) was transient ischemic attack.Results: A number of 140 patients were males and 80 were females. The mean age of the patients was between 41 and 70 years. In ischemic patients,357 major, 282 moderate, and 38 mild DDIs were reported using a specific database, while in hemorrhagic patients, 10 major, 7 moderate, and 1 mildinteraction were reported using a specific database. 18 DDIs were observed clinically and confirmed with evidence. 8 DDI-induced ADRs and 10 ADRscaused by individual drugs were observed in our study population. 18 DDIs were observed clinically and confirmed with evidence. 8 DDI-inducedADRs and 10 ADRs caused by individual drugs were observed in our study population.Conclusion: Drugs if wrongly prescribed may cause negative outcomes and pose significant challenge to health-care providers and may contribute tomorbidity and mortality. Clinical pharmacist can play an important role in identifying and resolving drug-related problems through pharmaceuticalcare practices.Keywords: Stroke, Drug–drug interactions, Adverse drug reactions, Clinical pharmacist.

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Prevalence, severity, and nature of risk factors associated with drug-drug interactions in geriatric patients receiving cancer chemotherapy: A prospective study in a tertiary care teaching hospital

Cancer Treatment and Research Communications ◽

10.1016/j.ctarc.2020.100277 ◽

2021 ◽

Vol 26 ◽

pp. 100277

Author(s):

Saravana Kumar Ramasubbu ◽

Sumit Kumar Mahato ◽

Akash Agnihotri ◽

Rajesh Kumar Pasricha ◽

Uttam Kumar Nath ◽

...

Keyword(s):

Risk Factors ◽

Prospective Study ◽

Drug Interactions ◽

Cancer Chemotherapy ◽

Teaching Hospital ◽

Geriatric Patients ◽

Tertiary Care ◽

Tertiary Care Teaching Hospital ◽

Factors Associated ◽

A Prospective Study

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Prevalence study on potential drug–drug interaction in cancer patients in Piacenza hospital’s Onco-Haematology department

Journal of Oncology Pharmacy Practice ◽

10.1177/1078155217717324 ◽

2017 ◽

Vol 24 (7) ◽

pp. 490-493 ◽

Cited By ~ 2

Author(s):

Stefano Vecchia ◽

Elena Orlandi ◽

Corrado Confalonieri ◽

Enrico Damonti ◽

Alessandra Riva ◽

...

Keyword(s):

Drug Interaction ◽

Supportive Care ◽

Drug Interactions ◽

Cancer Patients ◽

Scientific Evidence ◽

Chemotherapeutic Agents ◽

Human Model ◽

Potential Drug Interaction ◽

Potential Drug ◽

A Prospective Study

Background Cancer patients can be a human model of potential drug interactions. Usually they receive a large number of different medications, including antineoplastic agents, drugs for comorbid illness and medication for supportive care, however information about these interactions are fragmented and poor. Objective We assessed a prospective study to evaluate the prevalence of drug interaction among patients hospitalized in the Onco-Haematology department, Hospital of Piacenza. Methods Data on drugs administered for cancer, comorbidities, or supportive care were collected from different computerized prescription software in use in the department; we compared them with a database to focus on the co-administration of drugs. A literature review was performed to identify major potential drug interaction and to classify them by level of severity and by strengths of scientific evidence. Results In this study 284 cancer patients were enrolled; patients had taken an average of seven drugs on each day of therapy plus chemotherapeutic agents, we identified 67 potential drug interactions. At least 53 patients had one potential drug interaction. Of all potential drug interactions 63 were classified as moderate severity and only four as major. In 55 cases chemotherapeutic agents were involved in possible interactions with supportive care drugs, meanwhile in 12 cases the potential drug interactions were between supportive care drugs. Conclusions In our centre, thanks to a computerized prescription software, integrated with caution alarm in case of possible interaction, we had a lower rate of potential drug interactions than the one from literature. It is possible to improve the software integrating the alarm with the potential drug interactions between chemotherapy agents and supportive care drugs.

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