Drug-drug interactions in patients treated for cancer: a prospective study on clinical interventions

被引:106
作者
van Leeuwen, R. W. F. [1 ,4 ]
Jansman, F. G. A. [2 ,3 ]
van den Bemt, P. M. L. A. [1 ]
de Man, F. [1 ]
Piran, F. [1 ]
Vincenten, I. [1 ]
Jager, A. [4 ]
Rijneveld, A. W. [5 ]
Brugma, J. D. [1 ]
Mathijssen, R. H. J. [4 ]
van Gelder, T. [1 ,6 ]
机构
[1] Erasmus Univ, Med Ctr, Dept Hosp Pharm, NL-3015 CE Rotterdam, Netherlands
[2] Deventer Hosp, Dept Clin Pharm, Deventer, Netherlands
[3] Univ Groningen, Univ Med Ctr Groningen, Dept Pharmacotherapy & Pharmaceut Care, Groningen, Netherlands
[4] Erasmus Univ, Med Ctr, Erasmus MC Canc Inst, Dept Med Oncol, Rotterdam, Netherlands
[5] Erasmus MC Canc Inst, Dept Hematol, Rotterdam, Netherlands
[6] Erasmus Univ, Med Ctr, Dept Internal Med, Rotterdam, Netherlands
关键词
drug-drug interactions; cancer; pharmacology; pharmacokinetics; pharmacodynamics; medication review; PREVALENCE; EVENTS;
D O I
10.1093/annonc/mdv029
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
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.
引用
收藏
页码:992 / 997
页数:6
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