Around 10 million deaths occurred due to cancer in 2020, with a ratio of one in six deaths. It remains the second most common cause of mortality worldwide. Drug-related problems (DRPs) were a major risk factor for patients with cancer due to the complex nature of treatment, which frequently involves a variety of therapeutic approaches. The purpose of this observational study was to assess the types and prevalence of DRPs in cancer patients in a tertiary care hospital.
The study included a total of 107 patients who fulfilled the inclusion and exclusion criteria. 88 patients (82.2%) reported at least 1 DRP, with a total of 325 DRPs. However, 19 patients had no DRPs at all. DRPs were slightly more common in male patients (54.5%) than in female patients (45.4%), and a high incidence occurred in patients between 66 and 75 years old. Out of 325 DRPs found, 34.4% were treated (serious and life-threatening), while the remaining 65.5% were left untreated because they spontaneously resolved on their own.
Local tissue invasion, distant metastases, and unchecked cellular development cause cancer. In 2020, the most common types of cancer-related deaths were stomach, colon and rectum, breast, liver, and lung. Patients with a confirmed diagnosis of cancer and above 2 years old are included in the criteria, while neonates and infants should be excluded from the study. A total of 325 DRPs were found in the patients in this investigation. Adverse drug reactions (ADRs) (n=265) were the most common DRP, followed by dosing errors (n=22) and medication interactions (n=38).
The difference in DRPS between male and female cancer patients was evaluated by using the chi-square test. According to this study, the gastrointestinal and hematological systems accounted for the largest percentage of ADR. The hematological system showed the largest number of ADRs, with 134 ADRs of various degrees. These included erythrocytopenia (Grades I-8, II-5), lymphocytopenia (Grades I-2, II-5, and III-7), and anemia (Grades I-23, II-19, II-8).
Of the 22 dosing errors (100%) in this investigation, 81.8% were underdosing and 18.1% were overdosing. According to the study, patients with stomach cancer show the highest frequency of drug-related issues, followed by those with breast cancer, and those with nasopharyngeal cancer had the lowest DRPs. Out of 325 DRPs, a total of 34.4% of DRPs were treated, and 65.5% were untreated in this study. As per this study, breast, cervical, and ovarian cancers were observed frequently in females, which are linked to factors like hormonal status, infections, and obesity.
In this study, 44.2% of DRPs occurred with monotherapy, 40.9% with combination, and 14% with supportive therapy. Most DRPs were linked with suboptimal drug treatment due to improper drug and dose selection, resulting in incomplete therapy despite clear indications.
The study reveals that anticancer drugs often necessitate the use of additional agents to mitigate side effects and reduce the potential for interactions. Chemotherapy subjects showed the highest incidence of ADRs with various grades. Careful monitoring for ADRs is crucial for older adults on complex chemotherapy. Improving drug therapy is essential to balance efficacy and safety, minimize ADRs, drug interactions, and dosing errors.
