Drug-related problems in elderly patients with cancer receiving outpatient chemotherapy

Abstract

Purpose: This study aimed to identify common drug-related problems(s) (DRP) among elderly patients receiving outpatient chemotherapy, common drugs involved, and common actions taken to resolve key DRP detected.

Methods: A retrospective study was conducted at the National Cancer Centre Singapore (NCCS). Elderly patients (aged≥65) with any cancer type and stage, taking at least 3 chronic medications, and who received medication therapy management (MTM) between January 2011 and December 2012 were included in the study.

Results: Two hundred ninety-four patients were included in the final analysis. The mean age of the patients was 71.8 years. The patients had a median of 3 co-morbid conditions and were taking a median of 6 chronic medications. The common DRP detected were potential drug interactions (DDI) (398 cases, 36.4%), adverse drug events (346 cases, 31.7%), and non-adherence (97 cases, 8.9%). Majority of potential DDI detected involved non-chemotherapeutic agents (369 cases, 92.7%) and monitoring of patient was the most common action taken (316 cases, 79.4%). Adverse drug events detected were mostly associated with chemotherapy (316 cases, 91.3%) and patient education was the most common action taken (236 cases, 68.2%). Non-adherence in patients was commonly resolved by patient education (59 cases, 60.8%). Only 5 or more chronic medications taken were found to be associated with the presence of DRP in multivariate analysis (p≤0.05).

Conclusion: Greater understanding of DRP will enable early detection and appropriate management of DRP, thereby improving patient care for elderly patients with cancer.

Keywords: Drug-related problems; Geriatric oncology; Medication therapy management.