Epidemiology of chemotherapy-related adverse drug reactions among patients with cancer in Ethiopia: A systematic review and meta-analysis

Abstract

Objective

Adverse drug reaction (ADR) induces iatrogenic harm, costs a lot in cancer care continuum. However, there is a dearth of concrete evidence regarding its prevalence in a resource-limited setting. Thus, the present systematic review set out to cohere the available evidences.

Design

systematic review and meta-analysis.

Data sources

PubMed, CINAHL, Web of Science, EMBASE, and Google Scholar databases were searched.

Eligibility criteria

observational studies focused on the magnitude of chemotherapy-related ADRs among patients with cancer were eligible.

Data extraction and synthesis

Primary studies quality was appraised employing the Joanna Briggs Institute (JBI) Checklist. A random-effects meta-analysis employing the meta package for proportions (Metaprop) was conducted. Heterogeneity was assessed with Cochrane's Q test and I² statistic, and publication bias with Egger's test and a funnel plot. Protocol was registered at PROSPERO with a reference number – [CRD42024546390].

Results

Out of 1507 identified studies, 7 were met the inclusion criteria. The pooled prevalence of ADRs was 43% [95% CI: 35%, 50%, I² = 87.06%]. Age > 65 years (p = 0.001), standard anticancer dose (p = 0.015), concomitant medication (p < 0.000), etoposide (p < 0.002), mercaptopurine (p < 0.041), doxorubicin (p < 0.005) and polychemotherapy (p < 0.001) were the predictors of chemotherapy-related ADRs.

Conclusion

Chemotherapy-related ADRs are quite common among patient with cancer in Ethiopia. Consequently, healthcare providers should pay closer attention to ADR assessment and monitoring by using tailored screening tools, with special emphasis on older adults, those receiving standard anticancer doses, concomitant medications, polychemotherapy, or regimens containing etoposide, mercaptopurine, or doxorubicin to improve safety and efficacy of chemotherapies.