Drug-related problems in hospitalized oncology patients,with special focus on radiotherapy units: Implications for oncology pharmacy practice

Abstract

Introduction

Drug-related problems (DRPs) represent a major challenge in contemporary oncology. In healthcare systems with limited clinical pharmacy resources, identification of high-risk patient groups and treatment settings is – from a clinical pharmacology perspective – essential to prioritize pharmacotherapeutic surveillance.

Methods

This single-centre, retrospective, high-risk cohort study analysed pharmacotherapy in 31 adult cancer patients hospitalized in a comprehensive oncology centre in Poland. Patients were selected for medication review based on clinicians’ suspicion of pharmacotherapy-related problems during hospitalization. DRPs were identified and classified according to the Pharmaceutical Care Network Europe classification version 9.1, focusing on pharmacotherapy-related complications rather than individual prescribing errors. Sociodemographic, clinical and pharmacotherapeutic variables were analysed. Statistical analyses were exploratory and hypothesis-generating.

Results

At least one DRP was identified in 29 out of 31 patients (94%). The most frequent DRPs were adverse drug reactions and drug therapy without a clearly documented current indication, predominantly involving proton pump inhibitors (PPIs). Antimicrobials, drugs for acid-related disorders and psycholeptics accounted for the highest number of DRPs. A numerically higher risk of DRPs was observed in patients with impaired renal function, excessive polypharmacy (≥ 10 drugs) and those receiving non-surgical treatment, particularly radiotherapy.

Conclusion

Hospitalized oncology patients with suspected pharmacotherapy-related complications are at high risk of DRPs. From an oncology pharmacy perspective, targeted medication review appears to be a rational approach to identify and mitigate pharmacotherapy-related risks in this setting. Radiotherapy units, patients with impaired renal function, antimicrobials and PPI use or extensive polypharmacy represent priority areas for enhanced clinical pharmacy involvement.