Workalemahu Gashaw, Abdela Ousman Abubeker, Yenit Melaku Kindie
Clinical Pharmacy Service Unit, Enat Primary Hospital, Alemketema, Ethiopia.
Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences and Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia.
Drug Healthc Patient Saf. 2020 Nov 3;12:195-205. doi: 10.2147/DHPS.S254644. eCollection 2020.
One of the prevalent treatment modalities for cancer is chemotherapy. Adverse drug reactions, however, are becoming the world's major public health problem. More than half (54.5 percent) of cancer patients need hospitalization for further management, in addition to the increased health-care costs of treatment. The aim of this study was to evaluate adverse drug reactions associated with chemotherapy and related factors in hospitalized paediatric cancer patients in Ethiopia's north-west hospitals.
From July 1, 2017, to August 13, 2019, a cross-sectional study was carried out among 311 paediatric cancer patients at Gondar Comprehensive University, Specialized Hospital and Felegehiwot referral hospital. The data were entered into Epi Info version 7 and exported for further analysis to Statistical Product and Service Solutions (SPSS). To identify associated variables, both the bi-variate and multi-variate logistic regression analyses were computed. Variables with a P-value of less than 0.05 were considered statistically significant in the multivariate logistic regression analysis.
The overall adverse drug reaction in this study was 41.5 percent ((95% CI: 35.8-47.2%)). Patients who received concomitant medications were at higher risk of experiencing adverse drug reactions (AOR: 2.60 (95% CI: 1.54-4.40)), according to the multivariate logistic regression analysis. Similarly, there was a risk of developing adverse drug reactions in patients taking four or more chemotherapy agents (AOR: 2.67 (95% CI: 1.52-4.68)). In addition, regimens based on etoposide (AOR: 1.99 (95% CI: 0.93-4.27)), mercaptopurine (AOR: 3.91 (95% CI: 1.06-14.46)) and doxorubicin (AOR: 2.32 (95% CI: 1.30-4.15)) were at higher risk for adverse drug reactions in patients.
Adverse drug reactions developed in a significant proportion of the study patients (2 out of 5 patients). Therefore, for pediatric cancer patients on concomitant medications and for patients on etoposide, mercaptopurine and doxorubicin drug regimens, efficient prevention and management of adverse drug reactions should be sought.
化疗是癌症常见的治疗方式之一。然而，药物不良反应正成为全球主要的公共卫生问题。除了治疗费用增加外，超过一半（54.5%）的癌症患者需要住院进一步治疗。本研究旨在评估埃塞俄比亚西北部医院住院儿童癌症患者中与化疗相关的药物不良反应及相关因素。
2017年7月1日至2019年8月13日，在贡德尔综合大学专科医院和费莱格希沃特转诊医院对311例儿童癌症患者进行了一项横断面研究。数据录入Epi Info 7版本，并导出至统计产品与服务解决方案（SPSS）进行进一步分析。为确定相关变量，进行了双变量和多变量逻辑回归分析。在多变量逻辑回归分析中，P值小于0.05的变量被认为具有统计学意义。
本研究中药物不良反应的总体发生率为41.5%（95%置信区间：35.8 - 47.2%）。多变量逻辑回归分析显示，接受联合用药的患者发生药物不良反应的风险更高（比值比：2.60，95%置信区间：1.54 - 4.40）。同样，服用四种或更多化疗药物的患者发生药物不良反应的风险也较高（比值比：2.67，95%置信区间：1.52 - 4.68）。此外，基于依托泊苷（比值比：1.99，95%置信区间：0.93 - 4.27）、巯嘌呤（比值比：3.91，95%置信区间：1.06 - 14.46）和阿霉素（比值比：2.32，95%置信区间：1.30 - 4.15）的治疗方案使患者发生药物不良反应的风险更高。
本研究中相当一部分患者（五分之二）出现了药物不良反应。因此，对于接受联合用药的儿童癌症患者以及使用依托泊苷、巯嘌呤和阿霉素治疗方案的患者，应寻求有效的药物不良反应预防和管理措施。
