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埃塞俄比亚肿瘤中心宫颈癌患者的管理实践、药物相关问题及其影响因素:一项基于医院的回顾性研究

Management Practice and Drug Related Problems and Its Contributing Factors Among Cervical Cancer Patients at Oncologic Center in Ethiopia: A Hospital-Based Retrospective Study.

作者信息

Kefale Belayneh, Engidaw Melaku Tadege, Tesfa Desalegn, Molla Mulugeta, Yismaw Malede Berihun

机构信息

Clinical Pharmacy Unit and Research Team, Department of Pharmacy, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Amhara, Ethiopia.

Department of Social and Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Amhara, Ethiopia.

出版信息

Ther Clin Risk Manag. 2022 Jun 10;18:643-655. doi: 10.2147/TCRM.S364923. eCollection 2022.

Abstract

INTRODUCTION

In cervical cancer therapy, there is a high prevalence of drug-related problems (DRPs) due to the high toxicity and complexity of most antineoplastic regimens. However, there is a paucity of data about DRPs among patients with cervical cancer in Ethiopia. Hence, the present study was aimed at investigating management practices and DRPs among patients diagnosed with cervical cancer.

METHODS

A registry-based retrospective cohort study was employed among cervical cancer patients at the oncology center of Felege Hiwot Comprehensive Specialized Hospital (FHCSH). All patients with a histologically confirmed diagnosis of cervical cancer from January 2016 to December 2020 were included. Relevant information was recorded by reviewing medical records. The possibility of DRPs was evaluated by comparing with standard guidelines. Logistic regression analysis was employed.

RESULTS

A total of 184 cervical cancer patients were included, with a mean age of 50.2±10.7 years. A total of 216 DRPs were identified from 93 cervical cancer patients, translating to a prevalence of 50.5% and a mean of 2.32±1.11 DRPs per patient. ADR (27.3%), DDI (25%), and the need for additional drug therapy (22.2%) were the most prevalent DRPs. DRPs were associated with the presence of co-morbidity (AOR = 4.23, 95% CI = 1.78-10.05, p = 0.001), complications (AOR = 2.99, 95% CI = 1.28-6.99, p = 0.011), being treated with ≥5 medications (AOR = 5.1, 95% CI = 2.38-10.95, p < 0.001), being stage II (AOR = 0.14, 95% CI = 0.02-0.90, p = 0.038), and stage III (AOR = 0.04, 95% CI = 0.01-0.32, p = 0.003).

CONCLUSION

Cisplatin-based chemotherapy was the frequently used therapeutic option. Co-morbidity and complication status, number of medication and stage of cancer were significantly associated with DRPs. The study highlights the need of clinical pharmacy services to optimize drug therapy and reduce DRPs.

摘要

引言

在宫颈癌治疗中,由于大多数抗肿瘤方案的高毒性和复杂性,药物相关问题(DRP)的发生率很高。然而,埃塞俄比亚宫颈癌患者中关于DRP的数据很少。因此,本研究旨在调查宫颈癌确诊患者的管理实践和DRP。

方法

在费莱格希沃特综合专科医院(FHCSH)肿瘤中心对宫颈癌患者进行基于登记的回顾性队列研究。纳入2016年1月至2020年12月间所有经组织学确诊为宫颈癌的患者。通过查阅病历记录相关信息。通过与标准指南比较评估DRP的可能性。采用逻辑回归分析。

结果

共纳入184例宫颈癌患者,平均年龄50.2±10.7岁。从93例宫颈癌患者中识别出216个DRP,患病率为50.5%,平均每位患者2.32±1.11个DRP。不良反应(27.3%)、药物相互作用(25%)和额外药物治疗需求(22.2%)是最常见的DRP。DRP与合并症的存在(比值比[AOR]=4.23,95%置信区间[CI]=1.78-10.05,p=0.001)、并发症(AOR=2.99,95%CI=1.28-6.99,p=0.011)、接受≥5种药物治疗(AOR=5.1,95%CI=2.38-10.95,p<0.001)、II期(AOR=0.14,95%CI=0.02-0.90,p=0.038)和III期(AOR=0.04,95%CI=0.01-0.32,p=0.003)相关。

结论

基于顺铂的化疗是常用的治疗选择。合并症和并发症状态、用药数量和癌症分期与DRP显著相关。该研究强调了临床药学服务对优化药物治疗和减少DRP的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fbdd/9196911/a50da9ff9b9d/TCRM-18-643-g0001.jpg

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