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坦桑尼亚穆希姆比利国家医院儿科患者化疗的药物使用模式及药物不良反应

Drug utilization pattern and adverse drug reactions of chemotherapy in pediatric patients at Muhimbili National Hospital, Tanzania.

作者信息

Efraim Josephine, Munisi Castory, Magige Auson, Msuya Kelvin, Marealle Alphonce Ignace, Kilonzi Manase, Mlyuka Hamu, Mikomangwa Wigilya, Mallya Bertha, Aswile Wema, Zimbwe Kauke Bakari, Mutagonda Ritah Francis

机构信息

Department of Clinical Pharmacy and Pharmacology, Muhimbili University of Health and Allied Sciences, Dar-es-salaam, Tanzania, 0255, Tanzania.

Department of Pharmaceutics and Pharmacy Practice, Muhimbili University of Health and Allied Sciences, Dar-es-salaam, Tanzania, 0255, Tanzania.

出版信息

F1000Res. 2022 Apr 6;11:396. doi: 10.12688/f1000research.110079.1. eCollection 2022.

Abstract

Cancer is a highly debilitating non-communicable disease and an essential contributor to the global burden of disease. Pediatric patients are highly exposed to multiple drugs for the management of cancer. Monitoring drug utilization patterns helps to provide feedback to healthcare providers to ensure the rational use of medicines; as a result, it increases the therapeutic efficacy and decreases the frequency and severity of adverse drug reactions (ADRs). Therefore, this study assessed the utilization pattern and ADRs of chemotherapy in pediatric patients at Muhimbili National Hospital (MNH). A descriptive cross-sectional study was conducted for three months from February to April 2021 in pediatric cancer patients undergoing chemotherapy at MNH. A total of 123 children diagnosed with cancer and on chemotherapy were enrolled in this study. Patients' socio-demographics, clinical information, chemotherapy status, prescribed medications, and prevalence of ADRs were collected. Descriptive statistics was used in data analysis, whereby frequency and proportions were used to summarize data. Out of 123 patients, 62.6% were male. Most patients received an average of four anticancer drugs. Vincristine (55.3%) was the most used anticancer drug, followed by cytarabine (44.7%) and methotrexate (42.3%). The most used adjuvant drugs were ondansetron (30.9%), hydrocortisone (27.6%), and piperacillin/tazobactam (23.6%). The percentage of drugs prescribed from the Tanzania Essential Medicine List (TEML) and World Health Organization (WHO) list was 66.4% and 93%. Most (87%) of the patients reported having experienced ADRs whereby nausea and vomiting (45.8%), hair loss (33.6%), and neutropenia (32.7%) were more prevalent ADRs reported. This study found the drug prescribing pattern to be in line with the essential medicine list, but the average number of drugs prescribed was higher than recommended. ADRs were prevalent among pediatric cancer patients.

摘要

癌症是一种极具危害性的非传染性疾病,也是全球疾病负担的重要成因。儿科患者在癌症治疗过程中会大量接触多种药物。监测药物使用模式有助于为医疗服务提供者提供反馈,以确保合理用药;从而提高治疗效果,降低药物不良反应(ADR)的发生频率和严重程度。因此,本研究评估了穆希姆比利国家医院(MNH)儿科患者化疗药物的使用模式及药物不良反应情况。2021年2月至4月,对MNH正在接受化疗的儿科癌症患者进行了为期三个月的描述性横断面研究。本研究共纳入123名被诊断为癌症且正在接受化疗的儿童。收集了患者的社会人口统计学信息、临床信息、化疗情况、所开药物以及药物不良反应的发生率。数据分析采用描述性统计方法,用频率和比例来汇总数据。123名患者中,62.6%为男性。大多数患者平均接受四种抗癌药物治疗。长春新碱(55.3%)是使用最多的抗癌药物,其次是阿糖胞苷(44.7%)和甲氨蝶呤(42.3%)。使用最多的辅助药物是昂丹司琼(30.9%)、氢化可的松(27.6%)和哌拉西林/他唑巴坦(23.6%)。坦桑尼亚基本药物清单(TEML)和世界卫生组织(WHO)清单上所列药物的处方比例分别为66.4%和93%。大多数(87%)患者报告有药物不良反应,其中恶心和呕吐(45.8%)、脱发(33.6%)和中性粒细胞减少(32.7%)是报告中较为常见的药物不良反应。本研究发现药物处方模式符合基本药物清单,但所开药物的平均数量高于推荐值。药物不良反应在儿科癌症患者中很普遍。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/da45/11053343/cc9b2a3265cd/f1000research-11-121654-g0000.jpg

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