背景:在接受化疗的癌症患者中,多药治疗会导致药物相互作用的风险增加,转化为潜在的有害健康结果。本研究旨在评估多重用药的患病率,药物-药物相互作用(DDI),以及老年癌症患者的严重药物相互作用(SDIs)。抗肿瘤药(ANA)参与和可能的风险背景(合并症与心脏风险,和高风险药物)也进行了分析。
方法:对诊断为癌症的老年人(≥65岁)的观察性研究,谁用抗肿瘤药(ANA)治疗;它是在葡萄牙北部的三家医院进行的。数据收集是使用自我报告和医疗记录获得的。使用Micromedex®软件鉴定和分类DDI。进行描述性和关联分析统计。p值小于0.05的统计假设检验被认为是显著的。所有统计程序和分析均使用R版本4.1.3进行。
结果:我们招募了552名患者。多重用药患病率为88.40%;76.45%和56.16%的患者出现DDI和SDI,分别。在21.20%的患者中发现了具有ANAs的SDI。高风险药物与多重用药的高风险相关,DDIs,和SDI。高血压或糖尿病患者的多药和DDI较高。糖尿病患者的SDI较高。
结论:综合制药,潜在的DDI和SDI在患有癌症的老年人中非常普遍。仔细审查给药是必要的,以减少它。这些发现值得进一步研究,以优化该人群的药物治疗并减少与药物相关的问题。这可能会导致急诊室就诊和住院,危及患者安全和/或正在进行的治疗。
BACKGROUND: Polypharmacy in older adults with cancer receiving chemotherapy leads to increased risks of drug interactions, translating in potential hazardous health outcomes. This study aims to assess the prevalence of polypharmacy, drug-drug interactions (DDIs), and severe-drug interactions (SDIs) in older patients with cancer. Antineoplastic agents (ANAs) involvement and possible risk contexts (comorbidities with cardiac risk, and high-risk medications) were also analysed.
METHODS: Observational study with older adults (≥ 65 years) diagnosed with cancer, who were treated with antineoplastic agents (ANAs); it was conducted in three hospitals from the north of Portugal. Data collection was obtained using self-reports and medical records. DDIs were identified and classified using Micromedex® software. Descriptive and association analyze statistics were performed. Statistical hypothesis tests with p value less than 0.05 were considered significant. All statistical procedures and analysis were performed with R version 4.1.3.
RESULTS: We enrolled 552 patients. Polypharmacy prevalence was 88.40%; 76.45% and 56.16% of the patients presented with DDIs and SDIs, respectively. SDIs with ANAs were found in 21.20% of the patients. High-risk medications were associated with a higher risk of polypharmacy, DDIs, and SDIs. Polypharmacy and DDIs were higher in patients with hypertension or diabetes. SDIs were higher in patients with diabetes.
CONCLUSIONS: Polypharmacy, potential DDIs and SDIs were highly prevalent in older adults with cancer. A careful review of the medication administered is necessary to decrease it. These findings warrant further research to optimize medication in this population and decrease problems related to medication, which may lead to emergency room visits and hospitalisations, compromising patient safety and/or ongoing treatments.