Abstract
Purpose
Due to polypharmacy and the rising popularity of complementary and alternative medicines (CAM), oncology patients are particularly at risk of drug–drug interactions (DDI) or herb–drug interactions (HDI). The aims of this study were to assess DDI and HDI in outpatients taking oral anticancer drug.
Method
All prescribed and non-prescribed medications, including CAM, were prospectively collected by hospital pharmacists during a structured interview with the patient. DDI and HDI were analyzed using four interaction software programs: Thériaque®, Drugs.com®, Hédrine, and Memorial Sloan Kettering Cancer Center (MSKCC) database. All detected interactions were characterized by severity, risk and action mechanism. The need for pharmaceutical intervention to modify drug use was determined on a case-by-case basis.
Results
294 patients were included, with a mean age of 67 years [55–79]. The median number of chronic drugs per patient was 8 [1–29] and 55% of patients used at least one CAM. At least 1 interaction was found for 267 patients (90.8%): 263 (89.4%) with DDI, 68 (23.1%) with HDI, and 64 (21.7%) with both DDI and HDI. Only 13% of the DDI were found in Thériaque® and Drugs.com® databases, and 125 (2.5%) were reported with similar level of risk on both databases. 104 HDI were identified with only 9.5% of the interactions found in both databases. 103 pharmaceutical interventions were performed, involving 61 patients (20.7%).
Conclusion
Potentially clinically relevant drug interaction were frequently identified in this study, showing that several databases and structured screening are required to detect more interactions and optimize medication safety.
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Acknowledgements
The authors gratefully acknowledge all pharmacy students, pharmacy residents and pharmacists who participated to this study.
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No direct funding was received for this study. The authors were personally salaried by their institutions during the period of writing, although no specific payment was set aside or made for writing the paper.
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Conception and design (OP, CH, AGC, AB, VL, MM, VS, NV, FR, CR), data collection (OP, CH, VL, AGC, MM), data analysis (OP, MM, AGC, AB, FR), manuscript drafting (OP, FR, CH), manuscript revisions (OP, CH, AGC, AB, VL, MM, VS, NV, FR, CR). All authors declare final approval of the version to be published and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
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All patients provided written informed consent to the processing of their personal data. The study was registered in the National Data Protection Commission register authorized for Hospices Civils de Lyon (n° 15–122).
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Prely, H., Herledan, C., Caffin, A.G. et al. Real-life drug–drug and herb–drug interactions in outpatients taking oral anticancer drugs: comparison with databases . J Cancer Res Clin Oncol 148, 707–718 (2022). https://doi.org/10.1007/s00432-021-03645-z
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DOI: https://doi.org/10.1007/s00432-021-03645-z