Assessment of Drug-related Problems in an Oncology Unit of a Tertiary Care Hospital in Sri Lanka: A Cross-sectional Observational Study.

Abstract

Background: Incidents of drug-related problems (DRPs) in oncology units are common due to polypharmacy and comorbidities. Additionally, the use of highly toxic medications for cancer treatment increases the severity of such DRPs. Clinical pharmacists' interventions in oncology units can contribute to optimising drug therapy by identifying and resolving DRPs. Objectives: To identify DRPs in the inward medication lists of patients in an oncology unit and classify them using a standard approach Method: A cross-sectional observational study was carried out from July to September 2023 in the oncology unit of National Hospital Kandy by a trained student pharmacist under the guidance of experienced clinical pharmacy educators. Patients diagnosed with cancer and ≥ 18 years were recruited using convenient sampling. Patients who were diagnosed with psychological conditions, and with communication difficulties were excluded from the study. A comprehensive medication history was obtained following written and verbal consent from the participants. Patients’ inward medications from bed head tickets were reconciled and reviewed. DRPs were detected by this process were classified according to the PCNE V9.1 classification.

Results: Seventy-four cancer patients were recruited and (20, 27.02%) of them had at least one DRP. The majority of DRPs were caused by inappropriate combination of drugs (10, 45.45%) followed by communication errors and poor medication adherence (8, 36.36%) untreated symptoms or indications (1, 4.54%) adverse drug events (1, 4.54%) incomplete drug treatment (1, 4.54%) and drug unavailability (1, 4.54%). Conclusion: A considerable number of DRPs were identified and classified by the student pharmacist in the inward medication lists of oncology patients, highlighting the importance of identifying and correcting these issues. The findings underscore the necessity for targeted interventions to improve drug therapy outcomes in oncology patients and future studies on clinical pharmacy interventions to enhance the patient safety and treatment efficacy.