Prevalence of the Coprescription of Clinically Important Interacting Drug Combinations Involving Oral Anticancer Agents in Singapore

A Retrospective Database Study

Yu Ko, Sze Ling Daphne Tan, Alexandre Chan, Yuet Peng Wong, Wei Peng Yong, Raymond Chee Hui Ng, Siew Woon Lim, Agus Salim

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Background: There has been a recent increase in the availability and use of oral anticancer agents (OAAs). Drug-drug interactions (DDIs) involving OAAs pose a major concern in oncology practice due to these drugs' narrow therapeutic indices and potential for compromised efficacy and fatal adverse events. Objective: To assess the prevalence of the coprescription of potentially interacting drug combinations involving OAAs in Singapore. Methods: A retrospective review of physicians' electronic prescription records between the years 2007 and 2009 was performed in the largest cancer center in Singapore. An overall prevalence rate of potential DDIs and a prevalence rate for each individual DDI pair were calculated. Logistic regression was used to identify risk factors for potential DDIs. Results: Fifty-eight clinically significant DDIs were selected for evaluation from Drug Interaction Facts and Micromedex DrugDex. A total of 39,772 OAA prescriptions prescribed to 8837 patients were reviewed. Potential DDI coprescription was found in 5.4% of the patients on OAAs and in 4.7% of the OAA prescriptions. The drug pair prescribed to the largest number of patients was prednisolone and aspirin. About half (53.3%) of the observed DDIs were found on the same prescription. On multivariate analysis, older patients, males, and those taking prednisolone had a higher risk for potential DDIs. Conclusion: Although limited by the data available, the analysis of prescription records found that ~5% of patients taking OAAs in Singapore were exposed to ≥1 potentially interacting drug combination.

Original languageEnglish
Pages (from-to)1696-1704
Number of pages9
JournalClinical Therapeutics
Volume34
Issue number8
DOIs
Publication statusPublished - 2012
Externally publishedYes

Fingerprint

Singapore
Drug Combinations
Antineoplastic Agents
Drug Interactions
Retrospective Studies
Databases
Pharmaceutical Preparations
Prescriptions
Prednisolone
Electronic Prescribing
Aspirin
Multivariate Analysis
Logistic Models
Physicians

Keywords

  • Cancer
  • Drug interactions
  • Oral anticancer agents
  • Prescriptions
  • Prevalence

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

Cite this

Prevalence of the Coprescription of Clinically Important Interacting Drug Combinations Involving Oral Anticancer Agents in Singapore : A Retrospective Database Study. / Ko, Yu; Tan, Sze Ling Daphne; Chan, Alexandre; Wong, Yuet Peng; Yong, Wei Peng; Ng, Raymond Chee Hui; Lim, Siew Woon; Salim, Agus.

In: Clinical Therapeutics, Vol. 34, No. 8, 2012, p. 1696-1704.

Research output: Contribution to journalArticle

Ko, Yu ; Tan, Sze Ling Daphne ; Chan, Alexandre ; Wong, Yuet Peng ; Yong, Wei Peng ; Ng, Raymond Chee Hui ; Lim, Siew Woon ; Salim, Agus. / Prevalence of the Coprescription of Clinically Important Interacting Drug Combinations Involving Oral Anticancer Agents in Singapore : A Retrospective Database Study. In: Clinical Therapeutics. 2012 ; Vol. 34, No. 8. pp. 1696-1704.
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abstract = "Background: There has been a recent increase in the availability and use of oral anticancer agents (OAAs). Drug-drug interactions (DDIs) involving OAAs pose a major concern in oncology practice due to these drugs' narrow therapeutic indices and potential for compromised efficacy and fatal adverse events. Objective: To assess the prevalence of the coprescription of potentially interacting drug combinations involving OAAs in Singapore. Methods: A retrospective review of physicians' electronic prescription records between the years 2007 and 2009 was performed in the largest cancer center in Singapore. An overall prevalence rate of potential DDIs and a prevalence rate for each individual DDI pair were calculated. Logistic regression was used to identify risk factors for potential DDIs. Results: Fifty-eight clinically significant DDIs were selected for evaluation from Drug Interaction Facts and Micromedex DrugDex. A total of 39,772 OAA prescriptions prescribed to 8837 patients were reviewed. Potential DDI coprescription was found in 5.4{\%} of the patients on OAAs and in 4.7{\%} of the OAA prescriptions. The drug pair prescribed to the largest number of patients was prednisolone and aspirin. About half (53.3{\%}) of the observed DDIs were found on the same prescription. On multivariate analysis, older patients, males, and those taking prednisolone had a higher risk for potential DDIs. Conclusion: Although limited by the data available, the analysis of prescription records found that ~5{\%} of patients taking OAAs in Singapore were exposed to ≥1 potentially interacting drug combination.",
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