Skip to main content

Advertisement

SpringerLink
Log in

Network analysis of drug-related problems in hospitalized patients with hematologic malignancies

  • Original Article
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Purpose

Network analysis was conducted to systematically analyze the relationship between causative drugs and types of drug-related problems (DRPs) in hospitalized patients with hematologic malignancies.

Methods

A total of 1187 DRPs identified in hematology wards between 2013 and 2015 were analyzed. DRPs were classified into 11 sub-domains for problems and 35 sub-domains for causes according to Pharmaceutical Care Network Europe classification. Causative drugs were classified by Anatomical Therapeutic Chemical code. Network analytic tool was used to represent the relationship between drugs, causes, and problems. In-degree centrality (CD-in) was calculated to identify major causes of DRPs.

Results

The following drugs accounted for more than 5% of DRP, including antibacterials (J01, 26.5%), drugs for acid-related disorders (A02, 11.5%), antiemetics (A04, 9.7%), antifungals (J02, 8.8%), and antineoplastic agents (L01, 7.0%). Inappropriate combinations (C1.3, CD-in of 161) of drugs for acid-related disorders, antifungals, and antineoplastic agents were major causes of DRPs and induced non-optimal effects of drug treatment (P1.2). Inappropriate dose adjustments (C3.6, CD-in of 151) of antibacterials lowered effects (P1.2) and increased side effects (P2.1). Missing necessary synergistic or preventive drugs, especially antiemetics, (C1.8, CD-in of 54) resulted in untreated indication (P1.4).

Conclusions

DRPs were mainly related to medications for supportive care. More attention should be paid to interactions of drugs used for acid-related disorders, dose adjustment of antibacterials, and omission of antiemetics in hospitalized patients with hematologic malignancy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Koh Y, Kutty FB, Li SC (2005) Drug-related problems in hospitalized patients on polypharmacy: the influence of age and gender. Ther Clin Risk Manag 1:39–48

    Article  PubMed  PubMed Central  Google Scholar 

  2. Pharmaceutical Care Network Europe Foundation (2010) Classification for drug related problems V6.2. http://www.pcne.org/upload/files/11_PCNE_classification_V6-2.pdf. Accessed 8 February 2017

  3. Ko Y, Gwee YS, Huang YC, Chiang J, Chan A (2014) Costs and length of stay of drug-related hospital admissions in cancer patients. Clin Ther 36:588–592. https://doi.org/10.1016/j.clinthera.2014.02.014

    Article  PubMed  Google Scholar 

  4. Chan A, Soh D, Ko Y, Huang YC, Chiang J (2014) Characteristics of unplanned hospital admissions due to drug-related problems in cancer patients. Support Care Cancer 22:1875–1881. https://doi.org/10.1007/s00520-014-2160-0

    Article  PubMed  Google Scholar 

  5. Edwards SJ, Abbott R, Edwards J, LeBlanc M, Dranitsaris G, Donnan J, Laing K, Whelan MA, MacKinnon NJ (2014) Outcomes assessment of a pharmacist-directed seamless care program in an ambulatory oncology clinic. J Pharm Pract 27:46–52. https://doi.org/10.1177/0897190013504954

    Article  PubMed  Google Scholar 

  6. Ribed A, Romero-Jimenez RM, Escudero-Vilaplana V, Iglesias-Peinado I, Herranz-Alonso A, Codina C, Sanjurjo-Saez M (2016) Pharmaceutical care program for onco-hematologic outpatients: safety, efficiency and patient satisfaction. Int J Clin Pharm 38:280–288. https://doi.org/10.1007/s11096-015-0235-8

    Article  PubMed  CAS  Google Scholar 

  7. Yeoh TT, Tay XY, Si P, Chew L (2015) Drug-related problems in elderly patients with cancer receiving outpatient chemotherapy. J Geriatr Oncol 6:280–287. https://doi.org/10.1016/j.jgo.2015.05.001

    Article  PubMed  Google Scholar 

  8. Bremberg ER, Hising C, Nylen U, Ehrsson H, Eksborg S (2006) An evaluation of pharmacist contribution to an oncology ward in a Swedish hospital. J Oncol Pharm Pract 12:75–81. https://doi.org/10.1177/1078155206070412

    Article  PubMed  Google Scholar 

  9. Bulsink A, Imholz AL, Brouwers JR, Jansman FG (2013) Characteristics of potential drug-related problems among oncology patients. Int J Clin Pharm 35:401–407. https://doi.org/10.1007/s11096-012-9747-7

    Article  PubMed  Google Scholar 

  10. Yeoh TT, Si P, Chew L (2013) The impact of medication therapy management in older oncology patients. Support Care Cancer 21:1287–1293. https://doi.org/10.1007/s00520-012-1661-y

    Article  PubMed  Google Scholar 

  11. Puts MT, Monette J, Girre V, Costa-Lima B, Wolfson C, Batist G, Bergman H (2010) Potential medication problems in older newly diagnosed cancer patients in Canada during cancer treatment: a prospective pilot cohort study. Drugs Aging 27:559–572. https://doi.org/10.2165/11537310-000000000-00000

    Article  PubMed  CAS  Google Scholar 

  12. Delpeuch A, Leveque D, Gourieux B, Herbrecht R (2015) Impact of clinical pharmacy services in a hematology/oncology inpatient setting. Anticancer Res 35:457–460

    PubMed  Google Scholar 

  13. Cavero Rodrigo E, Climente Martí M, Navarro Fontestad MC, Jiménez Torres NV (2007) Quality assessment of two pharmaceutical care models for onco-haematological patients. Farm Hosp 31:231–237

    Article  PubMed  CAS  Google Scholar 

  14. Farias TF, Aguiar KD, Rotta I, Belletti KM, Carlotto J (2016) Implementing a clinical pharmacy service in hematology. Einstein (Sao Paulo) 14:384–390. https://doi.org/10.1590/S1679-45082016AO3667

    Article  Google Scholar 

  15. Chew C, Chiang J, Yeoh TT (2015) Impact of outpatient interventions made at an ambulatory cancer centre oncology pharmacy in Singapore. J Oncol Pharm Pract 21:93–101. https://doi.org/10.1177/1078155213519836

    Article  PubMed  Google Scholar 

  16. Lopez-Martin C, Garrido Siles M, Alcaide-Garcia J, Faus Felipe V (2014) Role of clinical pharmacists to prevent drug interactions in cancer outpatients: a single-centre experience. Int J Clin Pharm 36:1251–1259. https://doi.org/10.1007/s11096-014-0029-4

    Article  PubMed  Google Scholar 

  17. WHO Collaborating Centre for Drug Statistics Methodology (2017). ATC/DDD Index 2017. https://www.whocc.no/atc_ddd_index/updates_included_in_the_atc_ddd_index/new_atc_codes_2017/. Accessed 8 February 2017

  18. Overhage JM, Lukes A (1999) Practical, reliable, comprehensive method for characterizing pharmacists' clinical activities. Am J Health Syst Pharm 56:2444–2450

    PubMed  CAS  Google Scholar 

  19. Opsahl T, Agneessens F, Skvoretz J (2010) Node centrality in weighted networks: generalizing degree and shortest paths. Soc Networks 32:245–251

    Article  Google Scholar 

  20. Merck Sharp & Dohme Corp. (2016) Noxafil (posaconazole): Highlights of prescribing information. https://www.merck.com/product/usa/pi_circulars/n/noxafil/noxafil_pi.pdf. Accessed 20 Feb 2018

  21. Bristol-Myers Squibb (2010) Sprycel (dasatinib): Highlights of prescribing information. https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/021986s7s8lbl.pdf. Accessed 20 Feb 2018

  22. Novartis Pharmaceuticals Corporation (2017) Tasigna (nilotinib): Highlights of prescribing information. https://www.pharma.us.novartis.com/sites/www.pharma.us.novartis.com/files/tasigna.pdf?printmode=true. Accessed 20 Feb 2018

  23. Kim DS, Park CS, Jang SM (2008) The impacts of guideline for digestives on physicians’ prescription of GI medication. Korean J Clin Pharm 18:124–131

    Google Scholar 

  24. Darmon M, Ciroldi M, Thiery G, Schlemmer B, Azoulay E (2006) Clinical review: specific aspects of acute renal failure in cancer patients. Crit Care 10:211

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

This work was supported by The Health Fellowship Foundation and the 2017 Brain Korea (BK) 21 Plus.

Financial disclosure

The Health Fellowship Foundation, National Research Foundation of Korea (BK Plus 2017).

Author information

Authors and Affiliations

  1. College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 151-742, South Korea

    Myeong Gyu Kim, Chae Reen Jeong, Hyun Jee Kim, Jae Hyun Kim, Yun-Kyoung Song, In-Wha Kim & Jung Mi Oh

  2. Graduate School of Clinical Pharmacy, CHA University, Pocheon, South Korea

    Myeong Gyu Kim

  3. Department of Pharmacy, Seoul National University Hospital, Seoul, South Korea

    Hyun Jee Kim & Yoon-Sook Cho

  4. College of Pharmacy, Korea University, Sejong, South Korea

    Kyung Im Kim

  5. College of Pharmacy, Gachon University, Incheon, South Korea

    Eunhee Ji

  6. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea

    Sung-Soo Yoon & Youngil Koh

Authors
  1. Myeong Gyu Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Chae Reen Jeong
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hyun Jee Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jae Hyun Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yun-Kyoung Song
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Kyung Im Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Eunhee Ji
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Sung-Soo Yoon
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Youngil Koh
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Yoon-Sook Cho
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. In-Wha Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Jung Mi Oh
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jung Mi Oh.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Electronic supplementary material

ESM 1

(DOCX 164 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kim, M.G., Jeong, C.R., Kim, H.J. et al. Network analysis of drug-related problems in hospitalized patients with hematologic malignancies. Support Care Cancer 26, 2737–2742 (2018). https://doi.org/10.1007/s00520-018-4106-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-018-4106-4

Keywords

Search

Navigation