종양내과 퇴원 환자의 다제병용 분석
Polypharmacy in Patients Discharged from Oncology Department
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Background: Patients diagnosed with cancer tend to have multiple risk factors for drug related problems such as old age, comorbid conditions, self-medication, additional medications for supportive therapy, and the cancer treatment itself. Objective: The aim of this study was to investigate notable polypharmacy and related problems in oncology patients during hospitalization or following clinic visit. Method: The electronic medical records of patients who were and in 94.7% of patients at their first visit after discharge. Antidiarrheal agent (loperamide) was prescribed along discharged from oncology division at Seoul National University Hospital (SNUH) from June 1st to June 30th, 2011 were retrospectively reviewed. Results: A total of 334 discharged patients were included in this study. Among them, 221 patients had pre-admission medications. Forty percent of the patients, including 60.3% of elderly patients (over 65 years of age) were prescribed more than 5 kinds of medications. Twenty percent of the patients were prescribed to take medications more than 7 times a day. Medication duplications were observed in 2.4% of patients. In 10.5% of the reviewed patients, 47 cases of potential drug-drug interaction including 3 cases of contraindication and 17 cases of major clinical implication according to Micromedex were detected. Medication changes were made in 88% of patients during hospitalization with laxatives in 18.5% of the prescriptions and inadequate instructions on how to take it were observed in 63% of the prescriptions. Conclusion: This study identified the prevalence of polypharmacy and related problems in cancer patients, which presents the need for an active role of pharmacists in pharmaceutical care in oncology wards.
Abstract
Background: Patients diagnosed with cancer tend to have multiple risk factors for drug related problems such as old age, comorbid conditions, self-medication, additional medications for supportive therapy, and the cancer treatment itself. Objective: The aim of this study was to investigate notable polypharmacy and related problems in oncology patients during hospitalization or following clinic visit. Method: The electronic medical records of patients who were and in 94.7% of patients at their first visit after discharge. Antidiarrheal agent (loperamide) was prescribed along discharged from oncology division at Seoul National University Hospital (SNUH) from June 1st to June 30th, 2011 were retrospectively reviewed. Results: A total of 334 discharged patients were included in this study. Among them, 221 patients had pre-admission medications. Forty percent of the patients, including 60.3% of elderly patients (over 65 years of age) were prescribed more than 5 kinds of medications. Twenty percent of the patients were prescribed to take medications more than 7 times a day. Medication duplications were observed in 2.4% of patients. In 10.5% of the reviewed patients, 47 cases of potential drug-drug interaction including 3 cases of contraindication and 17 cases of major clinical implication according to Micromedex were detected. Medication changes were made in 88% of patients during hospitalization with laxatives in 18.5% of the prescriptions and inadequate instructions on how to take it were observed in 63% of the prescriptions. Conclusion: This study identified the prevalence of polypharmacy and related problems in cancer patients, which presents the need for an active role of pharmacists in pharmaceutical care in oncology wards.
참고문헌 (21)
- "Demographic facts for the world population"[URL]
- Lees J, Chan A, "Polypharmacy in elderly patients with cancer : clinical implications and management", Lancet Oncol, 12, pp.1249~1257 (2011)
- Puts MT, "Medication problems in older, newly diagnosed cancer patients in Canada: how common are they? A prospective pilot study", Drugs Aging, 26, pp.519~536 (2009)
- Hanigan MH, "Use of prescription and nonprescription medications and supplements by cancer patients during chemotherapy : questionnaire validation", J Oncol Pharm Pract, 14, pp.123~130 (2008)
- Riechelmann RP, "Potential Drug Interactions and Duplicate Prescriptions Among Cancer Patients", J Natl Cancer Inst, 99, pp.592~600 (2007)
- "Micromedex Drugdex (TM) (Thomson, Green wood, co, USA)", ~
- Cashman J, "The treatment of comorbidities in older patients with metastatic cancer", Support Care Cancer, 18, pp.651~655 (2010)
- Koh Y, "Drug-related problems in hospitalized patients on polypharmacy : the influence of age and gender", Ther Clin Risk Manag, 1(1), pp.39~48 (2005)
- Claxton AJ, "A systematic review of the associations between dose regimens and medication compliance", Clin Ther, 23(8), pp.1296~1310 (2001)
- Johnell K, "The relationship between number of drugs and potential drug-drug interactions in the elderly: a study of over 600,000 elderly patients from the Swedish Prescribed Drug Register", Drug Saf, 30(10), pp.911~918 (2007)
- Fulton MM, "Polypharmacy in the elderly: a literature review", J Am Acad Nurse Pract, 17, pp.123~132 (2005)
- Goldberg RM, "Drug–drug and drug–disease interactions in the ED : analysis of a high-risk population", Am J Emerg Med, 14(5), pp.447~450 (1996)
- Maggiore RH, "Polypharmacy in older adults with cancer", Oncologist, 15, pp.507~522 (2010)
- Yap KY, "An onco-infomatics database for anticancer drug interactions with complementary and alternative medicines used in cancer treatment and supportive care : an overview of the OncoRx project", Support Care Cancer, 10, pp.1011~1019 (2009)
- Kongkaew C, "Hospital admissions associated with adverse drug reactions: a systematic review of prospective observational studies", Ann Pharmacother, 42, pp.1017~1025 (2008)
- 이현주, "약사에 의해 탐지된 항암제 처방오류 분석", 한국임상약학회지, 20(2), pp.120~127 (2010), 한국임상약학회
- 이주연, "순환기 내과 병동 담당 약사에 의한 자가약 관리 및 퇴원약 처방 중재 효과", 병원약사회지, 26(4), pp.356~361 (2009), 한국병원약사회
- Joo EH, "Survery on the Polypharmacy for the Outpatients in General Hospital", J Kor Soc Health-Syst Pharm, 14(2), pp.129~134 (1997)
- Achieving quality use of medicines in the community for palliative and end of life care: A consultation report, "National Prescribing Service Limited and Palliative Care Australia", National Prescribing Service, ~ (2009)
- C R Goh, "Minimising Polypharmacy – a Challenge in Palliative Care", Singapore Med J, 43(6), pp.273~275 (2002)
- Koh NY, "Polypharmacy in palliative care: can it be reduced?", Singapore Med J, 43(6), pp.279~283 (2002)
