Determination of drug-drug interaction in breast cancer patients receiving doxorubicin and cyclophosphamide regimen.

INTRODUCTION: Drug interactions constitute a significant issue in cancer treatment. Therefore, it is important to assess and analyze all cancer patients' therapies prior to the initiation of chemotherapy. METHODS: A retrospective observational study was conducted at the Near East University Hospital Oncology Department located in North Cyprus between June 2019 and December 2021. The aim of the study was to determine the nature, type, and frequency of potential drug-drug interactions in breast cancer patients receiving a doxorubicin and cyclophosphamide regimen using Drugs.com, Lexicomp, and Micromedex databases while comparing the three electronic databases, according to the frequency, mechanism, and severity of drug-drug interactions. RESULTS: The study included 40 patients (44.4%) out of 90 patients diagnosed with breast cancer, as 50 patients (55.6%) who did not match the criteria were excluded. According to the Lexicomp database, 12 patients (30%) with breast cancer had 14 potential drug-drug interactions, according to the Drugs.com database, 15 patients (37.5%) with breast cancer had 22 potential drug-drug interactions, and according to the Micromedex database, 13 patients (32.5%) with breast cancer had 15 potential drug-drug interactions. Pearson correlation indicated a weak association (Lexicomp: r = 0.475, p = 0.002 and Micromedex: r = 0.491, p = 0.001) and a moderate association (Drugs.com: r = 0.500, p = 0.001) between potential drug-drug interactions and five or more medications. CONCLUSION: This study showed that the Drugs.com database detected more potential drug interactions between chemotherapy and nonchemotherapy than the Lexicomp and Micromedex databases. Comprehensive drug review, use of electronic health record systems, and collaboration between healthcare providers such as pharmacists and physicians may be necessary strategies to minimize potential drug-drug interactions and optimize cancer treatment in patients with breast cancer.

Assessment of pharmacy students' knowledge about breast cancer and colon cancer in Northern Cyprus universities.

BACKGROUND: Colon and breast cancer are the most common types of cancer in cancer patients worldwide. Therefore, health students, especially pharmacy students, should be well-educated about colon and breast cancer. Adequate education and knowledge provide significant benefits from early diagnosis to treatment. METHODOLOGY: This study was conducted as a cross-sectional study for 3 months between 1 November 2022, and 31 January 2023, in Northern Cyprus. The aim of this study was to assess pharmacy students' knowledge of breast cancer and colon cancer in North Cyprus Universities. RESULT: A total of 494 pharmacy students participated in this study. Twenty-three incompletely filled questionnaires were excluded from the study. Regarding Near East University and Cyprus International University pharmacy students' knowledge of colon cancer, 298 out of 494 had good knowledge and 196 out of 494 had poor knowledge. Regarding Near East University and Cyprus International University pharmacy students' knowledge of breast cancer, 317 out of 494 had good knowledge and 177 out of 494 had poor knowledge. The total score of knowledge of Near East University and Cyprus International University pharmacy students about breast cancer was 10 ± 3.43 and 11.40 ± 3.67, respectively. The total score of knowledge of Near East University and Cyprus International University pharmacy students about colon cancer was 7.54 ± 3.67 and 9.19 ± 4.08, respectively. CONCLUSIONS: The findings of the study indicate that most of the pharmacy students have good knowledge about the risk factors and symptoms of breast and colon cancer, but are not at the ideal knowledge level expected in the fight against cancer after graduation.

Community pharmacists preparedness and barriers for cancer health promotion in North Cyprus.

INTRODUCTION: The role of a community pharmacist is well recognized in the literature as the most accessible health care provider that promotes health wellness and disease prevention. Evidence supports their role in cancer health promotion though this is not seen yet in practice. The aim of the study was to assess community pharmacists' preparedness in terms of knowledge, role perception and barriers for providing cancer health promotion in North Cyprus. METHODS: A cross-sectional face-to-face questionnaire-based study was carried among a randomly selected representative sample of community pharmacists in North Cyprus between June 2020 and August 2020. A pre-validated 31-item questionnaire tool was revised by an expert panel and adopted for purpose of this study. RESULTS: 200 (64.5%) out of 310 approached community pharmacists' have accepted and responded to the questionnaire of which 183 were fully answered. The community pharmacists' awareness of cancer was moderate, as 70% answered correctly. Most respondents (93.4%) agree that pharmacists should be involved in cancer health promotion. Most respondents (> 90%) agree that pharmacist's lack of interest in oncology, lack of educational material and pharmacist's hesitancy about their knowledge of cancer are respectively the most important barriers for cancer health promotion. CONCLUSION: The study shows that community pharmacist well perceives their role in cancer health promotion despite moderate awareness of cancer related facts and hesitancy of their knowledge necessary for assuming their role. Lack of interest, motivation and cancer educational materials availability are also major barrier to address.

The role of the pharmacist in improving medication beliefs and adherence in cancer patients.

BACKGROUND: Multiple factors have been reported to affect adherence to medication, including beliefs about medicines, while specifically tailored pharmaceutical care services for patients may improve adherence. The aim was to assess the impact of counselling by an oncology pharmacist on patients' medication adherence and beliefs. METHODS: An interventional prospective study was performed in the oncology department at a tertiary hospital in Northern Cyprus from November 2017 to April 2018. The Beliefs about Medicines Questionnaire was used to evaluate the balance between beliefs about necessity and concerns and medication beliefs before and after an educational intervention. The Morisky Green Levine Test 2018 was used to evaluate adherence. RESULTS: In total, 81 patients (65.4% females; mean age: 59.1 ± 11.34 years; 34.6% hypertensive; 19.8% with diabetes) were analysed before and after receiving counselling from an oncology pharmacist. Pharmacist education significantly enhanced the mean patient necessity-concern balance scores by two-fold (MT0(baseline) = -3.1 ± 8.6; MT1(posteducation) =3.0 ± 7.3; p < 0.0001), with patients who received counselling for the first time experiencing the greatest benefit. Multivariate analysis showed that patients who had a negative balance between their beliefs about the necessity of the medication and their concerns were less likely to adhere to the medication (0.138 (0.025-0.772)). CONCLUSION: Counselling by an oncology pharmacist was effective in decreasing patient concerns and increasing their understanding of the necessity of the medication, thus enhancing their adherence and consequently improving the care they received.

The role of the pharmacist in the multidisciplinary approach to the prevention and resolution of drug-related problems in cancer chemotherapy.

BACKGROUND: Clinical pharmacists have important roles in implementing scientifically valid knowledge and advice on safe, reasonable use of pharmaceuticals. Clinical pharmacy services were introduced and evaluated in oncology clinic in a tertiary university hospital. METHODS: A prospective interventional study was conducted from November 2017 to March 2018. Drug-related problems were classified using the Pharmaceutical Care Network Europe drug-related problem classification tool v8.01. The main outcome measure is the proposed interventions aimed at identification of the drug-related problems, the role of the pharmacists in the resolution, and the rate of acceptance of these recommendations by physicians. RESULTS: A total of 102 patients were included in the study, who were treated with at least two cycles of any cancer type and stage. A total of 55 (53.9%) patients had 251 drug-related problems. Drug-related problems mainly involved antihypertensive (31.6%), antidiabetic (17.8%), and herbal agents (31.6%). Treatment effectiveness was the major type of drug-related problems (50.2%) followed by treatment safety (29.1%). A total of 211 (100%) interventions were accepted and regarded as clinically relevant. Prescriber informed only were the most common types of intervention at the prescriber level. Eighty-six point four percent identified drug-related problems were solved, 9.8% of the problems were partially solved, 2.3% problems were unsolved. CONCLUSION: Clinical pharmacy services may have optimized therapy effectiveness, prevent adverse effects and unclear/compliant problems. The pharmacist interventions were highly acknowledged by oncologists and patients; this may indicate the presence of a great convenience and need to implement Clinical pharmacy services in alternative hospitals in Northern Cyprus.