The prevalence of drug-drug interactions in cancer therapy and the clinical outcomes.

BACKGROUND: When a patient concomitantly uses two or more drugs, a drug-drug interaction (DDI) may occur, and patients with cancer are at high risk of DDIs because they commonly receive multiple medications. However, data on the prevalence of DDIs are scarce, especially in Saudi Arabia. OBJECTIVE: Our aim was to evaluate the occurrence of DDIs in patients with cancer and identify risk factors for these DDIs and the clinical outcomes. METHOD: A retrospective cross-sectional study was conducted in KFMC. Data were collected from the medical records and phone calls, and the patient's drugs were screened for interactions using Micromedex and Lexi-Comp. The data were statistically analysed using IBM SPSS version 24 statistical program. RESULTS: In 72 patients (mean age of 47 years; 11 medications), the prevalence of DDIs was 60 %, and 2 potential DDIs were identified. According to Lexi-Comp, 137 (51.8 %) were categorized as pharmacodynamics interactions. In Micromedex, 94 potential DDIs were identified, 68.1 % were categorized as pharmacokinetic interactions, the comparison between the interaction of Lexi-Comp and Micromedex for 9 drugs. Eight drug pairs showed statistically significant difference in category of interaction (P < 0.05). Six pair of drugs showed statistically significant difference in mechanism of action (p < 0.05). Number of drugs was reported as significant risk factor (p = 0.007), type of treatment such as chemotherapy (p = 0.0000) and inpatient admission in terms of length of stay in hospital was also found significant risk factor (p = 0.031). CONCLUSION: To prevent DDIs, Physicians and pharmacists should be more aware of these potential interactions to prevent DDIs.

Hospital pharmacy practice in Saudi Arabia: Prescribing and transcribing in the Riyadh region.

PURPOSE: The purpose of this survey is to outline pharmacy services in hospitals on a regional level in the Kingdom of Saudi Arabia. METHODS: A modified-American Society of Health-System Pharmacists (ASHP) survey questionnaire as pertinent to Saudi Arabia was used to conduct a national survey. After discussing with the pharmacy directors of 48 hospitals in the Riyadh region over the phone on the survey's purpose, the questionnaires were personally delivered and collected upon completion. The hospital lists were drawn from the Ministry of Health hospital database. RESULTS: Twenty-nine hospitals participated in the survey giving a response rate of 60.4%. Approximately 60% of the hospitals which participated in the survey required prior approval for the use of non-formulary medications. About 83.3% of hospitals reviewed compliance with clinical practice guidelines and 72.7% hospitals reported that pharmacists are also actively involved in these activities. Pharmacists in more than 95% of hospitals provided consultations on drug information. A staff pharmacist routinely answering questions was the most frequently cited (74.1%) method by which objective drug information was provided to prescribers. Electronic drug information resources were available in 77.7% of hospitals, although internet use is not widely available to hospital pharmacists, with only 58.6% of hospitals providing pharmacist access to the internet. About, 34.5% of hospitals had computerized prescriber order entry (CPOE) systems with clinical decision-support systems (CDSSs) and 51.9% of the hospitals had electronic medical record (EMR) system. CONCLUSION: Hospital pharmacists are increasingly using electronic technologies to improve prescribing and transcribing of medications in Saudi Arabia.