Drugs Prescribing Pattern Among Patients with Cancer in Teaching Pharmacy of Shahid Chamran, Yazd, Iran (2020): A Cross-Sectional Study

Authors
Eftekhar Morabi
Seyedeh Mohadeseh Mazhari
Mohsen Nabi Meybodi
Golnaz Afzal
10.61186/ibj.25th-11th-IACRTIMSS
Abstract
Introduction: Considering the growing prescribing of nutritional supplements (including vitamins, minerals, and herbal supplements) in the prescriptions of patients with advanced cancer, the significant economic burden of treatment, the possibility of drug interactions, and reducing the effects of increasing the side effects of chemotherapy drugs, evaluation the pattern of prescribing chemotherapy drugs and nutritional supplements in the prescription of people with advanced cancer is significant. The present study aimed to determine the pattern of prescribing chemotherapy drugs and nutritional supplements for cancer patients in the teaching pharmacy of Shahid Chamran, Yazd, Iran, between October and March 2020.

Methods and Materials: This cross-sectional study was performed on the prescriptions of all cancer patients referred to Shahid Chamran Teaching Pharmacy, affiliated with the Faculty of Pharmacy, Shahid Sadouqi University of Medical Sciences, Yazd, Iran, in 2020. The pharmacist collected and recorded the information using the checklist, including prescribed chemotherapy drugs, pharmacology category, the dosage form of chemotherapy drugs, the brand or generic name of the prescribed chemotherapy drugs, and chemotherapy drugs from the Essential drug list. Also, the number and type of prescribed supplements and adjuvant medications used, such as anti-nausea drugs, gastric acid-suppressing, and corticosteroids. After collecting the information, the data were analyzed using SPSS Version 22 and appropriate statistical tests.

Results: On average, prescribed chemotherapy drugs, generic chemotherapy drugs, EDL chemotherapy drugs, and injectable chemotherapy drugs in each prescription were 2.37 ± 1.22, 1.89 ± 1.28, 2.21 ± 1.29, and 1.39 ± 1.99, respectively. One and two chemotherapy drugs were prescribed in 29% of the prescriptions, and three in 24% of the prescriptions. Also, 29.5% of prescriptions were monotherapy, and the rest were combination chemotherapy. Furthermore, 9.8% of the drugs were oral; the rest were administered as injections. Cyclophosphamide had the highest frequency. Dexamethasone and then Granisteron were the most adjuvant drugs. The frequency distribution of prescribed significant polypharmacy based on the prescription of any supplements and chemotherapy adjuvants, the prescribing anti-nausea drugs was significant (p ≤ 0.001).

Conclusion and Discussion: The average number of prescribed drugs per prescription was significant compared to other countries, and more than half of all prescriptions included significant polypharmacy. Although the American guidelines do not recommend supplements for cancer patients, 20% of the prescriptions in the present study included dietary supplements. Therefore, it is essential to implement special training programs for doctors and monitor doctors’ performance by designing programs on prescription pattern monitoring.



Keywords
Drug prescriptions
Polypharmacy
Neoplasms