title: Characteristics of unplanned hospital admissions due to drug-related problems in cancer patients.
abstract: BACKGROUND
  Studies have examined drug-related problems (DRPs) that have led to hospital admissions in the general population. However, there is a lack of information on the characteristics of DRPs in the cancer population.
  
  
  OBJECTIVE
  The objective of this study was to investigate the type, causality, severity, and preventability of DRPs that result in unplanned hospitalizations among cancer patients.
  
  
  METHODS
  This was a prospective, cohort study conducted in two oncology wards between July and December 2012. All patients who were diagnosed with solid tumor or lymphoma and required unplanned hospitalization were included. The incidence of DRPs among hospital admissions was captured, and the nature of the DRPs (causality, severity, and preventability) was characterized.
  
  
  RESULTS
  There were 1,299 admissions and 1,275 were eligible for analysis. Among the 1,275 eligible admissions, 158 (12.4%) were considered to be associated with a DRP. In the 158 admissions associated with DRPs, 164 DRPs were found. The majority of the DRP-related admissions were adverse drug reactions (ADRs) (n=155/164, 94.5%), probable (n=98, 59.8%), moderately severe (n=155, 94.5%), and probably or definitely preventable (n=86, 52.4%). Most patients with DRPs recovered and were discharged. Febrile neutropenia was the most common adverse drug reaction, and drug combinations involving antihypertensives and long-term corticosteroids raised the risks for potential drug-drug interactions among patients with cancer.
  
  
  CONCLUSIONS
  The incidence of DRP-induced unplanned hospital admissions was 12.4% among cancer patients. Approximately half of these were preventable events.
authors.affiliation: Department of Pharmacy, Faculty of Science, National University of Singapore, Block S4, 18 Science Drive 4, 117543, Singapore, Singapore, phaac@nus.edu.sg.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Chan
authors.forename: Deren
authors.initials: D
authors.lastname: Soh
authors.forename: Yu
authors.initials: Y
authors.lastname: Ko
authors.forename: Yu-Chu
authors.initials: YC
authors.lastname: Huang
authors.forename: Joen
authors.initials: J
authors.lastname: Chiang
mesh_terms: D000305:Adrenal Cortex Hormones / Q000009:adverse effects; D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000009:adverse effects; D000970:Antineoplastic Agents / Q000009:adverse effects; D015331:Cohort Studies; D004347:Drug Interactions; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control / Q000628:therapy*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy*; D010351:Patient Discharge; D011446:Prospective Studies; D012846:Singapore / Q000453:epidemiology
chemical_list: D000305:Adrenal Cortex Hormones; D000959:Antihypertensive Agents; D000970:Antineoplastic Agents