title: Drug-related problems in elderly patients with cancer receiving outpatient chemotherapy.
abstract: OBJECTIVE
  This study aimed to identify common drug-related problems(s) (DRP) among elderly patients receiving outpatient chemotherapy, common drugs involved, and common actions taken to resolve key DRP detected.
  
  
  METHODS
  A retrospective study was conducted at the National Cancer Centre Singapore (NCCS). Elderly patients (aged≥65) with any cancer type and stage, taking at least 3 chronic medications, and who received medication therapy management (MTM) between January 2011 and December 2012 were included in the study.
  
  
  RESULTS
  Two hundred ninety-four patients were included in the final analysis. The mean age of the patients was 71.8 years. The patients had a median of 3 co-morbid conditions and were taking a median of 6 chronic medications. The common DRP detected were potential drug interactions (DDI) (398 cases, 36.4%), adverse drug events (346 cases, 31.7%), and non-adherence (97 cases, 8.9%). Majority of potential DDI detected involved non-chemotherapeutic agents (369 cases, 92.7%) and monitoring of patient was the most common action taken (316 cases, 79.4%). Adverse drug events detected were mostly associated with chemotherapy (316 cases, 91.3%) and patient education was the most common action taken (236 cases, 68.2%). Non-adherence in patients was commonly resolved by patient education (59 cases, 60.8%). Only 5 or more chronic medications taken were found to be associated with the presence of DRP in multivariate analysis (p≤0.05).
  
  
  CONCLUSIONS
  Greater understanding of DRP will enable early detection and appropriate management of DRP, thereby improving patient care for elderly patients with cancer.
authors.affiliation: Oncology Pharmacy, National Cancer Centre Singapore, 11 Hospital Drive, Singapore 169610.
authors.forename: Ting Ting
authors.initials: TT
authors.lastname: Yeoh
authors.affiliation: Oncology Pharmacy, National Cancer Centre Singapore, 11 Hospital Drive, Singapore 169610.
authors.forename: Xin Yin
authors.initials: XY
authors.lastname: Tay
authors.affiliation: Oncology Pharmacy, National Cancer Centre Singapore, 11 Hospital Drive, Singapore 169610.
authors.forename: Phebe
authors.initials: P
authors.lastname: Si
authors.affiliation: Oncology Pharmacy, National Cancer Centre Singapore, 11 Hospital Drive, Singapore 169610. Electronic address: npacst@nccs.com.sg.
authors.forename: Lita
authors.initials: L
authors.lastname: Chew
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D004347:Drug Interactions; D005260:Female; D015577:Geriatric Assessment / Q000379:methods / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000188:drug therapy*; D010045:Outpatients / Q000706:statistics & numerical data*; D010349:Patient Compliance / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012846:Singapore
chemical_list: D000970:Antineoplastic Agents
keywords: Drug-related problems; Geriatric oncology; Medication therapy management