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Clinically significant drug—drug interactions between oral anticancer agents and nonanticancer agents: a delphi survey of oncology pharmacists

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Chan, Alexandre, Tan, S. H. (Seow-Hwei), Wong, Chen May, Yap, Kevin Yi-Lwern and Ko, Yu. (2009) Clinically significant drug—drug interactions between oral anticancer agents and nonanticancer agents: a delphi survey of oncology pharmacists. Clinical Therapeutics, Vol.31 (Part 2). pp. 2379-2386. ISSN 0149-2918

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Official URL: http://dx.doi.org/10.1016/j.clinthera.2009.11.008

Abstract

Background: Drug-drug interactions (DDIs) can lead to adverse clinical outcomes, particularly in oncology, because of the narrow therapeutic index of chemotherapeutic agents and because patients with cancer are at a high risk due to polypharmacy and age-related organ dysfunction. In a previously published study, drug profiles were developed based on primary and tertiary literature reviews for a list of clinically significant DDIs involving 28 oral anticancer agents (OAAs). Objective: This study was based on a Delphi survey of oncology pharmacists; the survey results were used to develop a consensus list of clinically significant DDIs involving OAAs and nonanticancer agents. Methods: In this study, the DDI profiles previously developed were updated, and the DDI pairs that were listed both in the 2009 Drug Interaction Facts (DIF) and the Thomson Micromedex DrugDex System compendia and that also met the predetermined criteria for clinical significance were selected for further evaluation. In a 2-round, electronically administered Delphi survey of oncology pharmacists, a 5-point Likert scale (1–5, where 1 = strongly agree and 5 = strongly disagree) was used to evaluate the DDI pairs based on 8 clinical aspects (clinical importance; irreversible morbidity and mortality; quality of data; quantity of data; patient's organ functions; comorbid conditions; awareness of interaction; and management burden). International pharmacists who specialized in oncology pharmacy practice and had ≥5 years of practice experience were eligible to participate. Results: Nine of the 23 surveyed pharmacists responded, giving a response rate of 39.1%. A total of 37 DDI pairs were selected from DIF and DrugDex and evaluated by the survey respondents, resulting in the identification, via consensus, of 12 clinically significant DDI pairs. The clinical aspects with the most DDIs that reached consensus of agreement were clinical importance (82.9%) and awareness of interaction (73.2%). Conclusion: An expert panel identified 12 clinically significant DDIs involving OAAs.

Item Type: Journal Article
Subjects: H Social Sciences > HA Statistics
R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
R Medicine > RM Therapeutics. Pharmacology
Divisions: Faculty of Science > WMG (Formerly the Warwick Manufacturing Group)
Journal or Publication Title: Clinical Therapeutics
Publisher: Excerpta Medica, Inc.
ISSN: 0149-2918
Date: 2009
Volume: Vol.31
Number: Part 2
Number of Pages: 8
Page Range: pp. 2379-2386
Identification Number: 10.1016/j.clinthera.2009.11.008
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Restricted or Subscription Access
Funder: Department of Pharmacy, National University of Singapore
URI: http://wrap.warwick.ac.uk/id/eprint/47884

Data sourced from Thomson Reuters' Web of Knowledge

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