TY - JOUR
T1 - Network analysis of drug-related problems in hospitalized patients with hematologic malignancies
AU - Kim, Myeong Gyu
AU - Jeong, Chae Reen
AU - Kim, Hyun Jee
AU - Kim, Jae Hyun
AU - Song, Yun Kyoung
AU - Kim, Kyung Im
AU - Ji, Eunhee
AU - Yoon, Sung Soo
AU - Koh, Youngil
AU - Cho, Yoon Sook
AU - Kim, In Wha
AU - Oh, Jung Mi
N1 - Publisher Copyright:
© 2018, Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2018/8/1
Y1 - 2018/8/1
N2 - Purpose: Network analysis was conducted to systematically analyze the relationship between causative drugs and types of drug-related problems (DRPs) in hospitalized patients with hematologic malignancies. Methods: A total of 1187 DRPs identified in hematology wards between 2013 and 2015 were analyzed. DRPs were classified into 11 sub-domains for problems and 35 sub-domains for causes according to Pharmaceutical Care Network Europe classification. Causative drugs were classified by Anatomical Therapeutic Chemical code. Network analytic tool was used to represent the relationship between drugs, causes, and problems. In-degree centrality (C D-in ) was calculated to identify major causes of DRPs. Results: The following drugs accounted for more than 5% of DRP, including antibacterials (J01, 26.5%), drugs for acid-related disorders (A02, 11.5%), antiemetics (A04, 9.7%), antifungals (J02, 8.8%), and antineoplastic agents (L01, 7.0%). Inappropriate combinations (C1.3, C D-in of 161) of drugs for acid-related disorders, antifungals, and antineoplastic agents were major causes of DRPs and induced non-optimal effects of drug treatment (P1.2). Inappropriate dose adjustments (C3.6, C D-in of 151) of antibacterials lowered effects (P1.2) and increased side effects (P2.1). Missing necessary synergistic or preventive drugs, especially antiemetics, (C1.8, C D-in of 54) resulted in untreated indication (P1.4). Conclusions: DRPs were mainly related to medications for supportive care. More attention should be paid to interactions of drugs used for acid-related disorders, dose adjustment of antibacterials, and omission of antiemetics in hospitalized patients with hematologic malignancy.
AB - Purpose: Network analysis was conducted to systematically analyze the relationship between causative drugs and types of drug-related problems (DRPs) in hospitalized patients with hematologic malignancies. Methods: A total of 1187 DRPs identified in hematology wards between 2013 and 2015 were analyzed. DRPs were classified into 11 sub-domains for problems and 35 sub-domains for causes according to Pharmaceutical Care Network Europe classification. Causative drugs were classified by Anatomical Therapeutic Chemical code. Network analytic tool was used to represent the relationship between drugs, causes, and problems. In-degree centrality (C D-in ) was calculated to identify major causes of DRPs. Results: The following drugs accounted for more than 5% of DRP, including antibacterials (J01, 26.5%), drugs for acid-related disorders (A02, 11.5%), antiemetics (A04, 9.7%), antifungals (J02, 8.8%), and antineoplastic agents (L01, 7.0%). Inappropriate combinations (C1.3, C D-in of 161) of drugs for acid-related disorders, antifungals, and antineoplastic agents were major causes of DRPs and induced non-optimal effects of drug treatment (P1.2). Inappropriate dose adjustments (C3.6, C D-in of 151) of antibacterials lowered effects (P1.2) and increased side effects (P2.1). Missing necessary synergistic or preventive drugs, especially antiemetics, (C1.8, C D-in of 54) resulted in untreated indication (P1.4). Conclusions: DRPs were mainly related to medications for supportive care. More attention should be paid to interactions of drugs used for acid-related disorders, dose adjustment of antibacterials, and omission of antiemetics in hospitalized patients with hematologic malignancy.
KW - Drug-related problem
KW - Hematologic malignancy
KW - Inpatient
KW - Network analysis
UR - http://www.scopus.com/inward/record.url?scp=85042603398&partnerID=8YFLogxK
U2 - 10.1007/s00520-018-4106-4
DO - 10.1007/s00520-018-4106-4
M3 - Article
C2 - 29488017
AN - SCOPUS:85042603398
SN - 0941-4355
VL - 26
SP - 2737
EP - 2742
JO - Supportive Care in Cancer
JF - Supportive Care in Cancer
IS - 8
ER -