Network analysis of drug-related problems in hospitalized patients with hematologic malignancies

Myeong Gyu Kim, Chae Reen Jeong, Hyun Jee Kim, Jae Hyun Kim, Yun Kyoung Song, Kyung Im Kim, Eunhee Ji, Sung Soo Yoon, Youngil Koh, Yoon Sook Cho, In Wha Kim, Jung Mi Oh

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

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.

Original languageEnglish
Pages (from-to)2737-2742
Number of pages6
JournalSupportive Care in Cancer
Volume26
Issue number8
DOIs
StatePublished - 1 Aug 2018

Keywords

  • Drug-related problem
  • Hematologic malignancy
  • Inpatient
  • Network analysis

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