Dissertation CC BY 4.0
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Potential interactions of medication prescribed in discharge letters from a clinic for hematology and oncology

Background As there is little data worldwide concerning the frequency and relevance of interactions of prescribed drugs in hemato-oncology we analysed the medication prescribed to patients of a clinic for hematology and oncology within a Comprehensive Cancer Center. Patients and methods Prescribed medication of all patients in 2011 were extracted from discharge letters. All potential medication combinations were assess with respect to the risk of interaction using three specialized websites. Results The files of 202 patients receiving 275 drugs were extracted. 4303 combinations were created. Overall, 88% of these combinations were found to be harmless with an interaction value (IV) of 1. However 10% showed potential risk of probable interaction (IV 2 + 3). A total of 47% of the patients had at least one drug combination with a risk of interaction. A maximum of 29 drugs with 15 probable and possible interactions were found. Conclusion Awareness to the topic should be raised in physicians as well as in patients. An important step to avoid risks from interactions is a systematic check of all drugs prescribed. There is urgent need in reliable data on clinical relevant interactions and in a better network of physicians and pharmacists can contribute to data exchange about relevant interactions. Key message In cancer care, a structured assessment of risks for interactions for all patients is mandatory. Patients should be encouraged to disclose any intake of additional substances to the oncologist. Interactions, drug intake and self-medication should be addressed at every contact. Web-based interaction check software helps to discover risks. Drugs less urgently needed may be paused.

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