Management Practice and Drug Related Problems and Its Contributing Factors Among Cervical Cancer Patients at Oncologic Center in Ethiopia: A Hospital-Based Retrospective Study

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Abstract

Introduction

In cervical cancer therapy, there is a high prevalence of drug-related problems (DRPs) due to the high toxicity and complexity of most antineoplastic regimens. However, there is a paucity of data about DRPs among patients with cervical cancer in Ethiopia. Hence, the present study was aimed at investigating management practices and DRPs among patients diagnosed with cervical cancer.

Methods

A registry-based retrospective cohort study was employed among cervical cancer patients at the oncology center of Felege Hiwot Comprehensive Specialized Hospital (FHCSH). All patients with a histologically confirmed diagnosis of cervical cancer from January 2016 to December 2020 were included. Relevant information was recorded by reviewing medical records. The possibility of DRPs was evaluated by comparing with standard guidelines. Logistic regression analysis was employed.

Results

A total of 184 cervical cancer patients were included, with a mean age of 50.2±10.7 years. A total of 216 DRPs were identified from 93 cervical cancer patients, translating to a prevalence of 50.5% and a mean of 2.32±1.11 DRPs per patient. ADR (27.3%), DDI (25%), and the need for additional drug therapy (22.2%) were the most prevalent DRPs. DRPs were associated with the presence of co-morbidity (AOR = 4.23, 95% CI = 1.78–10.05, p = 0.001), complications (AOR = 2.99, 95% CI = 1.28–6.99, p = 0.011), being treated with ≥5 medications (AOR = 5.1, 95% CI = 2.38–10.95, p < 0.001), being stage II (AOR = 0.14, 95% CI = 0.02–0.90, p = 0.038), and stage III (AOR = 0.04, 95% CI = 0.01–0.32, p = 0.003).

Conclusion

Cisplatin-based chemotherapy was the frequently used therapeutic option. Co-morbidity and complication status, number of medication and stage of cancer were significantly associated with DRPs. The study highlights the need of clinical pharmacy services to optimize drug therapy and reduce DRPs.

Most cited references 46

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Estimates of incidence and mortality of cervical cancer in 2018: a worldwide analysis

Marc Arbyn, Elisabete Weiderpass, Laia Bruni … (2019)

Summary Background The knowledge that persistent human papillomavirus (HPV) infection is the main cause of cervical cancer has resulted in the development of prophylactic vaccines to prevent HPV infection and HPV assays that detect nucleic acids of the virus. WHO has launched a Global Initiative to scale up preventive, screening, and treatment interventions to eliminate cervical cancer as a public health problem during the 21st century. Therefore, our study aimed to assess the existing burden of cervical cancer as a baseline from which to assess the effect of this initiative. Methods For this worldwide analysis, we used data of cancer estimates from 185 countries from the Global Cancer Observatory 2018 database. We used a hierarchy of methods dependent on the availability and quality of the source information from population-based cancer registries to estimate incidence of cervical cancer. For estimation of cervical cancer mortality, we used the WHO mortality database. Countries were grouped in 21 subcontinents and were also categorised as high-resource or lower-resource countries, on the basis of their Human Development Index. We calculated the number of cervical cancer cases and deaths in a given country, directly age-standardised incidence and mortality rate of cervical cancer, indirectly standardised incidence ratio and mortality ratio, cumulative incidence and mortality rate, and average age at diagnosis. Findings Approximately 570 000 cases of cervical cancer and 311 000 deaths from the disease occurred in 2018. Cervical cancer was the fourth most common cancer in women, ranking after breast cancer (2·1 million cases), colorectal cancer (0·8 million) and lung cancer (0·7 million). The estimated age-standardised incidence of cervical cancer was 13·1 per 100 000 women globally and varied widely among countries, with rates ranging from less than 2 to 75 per 100 000 women. Cervical cancer was the leading cause of cancer-related death in women in eastern, western, middle, and southern Africa. The highest incidence was estimated in Eswatini, with approximately 6·5% of women developing cervical cancer before age 75 years. China and India together contributed more than a third of the global cervical burden, with 106 000 cases in China and 97 000 cases in India, and 48 000 deaths in China and 60 000 deaths in India. Globally, the average age at diagnosis of cervical cancer was 53 years, ranging from 44 years (Vanuatu) to 68 years (Singapore). The global average age at death from cervical cancer was 59 years, ranging from 45 years (Vanuatu) to 76 years (Martinique). Cervical cancer ranked in the top three cancers affecting women younger than 45 years in 146 (79%) of 185 countries assessed. Interpretation Cervical cancer continues to be a major public health problem affecting middle-aged women, particularly in less-resourced countries. The global scale-up of HPV vaccination and HPV-based screening—including self-sampling—has potential to make cervical cancer a rare disease in the decades to come. Our study could help shape and monitor the initiative to eliminate cervical cancer as a major public health problem. Funding Belgian Foundation Against Cancer, DG Research and Innovation of the European Commission, and The Bill & Melinda Gates Foundation.

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Preventability and severity assessment in reporting adverse drug reactions.

S Hartwig, J. Siegel, P Schneider (1992)

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Knowledge, attitude and practice for cervical cancer prevention and control among women of childbearing age in Hossana Town, Hadiya zone, Southern Ethiopia: Community-based cross-sectional study

Yitagesu Aweke, Samuel Ayanto, Tariku Laelago Ersado (2017)

Background Cervical cancer is the second most common female cancer which Ethiopia put a strategic goal to reduce its incidence and mortality by 2020. Lack of knowledge and poor attitude towards the disease and risk factors can affect screening practice and development of preventive behavior for cervical cancer. The aim of this study was to assess knowledge, attitude, practices and factors for each domain for cervical cancer among women of child bearing age in Hossana town, Southern, Ethiopia. Methods Community based cross sectional study was carried out in June 2015. A total of 583 participants were selected using systematic random sampling technique. Pretested structured interviewer administered questionnaire was used to gather the data. Data were entered in to Epi Info software version 3.5.4 and exported to SPSS version 16 for descriptive and logistic regression analysis. Results Two hundred seventy (46.3%) of the respondents had poor comprehensive knowledge. Only 58 (9.9%) of participants had been screed for the cervical cancer before the survey. Two hundred three (34.8%) of participants had negative attitude towards selected proxy variables. Not having health seeking behavior for cervical cancer [AOR: 5.45, 95% CI: (1.18, 30.58), P <0.031], had not ever received information about cervical cancer and its prevention [AOR: 2.63, 95%CI: (1.78,8.84), P < 0.018] and not actively seeking health information about cervical cancer [AOR: 6.25, (95%CI: (1.26, 31.06) P < 0.025] were significantly associated factors with poor knowledge. Poor knowledge score was associated with poor attitude [AOR: 56.51, 95%CI: (23.76, 134.37), P <0.001]. Had not ever received information about the disease from any source [AOR: 45.24, (95%CI: (11.47, 178.54), P <0.001] was significantly associated factor with not to be screened for the disease. Conclusion This study highlighted the importance of awareness creation, increasing knowledge, promoting active searching for health information and experiences of receiving information from any information sources regarding cervical cancer. Therefore, it will be essential to integrate cervical cancer prevention strategies with other reproductive health services at all level of health care delivery system.

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Journal

Journal ID (nlm-ta): Ther Clin Risk Manag

Journal ID (iso-abbrev): Ther Clin Risk Manag

Journal ID (publisher-id): tcrm

Title: Therapeutics and Clinical Risk Management

Publisher: Dove

ISSN (Print): 1176-6336

ISSN (Electronic): 1178-203X

Publication date (Electronic): 10 June 2022

Publication date Collection: 2022

Volume: 18

Pages: 643-655

Affiliations

[1 ]Clinical Pharmacy Unit and Research Team, Department of Pharmacy, College of Medicine and Health Sciences, Bahir Dar University , Bahir Dar, Amhara, Ethiopia

[2 ]Department of Social and Public Health, College of Health Sciences, Debre Tabor University , Debre Tabor, Amhara, Ethiopia

[3 ]Pharmacology and Toxicology Unit, Department of Pharmacy, College of Health Sciences, Debre Tabor University , Debre Tabor, Amhara, Ethiopia

Author notes

Correspondence: Belayneh Kefale, Clinical Pharmacy and Research Unit, Department of Pharmacy, College of Medicine and Health Sciences, Bahir Dar University , Bahir Dar, Amhara, Ethiopia, Email bkefale5@gmail.com

Author information

Belayneh Kefale http://orcid.org/0000-0003-4841-0861

Melaku Tadege Engidaw http://orcid.org/0000-0002-1970-5102

Desalegn Tesfa http://orcid.org/0000-0003-1095-9373

Malede Berihun Yismaw http://orcid.org/0000-0003-2488-304X

Article

Publisher ID: 364923

DOI: 10.2147/TCRM.S364923

PMC ID: 9196911

SO-VID: 89323550-314e-4e56-98be-8610b25acf32

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This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

History

Date received : 03 March 2022

Date accepted : 04 June 2022

Page count

Figures: 2, Tables: 6, References: 50, Pages: 13

Funding

Funded by: by Debre Tabor University;

This work was supported by Debre Tabor University (grant no. DTU/RE/1/3059/2013).

Management Practice and Drug Related Problems and Its Contributing Factors Among Cervical Cancer Patients at Oncologic Center in Ethiopia: A Hospital-Based Retrospective Study

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Abstract

Introduction

Methods

Results

Conclusion

Most cited references 46

Estimates of incidence and mortality of cervical cancer in 2018: a worldwide analysis

Preventability and severity assessment in reporting adverse drug reactions.

Knowledge, attitude and practice for cervical cancer prevention and control among women of childbearing age in Hossana Town, Hadiya zone, Southern Ethiopia: Community-based cross-sectional study

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