Drug-related problems in pediatric, adult and geriatric cancer patients: A systematic review

BACKGROUND AND AIM: Drug-related problems (DRPs) are common in cancer treatment due to several reasons, including high doses of drugs and multiple medications. This study aimed to estimate the prevalence of DRPs and to evaluate the types, causes and risk factors of DRPs in pediatric, adult and geriatric cancer patients. METHODS: Studies investigating DRPs in paediatric, adult, and geriatric cancer patients were searched in electronic bibliographical databases. The protocol has been registered with PROSPERO (CRD42022352133). The Joanna Briggs Institute (JBI) tool was used to perform quality assessments of the extracted data. RESULTS: A total of 4211 unique titles were identified; with 35 meeting the inclusion criteria. The prevalence of DRPs in paediatric, adult, and geriatric cancer patients were reported between 2.6% - 88%. Variations in age group, cancer types and different DDI screening tools are key factors in the heterogeneity observed. The most common DRPs included drug-drug interactions (DDI) (4-96%), adverse drug reactions (ADRs) (13 - 87.3%), the need for additional drug therapy (50%), and potentially inappropriate medications (50%). Adriamycin and Cyclophosphamide, Tramadol and proton pump inhibitors were common drugs and drug classes causing DRPs. The most common factors associated with DRPs were the presence of comorbidity, age, polypharmacy, and poor renal function. CONCLUSION: Among the various DRPs, DDIs and ADRs were the most common with cancer treatment in paediatric, adult, and geriatric patients. Healthcare providers should carefully monitor patients receiving cancer treatment and manage DRPs as they arise for better patient care.