Factors associated with occurrence of drug therapy problems among patients with neoplasms of digestive organs at Uganda Cancer Institute, Mbarara: a cross-sectional study

BACKGROUND: The global burden of neoplasms of digestive organs (NDOs) is on the rise. Various stakeholders have made significant efforts to ensure access to effective and relatively safe chemotherapy for the treatment of NDOs. However, the use of cancer chemotherapy has been associated with drug therapy problems (DTPs). These potentially compromise desired treatment outcomes. There is limited knowledge among stakeholders regarding the burden of DTPs among patients on cancer chemotherapy in Uganda. METHOD: This was a cross-sectional study which enrolled 196 participants with NDOs. It was conducted at Uganda Cancer Institute (UCI), Mbarara. Data was collected using a questionnaire and checklist. Data analysis was performed using Statistical Package for Social Sciences (SPSS) version 22.0. The prevalence of DTPs was expressed as a percentage of the sample size. Factors associated with occurrence of DTPs were analyzed using logistic regression. Variables with p-values less than 0.25 at univariate analysis were subjected to multivariate analysis. Variables were considered statistically significant if p-values were less than 0.05 at 95% confidence interval. RESULTS: Out of 196 participants 86 (43.9%) experienced DTPs. The most common DTPs were: need for additional therapy (135/535, 25.2%), unnecessary drug therapy (86/535, 16.1%) and adverse drug reactions (ADRs) (86/535, 16.1%). On performing logistic regression, female gender (aOR: 2.11; 95% CI: 1.01–4.42, p = 0.047), unemployment (aOR: 7.17; 95% CI: 1.31–39.02, p = 0.023) or older age (aOR: 2.67; 95% CI: 1.31–5.47, p = 0.007) were significantly associated with occurrence of DTPs. CONCLUSION: This study demonstrates that the use of cancer chemotherapy to achieve desired therapy outcomes among patients with NDOs is still challenged by DTPs. The findings are suggestive of a gap in rational medicines use in the treatment of cancers in a LMIC setting.