A STUDY OF DRUG UTILIZATION IN PATIENTS OF CARCINOMA BREAST RECEIVING SYSTEMIC CHEMOTHERAPY IN TERTIARY CARE HOSPITALS
Objective: The objective of the study is to study drug utilization in patients with breast carcinoma receiving systemic chemotherapy in government as well as private set-up.
Methods: This was a record-based, retrospective-prospective study, analyzing the prescription pattern of drugs used for systemic chemotherapy in patients diagnosed with carcinoma breast at government teaching hospital (GTH) and private trust hospital (PTH) for 1 year in 600 patients. Patient’s demographic, clinical, and therapeutic data were collected from the files and personal interviews and analyzed in Microsoft Excel.
Results: Diagnosis of breast carcinoma was highest in age bracket of 40–49 years (32.33% GTH and 32.67% PTH), and the most common presenting symptom was painless lump (76.33% GTH and 83% PTH). In GTH, most frequently prescribed regimen was 4AC → 4T → RT (17.33%). In PTH, most commonly prescribed regimen was 6FEC → RT (19.33%). Highest prescribed drugs were A (32.8%), C (29.12%), and F (20.24%) in GTH and A (32.26%), F (31.68%), and E (16.45%) in PTH. Average number of drugs prescribed per prescription was 12.55 and 11.37; percentage of chemotherapeutic agents prescribed by generic name was 100 and 95.02, and from the WHO essential drug list (2015) was 96.43 and 82.77 in GTH and PTH, respectively (A= Cyclophosphamide, C= Doxorubicin, T=Taxanes [Paclitaxel/Docetaxel], F=5-fluorouracil, E=Epirubicin, RT=Radiotherapy, → followed by, the number indicates chemotherapy cycle).
Conclusion: The study results can help in generating local data regarding drug use pattern of the systemic chemotherapeutic agents in breast cancer patients and promote rational drug use.
2. American Cancer Society. Atlanta: The Association. Global Cancer Facts and Figures; 2021. Available from: https://www.cancer.org/research/ cancer-facts-statistics/global.html. [Last accessed on 2021 Jan 07].
3. Lester SC. The breast. In: Kumar V, Abbas AK, Aster JC, editors. Robbins and Cotran Pathologic Basis of Disease. Vol. 2. New Delhi: Elsevier Limited; 2014. p. 1051-4.
4. Dar M, Sharma K. Burden of cancer in India: GLOBOCAN 2018 estimates incidence, mortality, prevalence and future projections of cancer in India. J Emerg Technol Innov Res 2018;6:e505.
5. Bray F, Jemal A, Grey N, Ferlay J, Forman D. Global cancer transitions according to the human development index (2008-2030): A population-based study. Lancet Oncol 2012;13:790-801.
6. Gennari R, Curigliano G, Rotmensz N, Robertson C, Colleoni M, Zurrida S, et al. Breast carcinoma in elderly women: Features of disease presentation, choice of local and systemic treatments compared with younger postmenopasual patients. Cancer 2004;101:1302-10.
7. Ladewski LA, Belknap SM, Nebeker JR, Sartor O, Lyons EA, Kuzel TC, et al. Dissemination of information on potentially fatal adverse drug reactions for cancer drugs from 2000 to 2002: First results from the research on adverse drug events and reports project. J Clin Oncol 2003;21:3859-66.
8. Maiti R. Drug utilization studies. In: Postgraduate Topics in Pharmacology. 2nd ed. Hyderabad: Paras Medical Books Private Ltd.;2015. p. 218-30.
9. Chopra B, Kaur V, Singh K, Verma M, Singh S, Singh A. Age shift: Breast cancer is occurring in younger age groups - Is it true? Clin Cancer Invest J 2014;3:526-9.
10. Anderson WF, Pfeiffer RM, Dores GM, Sherman ME. Comparison of age distribution patterns for different histopathologic types of breast carcinoma. Cancer Epidemiol Biomarkers Prev 2006;15:1899-905.
11. Chauhan A, Subba SH, Menezes RG, Shetty BS, Thakur V, Chabra S, et al. Younger women are affected by breast cancer in South India - a hospital-based descriptive study. Asian Pac J Cancer 2011;12:709-11.
12. Das K, Sarkar DK, Karim R, Manna AK. Preoperative ultrasound guided needle localisation for non-palpable breast lesions. Indian J Surg 2010;72:117-23.
13. Lester SC. The breast. In: Kumar V, Abbas AK, Aster JC, editors. Robbins and Cotran Pathologic Basis of Disease. Vol. 2. New Delhi: Elsevier Limited; 2014. p. 1051-71.
14. Van Herk-Sukel M. Medication Use among Women with Breast Cancer in the Netherlands: Pharmacoepidemiological Studies based on Data from the Eindhoven Cancer Registry-PHARMO Linkage; 2011.
15. Heparin (Flush); 1996-2020. Available from: https://www.drugs.com/ mtm/heparin-flush.html. [Last accessed on 2021 Jan 07].
16. Tripathi KD. Essentials of Medical Pharmacology. 7th ed. New Delhi: Jaypee Brothers Medical Publishers; 2013. p. 86.
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