Transcript Beatrice_edited 1 - School of Pharmacy

A RETROSPECTIVE STUDY OF THE PRESCRIBING
PATTERN OF ANTICANCER DRUGS AT THE
KENYATTA NATIONAL HOSPITAL DURING THE
PERIOD JANUARY 2014 TO JULY 2014
By Nyamai Beatrice Kalekye
U29/35598/2010
Supervisor: Dr. P. M. Njogu
Introduction
 Cancer is an abnormal mass of tissue with growth that exceeds
and is uncoordinated with that of surrounding tissues.
 Prevalence: 7.4 million deaths ≈ 13% of all deaths in 2004
worldwide.
 In Kenya: ≈ 7% deaths annually.
 Treatment includes
a number of interventions such as
psychological support, surgery, radiotherapy, hormonal therapy
and chemotherapy.
 Chemotherapy is the mainstay of cancer treatment.
Justification
 Cancer is a growing problem in Kenya with over 82 000 new
cases reported annually in Kenya.
 Given that anticancer drugs are expensive, rational use of
anticancer agents is important. Hence, the need of the study.
 Patients travel many kilometers to the Kenyatta National
Hospital (KNH), a public hospital that hosts most of the
oncology expertise and technology in Kenya.
Study Objectives
Main objective
To evaluate the prescription patterns of anticancer drugs used in the
treatment of cancer out-patients at Kenyatta National Hospital.
Specific objectives
 To document the most common cancers encountered in KNH.
 To determine the cancer prevalence among the different genders and
age groups.
 To determine the drugs commonly used in the treatment of cancer.
Methodology
 A retrospective study was done at the Kenyatta National
Hospital to determine the common anticancer drugs prescribed
to out-patients at the oncology pharmacy for the time period of
January 2014-July 2014.
 Using the sample formula proposed by Cochran, a sample size
of 219 patient prescription sheets were analyzed.
 Only patients over the age of 18 attending the Radio-
chemotherapy clinic who had undergone chemotherapy of at
least one chemo-cycle were included.
 It was the prescribing pattern in the first chemo-plan treatment
that were studied.
 Permission to carry out the research was sought from the
Kenyatta National Hospital/ University of Nairobi Ethics and
Research Committee before the study was carried out.
 Information acquired treated with utmost confidentiality.
Results and Discussion
 The study captured a total of 219 patients.
Sex
6%
27%
67%
Missing
Male
Female
%
Age-wise Distribution Percentage of patients
90
80
70
60
50
40
30
20
10
0
Male
Female
Total
Below 25
25-34
35-44
45-54
55-64
Patient Age
65-74
Above 75
Missing
Age
Prevalence of cancer in KNH out-patient clinic
 A total of 44 cancers were observed in the study.
 Eighty nine percent of the cases had specified cancers while
only 11% had their cancers unspecified.
Cancer
Percentage
Breast cancer
32.9%
Cervical cancer
11.9%
Squamous cell carcinoma
5.9%
Nasopharyngeal carcinoma
5.5%
Prostate cancer
4.6%
Use of Anticancer Agents in Total No. of Patients
2.39%
0.22% 3.04%
15.87%
11.09%
Antibiotics
Alkylating agents
Natural products
Antimetabolites
Hormones and related agents
Biological response modifiers
Miscelaneous
27.39%
40.00%
0.32%
Use of Anticancer Agents in Females
0.32%
12.99%
1.95%
16.88%
Antibiotics
Alkylating agents
Natural products
Antimetabolites
26.62%
40.91%
Hormones and related
agents
Biological response
modifiers
Miscelaneous
Use of Anticancer Agents in Males
6.56%
13.93%
Antibiotics
8.20%
Alkylating agents
5.74%
Natural products
Antimetabolites
36.07%
29.51%
Hormones and related
agents
Miscelaneous
Conclusion
 The commonly prescribed anticancer drugs in KNH were
alkylating agents and natural products.
 There was a strong correlation between the type of cancer and
the sex (p=0.00).
 The most common cancers in females were breast and cervical
cancers, while in males, prostate and nasopharyngeal cancers
were predominant.
 The management of cancer in Kenyatta National Hospital is
commendable.
Recommendations
 There should be great emphasis on prevention through
modifiable risk factors.
 Public education about cancer and its prevention.
 Research using a larger sample size including other
hospitals.
 Research on use of oral anticancer agents to improve
cancer management in the country may be beneficial
as it is already on-going in developed countries.