Assessing anticancer drug utilization patterns through WHO prescribing indicators at a specialized cancer hospital in Peshawar

Muhammad Hasnain; Safa Bakhtawar; Marina Khan; Suhail Ahmad; Mohsin Raziq; Maria Ashfaq; Aimun Zeb Khan; Syed Abdullah Shah; Syed Muhammad Ashhad Halimi; Imran Farooq

doi:10.18203/2319-2003.ijbcp20250475

Authors

Muhammad Hasnain Department of Pharmacy, University of Peshawar, Peshawar, Pakistan
Safa Bakhtawar Department of Pharmacy, University of Peshawar, Peshawar, Pakistan
Marina Khan Department of Pharmacy, University of Peshawar, Peshawar, Pakistan
Suhail Ahmad North-West General and Research Hospital, Peshawar, Pakistan
Mohsin Raziq Department of Pharmacy, University of Peshawar, Peshawar, Pakistan
Maria Ashfaq Department of Pharmacy, University of Peshawar, Peshawar, Pakistan
Aimun Zeb Khan Department of Pharmacy, University of Peshawar, Peshawar, Pakistan
Syed Abdullah Shah Department of Pharmacy, University of Peshawar, Peshawar, Pakistan
Syed Muhammad Ashhad Halimi Department of Pharmacy, University of Peshawar, Peshawar, Pakistan
Imran Farooq Institue of Radiation and Nuclear Medicine Hospital, Peshawar, Pakistan

DOI:

https://doi.org/10.18203/2319-2003.ijbcp20250475

Keywords:

Anticancer drugs, Drug utilization pattern, WHO prescribing indicators

Abstract

Background: Efficient utilization of anticancer agents is crucial for effective malignancy treatment and cost management. WHO Prescribing Indicators provide a standardized measure for assessing drug usage. This study aimed to evaluate anticancer drug utilization patterns in a specialized oncology hospital using these indicators.

Methods: A cross-sectional analysis involved reviewing medical records of anticancer drug prescriptions at a designated cancer treatment facility. Key WHO prescribing indicators, including drug per prescription average, proportions of anticancer drugs and generics usage, were assessed.

Results: Analysis of 900 prescriptions revealed an average of 8.36 drugs per prescription, with 2.27 being anticancer drugs and 4.93 adjuvants. Notably, 71% of medications were prescribed generically 85% were on the Essential Medicines List. Opportunities for enhancing efficiency, like promoting generic drugs and reducing injectable anticancer agents, were identified.

Conclusions: This study highlights the value of WHO Prescribing Indicators in analysing anticancer drug utilization trends. Addressing prescribing deficiencies can refine treatment protocols, promote judicious pharmaceutical use and elevate patient care standards. Future efforts should focus on targeted strategies to rectify these shortcomings, emphasizing ongoing research and quality improvement in oncologic pharmacotherapy.

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References

World Health Organization. The Global Burden of Disease: 2004 Update. Geneva: World Health Organization; 2008.

Cancer. Available at: https://www.who.int. Accessed on 19 Nov 2019.

Guduru H, Jeevangi SR, Nigudgi S, Bhandare SV. A prospective study on the prescription pattern of anti-cancer drugs and adverse drug reaction in a tertiary care hospital. Int J Basic Clin Pharmacol. 2019;8:200-5. DOI: https://doi.org/10.18203/2319-2003.ijbcp20190134

WHO Model Lists of Essential Medicines. 2005. Available at: https://www.who.int. Assessed on 2019 9 September 2019.

Gisev N, Sluggett JK. Descriptive and drug utilization studies. In Encyclopedia of Pharmacy Practice and Clinical Pharmacy. 2019;(1-3):2-344.

Dukes MNG. Drug utilization studies: methods and uses. World Health Organization. Regional Office for Europe. 1993.

Tshilande N, Mammino L. Acylphloroglucinols with anticancer and/or antimalarial activities—An overview. Studies in Natural Products Chemistry. 2024;81:39-77. DOI: https://doi.org/10.1016/B978-0-443-15628-1.00005-2

Global burden of disease cancer collaboration. The global burden of cancer 2013. JAMA Oncol. 2015;1:505–27.

Tsukamoto S, Errani C, Kido A. (2021) What’s new in the management of metastatic bone disease. Euro J Orthop Surg Traumatol. 2021;31:1547–55. DOI: https://doi.org/10.1007/s00590-021-03136-4

Daltoé RD, Madeira KP, de Carvalho AA. Evaluation of the progesterone receptor status in breast cancer using three different antibodies: A comparison by Allred score system. Int J Clin Exp Pathol. 2014;7:331-9.

Longo DL. Cancer cell biology and angiogenesis. In: Harrison’s Principles of Internal Medicine. 18th ed., Ch. 84. New York: McGraw Hill Education. 2012: 693.

Murthy NS, Rajaram D, Gautham MS, Shivaraj NS, Nandakumar BS, Pruthvish S. Risk of cancer development in India. Asian Pac J Cancer Prev 2011;12:387-91.

Green AR, Soria D, Powe DG. Nottingham prognostic index plus (NPI+) predicts risk of distant metastases in primary breast cancer. Breast Cancer Res Treat. 2016;157:65-75. DOI: https://doi.org/10.1007/s10549-016-3804-1

Malhotra V, Perry MC. Classical chemotherapy: mechanisms, toxicities and the therapeutic window. Cancer Biol Ther. 2003;2(1):2-4. DOI: https://doi.org/10.4161/cbt.199

Bayat MR, Homayouni TS, Baluch N, Morgatskaya E, Kumar S, Das B, et al. Combination therapy in combating cancer. Oncotarget. 2017;8(23):38022-43. DOI: https://doi.org/10.18632/oncotarget.16723

Falzone L, Salomone S, Libra M. Evolution of cancer pharmacological treatments at the turn of the third millennium. Front Pharmacol. 2018;9:1300. DOI: https://doi.org/10.3389/fphar.2018.01300

Basini J, Bhargavi D, Kishore R, Bande K, Langipalli K. A Prospective Study on Drug Prescription Pattern of Chemotherapeutic Agents in Breast Cancer Patients in a Tertiary Care Hospital. Indian J Pharmacy Practice. 2023;16(3):206-12

Bepari A, Sakre N, Rahman I. The Assesment of drug utilization study of anticancer drugs using WHO prescribing indicators in a government tertiary care hospital of the Hyderabad-karnataka region of india ; Maced J Med Sci. 2019;7(7);1203-8. DOI: https://doi.org/10.3889/oamjms.2019.249

Kamlekar SK, Agarwal A, Latha PA, Gupta S. Evaluation of drug utilization pattern of anticancer drugs in oncology department of a tertiary care teaching hospital of southern Rajasthan. Natl J Physiol Pharm Pharmacol 2020;10(01):15-20.

Khan MK, Thapa RK, Adhikari DS, Rajbhandari M, Dwa P, Shrestha S, et al. Evaluation of cancer prevalence and cytotoxic medication prescribing in central region of Nepal. Kathmandu Univ J Sci Eng Technol. 2013;9:189–99. DOI: https://doi.org/10.3126/kuset.v9i1.63923

Kumar B.S, Maria S, Shejila C.H. Drug Utilization Review and Cost Analysis of Anticancer Drugs Used in a Tertiary Care Teaching Hospital. Indian J Pharm Sci 2018;80(4):686-93. DOI: https://doi.org/10.4172/pharmaceutical-sciences.1000408

Dave DJ, Pillai A, Shah DV, Agarwal S, Goel A. An analysis of utilization pattern of anticancer drugs in diagnosed cases of carcinoma in a tertiary care teaching hospital. Int J Basic Appl Med Sci. 2014;4:251-9.

Kirthi C, Afza A, Reddy M, Ali SA, Yerramilli A, Sharma S. A study on the adverse effects of anticancer drugs in an oncology centre of a tertiary care hospital. Int J Pharm Pharm Sci. 2014;6:580-3.

Siddiqua A, Jafar H, Tabassum N. Drug utilization evaluation of anticancer drugs. Am J Pharmtech Res. 2014;4:692-702.

Warszawik-Hendzel O, Olszewska M, Maj M, Rakowska A, Czuwara J, Rudnicka L. Non-invasive diagnostic techniques in the diagnosis of squamous cell carcinoma. J Dermatol Case Rep. 2015;9(4):89–97. DOI: https://doi.org/10.3315/jdcr.2015.1221

Alam M, Armstrong A, Baum C. Guidelines of care for the management of cutaneous squamous cell carcinoma. J Am Acad Dermatol. 2018;78(3):560–78. DOI: https://doi.org/10.1016/j.jaad.2017.10.007

Kim C, Cheng J, Colegio OR. Cutaneous squamous cell carcinomas in solid organ transplant recipients: emerging strategies for surveillance, staging and treatment. Semin Oncol. 2016;43(3):390–4. DOI: https://doi.org/10.1053/j.seminoncol.2016.02.019

Cardenas CA. Sarcomas: “A comprehensive review of classification, diagnosis, treatment and psychosocial aspects". Clin Oncol Case Rep. 2023;6:6

Nodar SR, Barbosa APO, García BE, Aguirre CC, Gomez JT. Primary angiosarcoma of the spleen with spontaneous rupture: A case report. Clin Oncol Case Rep. 2022;5:1-4.

Voon HP, Hii L, Garvie A, Udugama M, Krug B, Russo C, et al. Pediatric glioma histone H3. 3 K27M/G34R mutations drive abnormalities in PML nuclear bodies. Genome Biol. 2023;24(1):284. DOI: https://doi.org/10.1186/s13059-023-03122-5

Grünewald TG, Alonso M, Avnet S, Banito A, Burdach S, Cidre‐Aranaz F, et al. Sarcoma treatment in the era of molecular medicine. EMBO. 2020;12(11):11131. DOI: https://doi.org/10.15252/emmm.201911131

Swerdlow SH, Campo E, Pileri SA. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood. 2016;127(20):2375-90. DOI: https://doi.org/10.1182/blood-2016-01-643569

National Institutes of Health, National Cancer Institute. Surveillance, epidemiology and end results program cancer stat facts: non-Hodgkin lymphoma. Available at: https://seer.cancer. Accessed on 21 August 2024.

Campo E, Swerdlow SH, Harris NL. The 2008 WHO classification of lymphoid neoplasms and beyond: evolving concepts and practical applications. Blood. 2011;117(19):5019-32. DOI: https://doi.org/10.1182/blood-2011-01-293050

Kirthi C, Afzal A, Reddy M, Ali SA, Yerramilli A, Sharma S. A study on the adverse effects of anticancer drugs in an oncology center of a tertiary care hospital. Int J Pharm Pharm Sci. 2014;6:580-83.

Mugada V, Paruchuri A, Munagala M. Drug Utilization Evaluation of Anticancer Drugs in a Tertiary Care Teaching Hospital: a Descriptive Observational Study. J App Pharm Sci, 2016;6(10):98-101. DOI: https://doi.org/10.7324/JAPS.2016.601013