CC BY-NC-ND 4.0 · South Asian J Cancer 2019; 08(02): 130-133
DOI: 10.4103/sajc.sajc_218_18
ORIGINAL ARTICLE: Supportive Care and Others

Predictors of adverse drug reactions in geriatric patients: An exploratory study among cancer patients

S. George Sneha
Department of Pharmacy Practice, Faculty of Pharmacy, M. S. Ramaiah University of Applied Sciences, Bengaluru, Karnataka
Kalpana Simhadri
Department of Pharmacy Practice, Faculty of Pharmacy, M. S. Ramaiah University of Applied Sciences, Bengaluru, Karnataka
Viswam K. Subeesh
Department of Pharmacy Practice, Faculty of Pharmacy, M. S. Ramaiah University of Applied Sciences, Bengaluru, Karnataka
S. Varghese Sneha
Department of Pharmacy Practice, Faculty of Pharmacy, M. S. Ramaiah University of Applied Sciences, Bengaluru, Karnataka
› Author Affiliations
Financial support and sponsorship: Nil.


Objectives: The objective of this study was to study the predictors of adverse drug reactions (ADRs) among geriatric patients in the Department of Medical Oncology. Methods: A hospital-based prospective observational study was carried out among 153 inpatients in the Department of Medical Oncology for 6 months. Patients above 60 years of age with a confirmed history of malignancy were included in the study. The potential risk factors for ADR were defined in relation to the patient and chemotherapeutic regimen and relationship between them was assessed by univariate and multivariate logistic regression analysis. Results: Among 153 patients, 94 (64.43%) experienced ADRs. The mean ADR per patient was 0.88 ± 1.2. The common ADRs found were alopecia (30.18%) and diarrhea (28.68%). Risk estimates revealed that there was a significant association between smokers (odds ratio [OR] = 10.326; 95% confidence interval [CI] 2.345–45.47, P = 0.001), alcoholics (OR = 10.897; 95% CI 2.479–47.902, P = 0.001), increasing age (OR = 2.22; 95% CI 1.698–2.909, P = 0.001), overweight (OR = 16.68; 95% CI 2.179–127.741, P = 0.001), and male participants (OR = 0.143; 95% CI 0.05–0.390 P = 0.001) with the development of ADRs. The risk of carboplatin (OR = 13.359; 95% CI 3.056–58.406 P = 0.001) and 5-fluorouracil (OR = 1.938 95% CI 1.266–2.935 P = 0.001) use and occurrence of ADRs were also found to be high. Conclusion: The study findings showed that smoking, alcohol consumption, age more than 70 years, and overweight had a high risk for developing ADRs in geriatric patients who underwent chemotherapy. The independent risk factors identified should be targeted for preventive measures to improve anticancer agent prescription and reduce the risk of ADRs.

Publication History

Publication Date:
21 December 2020 (online)

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  • References

  • 1 Mohile S, Dale W, Hurria A. Geriatric oncology research to improve clinical care. Nat Rev Clin Oncol 2012;9:571-8.
  • 2 Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM, et al. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer 2010;127:2893-917.
  • 3 Lavan AH, Gallagher P. Predicting risk of adverse drug reactions in older adults. Ther Adv Drug Saf 2016;7:11-22.
  • 4 Korc-Grodzicki B, Boparai MK, Lichtman SM. Prescribing for older patients with cancer. Clin Adv Hematol Oncol 2014;12:309-18.
  • 5 Bowie MW, Slattum PW. Pharmacodynamics in older adults: A review. Am J Geriatr Pharmacother 2007;5:263-303.
  • 6 Silva TJ, Jerussalmy CS, Farfel JM, Curiati JA, Jacob-Filho W. Predictors of in-hospital mortality among older patients. Clinics (Sao Paulo) 2009;64:613-8.
  • 7 Sarkar A, Shahi U. Assessment of cancer care in Indian elderly cancer patients: A single center study. South Asian J Cancer 2013;2:202-8.
  • 8 Alomar MJ. Factors affecting the development of adverse drug reactions (Review article). Saudi Pharm J 2014;22:83-94.
  • 9 Lichtman SM, Boparai MK. Anticancer drug therapy in the older cancer patient: Pharmacology and polypharmacy. Curr Treat Options Oncol 2008;9:191-203.
  • 10 Maggiore RJ, Gross CP, Togawa K, Tew WP, Mohile SG, Owusu C, et al. Use of complementary medications among older adults with cancer. Cancer 2012;118:4815-23.
  • 11 Stevenson JM, Williams JL, Burnham TG, Prevost AT, Schiff R, Erskine SD, et al. Predicting adverse drug reactions in older adults; a systematic review of the risk prediction models. Clin Interv Aging 2014;9:1581-93.
  • 12 Angamo MT, Curtain CM, Chalmers L, Yilma D, Bereznicki L. Predictors of adverse drug reaction-related hospitalisation in southwest ethiopia: A prospective cross-sectional study. PLoS One 2017;12:e0186631.
  • 13 Sharma A, Kumari KM, Manohar HD, Bairy KL, Thomas J. Pattern of adverse drug reactions due to cancer chemotherapy in a tertiary care hospital in South India. Perspect Clin Res 2015;6:109-15.
  • 14 Shah R, Gajjar B, Desai S. A profile of adverse drug reactions with risk factors among geriatric patients in a tertiary care teaching rural hospital in India. Nat J Physiol Pharm Pharmacol 2012;2:113-22.
  • 15 Chopra D, Rehan HS, Sharma V, Mishra R. Chemotherapy-induced adverse drug reactions in oncology patients: A prospective observational survey. Indian J Med Paediatr Oncol 2016;37:42-6.
  • 16 Saini VK, Sewal RK, Ahmad Y, Medhi B. Prospective observational study of adverse drug reactions of anticancer drugs used in cancer treatment in a tertiary care hospital. Indian J Pharm Sci 2015;77:687-93.