Factors Associated With Drug Therapy Problems in the Management of Pediatric Wilms Tumor Patients at Kenyatta National Hospital

Abstract

Background Drug therapy problems are a common issue during the therapeutic management of pediatric cases of Wilms tumor. These drug therapy problems lead to events which require further medical attention therefore complicating the therapy process and lead to a consequent increased cost of treatment. This study sought to assess the drug therapy problems observed during management of Wilms tumor and their associated factors among pediatric patients in Kenyatta National Hospital. Methodology This was a hospital based cross sectional study where the patients and their guardians were interviewed, and data collected using a questionnaire and all other required data abstracted from patient files using a data abstraction tool. The patients included were pediatric patients between 0 and 15 years of age who received treatment within the study period of February 2023 to August 2023. Chi square test for independence and multivariate regression analysis were used to determine presence of significant association between drug therapy problems and associated factors. Results Out of a sample size of 66 pediatric Wilm’s tumor patients assessed, the median age was 4 years (IQR 2 – 6). There were 35 female and 31 male patients with Vincristine as a single drug and Cyclophosphamide/ Doxorubicin combination the most common drugs used. The drug therapy problems found were the need for additional therapy which was the most prevalent, followed by adverse drug reactions and unnecessary drug therapy. In this study, stage I of Wilms tumor was associated with unnecessary drug therapy (p-value=0.003). Conclusion and Recommendations The drug therapy problems found in this study were the need for additional therapy, adverse drug reactions and unnecessary drug use which was associated with stage 1 of disease. Continuous review and education of patients during therapy would be beneficial to reduce occurrence of drug therapy problems