Drug Therapy Problems and Associated Factors in Management of Wilms’ Tumor Among Pediatric Patients in Kenyatta National Hospital

Abstract

Drug therapy problems are common during the management of pediatric cases of Wilms’ tumor. They can lead to events requiring further medical attention thus complicating the therapy process and increasing the cost of treatment. The objective of this study was to determine drug therapy problems and the associated factors among pediatric Wilms’ tumor patients at Kenyatta National Hospital. A cross-sectional study recruiting pediatric patients (0 - 15 years) and their guardians was implemented. Data collection was done using a questionnaire and data abstraction tools. Chi square test and logistic regression in STATA version 15, were applied to identify possible associations between drug therapy problems and sociodemographic and clinical factors.  Significance was set at ≤ 0.05.  Between February and August 2023, 66 children were enrolled, mostly female (53%) with a median age of 4 (IQR 2-6) years. The most common drugs used were vincristine and cyclophosphamide/ doxorubicin combination. Drug therapy problems found were the need for additional therapy, adverse drug reactions and unnecessary drug therapy. Stage I of Wilms’ tumor was associated with unnecessary drug therapy (cOR 18, 95% CI 2.71 – 119.79, p = 0.003).  Need for additional therapy, adverse drug reactions and unnecessary drug use were the drug therapy problems identified. Continuous review and education of patients during therapy would be beneficial to reduce occurrence of drug therapy problems.