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This study aims to evaluate the epidemiology of potential drug interactions in terminally-ill cancer patients receiving exclusively supportive care. In this cross-sectional study, during a 6-month follow-up, we considered the medical record of terminally-ill cancer patients referred to palliative care at the cancer center in Isfahan, Iran. Potential drug-drug interactions (DDIs) were assessed by Lexi-Interact ver.1.1 online software. During the study period, 133 terminally-ill cancer patients were recruited. We detected 1678 DDIs with moderate or major severity levels. Among them, 330, 219, 32, 1075, and 51 interactions were categorized in B, C, D, and X drug interactions categories, respectively. One hundred and twenty-two patients (91.73%) encountered at least one potential drug-drug interaction during the end of life care. Mechanistically, most drug-drug interactions (64.5%) were pharmacodynamics. The most frequent pharmacological class of drugs responsible for DDIs were quetiapine (91 cases), oxycodone (87 cases), and sertraline (55 cases). Interaction between oxycodone and sertraline was found to be in the top 10 detected DDIs (13.7%). Our results showed that potentially moderate or major drug-drug interactions often occur among terminally-ill cancer patients and the clinical significance of DDIs should be considered meticulously in the palliative care cancer setting. [ABSTRACT FROM AUTHOR]

Background: Patients with multiple myeloma (MM) have compromised immune systems due to the nature of the malignancy and anticancer treatments. This study aims to report the effects of Bortezomib-containing chemotherapy regimens on the severity and mortality of MM patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-COV-2). Method: This retrospective cohort study enrolled MM patients presenting with coronavirus disease 2019 (COVID-19) infection referred to Omid Hospital. Patients were divided into two groups based on whether they received any chemotherapy regimens containing Bortezomib within the last 90 days of admission or not. Clinical and laboratory characteristics, severity, and outcomes of both groups were reported and compared. Results: Among 48 patients with MM diagnosed with COVID-19 (63% male; median age 66), 33 received chemotherapy. The most common symptoms were fever, cough, and dyspnea, and there was no significant difference between the groups. Only D-dimer had a significant difference in laboratory tests (P = 0.03) and was higher in the chemotherapy group. There was no significant relationship between chemotherapy and severity (risk ratio (RR) = 1.17; 95% confidence interval (CI): 0.37 to 3.71; P = 0.79) or chemotherapy and mortality (RR = 1.00; 95% CI: 0.39 to 2.61; P = 0.99), even after adjusting for baseline C-reactive protein and white blood cell counts. Conclusion: Our study showed that receiving Bortezomib-containing chemotherapy regimens did not worsen the symptoms and prognosis of MM patients infected with COVID-19. However, further studies with larger sample sizes and longer follow-up times are needed to provide better evidence on this subject. [ABSTRACT FROM AUTHOR]

Background: Palliative cancer patients suffer from a condition which needs to take many medications for supportive care and comorbid illnesses management. Therefore, they are at risk of drug-rated problems, such as futile medications. We aimed to discover the futile medication occurrence and identification as well as medication futility associated predictor factors. Method: In a prospective cross-sectional study, we included patients with advanced/incurable malignancies admitted to Ala palliative clinic, a charity clinic affiliated to Omid Hospital in Isfahan, Iran, between June 2018 and April 2019. To identify the use of fruitless medicine towards the end of life, we conducted a thorough analysis of the demographic information and prescription lists of terminally ill patients. The phrase "futile drugs" refers to those that are superfluous or redundant, have no significant benefits in terms of illness symptom management or survival time extension, or have a long-term chronic usage. Results: From 133 involved patients, 114 (85.7%) were considered to use at least one futile medication (including only administration of unnecessary medications (70%) or both unnecessary and duplicate medication (30%). 35 patients were encountered with 48 medication duplications of the different pharmacological class of medications mostly opioids (33%). According to multivariate logistic regression analysis, the number of drugs and the average time to death were related with the prevalence of medication futility. Conclusion: Palliative cancer patients were exposed to taking futile medications. More different prospective studies are warranted to evaluate the clinical and economic impact of futile medication use in oncology practice. [ABSTRACT FROM AUTHOR]

Aim and objectives: The present study aims at exploring oncology nurses' perceptions regarding work‐related stressors. Background: Oncology nurses work in an environment with a high degree of stress, which can negatively affect their health. There is limited research on work‐related stressors from the oncology nurses' perspective. Design: Qualitative descriptive study. Methods: Fifty‐two oncology nurses were selected purposefully from eight cancer treatment centres in different cities of Iran. Data were collected through semi‐structured interviews and analysed using conventional content analysis. The COREQ checklist was used to document the report of the study. Results: The extracted contents were classified into four main categories. The first category involved personal ability with two subcategories (person‐job fit and psychological competencies). The second category included physical environment arrangements with two subcategories (physical working conditions and equipment and facilities). The third category involved psychosocial safety in the workplace with four subcategories (creating a safe work environment, overcoming the challenges of providing care to cancer patients, work/life balance and social recognition of the nursing status). The fourth category holds an organisational context with four subcategories (organisational support, interpersonal relations, justice at work and human resources). Conclusion: It is necessary to find measures attenuating work‐related stresses in oncology nurses. These measures should be in line with developing personal abilities in nurses and creating a safe environment in terms of optimising physical, psychosocial and organisational conditions. It is also important to develop programmes protecting the oncology nurses' occupational health. Relevance to clinical practice: The results of this study can help improve nursing work conditions, attenuate work‐related stresses in nurses and introduce efficient interventions reducing occupational stressors. [ABSTRACT FROM AUTHOR]