mHealth Research Digest by Tim Bredrup

Cancer patients who combine complementary and alternative medicines (CAMs) with conventional chemotherapy treatments are at risk of developing anticancer drug-CAM interactions (DCIs), which can lead to negative therapeutic outcomes.

In efforts to help manage this circumstance, pharmacists in the UK and Singapore teamed up to develop an iPhone application, called OncoRX-MI, which identifies DCIs of single-agent and multiple-agent chemotherapy regimen (CReg) prescriptions.

Data for the app was compiled from various hard copy and soft copy sources, as well as published literature from PubMed. The overall management plans for the CRegs were then created. The developers used Adobe software and programming scripts to create the iPhone Web documents and mounted them onto a third-party server.

OncoRx-MI is customized for the iPhone screen layout to create a friendly end-user experience. A small usability study was also carried out and the user feedback presented. According to the study results, “OncoRx-MI is able to detect over 2700 interactions between 256 CRegs and 166 CAMs, making up a total of over 4400 DCI pairs”.

The researchers found that:

“the majority of the DCIs are pharmacokinetic in nature (79%), involving the induction and inhibition of the cytochrome P450 isozymes and p-glycoprotein. Pharmacodynamic DCIs include hepatotoxicity (39%), altered corticosteroid efficacies (30%), and increased risks of hypoglycemia (4%), hypertensive crisis (2%), bleeding, and serotonin syndrome (1% each).”

“OncoRx-MI is the first mobile application of its kind that allows searching of DCIs for CRegs through 3G networks,” the researchers concluded. The app is intended “to improve pharmaceutical care of patients with cancer by assisting health care practitioners in managing CReg interactions in their clinical practices.”

The lead author, Kevin Yap, PhD, ARPharmS shared the following details via correspondence with iMedicalApps:

“1) This research is a collaboration between the Institute of Digital Healthcare, WMG, University of Warwick, UK and the Department of Pharmacy, National University of Singapore, Singapore.

2) This is the first mobile app of its kind (as far as we know) that is catered towards combination chemotherapy regimen interactions, and can be searched by the regimen acronyms (instead of adding individual anticancer drugs in a prescription). This prevents drug-related problems in the clinical setting such as errors of omission during an interaction search.

3) This is a new database and it currently caters towards detecting interactions with certain classes of complementary and alternative medicines (e.g. traditional Chinese medicines in the 8 categories mentioned in the journal article), as well as pharmacological categories of drugs (e.g. psychotropics). However, more interaction modules are intended, and this database will continually be updated with the interactions of more drugs and herbs in time to come”

Authors: Yap KY, See CS, Kuo EY, Chui WK, Chan A.

Institutions: Institute of Digital Healthcare, WMG, University of Warwick, International Digital Laboratory, Coventry, UK; Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore; Department of Pharmacy, National Cancer Centre Singapore, Singapore.


Original Abstract: PubMed