{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T01:03:53Z","timestamp":1792112633933,"version":"4.4.0"},"reference-count":25,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Oncol Pharm Pract"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Oral anticancer therapy shifts substantial responsibility for medication administration, interaction management, toxicity recognition, and adherence to patients and outpatient teams. We aimed to quantify early clinically significant medication-related harm and develop an internally validated model to estimate individual 90-day risk at treatment initiation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A multicenter prospective inception cohort enrolled 610 adults initiating a new oral anticancer therapy across four tertiary oncology centres during 2024\u20132025. The primary outcome was first clinically significant medication-related harm within 90 days. Thirteen prespecified predictor parameters were entered into a Cox proportional-hazards model. Internal validation used 1000 bootstrap resamples with uniform coefficient shrinkage and baseline-survival recalibration. Discrimination, calibration, Brier score, internal-external centre validation, and decision-curve analysis were evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During 45,048 person-days, 137 participants experienced harm. The Kaplan-Meier estimated 90-day risk was 22.9% (95% CI 19.7\u201326.5), and median time to first harm was 25 days (IQR 14\u201339); 60.6% of events occurred by day 30. Higher ECOG performance status, Charlson Comorbidity Index, organ-dysfunction severity, baseline clinically significant drug-drug interactions and medication-regimen complexity were associated with greater hazard, whereas higher health literacy was protective. The optimism-corrected C-index was 0.701, 90-day AUC 0.735 and Brier score 0.157. The shrinkage factor was 0.867. At the illustrative 20% risk threshold, sensitivity was 78.8%, specificity 60.8% and negative predictive value 90.6%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Clinically significant medication-related harm was common and concentrated early after initiation of oral anticancer therapy. A model based on routinely available baseline clinical and medication factors provided moderate discrimination and useful risk stratification after internal validation. Independent external validation is required before clinical implementation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10781552261485454","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T14:52:32Z","timestamp":1789656752000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Development and internal validation of a clinical prediction model for 90-day clinically significant medication-related harm in adults initiating oral anticancer therapy: A multicenter prospective cohort study"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7329-6680","authenticated-orcid":false,"given":"Vivek","family":"Jayan","sequence":"first","affiliation":[{"name":"Saveetha Medical College and Hospitals, SIMATS"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1648-6867","authenticated-orcid":false,"given":"Sankiya","family":"M","sequence":"additional","affiliation":[{"name":"Kanyakumari Medical Mission Research Centre"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-1794-4704","authenticated-orcid":false,"given":"Sudhakar","family":"S","sequence":"additional","affiliation":[{"name":"Sri Devaraj Urs Medical College and Hospitals"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hana","family":"Zaiba Z","sequence":"additional","affiliation":[{"name":"Sri Devaraj Urs Medical College"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aiswarya","family":"Lily Ray","sequence":"additional","affiliation":[{"name":"Sri Devaraj Urs Medical College and Research Centre"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8829-4028","authenticated-orcid":false,"given":"Rakesh","family":"M","sequence":"additional","affiliation":[{"name":"Mount Zion Medical College"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,17]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1200\/OP.24.00216"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1080\/14740338.2019.1641197"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.20.03088"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/cpt.2338"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1200\/JOP.2017.020859"},{"key":"e_1_3_3_7_2","article-title":"Drug interactions with oral antineoplastic drugs: the role of the pharmacist","volume":"28","author":"Riu-Viladoms G","year":"2019","unstructured":"Riu-Viladoms G, Carcelero San Martin E, Martin-Conde MT, et al. Drug interactions with oral antineoplastic drugs: the role of the pharmacist. 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