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Pharmacist interventions in optimising opioid medication therapy in pain management for palliative care patients: A
Rajeev Shrestha1, Sunil Shrestha2, Ayesha Iqbal3
1INF Nepal Green Pastures Hospital and Rehabilitation Centre, Pokhara, Nepal.
Abstract:
BackgroundOpioid therapy is a critical component in managing pain in palliative care, where pharmacists' specialised expertise is crucial in ensuring quality care for patients. This systematic review aims to document available evidence on pharmacist interventions and their impact on optimising opioid therapy for pain management in palliative care patients.MethodsWe searched Medline (OVID), Embase (OVID), APA PsycINFO and Cochrane Central Register of Controlled Trials (CENTRAL) for relevant articles published from the beginning to 31st December, 2022. All original studies documenting pharmacists' intervention and impact in optimising patients receiving opioid therapy for their pain management in palliative care settings were included in this review.ResultsThe database and reference search yielded to a total of 7154 studies. Out of these, only 3 studies met the eligibility criteria and were included in this study. These studies were conducted in Korea, Canada and United States. Pharmacists were involved in assessing pain, suggesting medication for pain and other symptom management, providing patient education, counselling and recommendation, assessing patient's medication effects such as adverse effects, drug interaction and duplication, and adjusting medication. Similarly, their involvement showed improvements in pain management, opioid usage and management strategies.ConclusionThis systematic review highlights the important role of pharmacists in optimising opioid medication therapy for pain management in palliative care patients. Their contributions to palliative patient care improve pain outcomes and overall quality of life. Integrating pharmacists into palliative care teams can enhance pain management practices and provide better care for palliative patients. Further studies accompanying the robust methodologies and broader settings will validate the findings of this review.
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