慢性疼痛の薬物療法改善と生活の質の向上：パイロット無作為化比較試験

Chronic pain is a complex condition that benefits from a multidisciplinary approach. This pilot parallel-group single-blinded randomized controlled study evaluated the feasibility, acceptability and adherence by patients and physicians of pharmacist-led medication review on chronic pain patients. Trends in pain intensity, quality of life and patient satisfaction were examined. Twenty adults were recruited from two primary care units in Porto, Portugal, and randomly assigned to either the medication review (MR) group, (n = 10) using the Dader method, or the usual care (UC) group, (n = 10) and given general advice, for 16-weeks. Pain intensity decreased by 2.07 (MR group) and increased by 0.52 (UC group), yielding an adjusted mean difference of 2.77 (95% CI, -4.93 to -0.62; p = 0.008). Pain relief was reported by 62.5% in the MR group versus 37.5% in UC (p = 0.357). The MR group showed significant improvement in physical functioning (p = 0.019) and higher treatment satisfaction (p = 0.029). The acceptance rate of MR interventions was 71%, which resolved 63% of negative medication outcomes. Acceptability was high (> 90% of planned interviews). Conducting pharmacist-led MR for chronic pain management in primary care is feasible and well accepted by patients and physicians. Observed trends toward improved pain and QoL warrant confirmation in a larger trial. This pilot trial was registered in clinicaltrials.gov (NCT06997861).