临床药剂师对癌症患者疼痛管理的干预 (PharmaCAP):一个多中心可行性试点随机对照试验
Sunil Shrestha1, Simit Sapkota2,3, Siew Li Teoh4
1School of Pharmacy, Monash University Malaysia, Bandar Sunway, 47500, Subang Jaya, Selangor, Malaysia. Sunil.shrestha@monash.edu.
概括
将临床药剂师整合到癌症疼痛管理团队中,在资源较少的环境中是可行的. 这种方法改善了生活质量,减少了焦虑和抑郁,并提高了癌症患者的药物坚持.
科学领域:
- 在瘤学瘤学.
- 药理学 药理学是指药理学的学科.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 癌症疼痛管理是一个全球性的挑战,特别是在低收入和中等收入国家,因为资源有限.
- 临床药剂师在改善这些环境中的癌症疼痛管理结果方面的作用尚未得到充分研究.
研究的目的:
- 评估将临床药剂师纳入癌症疼痛管理多学科团队的可行性和可接受性.
- 评估接受药剂师领导的疼痛管理的癌症患者的初步结果.
- 为未来最终随机对照试验 (RCT) 的设计提供信息.
主要方法:
- 在尼泊尔进行了一项试点随机对照试验 (PharmaCAP),将通常的护理与临床药剂师主导的干预进行了比较.
- 干预包括药物审查,与药物相关问题的识别,以及针对疼痛管理优化的个性化建议.
- 可行性指标 (招聘,留住,满意度) 和次要结果 (疼痛强度,生活质量,焦虑,抑郁,坚持) 在4周后被评估.
主要成果:
- 该研究成功招募了91名患者,具有高保留率 (91.3%的UC,93.4%的PharmaCAP) 和100%的随机分配可接受性.
- 在PharmaCAP的干预显著改善了生活质量,身体功能,并减少了财务困难 (P < 0.001).
- 在减少焦虑和抑郁症 (P < 0.001) 和增强药物坚持 (P < 0.001) 中观察到显著的益处. 在不同组之间,疼痛强度的减少在统计学上没有显著意义.
结论:
- 将临床药剂师整合到多学科团队中,在癌症疼痛管理的低资源环境中是可行的和有益的.
- 该干预措施有望改善患者的生活质量,心理健康和药物坚持.
- 结果支持大规模RCT的可行性,并突出了临床药剂师在资源有限的瘤护理中的价值.
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