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作者

Haiying Ding, Yu Song, Nan Wu, Xiaowei Zheng, Qing Wei, Yancai Sun, Ruixiang Xie, Qing Zhai, Silu Xu, Yajun Qi, Yinghong Wang, Hui Li, Lin Yang, Qing Fan, Qiuling Zhao, Juan Chen, Jing Shi, Cunxian Duan, Qiong Du, Yiwen Zhang, Zhengbo Song, Shuang Fu, Yunfang Cai, Xianhong Huang, Luo Fang, Yuguo Liu, Ping Huang

作者单位

Affiliations ¹ Department of Pharmacy, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China. ² Department of Pharmacy, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China. ³ Center for Clinical Pharmacy, Cancer Center, Department of Pharmacy, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, China. ⁴ Department of Pharmacy, Anhui Provincial Cancer Hospital, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China. ⁵ Department of Pharmacy, Fujian Cancer Hospital, Fujian Medical University Cancer Hospital, Fuzhou, China. ⁶ Department of Pharmacy, Fudan University Shanghai Cancer Center, Shanghai, China. ⁷ Department of Pharmacy, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China. ⁸ Department of Clinical Trial, Cancer Hospital of University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, China. ⁹ Department of Anesthesiology, Cancer Hospital of University of Chinese Academy of Sciences, Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, China. ¹⁰ Department of Health Policy and Management, School of Public Health, Hangzhou Normal University, Hangzhou, China.

刊名

Annals of translational medicine

年份

2022

卷号

Vol.10 No.18

页码

989

ISSN

2305-5839

关键词

Cancer pain opioids outpatients pharmaceutical service pharmacists.

摘要

Background: Managing cancer pain is a growing challenge. Individualized pharmaceutical care is particularly important for opioid-tolerant outpatients due to variation in terms of their knowledge about pain, treatment adherence, and risk of experiencing inadequate analgesia and severe adverse events. This study aimed to determine the influence of individualized pharmaceutical care on outcomes in opioid-tolerant outpatients with cancer pain. Methods: A multicenter, open-label, randomized, controll...更多

Background: Managing cancer pain is a growing challenge. Individualized pharmaceutical care is particularly important for opioid-tolerant outpatients due to variation in terms of their knowledge about pain, treatment adherence, and risk of experiencing inadequate analgesia and severe adverse events. This study aimed to determine the influence of individualized pharmaceutical care on outcomes in opioid-tolerant outpatients with cancer pain. Methods: A multicenter, open-label, randomized, controlled study was carried out. Opioid-tolerant outpatients experiencing chronic cancer pain and receiving sustained-release opioids were randomly assigned to the intervention group and the control group with a 1:1 ratio. The intervention group received individualized pharmaceutical care, while the control group received conventional care during 4-week period. The primary endpoint was medication adherence on the intention-to-treat population. Secondary outcomes included the patients' knowledge of cancer pain and pain medications, pain score, frequency of breakthrough pain, quality of life which were assessed on the ITT population. Adverse events were evaluated according to the National Cancer Institute Common Terminology Criteria for Adverse Event version 4.0 on the per-protocol population. Results: A total of 118 patients were enrolled, and 102 patients completed the 30-day follow-up from six oncology centers in China. The proportion of patients adhering to opioid medication increased to similar levels in the two groups during the 4 weeks . The intervention group had a significantly lower pain score at 4 weeks compared to the control group , and the proportion of participants without breakthrough pain was significantly higher at 4 weeks than at baseline in the intervention group , but not in the control group . The two groups did not differ significantly in terms of QoL or adverse events. Conclusions: Our results suggest that individualized pharmaceutical care can markedly reduce patient-related problems and significantly improve pain control in opioid-tolerant outpatients. These findings validate the recommendations to include clinical pharmacists in the management of cancer pain. Trial registration: ClinicalTrials.gov identifier: NCT03439904.收起

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