1 Faculty of Health Sciences, University of Southampton, Southampton, UK.
2 School of Healthcare Sciences, Cardiff University, Cardiff, UK.
Palliat Med. 2018 Jan;32(1):246-256. doi: 10.1177/0269216317715197. Epub 2017 Jul 5.
Carers of people with advanced cancer play a significant role in managing pain medication, yet they report insufficient information and support to do so confidently and competently. There is limited research evidence on the best ways for clinicians to help carers with medication management.
To develop a pain medicines management intervention (Cancer Carers Medicines Management) for cancer patients' carers near the end of life and evaluate feasibility and acceptability to nurses and carers. To test the feasibility of trial research procedures and to inform decisions concerning a full-scale randomised controlled trial.
Phase I-II clinical trial. A systematic, evidence-informed participatory method was used to develop CCMM: a nurse-delivered structured conversational process. A two-arm, cluster randomised controlled feasibility trial of Cancer Carers Medicines Management was conducted, with an embedded qualitative study to evaluate participants' experiences of Cancer Carers Medicines Management and trial procedures.
Community settings in two study sites.
Phase I comprises 57 carers, patients and healthcare professionals and Phase II comprises 12 nurses and 15 carers.
A novel intervention was developed. Nurses were recruited and randomised. Carer recruitment to the trial was problematic with fewer than predicted eligible participants, and nurses judged a high proportion unsuitable to recruit into the study. Attrition rates following recruitment were typical for the study population. Cancer Carers Medicines Management was acceptable to carers and nurses who took part, and some benefits were identified.
Cancer Carers Medicines Management is a robustly developed medicines management intervention which merits further research to test its effectiveness to improve carers' management of pain medicines with patients at the end of life. The study highlighted aspects of trial design that need to be considered in future research.
在管理癌症晚期患者的止痛药物方面，护理人员发挥着重要作用，但他们报告称，在这方面，他们获得的信息和支持不足，无法自信且熟练地完成工作。虽然有一些关于临床医生帮助护理人员管理药物的最佳方法的有限研究证据，但还需要进一步研究。
为接近生命终点的癌症患者的护理人员开发一种止痛药物管理干预措施（癌症护理人员药物管理），并评估该措施对护士和护理人员的可行性和可接受性。旨在检验试验研究程序的可行性，并为一项全面的随机对照试验提供决策依据。
这是一项 I 期- II 期临床试验。采用系统的、循证的参与式方法来开发 CCMM：一种由护士提供的结构化对话过程。进行了一项有两个组、组间随机对照的可行性试验，其中嵌入了一项定性研究，以评估参与者对癌症护理人员药物管理和试验程序的体验。
两个研究地点的社区环境。
I 期包括 57 名护理人员、患者和医疗保健专业人员，II 期包括 12 名护士和 15 名护理人员。
开发了一种新的干预措施。招募了护士并对其进行了随机分组。但对护理人员的招募遇到了问题，符合条件的参与者少于预期，而且护士认为有相当一部分人不适合参与研究。招募后的流失率与研究人群的典型流失率一致。参与试验的护理人员和护士认为癌症护理人员药物管理是可以接受的，并且发现了一些益处。
癌症护理人员药物管理是一种经过充分开发的药物管理干预措施，值得进一步研究，以检验其在改善护理人员在患者生命末期管理疼痛药物方面的有效性。该研究强调了未来研究中需要考虑的试验设计方面。
