Kawaguchi Fumitaka, Watanabe Jun, Tsuneki Takafumi, Kikkawa Akihiko
Dept. of Pharmacy, Yokosuka Kyosai Hospital.
Gan To Kagaku Ryoho. 2018 Mar;45(3):443-447.
It was reported that focusing on palliative care for patients with cancer improved their anxiety and depression and prolonged their survival. Similarly, the pharmacist intervention for cancer patients suggested the improvement in anxiety and depression; but, such improvement has not yet been demonstrated by focusing on pharmacist attitudes and behaviors of which the patients were the primary beneficiaries. Therefore, we evaluated the significance of pharmacist intervention focusing on improvement of adverse events and cancer pain. We randomized patients to pharmacist intervention group or no intervention group and evaluated whether the pharmacist intervention improved patients' anxiety and depression. Patients receiving new chemotherapy in the outpatient chemotherapy room were invited to enroll in this study between July 2015 and February 2017. The patients were assessed for their quality of life using the Structured Clinical Interview for ACD and for anxiety and depression using the Structured Clinical Interview for HAD at baseline and again at the 4th chemotherapy. The difference between the baseline and 4th chemotherapy scores was calculated and compared between the pharmacist intervention and no intervention groups. HAD depression subscale and HAD scale scores decreased in the pharmacist intervention group compared to the no intervention group,(-1 versus 0.5, p=0.024)and(-3 versus 0.5, p=0.011)respectively. We demonstrated that the pharmacist intervention focused on improvement of adverse event and cancer pain decreased cancer patients' anxiety and depression.
据报道，关注癌症患者的姑息治疗可改善其焦虑和抑郁状况，并延长生存期。同样，对癌症患者的药剂师干预也显示出焦虑和抑郁有所改善；但是，以患者为主要受益对象，关注药剂师态度和行为所带来的这种改善尚未得到证实。因此，我们评估了以改善不良事件和癌症疼痛为重点的药剂师干预的意义。我们将患者随机分为药剂师干预组或无干预组，并评估药剂师干预是否能改善患者的焦虑和抑郁。2015年7月至2017年2月期间，邀请在门诊化疗室接受新化疗的患者参与本研究。在基线时以及第4次化疗时，使用针对ACD的结构化临床访谈评估患者的生活质量，使用针对HAD的结构化临床访谈评估患者的焦虑和抑郁情况。计算并比较药剂师干预组和无干预组在基线和第4次化疗评分之间的差异。与无干预组相比，药剂师干预组的HAD抑郁分量表和HAD量表评分分别下降，（-1对0.5，p=0.024）和（-3对0.5，p=0.011）。我们证明，以改善不良事件和癌症疼痛为重点的药剂师干预可减轻癌症患者的焦虑和抑郁。
