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药剂师对癌症疼痛管理的教育干预措施:一项系统评价和荟萃分析。

Pharmacist educational interventions for cancer pain management: a systematic review and meta-analysis.

作者信息

Edwards Zoe, Ziegler Lucy, Craigs Cheryl, Blenkinsopp Alison, Bennett Michael I

机构信息

University of Bradford, Bradford, UK.

University of Leeds, Leeds, UK.

出版信息

Int J Pharm Pract. 2019 Aug;27(4):336-345. doi: 10.1111/ijpp.12516. Epub 2019 Feb 1.

Abstract

OBJECTIVES

Educational interventions by pharmacists for patients with cancer pain aim to improve pain management, but little is known about the different components of interventions and their effectiveness. Our aim was to assess the benefit of pharmacist delivered educational interventions for patients with cancer pain. A systematic review and meta-analysis of experimental trials testing pharmacist delivered educational interventions for cancer pain was carried out to identify the components of interventions and effectiveness at improving pain-related outcomes for patients with cancer. A literature review was conducted in EMBASE, MEDLINE, CINAHL, PsycINFO, ASSIA, Web of Science and CENTRAL from inception until January 2018 searching for educational interventions involving a pharmacist for patients with cancer pain. Four studies were included involving 944 patients. Meta-analysis was carried out where possible.

KEY FINDINGS

Meta-analysis of three of the four studies found that mean pain intensity in the intervention group was reduced by 0.76 on a 0-10 scale (95% confidence interval), although only two of the studies used validated measures of pain. Improvements in knowledge, side effects and patient satisfaction were seen although with less reliable measures.

SUMMARY

Pharmacist educational interventions for patients with cancer pain have been found to show promise in reducing pain intensity. Studies were few and of varying quality. Further, good quality studies should be carried out in this area and these should be comprehensively reported. Trials measuring patient self-efficacy and patient satisfaction are needed before the impact of the pharmacist delivered interventions on these outcomes can be established.

摘要

目的

药剂师针对癌症疼痛患者开展的教育干预旨在改善疼痛管理,但对于干预的不同组成部分及其有效性了解甚少。我们的目的是评估药剂师提供的教育干预对癌症疼痛患者的益处。我们对测试药剂师提供的癌症疼痛教育干预的实验性试验进行了系统评价和荟萃分析,以确定干预的组成部分以及改善癌症患者疼痛相关结局的有效性。从创刊至2018年1月,我们在EMBASE、MEDLINE、CINAHL、PsycINFO、ASSIA、科学引文索引和考克兰系统评价数据库中进行了文献检索,以寻找涉及药剂师对癌症疼痛患者的教育干预。纳入了四项研究,涉及944名患者。在可能的情况下进行了荟萃分析。

主要发现

四项研究中的三项进行荟萃分析发现,干预组的平均疼痛强度在0至10分的量表上降低了0.76(95%置信区间),不过只有两项研究使用了经过验证的疼痛测量方法。虽然测量方法可靠性较低,但在知识、副作用和患者满意度方面有改善。

总结

已发现药剂师对癌症疼痛患者的教育干预在降低疼痛强度方面显示出前景。研究数量少且质量参差不齐。此外,该领域应开展高质量研究,并应全面报告。在确定药剂师提供的干预对这些结局的影响之前,需要进行测量患者自我效能和患者满意度的试验。

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