The Ohio State University Division of General Internal Medicine, Columbus, OH.
The Ohio State University College of Pharmacy, Columbus, OH.
Am J Health Syst Pharm. 2019 May 17;76(Supplement_2):S49-S54. doi: 10.1093/ajhp/zxy084.
The primary objective of this project was to evaluate an existing interprofessional, nonmalignant pain service by measuring the difference in patient pain scores (numeric rating scale-11) before and after a pharmacist-led pain education class and medication therapy management (MTM) visit. Secondary objectives included determining the percentage of pharmacist recommendations approved, patient satisfaction, and difference in immediate release (IR) and extended release (ER) opioid use before and after enrollment.
Baseline data were obtained from a retrospective chart review. Enrolled patients attended an educational pain class with the pharmacist. At the MTM visit with the pharmacist 3-14 days after the initial education class, the patient's pain score was assessed along with his/her medication use, and a care plan was developed and forwarded to the referring provider for implementation. Three months after the pain class and participation in the MTM visit, patients were contacted via telephone to complete a survey. The survey questions assessed patient satisfaction with the pain education program, their current pain score, and their knowledge of information covered during the pain class.
Patients reported an average preenrollment pain score of 8.3/10 (n = 39) and a post-survey pain score of 5.6/10 (n = 39). The IR opioid use averaged 19.7 morphine equivalent daily dose (MEDD) at enrollment and decreased by 40% to 11.8 MEDD. The provider approval rate of the pharmacist-recommended interventions ranged from 80% to 92%, depending on the predesignated disease state category.
An interprofessional, nonmalignant-pain service including a pharmacist-led class resulted in a decrease in average pain scores and MEDD in an underserved population.
本项目的主要目的是通过测量药剂师主导的疼痛教育课程和药物治疗管理(MTM)就诊前后患者疼痛评分(数字评定量表-11)的差异,评估现有的跨专业非恶性疼痛服务。次要目标包括确定药剂师建议被批准的百分比、患者满意度以及登记前后即释(IR)和缓释(ER)阿片类药物使用量的差异。
基线数据来自回顾性病历审查。登记的患者参加了药剂师主导的教育疼痛课程。在初始教育课程后 3-14 天的 MTM 就诊时,评估患者的疼痛评分及其药物使用情况,并制定护理计划并转发给转诊提供者实施。在疼痛课程和 MTM 就诊后 3 个月,通过电话联系患者完成调查。调查问题评估了患者对疼痛教育计划的满意度、他们目前的疼痛评分以及他们对疼痛课程中涵盖信息的了解。
患者报告平均入组前疼痛评分为 8.3/10(n=39),调查后疼痛评分为 5.6/10(n=39)。IR 阿片类药物的平均每日剂量(MEDD)为 19.7 吗啡当量,下降了 40%,至 11.8 MEDD。药剂师建议干预措施的提供者批准率因预定疾病状态类别而异,范围为 80%至 92%。
包括药剂师主导课程在内的跨专业非恶性疼痛服务可降低服务不足人群的平均疼痛评分和 MEDD。