School of Pharmacy, Faculty of Life Sciences, University of Bradford, Richmond Building, Richmond Road, Bradford, West Yorkshire, BD7 1DP, UK.
University of Leeds, Leeds, UK.
Int J Clin Pharm. 2019 Jun;41(3):700-710. doi: 10.1007/s11096-019-00820-8. Epub 2019 Apr 9.
Background Patients with advanced cancer commonly experience pain and it is least controlled in community settings. Community pharmacists in the UK already offer medicines optimisation consultations although not for this patient group. Objective To determine whether medicines consultations for patients with advanced cancer pain are feasible and acceptable. Setting Community-dwelling patients with advanced cancer pain were recruited from primary, secondary and tertiary care using purposive sampling in one UK city. Methods One face-to-face or two telephone delivered medicines optimisation consultations by pharmacists were tested. These were based on services currently delivered in UK community pharmacies. Feedback was obtained from patients and healthcare professionals involved to assess feasibility and acceptability. Main outcome measure Recruitment, acceptability and drug related problems. Results Twenty-three patients, (range 33-88 years) were recruited, 19 completed consultation(s) of whom 17 were receiving palliative care services. Five received face-to-face consultations and 14 by telephone during which 47 drug related problems were identified from 33 consultations (mean 2.5). Advice was provided for 34 drug related problems in 17 patients and referral to other healthcare professionals for 13 in 8 patients, 2 patients had none. Eleven patients returned questionnaires of which 8 (73%) would recommend the consultations to others. Conclusion The consultations were feasible as patients were recruited, retained, consultations delivered, and data collected. Patients found the 20-30 min intervention acceptable, found a self-perceived increase in medicines knowledge and most would recommend it to others. Community pharmacists were willing to carry out these services however they had confidence issues in accessing working knowledge. Most drug related problems were resolved by the pharmacists and even among patients receiving palliative care services there were still issues concerning analgesic management. Pharmacist-conducted medicines consultations demonstrate potential which now needs to be evaluated within a larger study in the future.
晚期癌症患者常伴有疼痛，且在社区环境中疼痛控制效果最差。英国社区药剂师已经提供药物优化咨询服务，但尚未针对这一患者群体。
确定为晚期癌症疼痛患者提供药物咨询是否可行且可接受。
在英国的一个城市，通过有目的的抽样方法，从初级、二级和三级护理中招募了患有晚期癌症疼痛的社区居民。
通过药剂师进行一次面对面或两次电话传递的药物优化咨询。这些咨询是基于英国社区药房目前提供的服务。从参与的患者和医疗保健专业人员那里获得反馈，以评估可行性和可接受性。
招募、可接受性和与药物相关的问题。
共招募了 23 名患者（年龄 33-88 岁），其中 19 名完成了咨询，17 名正在接受姑息治疗服务。5 名患者接受了面对面咨询，14 名患者通过电话咨询，在 33 次咨询中发现了 47 个与药物相关的问题（平均 2.5 个）。在 17 名患者中为 34 个与药物相关的问题提供了建议，并向 8 名患者中的 13 名其他医疗保健专业人员转介，2 名患者没有。11 名患者返回了调查问卷，其中 8 名（73%）会向他人推荐这些咨询。
由于患者被招募、保留、咨询交付和数据收集，因此咨询是可行的。患者认为 20-30 分钟的干预是可以接受的，他们认为自己的药物知识有所增加，大多数人会向他人推荐。社区药剂师愿意开展这些服务，但他们对获取工作知识缺乏信心。药剂师解决了大多数与药物相关的问题，即使在接受姑息治疗服务的患者中，仍然存在与镇痛管理相关的问题。药师进行的药物咨询显示出潜力，这需要在未来的更大规模研究中进行评估。
