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药剂师参与多学科团队的口腔黏膜炎教育计划:对头颈部癌症患者的影响。

Pharmacist involved education program in a multidisciplinary team for oral mucositis: Its impact in head-and-neck cancer patients.

机构信息

Division of Oral and Maxillofacial Surgery, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.

Division of Hospital Pharmacy, Niigata University Medical and Dental Hospital, Niigata, Japan.

出版信息

PLoS One. 2021 Nov 22;16(11):e0260026. doi: 10.1371/journal.pone.0260026. eCollection 2021.

Abstract

OBJECTIVES

This retrospective study examined how a pharmacist-involved education program in a multidisciplinary team (PEMT) for oral mucositis (OM) affected head-and-neck cancer (HNC) patients receiving concurrent chemoradiotherapy (CCRT).

MATERIALS AND METHODS

Total samples data of 53 patients during the stipulated timeframe were retrospectively collected from electronic medical records from February 2017 to January 2019. We compared the presence/absence of OM (OM: yes/no) between patients with and without PEMT (PEMT: yes/no) as the primary endpoint and OM severity as the secondary endpoint. The following information was surveyed: age, gender, weight loss, steroid or immunosuppressant use, hematological values (albumin, white blood cell count, blood platelets, and neutrophils), cancer grade, primary cancer site, type and use of mouthwash and moisturizer, opioid use (yes/no, days until the start of opioid use, and dose, switch to tape), and length of hospital day (LOD). The two groups were compared using Fisher's exact test for qualitative data and the Mann-Whitney U test for quantitative data, and a significance level of p<0.05 was set.

RESULTS

The group managed by PEMT had significantly lower weight loss and a significantly lower incidence of local anesthetic and opioid use and switch to tape compared with the group not managed by PEMT (p<0.05). The two groups showed no significant difference in OM (yes/no) or OM severity. The PEMT group had significantly shorter LOD at 57 (53-64) days compared with the non-PEMT group at 63.5 (57-68) days (p<0.05).

CONCLUSIONS

Our results showed that PEMT did not improve OM (yes/no) or OM severity in HNC patients undergoing CCRT. However, the PEMT group had a lower incidence of grades 3 and 4 OM than the non-PEMT group, although not significantly. In addition, PEMT contributed to oral pain relief and the lowering of the risk for OM by reduction in weight loss.

摘要

目的

本回顾性研究探讨了多学科团队(PEMT)中涉及药剂师的口腔黏膜炎(OM)教育计划如何影响接受同期放化疗(CCRT)的头颈部癌症(HNC)患者。

材料与方法

我们从 2017 年 2 月至 2019 年 1 月的电子病历中回顾性地收集了规定时间内的 53 例患者的总样本数据。我们将是否存在 OM(OM:是/否)作为主要终点,将 OM 严重程度作为次要终点,将接受和不接受 PEMT(PEMT:是/否)的患者进行比较。调查的信息包括:年龄、性别、体重减轻、使用类固醇或免疫抑制剂、血液学值(白蛋白、白细胞计数、血小板和中性粒细胞)、癌症分级、原发癌部位、漱口水和保湿剂的类型和使用、阿片类药物的使用(是/否、开始使用阿片类药物的天数和剂量、改用胶带)和住院天数(LOD)。使用 Fisher 确切检验对定性数据进行比较,使用 Mann-Whitney U 检验对定量数据进行比较,设定显著性水平 p<0.05。

结果

与未接受 PEMT 管理的患者相比,接受 PEMT 管理的患者体重减轻明显减少,局部麻醉和阿片类药物的使用以及改用胶带的发生率明显降低(p<0.05)。两组在 OM(是/否)或 OM 严重程度方面无显著差异。PEMT 组的 LOD 明显短于非 PEMT 组,分别为 57(53-64)天和 63.5(57-68)天(p<0.05)。

结论

我们的结果表明,PEMT 并未改善接受 CCRT 的 HNC 患者的 OM(是/否)或 OM 严重程度。然而,PEMT 组 3 级和 4 级 OM 的发生率低于非 PEMT 组,尽管差异无统计学意义。此外,PEMT 通过减轻体重减轻有助于缓解口腔疼痛和降低 OM 风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ef8e/8608342/20810d36ad49/pone.0260026.g001.jpg

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