Franco Julia, de Souza Rafael N, Lima Tácio de M, Moriel Patricia, Visacri Marília B
School of Medical Sciences, University of Campinas, Campinas, SP, Brazil.
Department of Pharmaceutical Sciences, 67825Federal Rural University of Rio de Janeiro, Seropédica, RJ, Brazil.
J Oncol Pharm Pract. 2022 Apr;28(3):664-685. doi: 10.1177/10781552211073470. Epub 2022 Jan 12.
We conducted this scoping review to map and summarize scientific evidence on the role of clinical pharmacists in the palliative care of adults and elderly patients with cancer.
A literature search was performed in MEDLINE, PubMed Central, Embase, Web of Science, Scopus, and BVS/BIREME for studies published until November 22nd, 2020. Studies that reported work experiences adopted by clinical pharmacists in the palliative care of adults and elderly patients with cancer were included. Two independent authors performed study selection and data extraction. Any disagreements were resolved by discussion with the third and fourth authors. The pharmacist interventions identified in the included studies were described based on key domains in the DEPICT v.2.
A total of 586 records were identified, of which 14 studies fully met the eligibility criteria. Most of them were conducted in the United States of America (n = 5) and Canada (n = 5) and described the workplace of the pharmacist in clinic/ambulatory (n = 10). Clinical pharmacists performed several activities and provided services, highlighting medication review (n = 12), patient and caregivers education (n = 12), medication histories and-or medication reconciliation (n = 6). The pharmacist interventions were mostly conducted for patients/caregivers (n = 13), by one-on-one contact (n = 14), and by face-to-face (n = 13). Pharmacists were responsible mainly for change or suggestion for change in therapy (n = 12) and patient counselling (n = 12). Pharmacist interventions were well accepted by the clinical team. Overall, studies showed that pharmacists, within an interdisciplinary team, had significant impacts on measured outcomes.
In recent years, there have been advances in the role of the pharmacist in palliative care of patients with cancer and there are great opportunities in this field. They play an important role in managing cancer pain and other symptoms, as well as resolving drug related problems. We encourage more research to be carried out to strengthen this field and to benefit patients with advanced cancer with higher quality of life.
我们开展了这项范围综述,以梳理和总结关于临床药师在成年及老年癌症患者姑息治疗中作用的科学证据。
在MEDLINE、PubMed Central、Embase、Web of Science、Scopus和BVS/BIREME中进行文献检索,纳入截至2020年11月22日发表的研究。纳入报告临床药师在成年及老年癌症患者姑息治疗中工作经验的研究。两名独立作者进行研究筛选和数据提取。如有分歧,通过与第三和第四作者讨论解决。根据DEPICT v.2中的关键领域描述纳入研究中确定的药师干预措施。
共识别出586条记录,其中14项研究完全符合纳入标准。大多数研究在美国(n = 5)和加拿大(n = 5)进行,并描述了药师在诊所/门诊的工作场所(n = 10)。临床药师开展了多项活动并提供服务,突出的有药物审查(n = 12)、患者及护理人员教育(n = 12)、用药史和/或用药核对(n = 6)。药师干预大多针对患者/护理人员(n = 13),通过一对一接触(n = 14)和面对面方式(n = 13)进行。药师主要负责治疗方案的变更或变更建议(n = 12)以及患者咨询(n = 12)。药师干预得到临床团队的良好接受。总体而言,研究表明药师在跨学科团队中对所测量的结果有显著影响。
近年来,药师在癌症患者姑息治疗中的作用有了进展,该领域有很大机会。他们在管理癌症疼痛和其他症状以及解决药物相关问题方面发挥着重要作用。我们鼓励开展更多研究以加强该领域,使晚期癌症患者受益,提高生活质量。