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由社区药剂师主导的即时护理结直肠癌筛查项目:高危患者结直肠癌的早期检测

Community pharmacist-led point-of-care colorectal cancer screening program: Early detection of colorectal cancer in high-risk patients.

作者信息

Jairoun Ammar Abdulrahman, Al-Hemyari Sabaa Saleh, Shahwan Moyad, Zyoud Samer H, Saleh Jaber Ammar Ali

机构信息

Health and Safety Department, Dubai Municipality, Dubai, United Arab Emirates; Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia (USM), Pulau Pinang, 11500, Malaysia.

Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia (USM), Pulau Pinang, 11500, Malaysia; Pharmacy Department, Emirates Health Services, Dubai, United Arab Emirates.

出版信息

Res Social Adm Pharm. 2025 Mar;21(3):185-192. doi: 10.1016/j.sapharm.2024.12.006. Epub 2024 Dec 13.

Abstract

BACKGROUND

The prevalence of colorectal cancer (CRC) is on the rise among the younger population, with an anticipated increase in new cases for individuals aged 20-49 years by 2030. The accessibility of community pharmacists and their strong community connections present unique opportunities to enhance patient engagement in a population-based CRC screening program.

OBJECTIVES

This study seeks to assess the effectiveness of a community pharmacist-led point-of-care CRC screening program utilizing fecal immunochemical test (FIT) kits to identify CRC prevalence in high-risk individuals.

METHODS AND MATERIALS

Over the course of a 10-month prospective intervention conducted in UAE community pharmacies, we evaluated the impact of a pharmacist-led point-of-care colorectal cancer screening program. Six pharmacies were selected based on their services and capabilities. Eligible participants were those identified during medication reviews as exhibiting colorectal cancer risk factors. Pharmacists provided communication materials, distributed FIT kits, and implemented reminders. Participants collected samples for hemoglobin analysis, which served as an indicator of colorectal bleeding. Collected data encompassed demographics, lifestyle, and health-related characteristics. Pharmacists performed medication reviews and offered recommendations.

RESULTS

A total of four hundred and one recruited int the study. The mean age of study cohort at baseline was 66.6 ± 11.3 years. In our study with 401 participants, 36.4 % had undiagnosed colorectal cancer (CRC). Univariate logistic regression identified older age, a history of Type 2 diabetes mellitus (DM), and inflammatory bowel disease (IBD) as significant factors associated with increased CRC prevalence, while aspirin users exhibited a lower likelihood of CRC. In the multivariate regression model, the history of Type 2 DM and IBD remained significant predictors for heightened CRC risk.

CONCLUSION

This study strengthens the plausibility of cause-and-effect relationships between colorectal cancer and demographic variables using epidemiological evidence. The significant relationships found between prevalence of CRC and age, type 2 diabetes, IBD and aspirin use support the effectiveness of using FIT kits in community pharmacist-led point-of-care CRC screening program to identify high-risk individuals. The finding highlights the significance of improving efforts on colorectal cancer prevention and control.

摘要

背景

结直肠癌(CRC)在年轻人群中的患病率呈上升趋势,预计到2030年,20 - 49岁个体的新发病例数将会增加。社区药剂师的可及性及其与社区的紧密联系为加强基于人群的CRC筛查项目中的患者参与度提供了独特机遇。

目的

本研究旨在评估由社区药剂师主导的即时护理CRC筛查项目利用粪便免疫化学检测(FIT)试剂盒来识别高危个体中CRC患病率的有效性。

方法和材料

在阿联酋社区药房进行的为期10个月的前瞻性干预过程中,我们评估了由药剂师主导的即时护理结直肠癌筛查项目的影响。根据其服务和能力选择了6家药房。符合条件的参与者是在用药审查期间被确定为具有结直肠癌风险因素的人。药剂师提供宣传材料、分发FIT试剂盒并实施提醒。参与者采集样本进行血红蛋白分析,以此作为结直肠出血的指标。收集的数据包括人口统计学、生活方式和健康相关特征。药剂师进行用药审查并提供建议。

结果

本研究共招募了401人。研究队列在基线时的平均年龄为66.6 ± 11.3岁。在我们有401名参与者的研究中,36.4%的人患有未确诊的结直肠癌(CRC)。单因素逻辑回归确定年龄较大、2型糖尿病(DM)病史和炎症性肠病(IBD)是与CRC患病率增加相关的重要因素,而服用阿司匹林的人患CRC的可能性较低。在多变量回归模型中,2型DM和IBD病史仍然是CRC风险升高的重要预测因素。

结论

本研究利用流行病学证据加强了结直肠癌与人口统计学变量之间因果关系的合理性。CRC患病率与年龄、2型糖尿病、IBD和阿司匹林使用之间发现的显著关系支持了在社区药剂师主导的即时护理CRC筛查项目中使用FIT试剂盒来识别高危个体的有效性。这一发现凸显了加强结直肠癌预防和控制工作的重要性。

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