Shrestha Rajeev, Shrestha Sunil, Iqbal Ayesha, Gülpınar Gizem
INF Nepal Green Pastures Hospital and Rehabilitation Centre, Pokhara, Nepal.
Department of Research and Academics, Kathmandu Cancer Center, Tathali, Bhaktapur, Nepal.
J Oncol Pharm Pract. 2025 Mar;31(2):282-293. doi: 10.1177/10781552241296516. Epub 2024 Dec 30.
BackgroundOpioid therapy is a critical component in managing pain in palliative care, where pharmacists' specialised expertise is crucial in ensuring quality care for patients. This systematic review aims to document available evidence on pharmacist interventions and their impact on optimising opioid therapy for pain management in palliative care patients.MethodsWe searched Medline (OVID), Embase (OVID), APA PsycINFO and Cochrane Central Register of Controlled Trials (CENTRAL) for relevant articles published from the beginning to 31 December, 2022. All original studies documenting pharmacists' intervention and impact in optimising patients receiving opioid therapy for their pain management in palliative care settings were included in this review.ResultsThe database and reference search yielded to a total of 7154 studies. Out of these, only 3 studies met the eligibility criteria and were included in this study. These studies were conducted in Korea, Canada and United States. Pharmacists were involved in assessing pain, suggesting medication for pain and other symptom management, providing patient education, counselling and recommendation, assessing patient's medication effects such as adverse effects, drug interaction and duplication, and adjusting medication. Similarly, their involvement showed improvements in pain management, opioid usage and management strategiesConclusionThis systematic review highlights the important role of pharmacists in optimising opioid medication therapy for pain management in palliative care patients. Their contributions to palliative patient care improve pain outcomes and overall quality of life. Integrating pharmacists into palliative care teams can enhance pain management practices and provide better care for palliative patients. Further studies accompanying the robust methodologies and broader settings will validate the findings of this review.
背景
阿片类药物治疗是姑息治疗中疼痛管理的关键组成部分,药剂师的专业知识对于确保为患者提供优质护理至关重要。本系统评价旨在记录有关药剂师干预措施及其对优化姑息治疗患者疼痛管理中阿片类药物治疗影响的现有证据。
方法
我们检索了Medline(OVID)、Embase(OVID)、APA PsycINFO和Cochrane对照试验中央注册库(CENTRAL),以查找从开始到2022年12月31日发表的相关文章。本评价纳入了所有记录药剂师在姑息治疗环境中优化接受阿片类药物治疗以管理疼痛的患者方面的干预措施和影响的原始研究。
结果
数据库和参考文献检索共获得7154项研究。其中,只有3项研究符合纳入标准并被纳入本研究。这些研究分别在韩国、加拿大和美国进行。药剂师参与了疼痛评估、建议疼痛及其他症状管理的药物、提供患者教育、咨询和建议、评估患者的药物效果,如不良反应、药物相互作用和重复用药情况,以及调整用药。同样,他们的参与显示出在疼痛管理、阿片类药物使用和管理策略方面有所改善。
结论
本系统评价强调了药剂师在优化姑息治疗患者疼痛管理的阿片类药物治疗中的重要作用。他们对姑息治疗患者护理的贡献改善了疼痛结局和总体生活质量。将药剂师纳入姑息治疗团队可以加强疼痛管理实践,并为姑息治疗患者提供更好的护理。采用更完善的方法和更广泛的背景进行的进一步研究将验证本评价的结果。