Krick S E, Lindley C M, Bennett M
Campbell University School of Pharmacy, Buies Creek, NC.
Ann Pharmacother. 1994 Jul-Aug;28(7-8):857-62. doi: 10.1177/106002809402800706.
To assess pharmacists' knowledge, attitudes, and beliefs regarding the use of narcotics in cancer pain management, identify pharmacist counseling activities for cancer pain patients, assess pharmacy-related barriers to cancer pain management, and evaluate the availability of narcotic analgesics.
Mailing of a six-page survey.
Five hundred randomly selected pharmacists registered in North Carolina.
Of 500 pharmacists surveyed, 141 surveys were completed and returned for a response rate of 28.2 percent.
Pharmacists surveyed were knowledgeable regarding the problem of undertreatment of cancer pain. More than 80 percent of respondents replied that most cancer patients experience pain at some time during their illness. Eighty-five percent of respondents agreed that the nurse must believe the patient's report of pain and that the patient is the best judge of the intensity of the pain. Conservative physician prescribing patterns and conservative administration patterns of nurses were identified as perceived barriers to adequate pain management by 51 and 44 percent of respondents, respectively. Less than 30 percent of respondents frequently counseled cancer pain patients and were unable to identify patients who have cancer pain as a major medical illness. Hospital pharmacists recommended adjunctive therapy more often than did community pharmacists (p = 0.013). Interventions in pain management regimens were more often conducted by hospital pharmacists than by community pharmacists (p = 0.049). Differences in availability of narcotics was noted among practice sites for some more potent narcotics. Of the pharmacists surveyed, only 43 percent had attended a continuing education program on cancer pain management. Ninety-six percent of respondents were interested in attending a continuing education program in the future.
Pharmacists in North Carolina are aware that the undertreatment of cancer pain is a serious medical problem. Unfortunately, pharmacists appear to be unable to identify patients with cancer pain as a major medical problem; therefore, counseling activity is limited. Addiction is still perceived as a barrier by some pharmacists. Through organizations such as the North Carolina Pain Initiative, these problems can be addressed.
评估药剂师在癌症疼痛管理中使用麻醉药品方面的知识、态度和信念，确定针对癌症疼痛患者的药剂师咨询活动，评估癌症疼痛管理中与药房相关的障碍，并评估麻醉性镇痛药的可及性。
邮寄一份六页的调查问卷。
在北卡罗来纳州随机选取的500名注册药剂师。
在接受调查的500名药剂师中，141份调查问卷被填写并返回，回复率为28.2%。
接受调查的药剂师了解癌症疼痛治疗不足的问题。超过80%的受访者回答说，大多数癌症患者在患病期间的某个时候会经历疼痛。85%的受访者同意护士必须相信患者关于疼痛的报告，并且患者是疼痛强度的最佳判断者。分别有51%和44%的受访者认为，医生保守的开药模式和护士保守的给药模式是充分疼痛管理的障碍。不到30%的受访者经常为癌症疼痛患者提供咨询，并且无法将患有癌症疼痛的患者识别为一种主要的医疗疾病。医院药剂师比社区药剂师更常推荐辅助治疗（p = 0.013）。医院药剂师比社区药剂师更常对疼痛管理方案进行干预（p = 0.049）。在一些效力更强的麻醉药品的使用地点之间，注意到麻醉药品可及性存在差异。在接受调查的药剂师中，只有43%参加过关于癌症疼痛管理的继续教育项目。96%的受访者表示有兴趣在未来参加继续教育项目。
北卡罗来纳州的药剂师意识到癌症疼痛治疗不足是一个严重的医疗问题。不幸的是，药剂师似乎无法将患有癌症疼痛的患者识别为一个主要的医疗问题；因此，咨询活动有限。一些药剂师仍然将成瘾视为一个障碍。通过北卡罗来纳州疼痛倡议等组织，可以解决这些问题。
