Pharmacist Involvement in Cancer Pain Management: A Systematic Review and Meta-Analysis

Shrestha, Sunil; Kc, Bhuvan; Blebil, Ali Qais; Teoh, Siew Li

doi:10.1016/j.jpain.2022.02.002

Cited by 21 publications

(26 citation statements)

References 109 publications

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“…Literature also supports the pharmacist’s role in medication therapy management [ 45 , 46 , 47 ]. Drug information for healthcare professionals and patient counselling were among the pharmacists’ interventions identified in this review, which aligns with other studies [ 10 , 14 , 28 , 48 , 49 ]. These actions promote the safety of COVID-19 patients using anti-infectives, antibiotics, and anticoagulants.…”

Section: Discussionsupporting

confidence: 86%

“…Pharmacists have an established role in the planning of pharmacotherapies and decisions regarding clinical parameter evaluation and drug monitoring [ 12 , 13 , 14 , 15 ]. Their interventions are the first line of defense in preventing medication errors (MEs) and adverse drug events (ADEs) in the first place, thereby improving medication safety [ 16 , 17 , 18 ].…”

Section: Introductionmentioning

confidence: 99%

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Interventions and Impact of Pharmacist-Delivered Services for People Infected with COVID-19: A Systematic Review

et al. 2022

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Pharmacists are essential members of the healthcare team. The emergence of the novel coronavirus disease 2019 (COVID-19) pandemic has led pharmacists to undertake additional clinical roles. We aim to conduct a systematic review on the interventions and impact of pharmacist-delivered services in managing COVID-19 patients. We searched PubMed, Embase, Scopus, CINAHL plus, International Pharmaceutical Abstracts, and Web of Science from 1 December 2019 (the first case of COVID-19 emerged) to 13 January 2022 to retrieve the articles. Cochrane handbook and PRISMA guidelines were followed respectively to perform and report the review. The pharmacist-led interventions were reported following the Descriptive Elements of Pharmacist Intervention Characterization Tool (DEPICT) version 2. The protocol of systematic review was registered on PROSPERO (CRD42021277128). Studies quality was assessed with the modified NOS scale. In total, 7 observational studies were identified from 10,838 studies. Identification of dosage errors (n = 6 studies), regimen modifications (n = 5), removal of obsolete/duplicate medications (n = 5), identification and management of adverse drug reactions (n = 4), drug interactions prevention (n = 2), and physicians acceptance rate (n = 3) of therapy-related services delivered in-person or via tele-pharmacy were among the pharmacist-delivered services. Common interventions delivered by pharmacists also included optimizing the use of antibacterial, antivirals, and anticoagulants in COVID-19 infected patients. The acceptance of pharmacist-delivered services by physicians was high (88.5–95.5%). Included studies have described pharmacists’ beneficial role in managing patients with COVID-19 including detection, resolution, and prevention of medication-related problems, with physicians demonstrating high trust in pharmacists’ advice. Future research should assess the feasibility and scalability of such roles in real-world settings.

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Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Interventions and Impact of Pharmacist-Delivered Services for People Infected with COVID-19: A Systematic Review

et al. 2022

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“…Prior literature suggests the important potential involvement of pharmacists as multidisciplinary team (MDT) members in managing cancer pain in terms of improving HRQoL, reducing medication non-compliance, and adverse drug reactions (ADRs) [ 9 – 11 ]. In preparation for this trial, the investigators of this study conducted a systematic review and meta-analysis [ 12 ]. The pharmacological and non-pharmacological interventions provided by pharmacists to help cancer patients experiencing pain were highlighted by the systematic review and meta-analysis of 12,684 cancer patients from 64 studies [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical pharmacists’ intervention on pain management in cancer patients (PharmaCAP trial): study protocol for a randomized controlled trial

Shrestha

Blebil

Teoh

et al. 2023

J of Pharm Policy and Pract

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Introduction Evidence-based services to support cancer patients with pain via clinical pharmacy services are currently lacking. Therefore, there is a need to undertake a randomized controlled trial (RCT) to explore the effectiveness of clinical pharmacists (CPs)’ input into the multidisciplinary team (MDT) in providing better therapeutic outcomes for cancer pain management. Objectives The main aim of this pilot RCT is to determine the feasibility and preliminary efficacy of integrating CPs into the MDT for cancer pain management on the clinical outcomes of cancer patients experiencing pain. Methods This study protocol outlines two-armed multicenter pilot RCT. Cancer patients suffering from pain will be randomly allocated to receive either clinical pharmacy services, i.e., PharmaCAP trial intervention from the CP, or the usual standard care (i.e., control group). Patients will be recruited consecutively from two hospitals in Kathmandu valley, Nepal. The outcomes will be assessed at baseline (pre-intervention) and 4 weeks post-intervention. The primary feasibility outcomes will include eligibility rate, recruitment rate, willingness to participate, acceptability of screening procedures and random allocation, possible contamination between the groups, intervention fidelity and compliance, treatment satisfaction, and patient understanding of the provided interventions. Subsequently, the primary clinical outcome, i.e., pain intensity of cancer patients, will be assessed. The secondary clinical outcomes will include health-related quality of life (HRQoL), anxiety, depression, adverse drug reactions, and patient medication compliance following the integration of CP into the healthcare team. Discussion The feasibility and potential for integrating CP involvement in MDT to improve clinical outcomes of cancer patients with pain will be evaluated through the PharmaCAP trial. Trial registration: ClinicalTrials.gov NCT05021393. Registered on 25th August 2022.

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“…Opioid requirement and chronic pain are independent predictors of survival (10)(11)(12)(13)(14)(15), and severe pain is associated with shorter survival, with mean hazard ratios ranging from 1.04 to 1.39 (10,12,14,15). Pharmacists can improve the management of cancer pain through interventions such as medication reviews, patient education, the detection and management of adverse drug reactions, and pain assessments (16)(17)(18)(19)(20), which are well accepted by physicians in the United States (US) and Canada (16).…”

Section: Introductionmentioning

confidence: 99%

“…Nonetheless, this study only analyzed the impact of medication education provided by pharmacists (28). And other previous studies also have focused on only one or a few of the areas where pharmacists can contribute to cancer pain management, such as patient education, optimization of analgesic prescriptions, and monitoring of adverse drug reactions (16)(17)(18)(19)(20)(26)(27)(28)(29)(30). However, clinical practice requires that pharmacists continuously engage in all of these activities in a way that takes into account each patient individually.…”

Section: Introductionmentioning

confidence: 99%

Impact of individualized pharmaceutical care on efficacy and safety of opioid-tolerant outpatients with cancer pain: a multicenter randomized controlled trial

Ding¹,

Song²,

Wu³

et al. 2022

Ann Transl Med

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Background: Managing cancer pain is a growing challenge. Individualized pharmaceutical care is particularly important for opioid-tolerant outpatients due to variation in terms of their knowledge about pain, treatment adherence, and risk of experiencing inadequate analgesia and severe adverse events. This study aimed to determine the influence of individualized pharmaceutical care on outcomes in opioid-tolerant outpatients with cancer pain. Methods:A multicenter, open-label, randomized, controlled study was carried out. Opioid-tolerant outpatients experiencing chronic cancer pain and receiving sustained-release opioids were randomly assigned to the intervention group and the control group with a 1:1 ratio. The intervention group received individualized pharmaceutical care, while the control group received conventional care during 4-week period.

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Pharmacist Involvement in Cancer Pain Management: A Systematic Review and Meta-Analysis

Cited by 21 publications

References 109 publications

Interventions and Impact of Pharmacist-Delivered Services for People Infected with COVID-19: A Systematic Review

Interventions and Impact of Pharmacist-Delivered Services for People Infected with COVID-19: A Systematic Review

Clinical pharmacists’ intervention on pain management in cancer patients (PharmaCAP trial): study protocol for a randomized controlled trial

Impact of individualized pharmaceutical care on efficacy and safety of opioid-tolerant outpatients with cancer pain: a multicenter randomized controlled trial

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