多学科协作团队模式下药师干预在阿片类药物治疗中重度癌症疼痛中的作用

The role of pharmacists′ participation in opioid therapy for moderate to severe cancer pain under multi-disciplinary team

  • 摘要:
      目的   探讨多学科协作团队(MDT)模式下药师干预在阿片类药物治疗中重度癌症疼痛患者中的作用。
      方法   选取肿瘤内科住院患者120例,按照随机数字表法分为观察组和对照组,每组60例。比较2组患者疼痛评估合理率、阿片药物滴定合理率、疼痛强度(PI)、住院时间、阿片类药物升级指数百分比(OEI%)和阿片类药物不良反应发生情况。
      结果   结果观察组的疼痛评估合理率、阿片药物滴定合理率均高于对照组,差异有统计学意义(P <0.05)。出院时,观察组PI评分低于对照组,差异有统计学意义(P <0.05)。观察组患者初始口服吗啡等效日剂量(OMEDD)高于对照组,差异有统计学意义(P <0.05)。观察组OEI%>5%的患者比率低于对照组,阿片类药物使用天数、住院时间短于对照组,差异有统计学意义(P <0.05)。观察组患者便秘和恶心呕吐的发生率低于对照组,差异有统计学意义(P <0.05)。
      结论   在MDT模式下,药师参与癌症疼痛患者阿片类药物治疗和管理可有效提高用药合理性,改善患者疼痛和生存质量。

     

    Abstract:
      Objective   To explore the role of pharmacists′ participation in opioid therapy in patients with moderate to severe cancer pain under multi-disciplinary team (MDT) model.
      Methods   A total of 120 inpatients in oncology department were randomly divided into observation group and control group according to random number table method, with 60 cases in each group. The rational rate of pain assessment, rational rate of opioid titration, pain intensity (PI), length of hospital stay, opioid escalation index percentage (OEI%) and incidence of opioid adverse reactions were compared between two groups.
      Results   The rational rates of pain assessment and opioid titration in the observation group were significantly higher than those in the control group (P <0.05). At discharge, PI score of the observation group was significantly lower than that of the control group (P <0.05). The initial oral morphine equivalent daily dose (OMEDD) in the observation group was significantly higher than that in the control group (P <0.05). The proportion of patients with OEI%>5% in the observation group was significantly lower, and the days of opioid use and hospital stay were significantly shorter than those in the control group (P <0.05). The incidence of constipation and nausea as well as vomiting in the observation group was significantly lower than that in the control group (P <0.05).
      Conclusion   Under the MDT model, pharmacists′ participation in opioid therapy and management in patients with cancer pain can effectively enhance the rationality of drug use, improve patients′ pain and their quality of life.

     

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