Cargando…

Pharmacist-Led Management Improves Treatment Adherence and Quality of Life in Opioid-Tolerant Patients With Cancer Pain: A Randomized Controlled Trial

INTRODUCTION: Opioid-tolerant patients are more likely to deviate from recommended treatments and to experience inadequate analgesia than opioid-naive ones. The aim of this study was to examine whether pharmacist-led management could help improve treatment adherence and quality of life. METHODS: Eli...

Descripción completa

Detalles Bibliográficos
Autores principales: Zheng, Xiaowei, Ding, Haiying, Xu, Silu, Xie, Ruixiang, Liu, Yuguo, Zhai, Qing, Fang, Luo, Tong, Yinghui, Sun, Jiao, Xin, Wenxiu, Wu, Nan, Chen, Juan, Shi, Wenna, Yang, Ling, Li, Hui, Shao, Jingjing, Wang, Yangkui, Yu, Hui, Zhang, Bo, Du, Qiong, Yang, Yezi, Zhang, Xiaodan, Duan, Cunxian, Zhao, Qiulin, Shi, Jing, Huang, Jing, Fan, Qing, Cheng, Huawei, Chen, Lingya, Kong, Sisi, Zhang, Hui, Gong, Liyan, Zhang, Yiping, Song, Zhengbo, Yang, Yang, Zhou, Shoubing, Huang, Chengsuo, Lin, Jinyuan, Wang, Chenchen, Huang, Xianhong, Wei, Qing, Sun, Yancai, Huang, Ping
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Healthcare 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8861211/
https://www.ncbi.nlm.nih.gov/pubmed/35092599
http://dx.doi.org/10.1007/s40122-021-00342-0
_version_ 1784654840313413632
author Zheng, Xiaowei
Ding, Haiying
Xu, Silu
Xie, Ruixiang
Liu, Yuguo
Zhai, Qing
Fang, Luo
Tong, Yinghui
Sun, Jiao
Xin, Wenxiu
Wu, Nan
Chen, Juan
Shi, Wenna
Yang, Ling
Li, Hui
Shao, Jingjing
Wang, Yangkui
Yu, Hui
Zhang, Bo
Du, Qiong
Yang, Yezi
Zhang, Xiaodan
Duan, Cunxian
Zhao, Qiulin
Shi, Jing
Huang, Jing
Fan, Qing
Cheng, Huawei
Chen, Lingya
Kong, Sisi
Zhang, Hui
Gong, Liyan
Zhang, Yiping
Song, Zhengbo
Yang, Yang
Zhou, Shoubing
Huang, Chengsuo
Lin, Jinyuan
Wang, Chenchen
Huang, Xianhong
Wei, Qing
Sun, Yancai
Huang, Ping
author_facet Zheng, Xiaowei
Ding, Haiying
Xu, Silu
Xie, Ruixiang
Liu, Yuguo
Zhai, Qing
Fang, Luo
Tong, Yinghui
Sun, Jiao
Xin, Wenxiu
Wu, Nan
Chen, Juan
Shi, Wenna
Yang, Ling
Li, Hui
Shao, Jingjing
Wang, Yangkui
Yu, Hui
Zhang, Bo
Du, Qiong
Yang, Yezi
Zhang, Xiaodan
Duan, Cunxian
Zhao, Qiulin
Shi, Jing
Huang, Jing
Fan, Qing
Cheng, Huawei
Chen, Lingya
Kong, Sisi
Zhang, Hui
Gong, Liyan
Zhang, Yiping
Song, Zhengbo
Yang, Yang
Zhou, Shoubing
Huang, Chengsuo
Lin, Jinyuan
Wang, Chenchen
Huang, Xianhong
Wei, Qing
Sun, Yancai
Huang, Ping
author_sort Zheng, Xiaowei
collection PubMed
description INTRODUCTION: Opioid-tolerant patients are more likely to deviate from recommended treatments and to experience inadequate analgesia than opioid-naive ones. The aim of this study was to examine whether pharmacist-led management could help improve treatment adherence and quality of life. METHODS: Eligible patients were randomized in a 1:1 ratio to control group and intervention group. The control group received routine education and support, while the intervention group received additional individualized pharmacist-led care. The primary endpoint was treatment adherence in the per-protocol analysis, as evaluated by blinded assessors. An interim analysis was planned when 30% patients completed the study. Alpha was divided into the interim analysis (0.015) and the final analysis (0.035). RESULTS: In the interim analysis (97 and 87 patients in the control and intervention groups, respectively), the primary endpoint was met. Pharmacist-led intervention significantly increased treatment adherence (93.3 vs. 79.8%; OR: 2.25; 95% CI 1.02, 4.94; P = 0.013), quality of life (0.81 ± 0.17 vs. 0.72 ± 0.25; P = 0.008), and reporting of adverse events (82.7 vs. 61.9%; OR: 1.88; 95% CI 1.16, 3.07; P = 0.004). The two groups did not differ in pain control rate (66.7 vs. 57.1%; OR: 1.25; 95% CI 0.87, 1.78; P = 0.218), breakthrough pain-free rate (66.7 vs. 61.9%; OR: 1.12; 95% CI 0.78, 1.59; P = 0.532) and pain score (1.97 ± 1.04 vs. 2.15 ± 1.24; P = 0.522). CONCLUSIONS: Pharmacist-led management improved treatment adherence, quality of life, and the reporting of adverse events in opioid-tolerant patients with cancer pain. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03455023. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40122-021-00342-0.
format Online
Article
Text
id pubmed-8861211
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Springer Healthcare
record_format MEDLINE/PubMed
spelling pubmed-88612112022-03-02 Pharmacist-Led Management Improves Treatment Adherence and Quality of Life in Opioid-Tolerant Patients With Cancer Pain: A Randomized Controlled Trial Zheng, Xiaowei Ding, Haiying Xu, Silu Xie, Ruixiang Liu, Yuguo Zhai, Qing Fang, Luo Tong, Yinghui Sun, Jiao Xin, Wenxiu Wu, Nan Chen, Juan Shi, Wenna Yang, Ling Li, Hui Shao, Jingjing Wang, Yangkui Yu, Hui Zhang, Bo Du, Qiong Yang, Yezi Zhang, Xiaodan Duan, Cunxian Zhao, Qiulin Shi, Jing Huang, Jing Fan, Qing Cheng, Huawei Chen, Lingya Kong, Sisi Zhang, Hui Gong, Liyan Zhang, Yiping Song, Zhengbo Yang, Yang Zhou, Shoubing Huang, Chengsuo Lin, Jinyuan Wang, Chenchen Huang, Xianhong Wei, Qing Sun, Yancai Huang, Ping Pain Ther Original Research INTRODUCTION: Opioid-tolerant patients are more likely to deviate from recommended treatments and to experience inadequate analgesia than opioid-naive ones. The aim of this study was to examine whether pharmacist-led management could help improve treatment adherence and quality of life. METHODS: Eligible patients were randomized in a 1:1 ratio to control group and intervention group. The control group received routine education and support, while the intervention group received additional individualized pharmacist-led care. The primary endpoint was treatment adherence in the per-protocol analysis, as evaluated by blinded assessors. An interim analysis was planned when 30% patients completed the study. Alpha was divided into the interim analysis (0.015) and the final analysis (0.035). RESULTS: In the interim analysis (97 and 87 patients in the control and intervention groups, respectively), the primary endpoint was met. Pharmacist-led intervention significantly increased treatment adherence (93.3 vs. 79.8%; OR: 2.25; 95% CI 1.02, 4.94; P = 0.013), quality of life (0.81 ± 0.17 vs. 0.72 ± 0.25; P = 0.008), and reporting of adverse events (82.7 vs. 61.9%; OR: 1.88; 95% CI 1.16, 3.07; P = 0.004). The two groups did not differ in pain control rate (66.7 vs. 57.1%; OR: 1.25; 95% CI 0.87, 1.78; P = 0.218), breakthrough pain-free rate (66.7 vs. 61.9%; OR: 1.12; 95% CI 0.78, 1.59; P = 0.532) and pain score (1.97 ± 1.04 vs. 2.15 ± 1.24; P = 0.522). CONCLUSIONS: Pharmacist-led management improved treatment adherence, quality of life, and the reporting of adverse events in opioid-tolerant patients with cancer pain. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03455023. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40122-021-00342-0. Springer Healthcare 2022-01-29 2022-03 /pmc/articles/PMC8861211/ /pubmed/35092599 http://dx.doi.org/10.1007/s40122-021-00342-0 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by-nc/4.0/Open Access This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Original Research
Zheng, Xiaowei
Ding, Haiying
Xu, Silu
Xie, Ruixiang
Liu, Yuguo
Zhai, Qing
Fang, Luo
Tong, Yinghui
Sun, Jiao
Xin, Wenxiu
Wu, Nan
Chen, Juan
Shi, Wenna
Yang, Ling
Li, Hui
Shao, Jingjing
Wang, Yangkui
Yu, Hui
Zhang, Bo
Du, Qiong
Yang, Yezi
Zhang, Xiaodan
Duan, Cunxian
Zhao, Qiulin
Shi, Jing
Huang, Jing
Fan, Qing
Cheng, Huawei
Chen, Lingya
Kong, Sisi
Zhang, Hui
Gong, Liyan
Zhang, Yiping
Song, Zhengbo
Yang, Yang
Zhou, Shoubing
Huang, Chengsuo
Lin, Jinyuan
Wang, Chenchen
Huang, Xianhong
Wei, Qing
Sun, Yancai
Huang, Ping
Pharmacist-Led Management Improves Treatment Adherence and Quality of Life in Opioid-Tolerant Patients With Cancer Pain: A Randomized Controlled Trial
title Pharmacist-Led Management Improves Treatment Adherence and Quality of Life in Opioid-Tolerant Patients With Cancer Pain: A Randomized Controlled Trial
title_full Pharmacist-Led Management Improves Treatment Adherence and Quality of Life in Opioid-Tolerant Patients With Cancer Pain: A Randomized Controlled Trial
title_fullStr Pharmacist-Led Management Improves Treatment Adherence and Quality of Life in Opioid-Tolerant Patients With Cancer Pain: A Randomized Controlled Trial
title_full_unstemmed Pharmacist-Led Management Improves Treatment Adherence and Quality of Life in Opioid-Tolerant Patients With Cancer Pain: A Randomized Controlled Trial
title_short Pharmacist-Led Management Improves Treatment Adherence and Quality of Life in Opioid-Tolerant Patients With Cancer Pain: A Randomized Controlled Trial
title_sort pharmacist-led management improves treatment adherence and quality of life in opioid-tolerant patients with cancer pain: a randomized controlled trial
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8861211/
https://www.ncbi.nlm.nih.gov/pubmed/35092599
http://dx.doi.org/10.1007/s40122-021-00342-0
work_keys_str_mv AT zhengxiaowei pharmacistledmanagementimprovestreatmentadherenceandqualityoflifeinopioidtolerantpatientswithcancerpainarandomizedcontrolledtrial
AT dinghaiying pharmacistledmanagementimprovestreatmentadherenceandqualityoflifeinopioidtolerantpatientswithcancerpainarandomizedcontrolledtrial
AT xusilu pharmacistledmanagementimprovestreatmentadherenceandqualityoflifeinopioidtolerantpatientswithcancerpainarandomizedcontrolledtrial
AT xieruixiang pharmacistledmanagementimprovestreatmentadherenceandqualityoflifeinopioidtolerantpatientswithcancerpainarandomizedcontrolledtrial
AT liuyuguo pharmacistledmanagementimprovestreatmentadherenceandqualityoflifeinopioidtolerantpatientswithcancerpainarandomizedcontrolledtrial
AT zhaiqing pharmacistledmanagementimprovestreatmentadherenceandqualityoflifeinopioidtolerantpatientswithcancerpainarandomizedcontrolledtrial
AT fangluo pharmacistledmanagementimprovestreatmentadherenceandqualityoflifeinopioidtolerantpatientswithcancerpainarandomizedcontrolledtrial
AT tongyinghui pharmacistledmanagementimprovestreatmentadherenceandqualityoflifeinopioidtolerantpatientswithcancerpainarandomizedcontrolledtrial
AT sunjiao pharmacistledmanagementimprovestreatmentadherenceandqualityoflifeinopioidtolerantpatientswithcancerpainarandomizedcontrolledtrial
AT xinwenxiu pharmacistledmanagementimprovestreatmentadherenceandqualityoflifeinopioidtolerantpatientswithcancerpainarandomizedcontrolledtrial
AT wunan pharmacistledmanagementimprovestreatmentadherenceandqualityoflifeinopioidtolerantpatientswithcancerpainarandomizedcontrolledtrial
AT chenjuan pharmacistledmanagementimprovestreatmentadherenceandqualityoflifeinopioidtolerantpatientswithcancerpainarandomizedcontrolledtrial
AT shiwenna pharmacistledmanagementimprovestreatmentadherenceandqualityoflifeinopioidtolerantpatientswithcancerpainarandomizedcontrolledtrial
AT yangling pharmacistledmanagementimprovestreatmentadherenceandqualityoflifeinopioidtolerantpatientswithcancerpainarandomizedcontrolledtrial
AT lihui pharmacistledmanagementimprovestreatmentadherenceandqualityoflifeinopioidtolerantpatientswithcancerpainarandomizedcontrolledtrial
AT shaojingjing pharmacistledmanagementimprovestreatmentadherenceandqualityoflifeinopioidtolerantpatientswithcancerpainarandomizedcontrolledtrial
AT wangyangkui pharmacistledmanagementimprovestreatmentadherenceandqualityoflifeinopioidtolerantpatientswithcancerpainarandomizedcontrolledtrial
AT yuhui pharmacistledmanagementimprovestreatmentadherenceandqualityoflifeinopioidtolerantpatientswithcancerpainarandomizedcontrolledtrial
AT zhangbo pharmacistledmanagementimprovestreatmentadherenceandqualityoflifeinopioidtolerantpatientswithcancerpainarandomizedcontrolledtrial
AT duqiong pharmacistledmanagementimprovestreatmentadherenceandqualityoflifeinopioidtolerantpatientswithcancerpainarandomizedcontrolledtrial
AT yangyezi pharmacistledmanagementimprovestreatmentadherenceandqualityoflifeinopioidtolerantpatientswithcancerpainarandomizedcontrolledtrial
AT zhangxiaodan pharmacistledmanagementimprovestreatmentadherenceandqualityoflifeinopioidtolerantpatientswithcancerpainarandomizedcontrolledtrial
AT duancunxian pharmacistledmanagementimprovestreatmentadherenceandqualityoflifeinopioidtolerantpatientswithcancerpainarandomizedcontrolledtrial
AT zhaoqiulin pharmacistledmanagementimprovestreatmentadherenceandqualityoflifeinopioidtolerantpatientswithcancerpainarandomizedcontrolledtrial
AT shijing pharmacistledmanagementimprovestreatmentadherenceandqualityoflifeinopioidtolerantpatientswithcancerpainarandomizedcontrolledtrial
AT huangjing pharmacistledmanagementimprovestreatmentadherenceandqualityoflifeinopioidtolerantpatientswithcancerpainarandomizedcontrolledtrial
AT fanqing pharmacistledmanagementimprovestreatmentadherenceandqualityoflifeinopioidtolerantpatientswithcancerpainarandomizedcontrolledtrial
AT chenghuawei pharmacistledmanagementimprovestreatmentadherenceandqualityoflifeinopioidtolerantpatientswithcancerpainarandomizedcontrolledtrial
AT chenlingya pharmacistledmanagementimprovestreatmentadherenceandqualityoflifeinopioidtolerantpatientswithcancerpainarandomizedcontrolledtrial
AT kongsisi pharmacistledmanagementimprovestreatmentadherenceandqualityoflifeinopioidtolerantpatientswithcancerpainarandomizedcontrolledtrial
AT zhanghui pharmacistledmanagementimprovestreatmentadherenceandqualityoflifeinopioidtolerantpatientswithcancerpainarandomizedcontrolledtrial
AT gongliyan pharmacistledmanagementimprovestreatmentadherenceandqualityoflifeinopioidtolerantpatientswithcancerpainarandomizedcontrolledtrial
AT zhangyiping pharmacistledmanagementimprovestreatmentadherenceandqualityoflifeinopioidtolerantpatientswithcancerpainarandomizedcontrolledtrial
AT songzhengbo pharmacistledmanagementimprovestreatmentadherenceandqualityoflifeinopioidtolerantpatientswithcancerpainarandomizedcontrolledtrial
AT yangyang pharmacistledmanagementimprovestreatmentadherenceandqualityoflifeinopioidtolerantpatientswithcancerpainarandomizedcontrolledtrial
AT zhoushoubing pharmacistledmanagementimprovestreatmentadherenceandqualityoflifeinopioidtolerantpatientswithcancerpainarandomizedcontrolledtrial
AT huangchengsuo pharmacistledmanagementimprovestreatmentadherenceandqualityoflifeinopioidtolerantpatientswithcancerpainarandomizedcontrolledtrial
AT linjinyuan pharmacistledmanagementimprovestreatmentadherenceandqualityoflifeinopioidtolerantpatientswithcancerpainarandomizedcontrolledtrial
AT wangchenchen pharmacistledmanagementimprovestreatmentadherenceandqualityoflifeinopioidtolerantpatientswithcancerpainarandomizedcontrolledtrial
AT huangxianhong pharmacistledmanagementimprovestreatmentadherenceandqualityoflifeinopioidtolerantpatientswithcancerpainarandomizedcontrolledtrial
AT weiqing pharmacistledmanagementimprovestreatmentadherenceandqualityoflifeinopioidtolerantpatientswithcancerpainarandomizedcontrolledtrial
AT sunyancai pharmacistledmanagementimprovestreatmentadherenceandqualityoflifeinopioidtolerantpatientswithcancerpainarandomizedcontrolledtrial
AT huangping pharmacistledmanagementimprovestreatmentadherenceandqualityoflifeinopioidtolerantpatientswithcancerpainarandomizedcontrolledtrial