Authors (including presenting author) :
Li CW(1), Lau CY(1), Chan TMJ(2), Lau WM(1)
Affiliation :
(1)Pharmacy Department, Our Lady of Marynkoll Hospital (2)Palliative Care Unit, Our Lady of Maryknoll Hospital
Introduction :
Effective pain management is important in cancer patients receiving palliative care in order to reduce their unnecessary suffering. However, pain under-treatment is still very prevalent around the world. Recent pain guidelines have recommended pain education as a key to enhance pain control, in addition to pharmacological treatment.
Objectives :
To investigate the impact of pharmacist counselling on cancer patients' (1) opioid belief, based on a validated Chinese scale, the Pain and Opioid Analgesics Beliefs Scale – Cancer (POABS-CA); (2) pain control, based on numeric rating scale(NRS) To assess patients' satisfaction towards pharmacists counselling
Methodology :
It is a prospective, randomised and controlled study. The study was conducted from December 2019 to September 2020. Seventy-four patients were allocated to receive either pharmacist counselling on opioid analgesics and pain management (37) or routine medical care (37). All patients were assessed of their baseline opioid belief and pain level by POABS-CA and NRS respectively. Subsequent assessment in both group was conducted 1 week after the first visit. Patient satisfaction towards the service was evaluated using a validated questionnaire.
Result & Outcome :
Before any intervention, the overall opioid belief in both groups was similar, 31.1 ± 5.9 in the intervention group and 29.3 ± 8.9 in the control group respectively (P=0.30). The overall opioid belief reduced significantly from 31.1 ± 6.1 to 13.1 ± 6.1 in the intervention group (P< 0.001) after pharmacist counselling, while there was no significant change in the control group (P=0.083). The pain intensity in terms of NRS was reduced significantly from 3.7 ± 2.2 to 2.6 ± 2.1 in the intervention group (P=0.003), as well as the control group (P=0.013). However, the difference in the reduction was not significant between both groups. The average time used for counselling was 13.0 ± 2.6 minutes. Patients were satisfied with the counselling service, with more patients in the intervention group showed positive feedback on questions about the importance of seeing pharmacists before opioid use and improvement in medical knowledge (P< 0.005). Conclusion: Pharmacist counselling could significantly reduce patients’ negative belief on opioid and pain endurance in cancer patients receiving in-patient palliative care.
