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

作者：Xiaowei Zheng, Haiying Ding, Silu Xu, Ruixiang Xie, Yuguo Liu, Qing Zhai, Fang Luo, Yinghui Tong, Jiao Sun, Wenxiu Xin, Nan Wu, Juan Chen, Wenna Shi, Ling Yang, Hui Li, Jingjing Shao, Yangkui Wang, Hui Yu, Bo Zhang, Qiong Du, Yezi Yang, Xiaodan Zhang, Cunxian Duan, Qiulin Zhao, Jing Shi, Jing Huang, Qing Fan, Huawei Cheng, Lingya Chen, Sisi Kong, Hui Zhang, Liyan Gong, Yiping Zhang, Zhengbo Song, Yang Yang, Shoubing Zhou, Chengsuo Huang, Jinyuan Lin, Chenchen Wang, Xianhong Huang, Qing Wei, Yancai Sun, Ping Huang · 发表于：Pain and Therapy · 年份：2022 · DOI：10.1007/s40122-021-00342-0 · 被引用次数：8 · 研究领域：Pain Management and Opioid Use、Opioid Use Disorder Treatment、Medication Adherence and Compliance

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...