DEVELOPMENT OF THE PHARMACIST’S ROLE AS PART OF A MULTIDISCIPLINARY TEAM PROVIDING HOME PAIN MANAGEMENT TREATMENT TO ADVANCED-STAGE CANCER PATIENTS - NONGSUA HOSPITAL, PATHUMTHANI
DOI:
https://doi.org/10.69598/tbps.17.2.1-21Keywords:
pharmaceutical care, pain management, advanced cancer, pharmacist role, home health care, multidisciplinary teamAbstract
The objective of this research project was to expand the role of pharmacists working as part of a multidisciplinary team who were providing pain management treatment, through the administration of opioids, to advanced-stage cancer patients in their homes. The participants were divided into 2 groups made up of 14 medical staff and 38 advanced-stage cancer patients who were using opioids to control pain. They were selected through purposive sampling. After the patients were recruited into the study, each patient was provided home pain management by pharmacists in a multidisciplinary team during a home visit 3 times. The data was collected between May and October 2020. Analysis of the effect of the development of the pharmacist’s role in pain management was compared before a home visit, after a home visit for 1 and 2 weeks, showed that the median pain scores were reduced by a statistically significant amount to 6, 4, and 4 (out of 10), respectively. The medication adherence measurements showed median percentages of 75.00, 93.75, and 92.86, respectively. Medication taking behaviour as measured by the Thai (MTB-Thai) questionnaire was shown to improve, with a statistically significant increase in the median score to 19.5, 23, and 23 (out of 24), respectively. In addition, the results of the enhanced pharmacist’s role in pain management before and after the interventions showed a statistically significant increase in the median patient’s knowledge scores from 5 to 8 (out of 10) and the mean of patient’s quality of life from 53.09 to 74.57 (out of 108). Furthermore, the median score pertaining to drug-related problems was reduced by a statistically significant amount to 1 and 0, respectively. A statistically significant increase in the score for overall satisfaction from 3.24 to 4.50 (out of 5) was seen in the patient group, and from 3.00 to 4.60 in the team group. This research shows that pharmacists can play a role as part of a multidisciplinary team providing pain management treatment to advanced-stage cancer patients in their homes, as the results in better outcomes of pain management, quality of life, knowledge, medication adherence and satisfaction of patients and the multidisciplinary teams demonstrate.
References
Strategy and Planning Division. Public health statistics 2017 [online]. 2017 [cited Jan 5, 2019]. Available from: http://www.pcko.moph.go.th/Health-Statistics/stratistics60.pdf
Caraceni A, Hanks G, Kaasa S, Bennett MI, Brunelli C, Cherny N, et al. Use of opioid analgesics in the treatment of cancer pain: evidence-based recommendations from the EAPC. Lancet Oncol. 2012;13(2):e58-68.
Gonella S, Sperlinga R, Sciannameo V, Dimonte V, Campagna S. Characteristics of breakthrough pain and its impact on quality of life in terminally ill cancer patients. Integr Cancer Ther. 2019;18:1-7.
Hamieh NM, Akel R, Anouti B, Traboulsi C, Makki I, Hamieh L, et al. Cancer-related pain: prevalence, severity and management in a tertiary care center in the middle east. Asian Pac J Cancer Prev. 2018;19(3):769-75.
Department of Medical Services. Clinical practice guideline for palliative care 2014 [online]. 2014 [cited Jan 15, 2019]. Available from: http://203.157.177.7/dward/document_file/ perdev/common_form_upload_file/20150316154846_2129601774.pdf
National Cancer Institute. Service plan of palliative care 2018 [onine]. 2018 [cited Jan 5, 2019]. Available from: http://www.nci.go.th/th/File_download/filePlan/Template%20นิยามตัวชี้วัด%20Service%20Plan%20สาขามะเร็ง%20ปี61-65.pdf
Wannakhotra S. Development of palliative care system in end stage cancer patient: case study at Khaowong hospital [Dissertation]. Mahasarakham: Mahasarakham University; 2018. (in Thai)
Oonjantheuk W. A comparison of outcomes between before and after pharmaceutical care with palliative care patients in outpatient palliative clinic of Sikhio Hospital, Nakhon Ratchasima Province. HRD.NR. 2021;7(1):32-44. (in Thai)
Changpetch P, Miteemitr P. Development of participation of pharmacist for cancer patients in Jaokunpiboonphanomtuan Hospital. Veridian E J. 2015;2(2):50-75. (in Thai)
Pummangura C. Philosophy of pharmaceutical care practice. In: Pummangura C, Tanyasaensook K, editors. Pharmacotherapeutics. Bangkok: New Thai Mitr Printing 1996; 2000. p.1-19.
Montakantikul P. Systematic pharmaceutical care. In: Pummangura C, Tanyasaensook K, editors. Pharmacotherapeutics. 2nd ed. Bangkok: New Thai Mitr Printing 1996; 2000. p.35-56.
Hathirat S. Principles of family medicine and home visit for pharmacists. In: Ningsanont T, Montakantikul P, Wanakamanee U, Suansanae T, Thongaim J, editors. Textbook of family pharmacists. Bangkok: Prachachon; 2014. p.7-14.
Thongaim J. Principles for a family pharmacist on home visit. In: Ningsanont T, Montakantikul P, Wanakamanee U, Suansanae T, Thongaim J, editors. Textbook of family pharmacists. Bangkok: Prachachon; 2014. p.15-28.
Chinda M, Jaturapatporn D, Kirshen J, Udomsubpayakul U. Reliability and validity of a Thai version of the Edmonton Symptom Assessment Scale. J Pain Symptom Manage. 2011;42(6): 954-60. (in Thai)
Sakthong P, Sonsa-Ardjit N, Sukarnjanaset P, Munpan W, Suksanga P. Development and psychometric testing of the Medication Taking Behavior in Thai patients (MTB-Thai). Int J Clin Pharm. 2016;38:438-45.
Ratanatharathorn V, Sirilerttrakul S, Jirajarus M, Silpakit C, Maneechavakajorn J, Sailamai P, et al. Quality of life, functional assessment of cancer therapy-general. J Med Assoc Thai. 2001; 84:1430-42. (in Thai)
Cella DF, Tulsky DS, Gray G, Sarafian B, Linn E, Bonomi A, et al. The functional assessment of cancer therapy scale: development and validation of the general measure. J Clin Oncol. 1993;11:570-9.
Delgado G.M, Parsons H.A, Li Z, Palmer J.L, Bruera E. Symptom distress in advanced cancer patients with anxiety and depression in the palliative care setting. Support Care Center. 2009; 17(5):573-79.
Wongkray S. Impact of pharmaceutical care on quality of life in breast cancer patient receiving chemotherapy [Dissertation]. Phitsanulok: Naresuan University; 2020. (in Thai)
Sthapornnanon N. Medication nonadherence. Thai Bull Pharm Sci. 2012;7(1):1-17. (in Thai)
Dumchaom A, Oo-puthinun S. Effectiveness of a pharmaceutical care-based program to improve medication adherence in elderly patients receiving polypharmacy in a community hospital in Kanchanaburi. Thai J Pharm Prac. 2020;12(3):772-88. (in Thai)
Puripun N, Deethongkham D, Kunsara P. Development for clinical nursing practice guideline for pain management in end-stage of cancer with SKT-8. J Nurs Division. 2020;47(1):173-89. (in Thai)
Downloads
Published
How to Cite
Issue
Section
License
All articles published and information contained in this journal such as text, graphics, logos and images is copyrighted by and proprietary to the Thai Bulletin of Pharmaceutical Sciences, and may not be reproduced in whole or in part by persons, organizations, or corporations other than the Thai Bulletin of Pharmaceutical Sciences and the authors without prior written permission.
