临床药师在姑息性放疗患者癌痛管理中的作用

Role of Clinical Pharmacists in Tumor Pain Management of Palliative Radiotherapy

目的:探讨临床药师在姑息性放疗患者癌痛管理中的作用。方法:采用前瞻性随机对照研究,将我院放疗科进行姑息性放疗、符合病例入组条件的癌痛患者随机分为观察组和对照组,各30例。临床药师参与观察组患者的用药治疗,为医师提供药学服务,记录两组患者药物治疗情况、疼痛评分、服药依从性、卡氏(KPS)评分及生存质量评分。结果:综合治疗第5天,观察组患者疼痛缓解率为63.3%,高于对照组的缓解率36.7%(P<0.05)。治疗1个月,两组患者的疼痛缓解率为70%、80%(P>0.05);KPS评分、生存质量评分及服药依从性均较治疗前有明显改善(P<0.01或P<0.05),且观察组的服药依从性优于对照组(P<0.01)。结论:临床药师参与癌痛管理可明显提高患者服药依从性,更有效缓解癌痛。

OBJECTIVE： To explore the role of clinical pharmacists in tumor pain management for patients receiving tumor pain palliative radiotherapy. METHODS： In prospective randomized controlled study, 60 patients with tumor pain who received palliative radiotherapy in radiotherapy department of our hospital from June 1,2013 to May 31,2014, according with the selection criteria, were randomized into observation group （30 cases） and control group （30 cases）. Clinical pharmacists participated in the treatment of observation group; provided pharmaceutical care for doctors; and recorded drug treatment, pain evaluation, medica- tion compliance, Kamofsky Performance Status （KPS） and quality of life（QOL）of 2 groups. RESULTS： On the 5th day, the pain remission rate of observation group reached 63.3%, and was significantly higher than that （36.7%） of control group （P〈0.05）. 1 month treatment later, pain remission rate of 2 groups reached 70% and 80%, respectively （P〉0.05）. At the same time, KPS, QOL and medication adherence were all improved significantly, compared with before treatment （P〈0.01 or P〈0.05）, and medi- cation adherence of observation group was obviously better than that of control group （P〈0.01）. CONCLUSIONS： The participa- tion of clinical pharmacists in the pain management can obviously improve medication compliance, relieve pain more effectively, and promote rational drug use.