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纸质出版日期:2020,
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郑晓林, 林慧华, 张龙, 等. MDT模式下药师参与门诊癌痛患者阿片类药物治疗管理的作用研究[J]. 中国药房, 2020,31(6).
ZHENG Xiaolin, LIN Huihua, ZHANG Long, et al. Study on the Effect of Pharmacists Intervention on Opioid Treatment and Management in Outpatients with Cancer Pain under MDT Mode[J]. China Pharmacy, 2020,31(6).
目的:评价多学科协作团队(MDT)模式下药师参与门诊癌痛患者阿片类药物治疗管理的作用。方法:选择2016年1月-2018年12月于我院门诊就诊的120例癌痛患者,按随机数字表法分为观察组和对照组,每组60例。对照组患者根据疼痛程度选择阿片类药物+常规干预,观察组患者给予对照组治疗+MDT干预。随访1个月后,观察两组患者干预前后的疼痛情况、用药依从性情况、生存质量评分(QOL)、不良反应发生情况及满意度。结果:两组患者均完成随访。干预后,两组患者疼痛数字评分均显著低于同组干预前,且观察组显著低于对照组同期;两组患者用药依从性评分、QOL评分均显著高于同组干预前,且观察组显著高于对照组同期。随着治疗时间的延长,两组轻度疼痛及用药依从性中的患者例数逐渐增加,且观察组显著高于对照组同期,中、重度疼痛及用药依从性低的患者例数逐渐减少,且观察组显著少于对照组同期;观察组用药依从性高的患者例数显著高于同组干预前及对照组同期(P<0.05或P<0.01)。两组患者不良反应发生率比较差异无统计学意义(P>0.05)。观察组患者对疼痛控制结果、医师处理方法、药师随访的满意度均显著高于对照组(P<0.05或P<0.01)。结论:在MDT模式下,药师参与门诊癌痛患者阿片类药物治疗的管理可有效缓解其疼痛,提高用药依从性及生存质量。
OBJECTIVE:To eval uate the effect of pharmacists intervention on opioid treatment and management in outpatients with cancer pain under multidisciplinary team (MDT)mode. METHODS :Totally 120 outpatients with cancer pain were selected from outpatient department of our hospital from Jan. 2016 to Dec. 2018,and divided into observation group and control group according to random number table method ,with 60 cases in each group. After 1 month follow-up ,patients in the control group were given opioid analgesics and routine intervention according to pain degree ,while patients in the observation group were given same treatment as control group and pharmacist intervention based on MDT. The pain condition ,medication compliance condition , quality of life (QOL)score,the incidence of ADR and satisfaction degree were observed in 2 groups before and after intervention . RESULTS:Follow-up were completed in 2 groups. After intervention ,NRS scores of 2 groups were significantly lower than before intervention;the observation group was significantly lower than the control group ;medication compliance scores and QOL scores of 2 groups were significantly higher than before intervention ,the observation group was significantly higher than the control group at the same time . With the prolongation of treatment time ,the number of patients with mild pain and general medication compliance in 2 groups increased gradually ,and the observation group were significantly higher than the control group at the same time;the number of patients with moderate
severe pain and low medication compliance were significantly decreased gradually , and the observation group was significantly lower than the control group at the same time. The number of patients with good medication compliance in the observation group was significantly higher than that in the same group before intervention and the control group at the same time (P<0.05 or P<0.01). There was no significant difference in the incidence of ADR between 2 groups(P>0.05). The satisfaction of pain control results ,doctors’treatment and pharmacists follow-up in the observation group were significantly higher than control group (P<0.05 or P<0.01). CONCLUSIONS :Under MDT mode ,pharmacists participating in the management of opioid treatment for cancer pain outpatients can effectively relieve the pain ,and improve the medication compliance and quality of life .
多学科协作团队模式门诊癌痛患者阿片类药物用药依从性生存质量不良反应药师
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