内容紹介
Summary
It was reported that focusing on palliative care for patients with cancer improved their anxiety and depression and prolonged their survival. Similarly, the pharmacist intervention for cancer patients suggested the improvement in anxiety and depression; but, such improvement has not yet been demonstrated by focusing on pharmacist attitudes and behaviors of which the patients were the primary beneficiaries. Therefore, we evaluated the significance of pharmacist intervention focusing on improvement of adverse events and cancer pain. We randomized patients to pharmacist intervention group or no intervention group and evaluated whether the pharmacist intervention improved patients' anxiety and depression. Patients receiving new chemotherapy in the outpatient chemotherapy room were invited to enroll in this study between July 2015 and February 2017. The patients were assessed for their quality of life using the Structured Clinical Interview for ACD and for anxiety and depression using the Structured Clinical Interview for HAD at baseline and again at the 4th chemotherapy. The difference between the baseline and 4th chemotherapy scores was calculated and compared between the pharmacist intervention and no intervention groups. HAD depression subscale and HAD scale scores decreased in the pharmacist intervention group compared to the no intervention group,(-1 versus 0.5, p=0.024)and(-3 versus 0.5, p=0.011)respectively. We demonstrated that the pharmacist intervention focused on improvement of adverse event and cancer pain decreased cancer patients' anxiety and depression.
要旨
近年,がん患者に対して各職種が専門性を発揮して緩和的介入を行うことで,がん患者の不安・抑うつが改善し,生存期間が延長することが報告されている。また,薬剤師の介入により,がん患者の不安・抑うつの改善を示唆する報告もあるが,患者利益を据えた薬剤師の姿勢・行動に着目した報告はない。そこでわれわれは,副作用・疼痛改善を軸に据えた薬剤師介入の意義について検討した。薬剤師介入群,非介入群に無作為割り付けを行い,がん患者の不安・抑うつ,QOLの改善を検討した。2015年7月～2017年2月の期間に,横須賀共済病院の外来化学療法室で初回化学療法を受けた患者,また継続治療後にレジメンが変更された患者を対象とした。薬剤師介入群,非介入群に対してACD尺度を用いてQOLを評価し,HAD尺度を用いて不安・抑うつを評価した。ACD尺度,HAD尺度は化学療法実施前と4コース目の2回評価し,それぞれ差を求めて検定を行った。薬剤師介入群は非介入群に対してHAD抑うつ(-1 versus 0.5,p=0.024),HAD合計(-3 versus 0.5,p=0.011)のみ有意に減少しており,副作用・疼痛改善を軸に据えた薬剤師介入により不安・抑うつが改善することが示された。
目次
It was reported that focusing on palliative care for patients with cancer improved their anxiety and depression and prolonged their survival. Similarly, the pharmacist intervention for cancer patients suggested the improvement in anxiety and depression; but, such improvement has not yet been demonstrated by focusing on pharmacist attitudes and behaviors of which the patients were the primary beneficiaries. Therefore, we evaluated the significance of pharmacist intervention focusing on improvement of adverse events and cancer pain. We randomized patients to pharmacist intervention group or no intervention group and evaluated whether the pharmacist intervention improved patients' anxiety and depression. Patients receiving new chemotherapy in the outpatient chemotherapy room were invited to enroll in this study between July 2015 and February 2017. The patients were assessed for their quality of life using the Structured Clinical Interview for ACD and for anxiety and depression using the Structured Clinical Interview for HAD at baseline and again at the 4th chemotherapy. The difference between the baseline and 4th chemotherapy scores was calculated and compared between the pharmacist intervention and no intervention groups. HAD depression subscale and HAD scale scores decreased in the pharmacist intervention group compared to the no intervention group,(-1 versus 0.5, p=0.024)and(-3 versus 0.5, p=0.011)respectively. We demonstrated that the pharmacist intervention focused on improvement of adverse event and cancer pain decreased cancer patients' anxiety and depression.
要旨
近年,がん患者に対して各職種が専門性を発揮して緩和的介入を行うことで,がん患者の不安・抑うつが改善し,生存期間が延長することが報告されている。また,薬剤師の介入により,がん患者の不安・抑うつの改善を示唆する報告もあるが,患者利益を据えた薬剤師の姿勢・行動に着目した報告はない。そこでわれわれは,副作用・疼痛改善を軸に据えた薬剤師介入の意義について検討した。薬剤師介入群,非介入群に無作為割り付けを行い,がん患者の不安・抑うつ,QOLの改善を検討した。2015年7月～2017年2月の期間に,横須賀共済病院の外来化学療法室で初回化学療法を受けた患者,また継続治療後にレジメンが変更された患者を対象とした。薬剤師介入群,非介入群に対してACD尺度を用いてQOLを評価し,HAD尺度を用いて不安・抑うつを評価した。ACD尺度,HAD尺度は化学療法実施前と4コース目の2回評価し,それぞれ差を求めて検定を行った。薬剤師介入群は非介入群に対してHAD抑うつ(-1 versus 0.5,p=0.024),HAD合計(-3 versus 0.5,p=0.011)のみ有意に減少しており,副作用・疼痛改善を軸に据えた薬剤師介入により不安・抑うつが改善することが示された。