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Pharmacist Involvement in Cancer Pain Management: A Systematic Review and Meta-Analysis

  • Sunil Shrestha
    Affiliations
    School of Pharmacy, Monash University Malaysia, Subang Jaya, Selangor, Malaysia
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  • Bhuvan KC
    Affiliations
    School of Pharmacy, Monash University Malaysia, Subang Jaya, Selangor, Malaysia

    College of Public Health, Medical & Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
    Search for articles by this author
  • Ali Qais Blebil
    Affiliations
    School of Pharmacy, Monash University Malaysia, Subang Jaya, Selangor, Malaysia

    Department of Pharmacy, Al Rafidain University College, Baghdad, Iraq
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  • Siew Li Teoh
    Correspondence
    Address reprint requests to Siew Li Teoh, PhD, School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, 47500 Subang Jaya, Selangor, Malaysia.
    Affiliations
    School of Pharmacy, Monash University Malaysia, Subang Jaya, Selangor, Malaysia
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Published:February 09, 2022DOI:https://doi.org/10.1016/j.jpain.2022.02.002

      Highlights

      • Patients with cancer pain require a comprehensive management approach from multidisciplinary collaboration.
      • Medication review was the most common intervention employed by pharmacists.
      • The involvement of pharmacists significantly reduced pain intensity in cancer pain management.

      Abstract

      This review aimed to critically evaluate the impact of pharmacist involvement in managing pain in cancer patients. Databases (including MEDLINE, Embase and CENTRAL) were searched with a broad search strategy for studies involving pharmacists and cancer pain management until February 10, 2021. The quality of studies and evidence were assessed using standardized tools and GRADE, respectively. A random-effects model was used for meta-analysis. Sixty-four studies were included. Common interventions delivered by the pharmacists were medication review, patient education, adverse drug reactions (ADRs) detection and management, pharmacological recommendations (in dosing and pharmacotherapy choice), and pain assessment. A pooled analysis of 3 randomized control trials showed a significant reduction in pain intensity with a standardized mean difference (SMD) of 0.35 [95% confidence intervals (CI): -0.55, -0.16]. Pooled analyses from nonrandomized studies of interventions also showed significant results in reduction of ADRs with an odds ratio of 0.69 (95% CI: 0.61, 0.79) and improvement in quality of life with SMD of 0.80 (95% CI: 0.29, 1.32). Thus, pharmacists significantly improve the clinical outcomes of cancer patients related to pain. This indicates the involvement of pharmacists directly or in collaboration with healthcare professionals in the oncology team is highly beneficial for the patients.

      Perspectives

      This systematic review presents a comprehensive evaluation of pharmacist involvement in cancer pain management. This shows the importance of direct involvement of the pharmacist or as an important member of the multidisciplinary oncology team.

      Key words

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