Clinical pharmacists’ intervention on pain management in cancer patients (PharmaCAP trial): study protocol for a randomized controlled trial

Abstract

Introduction Evidence-based services to support cancer patients with pain via clinical pharmacy services are currently lacking. Therefore, there is a need to undertake a randomized controlled trial (RCT) to explore the effectiveness of clinical pharmacists (CPs)’ input into the multidisciplinary team (MDT) in providing better therapeutic outcomes for cancer pain management. Objectives The main aim of this pilot RCT is to determine the feasibility and preliminary efficacy of integrating CPs into the MDT for cancer pain management on the clinical outcomes of cancer patients experiencing pain. Methods This study protocol outlines two-armed multicenter pilot RCT. Cancer patients suffering from pain will be randomly allocated to receive either clinical pharmacy services, i.e., PharmaCAP trial intervention from the CP, or the usual standard care (i.e., control group). Patients will be recruited consecutively from two hospitals in Kathmandu valley, Nepal. The outcomes will be assessed at baseline (pre-intervention) and 4 weeks post-intervention. The primary feasibility outcomes will include eligibility rate, recruitment rate, willingness to participate, acceptability of screening procedures and random allocation, possible contamination between the groups, intervention fidelity and compliance, treatment satisfaction, and patient understanding of the provided interventions. Subsequently, the primary clinical outcome, i.e., pain intensity of cancer patients, will be assessed. The secondary clinical outcomes will include health-related quality of life (HRQoL), anxiety, depression, adverse drug reactions, and patient medication compliance following the integration of CP into the healthcare team. Discussion The feasibility and potential for integrating CP involvement in MDT to improve clinical outcomes of cancer patients with pain will be evaluated through the PharmaCAP trial. Trial registration: ClinicalTrials.gov NCT05021393. Registered on 25th August 2022.

Therapy by physician–pharmacist combination and economic returns for cancer pain management in China: a cost-effectiveness analysis

“…Recognizing the importance of their role, the National Health Commission in China initiated the training of clinical pharmacists in 2006 and established pain professional training centers. After a year of pain orientation training, pain pharmacists are equipped to conduct drug reviews, provide patient education and counseling, detect and manage adverse drug reactions (ADRs), recommend dose or treatment adjustments to physicians, and perform cancer pain assessments (Shrestha et al, 2023). Pharmacists play an active and significant role in facilitating the transition of care for patients with cancer pain.…”

Characteristics of the clinical pharmacist interventions at the National Center for Cancer Care and Research Hospital in Qatar

“…Thus, CPIs are essential in preventing and relieving adverse events in hospitalized patients. 21,22 Clinical pharmacists provide pharmaceutical care, reduce the intensity of pain as well as improve cancer patients' quality of life. 22 This study enlightens decision-makers in the healthcare system about the essential role of clinical pharmacists in improving health outcomes in fragile populations like cancer patients.…”

“…21,22 Clinical pharmacists provide pharmaceutical care, reduce the intensity of pain as well as improve cancer patients' quality of life. 22 This study enlightens decision-makers in the healthcare system about the essential role of clinical pharmacists in improving health outcomes in fragile populations like cancer patients. Findings from this study indicate that the addition of medication was the most frequent intervention as it represented around a quarter of the interventions in the study population.…”

Current practices, gaps, and opportunities on the role of clinical pharmacists in cancer pain management: Perspectives from Nepal

“…Clinical pharmacy services hold a pivotal role in cancer pain management, 30 , 31 especially within the context of Nepal's healthcare landscape. These services are essential in ensuring that cancer patients receive optimal pain management, a critical component of their overall care.…”