Interprofessional Collaboration Between a Multidisciplinary Palliative Care Team and the Team Pharmacist on Pain Management

Am J Hosp Palliat Care. 2019 Jul;36(7):616-622. doi: 10.1177/1049909119829047. Epub 2019 Feb 12.

Abstract

Purpose: The purpose of the study was to evaluate the impact on pain management by multidisciplinary palliative care team (mPCT) and the team pharmacist.

Methods: Patients who were admitted to palliative care unit (PCU) for at least 7 days between April 2014 and December 2015 were included. The mPCT consisted of a physician, a pharmacist, nurses, and non-clinical support staff. The team was on charge of pain management of patients who were admitted to PCU. Pain intensity was assessed at 3 time points in each patient; 1 week before PCU admission (day -7), on the day of admission (day 0), and 1 week after admission (day 7) using 0 to 10 numerical rating scale (NRS). Analgesic use was evaluated with 6 categories based on National Comprehensive Cancer Network and Korean pain management guidelines. Pain intensity and analgesic use appropriateness were compared at day -7, day 0, and day 7 for the patients who were admitted to the PCU.

Results: Pain intensity decreased significantly on day 7 of PCU admission compared to it on day 0 (NRS: 4.05 vs 2.66, P < .001). A significant negative correlation was found between pain intensity and the proper use of analgesics ( r = -0.407; P < .001, r = -0.309; P = .001, r = -0.241; P = .009, on day -7, day 0, day 7, respectively).

Conclusion: The mPCT contributed to the reduction of inappropriate use of analgesics and improved pain control. Pharmacist intervention appeared to have improved pain control in patients under palliative care. Each team member's role should be individualized and developed further.

Keywords: analgesics; appropriateness; multidisciplinary; pain management; palliative care; pharmacist.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Attitude of Health Personnel
  • Female
  • Humans
  • Interprofessional Relations*
  • Male
  • Middle Aged
  • Pain Management / psychology*
  • Palliative Care / standards*
  • Patient Care Team / standards*
  • Pharmacists / psychology*
  • Physicians / psychology*
  • Practice Guidelines as Topic*