医療用麻薬導入前における薬剤師による疼痛アセスメントと処方提案の有用性

抄録

Occasionally, we have experienced cases of patients with mild articulating pain who have been introduced to opioids. We considered the possibility that physician assessment alone might be insufficient. We developed and examined the usefulness of a system that helps pharmacists perform a pain assessment prior to consultation and suggest prescriptions for analgesics.

From March 1, 2020 to December 31, 2020, the number of prescription suggestions and the rate at which they were adopted were investigated in patients who were instructed before opioid introduction. The number of patients instructed was 226, whereas the number of prescription suggestions was 231, with an adoption rate of 98.3％. The 23 patients who did not use opioids showed significantly improved mean pain scores, from a median NRS of 3 - 2 (P = 0.0123), with the most intense pain decreasing from a median NRS of 7 - 5 (P = 0.0154). We believe that pain assessment before opioid induction facilitated the selection of an appropriate analgesic. However, among the nine patients who were instructed after opioid introduction, two expressed minor pain. We believe that the pharmacist's prescription suggestion, which is tailored to the patient’s life background and general condition, promoted the selection of an appropriate analgesic.

In conclusion, pharmacists should evaluate pain and prescription suggestions before introducing opioids as a strategy to support medical treatment and promote appropriate opioid use, thereby suggesting their active utilization in clinical practice throughout Japan.