Effect of team medical palliative care on chemotherapy for outpatients

Abstract

Background: Recently, ambulatory treatment is mainly on chemotherapy for cancer patients. It is problem that medical staffs could not sufficiently monitor patient's pain level on outpatients more than wards patients. Therefore, organization of palliative care for outpatients is so important. In the present report, we investigated the effects of team palliative care and chemotherapy on outpatients. Method(s): The study subjects were 10 out of 43 patients (23.3%) of breast cancer which treated by chemotherapy, and which complained cancer pain on ambulatory treatment center (ATC). After consultation of Dr., cancer pain management nurse (CPMN) heard pain levels and complaints from patients. In ATC, JSPHCS-certified Oncology Pharmacist (JOP) and other CPMN (ATC-CPMN) carried out a meeting and consultation for patients after received its status from CPMN. JOP and ATC-CPMN integrated problems related with patients, and approached it to improve. Result(s): All cases were subject to require the pain relief. CPMN proposed that use of narcotics to pain and use of preparations for dermal wound with consultation to JOP. After JOP checked pain and monitored adverse events for analgesics, he suggested to Drs. that appropriate dosage, route of administration and supportive care. JOP could assure adherence medicine by use of telephone in case of using difficult narcotics such as Rapid Onset Opioid. ATC-CPMN could support patients' living by integration and analysis to their pains in collaboration with JOP. Conclusion(s): Our results indicate that we can execute efficient and high-quality palliative care in busy ambulatory practice and chemotherapy on outpatients. Therefore, it is possible that patients having distress in daily life by cancer treatment and pain are willing. We will intend to develop these system and pursue other medical departments. We want to expand it for all cancer patients regardless with or without chemotherapy.