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Pharmacist educational interventions for patients with advanced cancer pain living in the community

Edwards, Zoe
Publication Date
2019
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Supervisor
Breen, Liz
Fylan, Beth
Blenkinsopp, Alison
Keywords
Pharmacy, Medicines optimisation, Palliative care, Remote consultation, Cancer, Pain, Pharmacists, Pain control
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Creative Commons License
The University of Bradford theses are licenced under a Creative Commons Licence.
Peer-Reviewed
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Accepted for publication
Institution
University of Bradford
Department
Faculty of Life Sciences
Awarded
2019
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PhD Thesis
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Abstract
Background: At the end of life, patients living in their own homes experience significantly more pain than those who die in either hospital or hospice care (Office for National Statistics, 2015). With an increasing prevalence of this, person-centred medicines optimisation is essential. Aim: To investigate the feasibility of community pharmacist medicines optimisation services for patients living with advanced cancer pain in community settings. Methods: Mixed methods were used, adopting a pragmatic stance and approach. Qualitative interviews, a systematic review and meta-analysis and a proof-of-concept study were undertaken. Results: Patients with advanced cancer pain need support with their medicines which could be provided by a pharmacist. Patients experienced a significant number of medicines related problems, even those already receiving specialist palliative care. Most problems were addressed by pharmacist advice with the remainder being referred for additional prescribing. Care for patients with cancer pain is currently not person-centred and the current medicines optimisation model is unsuitable for this patient group. An enhanced model of medicines optimisation is therefore presented for patients with advanced cancer and this model can be amended and adopted for other patient groups. Conclusions: An enhanced medicines optimisation model (MOCAP) has been created to inform person-centred medicines optimisation for patients with advanced cancer pain. Feasibility and acceptability were also confirmed and it can be adapted for further clinical use. This model contributes to the goals of the NHS agenda of choice and control of care as proposed in the NHS Long Term Plan (NHS, 2019b).
URI
http://hdl.handle.net/10454/18753
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Type
Thesis
Qualification name
PhD
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