1.Intervention by PCT and Problems Awaiting Solution at Anjo Kosei Hospital: Usefulness of Rounds of Patients Receiving Opioids
Kazuyuki NAKAMURA ; Takanori MIURA ; Hiroyuki MANSHIO ; Eiji YONEYAMA ; Yoji SUGIURA ; Akio KATSUMI ; Mika SHIMADA ; Akiko OGINO ; Tomoko KOIKE ; Mamiko TAKEUCHI ; Yoriyuki NAKAMURA ; Yoshitaka ONO ; Jinwoo LEE
Journal of the Japanese Association of Rural Medicine 2012;61(1):8-15
In order to intervene in the management of pain of cancer from an early stage. Our palliative care team (PCT), including pharmacists, makes the ward rounds (screening rounds) of the patients receiving opioids at our hospital. The purpose of this study was to analyze the effects of screening rounds activity by the PCT and its current problems, and to explore how to resolve the problems. We retrospectively studied the records of 196 patients who had receivede interventions by the PCT, with regard to intervention status and prescription proposal (228 subjects) about drug therapy by us. Study groups were as follows: 103 patients to whom interventions were deliveed at the request of medical doctors (intervention request group) and 93 patients who had interventions by the PCT after PCT-screening rounds (screening group). PCT-screening rounds caused to increase the number of interventions by the PCT. After PCT-screening rounds, the cases of intervention started by the request of medical doctors, who had given no heed to PCT intervention, also increased in numher. In this study, some problems with palliative intervention were also brought to light. Even in the screening group where the PCT largely intervened, 33% of prescription proposal by the PCT was ignored. This problem may be, at least in part, due to inadequate communication between PCT and ward staff through an electronic medical recording card, leading to poor relationship between PCT and ward staff. In the future, the PCT needs to work cooperatively with ward staff through direct communication such as medical conference to perform better intervention.
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