Hospital–pharmacy cooperative training and drug-taking compliance in outpatients with chronic pain: a case–control study

Figures & data

Figure 1 Design of the present study. 87 patients were measured at the first visit and at the second visit, and the differences between the three groups were compared.

Abbreviations: NRS, numerical rating scale; BPI, Brief Pain Inventory; HADS, Hospital Anxiety and Depression; QOL, quality of life.

Figure 2 Brief pain index questionnaire. Evaluation was performed in all patients at 11 levels based on the degree of pain and the mood and behavior disturbed by pain. Note: Copyright ©2009. MD Anderson Cancer Center. Reproduced from Cleeland CS. The Brief Pain Inventory User Guide. Available from: https://www.mdanderson.org/documents/Departments-and-Divisions/Symptom-Research/BPI_UserGuide.pdf.¹¹

Figure 3 Hospital Anxiety and Depression Scale questionnaire. To evaluate anxiety and depressive state of patients with physical symptoms, they were asked to attempt a questionnaire comprising 14 items.

Note: Copyright © 1983. John Wiley & Sons, Inc. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983 Jun;67(6):361–370.14

Figure 4 Locomo 25 questionnaire. Locomo 25 was developed as a screening tool of locomotive syndrome by a Japanese orthopedic surgeon group in 2008. It comprises 25 questions related to musculoskeletal disorders such as walking disability, difficulty in activities of daily living, or pain in the body.

Note: Translated with permission from The Japanese Orthopaedic Association. Locomo challenge. Available from: https://locomo-joa.jp/check/test/locomo25.html.²⁰

Table 1 Patient background

	Male	Female	P-value
Number of patients	24	63
Mean age (years)	65	58.37	0.019*
Pharmacies
Patients who consulted a pharmacy that received training	7	17	0.57**
Patients who consulted a pharmacy that did not receive training	12	38
Patients who do not have a preferred pharmacy	5	8
Chronic primary pain	15	37	0.56**
Chronic headache	0	0
Chronic orofacial pain	0	0
Chronic cancer pain	1	4
Chronic posttraumatic and postsurgical pain	0	4
Chronic neuropathic pain	7	9
Chronic visceral pain	0	2
Chronic musculoskeletal pain	1	7
The presence or absence of a pharmacy that is regularly used (individuals)
With	12	25	0.387**
Without	12	38
Compliance (individuals)
Good	11	21	0.325**
Poor	13	42
Preconsultation drug
Opioids	14	32	0.633**
NSAIDs	12	19	0.132**
Acetaminophen	5	23	0.164**
Antidepressants	8	28	0.350**
Pregabalin/Gabapentin	8	23	0.784**
Benzodiazepines	16	39	0.682**
Post-treatment drug
Opioid	12	27	0.632**
NSAIDs	10	17	0.048**
Acetaminophen	9	19	0.609**
Antidepressants	13	35	0.908**
Pregabalin/Gabapentin	13	43	0.316**
Benzodiazepines	14	30	0.473**
Pain site
Head and neck	2	4	0.744**
Shoulders and upper limbs	1	4	0.695**
Chest	3	13	0.381**
Abdomen	7	24	0.437**
Back	5	12	0.851**
Lower back	5	14	0.888**
Hips	2	5	0.951**
Lower limbs	5	8	0.341**
Other	1	2	0.820**
The presence or absence of consulting a pharmacy that has received training with the hospital
With consultation	7	17	0.84**
Without consultation	17	46
			**Chi-square test

Notes: *Mann–Whitney U test, **Chi-square test.

Abbreviation: NSAIDs, nonsteroidal anti-inflammatory drugs.

Table 2 A comparison of the pain treatment outcomes and compliance according to the presence or absence of a pharmacy regularly used and the presence or absence of training with the hospital

	Patients who prepared a pharmacy that received training	Patients who prepared a pharmacy that did not receive training	Patients without a pharmacy that they regularly use	P-value
Number of patients	24	13	50
Compliance
Good	20	5	7	<0.05*
Poor	4	8	43
Pretreatment evaluation (difference)
BPI	12	3.38	0.32	<0.05**
			*Chi-square test

Notes: *Chi-square test, **Kruskal Wallis test.

Abbreviation: BPI, Brief Pain Inventory.

Figure 5 BPI according to the presence or absence of training with a hospital and the presence or absence of a preferred pharmacy. Patients who consulted a trained pharmacy experienced pain relief compared with those who consulted an untrained pharmacy.Abbreviation: BPI, Brief Pain Inventory.

Table 3 A comparison of the treatment outcomes according to the presence or absence of a pharmacy regularly used and the presence or absence of training with the hospital

	Patients who prepared a pharmacy that received training	Patients who prepared a pharmacy that did not receive training	Patients without a pharmacy that they regularly use	P-value
Number of patients	24	13	50
Pretreatment evaluation (difference)
HADS – Anxiety	2.54	−0.85	−0.12	0.048
HADS – Depression	−1.63	−2.46	1.12	0.464
EuroQOL	0.63	0	−0.08	0.173
Athens Scale	4.63	3.08	−0.38	0.000003
Locomo 25	9.17	3	0.92	0.047

Note: All tests in this table were performed by Kruskal Wilis test.

Abbreviations: BPI, Brief Pain Inventory; HADS, Hospital Anxiety and Depression; QOL, quality of life.

Ceeland CS. The brief pain inventory user guide. Available from: https://www.mdanderson.org/documents/Departments-and-Divisions/Symptom-Research/BPI_UserGuide.pdf

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The Japanese Orthopaedic Association. Locomo challenge. Available from: https://locomo-joa.jp/check/test/locomo25.html. Accessed 12 4, 2018.

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