Abstract
BackgroundWith the development of pharmacotherapy and radiotherapy, cancer treatment is being shifted from surgical to outpatient services, consequently increasing insurance-covered pharmacies’ frequency of dealing with cancer patients. As the psychology of these patients is complex, it is necessary for pharmacists to educate them in consideration of their cognitive/medical and psychosocial aspects. This study analyzed cancer patient management by pharmacists working in such pharmacies and their communication skills before and after communication skill training based on SPIKES, a six-step protocol for delivering bad news, to confirm the usefulness of such training.MethodsThe study involved 20 pharmacists working in insurance-covered pharmacies within Aichi Prefecture. Before and after communication skill training, role-play sessions were held using standardized patients, whose levels of satisfaction were subsequently measured. Patient management by the pharmacists was analyzed using the Roter Interaction Analysis System as a method to analyze dialogues.ResultsThe rate of each category, representing the pharmacists’ conversation styles when dealing with the patients, changed after communication skill training as follows: [Giving information]: decreased from 37.0 to 27.6%; [Empathy statements]: increased from 12.0 to 17.2%; and [Data gathering]: increased from 18.0 to 23.3%. The increase was particularly marked in: [Acceptance], accepting patients’ emotions and events in line with [Empathy statements]; [Promoting dialogues] as a sub-category of [Building a relationship]; and [Checks for understanding] as a sub-category of [Data gathering]. Furthermore, the results of pharmacist assessment by the patients, including their levels of overall satisfaction, showed significant correlations with [Empathy statements] and [Building a relationship].ConclusionsCommunication skill training may be effective to improve pharmacists’ conversation styles to listen to patients more attentively, accept their emotions, and provide education in accordance with their needs, rather than unilaterally providing information.Trial registrationThe study was approved by the Ethical Review Board of Meijo University as a research activity involving humans (approval number: H26-1).
Highlights
With the development of pharmacotherapy and radiotherapy, cancer treatment is being shifted from surgical to outpatient services, increasing insurance-covered pharmacies’ frequency of dealing with cancer patients
The present study focused on cancer patient education, and examined whether participation in communication skill training (CST) based on SPIKES is effective for pharmacists to acquire communication skills to appropriately provide such education in individual situations
In the study, SPIKES was incorporated into CST for the management of cancer patients (Fig. 1)
Summary
With the development of pharmacotherapy and radiotherapy, cancer treatment is being shifted from surgical to outpatient services, increasing insurance-covered pharmacies’ frequency of dealing with cancer patients. In Japan, medical and pharmacy services are increasingly being provided separately, and it is possible for patients to receive anti-cancer medications at insurance-covered pharmacies based on prescriptions issued by doctors. Under these circumstances, insurancecovered pharmacies’ frequency of dealing with cancer patients is increasing, requiring pharmacists’ active commitments in cancer care, such as providing anti-cancer medication guidance, and monitoring adverse drug reactions [3–5]. There are concerns that even when patients seek information related to treatment methods or anti-cancer drugs for themselves, pharmacists may not be able to provide sufficient explanations due to a lack of patient information [4, 6]
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