-Original-

Nationwide Survey of Pharmacist Involvement in Managing Cancer Pain in Children

Kayoko Morio¹, Chikako Iwai², Shuntaro Yasuda³, Takehiro Kawashiri^4,5, Noriaki Hidaka^4,6, Aina Suzuki^4,7, Mayako Uchida^4,8 and Hisamitsu Takase^4,9

¹Department of Pharmacy, Kobe University Hospital, Hyogo, Japan
²Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
³Department of Pharmacy, Institute of Science Tokyo Hospital, Tokyo, Japan
⁴Task Force for Advanced Academic Palliative Care Pharmacy, Osaka, Japan
⁵Department of Clinical Pharmacy and Pharmaceutical Care, Graduate School of Pharmaceutical Sciences, Kyushu University, Fukuoka, Japan
⁶Division of Pharmacy, Ehime University Hospital, Ehime, Japan
⁷Department of Pharmacy, Juntendo University Hospital, Tokyo, Japan
⁸Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan
⁹Department of Pharmacy, Juntendo University Urayasu Hospital, Chiba, Japan

Background: Cancer pain distresses pediatric patients, affects quality of life, and is a psychological burden for families. The purpose of this study was to clarify the role of pharmacists in assisting children with cancer pain and their families.
Methods: Between February and May 2024, a nationwide questionnaire survey was conducted among hospital pharmacists from the Japanese Society for Pharmaceutical Palliative Care and Sciences. The survey examined pharmacist involvement with children <15 years of age with cancer pain and their families, particularly in pain assessment, explaining analgesic use, and managing psychological, social, and spiritual pain.
Results: Of 2,720 pharmacists, 219 (8.1%) responded, 57 of whom (26.0%) had pediatric palliative care experience. Most pharmacists performed pain assessments, provided analgesic explanations (86.0%), and intervened in psychological, social, and spiritual pain (54.4%). Among those who intervened, more than 90% either communicated with patients and their families or listened to their concerns. Pharmacists with ≥5 years of experience were significantly more involved in psychological, social, and spiritual pain than were those with <5 years of experience (odds ratio, 3.46; 95% confidence interval, 1.04-11.54). However, most pharmacists reported difficulties in pain assessment and providing analgesic explanations; the main reasons were "due to patient age and comprehension" (87.0%) and "reluctance to initiate opioid analgesics by patients or their families" (68.3%), respectively.
Conclusions: Pharmacists were actively engaged in pain management for children with cancer and their families. However, most reported difficulties, particularly in pain assessment and analgesic explanations. Therefore, educational programs should be developed to facilitate effective pain management.

J Nippon Med Sch 2025; 92: 337-348

Keywords
pediatric, pharmacist, cancer, pain, family

Correspondence to
Kayoko Morio, PhD, Department of Pharmacy, Kobe University Hospital, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
kayoko.morio0826@gmail.com

Received, January 8, 2025
Accepted, April 23, 2025