Abstract
BACKGROUND: Polypharmacy is common among people living with chronic pain. This study aimed to evaluate the clinical impact of pharmacist-led medication reviews (MRs) in a pain clinic and to explore the perceptions of the interdisciplinary team regarding these interventions. METHODS: We analysed data from pharmacist-led MRs performed on patients admitted to day hospitals between November 2022 and April 2023. The clinical impact of MRs was assessed using validated scoring tools, and predictors of MR performance were identified through multivariate analysis. Additionally, focus groups were conducted to capture the interdisciplinary team's perception of integrating MR into clinical practice. RESULTS: Among the 107 patients reviewed (88.8% over 40 years old; 67.3% female; 59.8% neuropathic pain), the most frequent pharmacist interventions included dosage adjustments (35%), treatment discontinuations (26%) or switches (22%), primarily targeting nervous system drugs (65%). These interventions were deemed clinically significant or very significant in 91% of cases based on the Hatoum Scale. Predictive factors influencing MR performance included the total number of medications, pain type and self-medication practices. Focus group discussions revealed three key themes: the value of interprofessional collaboration, the positive impact of pharmacist expertise on patient care and opportunities for practice evolution through pharmacist integration. CONCLUSION: Pharmacist-led MRs in a pain clinic have demonstrated significant clinical impact. By identifying predictors of effective interventions, this study provides insights for targeting patients who may benefit most. Furthermore, the recognition of pharmacists' expertise by the interdisciplinary team supports the integration of pharmacy-led initiatives to enhance collaborative care and improve pain management practices. SIGNIFICANCE STATEMENT: We conducted an original study combining quantitative and qualitative aspects. This study illustrates the value of developing pharmacist-led interventions in a pain clinic and suggests easily accessible criteria for prioritising medication reviews in clinical daily practice. It demonstrated the benefits of a pharmacist involvement in a specialised care unit, with actionable insights for optimising interprofessional collaboration and targeting priority patients.