Impact of pharmacist-led chemotherapy counseling on health-related quality of life and psychological outcomes of oncology patients in cancer hospital: A single center, open-label, randomized controlled trial

Abstract

Background

Chemotherapy often imposes significant psychological distress and impairs the health-related quality of life (HRQoL) of oncology patients. This study aimed to assess the impact of pharmacist-led chemotherapy counseling on HRQoL and psychological outcomes among oncology patients in a cancer hospital in Nepal.

Methods

A single-blind, randomized controlled trial was conducted from December 2022 to July 2023 among 128 patients receiving chemotherapy. Patients were randomly allocated in a 1:1 ratio to a control group (usual care) or an intervention group (pharmacist-led counseling plus usual care). The intervention comprised a structured 20–25 min face-to-face counseling session and an educational leaflet addressing cancer, chemotherapy, psychological aspects, and lifestyle modifications. Primary outcomes—anxiety (GAD-7), depression (PHQ-9), and HRQoL (EQ-5D-3L)—were measured at baseline and three months post-intervention. For GAD-7 and PHQ-9, lower scores indicate fewer symptoms; for EQ-5D-3L, higher scores reflect poorer quality of life. Data were analyzed using an intention-to-treat approach and a generalized estimating equation (GEE) model.

Results

The intervention group demonstrated significant improvements in anxiety (GAD-7: 13.57 ± 4.08 to 10.90 ± 3.79; p < 0.001), depression (PHQ-9: 17.71 ± 4.57 to 13.50 ± 4.17; p < 0.001), and HRQoL (EQ-5D-3L: 11.82 ± 3.41 to 9.85 ± 2.51; p < 0.001) at three months. The control group showed no significant changes in GAD-7 or EQ-5D-3L scores, but a small increase in PHQ-9 scores was observed. Adjusted GEE analyses confirmed significant reductions in anxiety and depression symptoms, as well as improvements in HRQoL for the intervention group compared with the control group.

Conclusion

Pharmacist-led chemotherapy counseling significantly improved psychological well-being and HRQoL among oncology patients, highlighting the valuable role of pharmacists in comprehensive cancer care, especially in low-resource settings.