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

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. 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.