Research on palliative care services in Thailand is incomplete. We conducted a countrywide cross-sectional postal survey to update the situation. We approached hospitals and asked them to respond to a questionnaire. The overall response rate of government hospitals was 61 percent (537 of 882 hospitals). Of these, 59 percent reported that they had personnel trained in palliative care; the majority had received less than a week of such training. In all, 60 percent of the hospitals reported that they offered palliative care services, but 25 percent of these services were delivered by staff who had no palliative care training. The criteria of having at least one trained doctor and nurse on staff was met by 17 percent of the hospitals. Only seven hospitals, most of them associated with medical schools, employed both a doctor and a nurse who had been trained in palliative care for one month or more; these professionals mainly provided hospital and home palliative care team services. Our survey reveals the lack of both health care personnel fully trained in palliative care and specialist palliative care services in Thailand.
Context:Palliative care in Thailand was not well developed in the past. Previous studies showed that the actual prescription of opioids was underutilized in palliative care by physicians compared with the estimated opioid need of patients. However, there were no studies regarding the regulation of opioids in Thailand.Aims:To provide an up-to-date overview of the role of multidisciplinary teams in the regulation of opioids in Thai government hospitals.Settings and Design:A questionnaire survey study was conducted from January to April 2012.Materials and Methods:The questionnaire was distributed to entire population of government hospitals in Thailand and all private hospitals in Bangkok. There were 975 hospitals, including 93 private hospitals in Bangkok and 882 government hospitals.Statistical analysis used:Results are presented as a frequency and percentage.Results:Special opioid prescription forms must be signed by doctors for all opioid prescriptions. Three-fourths of hospitals totally prohibited prescribing oral opioids by palliative care Advance Practice Nurses. Pharmacists were permitted to correct the technical errors on a prescription of oral morphine only after notifying the prescribing doctor in nearly 60% of hospitals. In terminal patients who could not go to the hospitals, caregivers were permitted to collect the opioids on behalf of patients in nearly 80% of hospitals.Conclusion:Our results illustrate that the regulation of opioids in government hospitals is mainly dependent on physician judgment. Patients can only receive oral morphine at a hospital pharmacy.
LH and PH have better overall nonopioid and opioid medication availability than CH and GH.
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