Pain and Policy Studies Group: Two Decades of Working to Address Regulatory Barriers to Improve Opioid Availability and Accessibility Around the World

Cleary, James F.; Maurer, Martha A.

doi:10.1016/j.jpainsymman.2017.03.029

Cited by 19 publications

(12 citation statements)

References 28 publications

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“…National laws and regulations governing opioids typically focus on prevention of diversion and illegal use of opioids and make production importation, and prescription of morphine and other opioids difficult or impossible (25). For this and other reasons, including supply chain logistics and a dearth of manufacturers, stock outs of this key, low cost medication are frequent (9,26). When short-acting formulations are available, patients are frequently given small supplies for fear of diversion (27)(28)(29)(30)(31).…”

Section: Palliative Infrastructure and Recent Developmentsmentioning

confidence: 99%

Global palliative radiotherapy: a framework to improve access in resource-constrained settings

Elmore¹,

Grover²,

Bourque³

et al. 2019

Ann. Palliat. Med.

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Radiotherapy is an essential component of cancer therapy. Lack of access to radiotherapy in lessdeveloped countries prevents its use for both cure and symptom relief, resulting in a significant disparity in patient suffering. Several recent initiatives have highlighted the need for expanded access to both palliative medicine and radiotherapy globally. Yet, these efforts have remained largely independent, without attention to overlap and integration. This review provides an update on the progress toward global palliative radiotherapy access and proposes a strategic framework to address further scale-up. Synergies between radiotherapy, palliative medicine, and other global health initiatives will be essential in bringing palliative radiotherapy to patients around the globe.

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Section: Palliative Infrastructure and Recent Developmentsmentioning

confidence: 99%

Global palliative radiotherapy: a framework to improve access in resource-constrained settings

Elmore¹,

Grover²,

Bourque³

et al. 2019

Ann. Palliat. Med.

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“…Essential treatment availability may be limited by state policy [ 1 ]. For example, some studies have found that morphine was available to only 20% of patients in low- to middle-income countries, which make up approximately 80% of the global population [ 2 ]. Disease burden may vary among different economic levels and country policies.…”

Section: Introductionmentioning

confidence: 99%

Systematic adaptation of the Thai version of the supportive and palliative care indicators tool for low-income setting (SPICT-LIS)

2021

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Background Identification of patients who might benefit from palliative care among countries with different socioeconomic and medical contexts is challenging. The Supportive and Palliative Care Indicators Tool for a Low-income Setting (SPICT-LIS) was designed to help physicians identify patients in low-income setting who might benefit from palliative care. We aimed to systematically adapt and refine the SPICT-LIS for Thai general palliative care providers. Methods We followed the WHO guidelines for translation, cross-cultural adaptation and validation of an instrument for the SPICT-LIS. Three expert panel members did the initial adaptation using forward and backward translations with pretested data. Two iterations of pretesting were conducted to test for applicability and reliability. The case vignettes which were used in the pretesting were modified hospital medical records. The pretesting was done with 30 respondents from various specialties in a community health center and 34 general palliative care providers from a regional referral hospital in the first and second iterations, respectively. To examine instrument reliability, interrater reliability and internal consistency were evaluated. Cognitive interviewing was conducted using semi-structured interviews with general practitioners (GPs) using the “think aloud strategy” and “probing questions”. Results The adapted Thai SPICT-LIS had a total of 34 indicators which included 6 general and 28 clinical indicators. The assessment of the adapted Thai SPICT-LIS found that it provided consistent responses with good agreement among the GPs, with a Fleiss kappa coefficient of 0.93 (0.76–1.00). The administration time was 2.3–4.3 min per case. Most respondents were female. The 8 interviewed GPs said they felt that the SPICT-LIS was appropriate for use in a general setting in Thailand. Conclusion The study found that the Thai SPICT-LIS could be an applicable, acceptable, and reliable tool for general palliative care providers in Thailand to identify patients who might benefit from palliative care.

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“…Pain management is a critical component of palliative care but inadequately treated pain remains a global public health problem. 1,2 Underassessment of pain has been found to be a significant cause of inadequate pain management. 3 The phrase "pain as the fifth vital sign" was initially promoted by the American Pain Society to elevate awareness of pain treatment among healthcare professionals and to make pain visiable.…”

Section: Introductionmentioning

confidence: 99%

Pain Assessment in Emergency Department of Teaching Hospital in Lalitpur

Gauchan

2019

J. Karnali Acad. Health Sci.

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Background: Proper pain assessment is directly related to proper pain management.The American pain society (APS) in 1996 instituted “the pain as the 5th vital sign”, in an effort to reduce the burden of underassessment and inadequate pain management. The objective of this study is to find out the practice of pain assessment and to make improvement. Methods: This was an observational study of pain assessment by the medical officer in emergency department (ED).Convenience sampling was done at three different shift in ED. All the data of pain assessment was taken and tabulated and analysed to know the practice of pain assessment. Standard as set at 80%. In first stage data collection was done for one month as per convenience. Following the observed finding, in the second stage intervention was done. After this in third stage re-data collection was done to see the improvement. Results: A total of 503 patients were enrolled in this study. Out of this 53% (n=265) were in first stage and 47% (n=238) in third stage of the study. In first stage of the study there was 7% (n=19) documentation of numerical rating scale (NRS) and PQRST (P-precipitating and palliating factor, Q-quality of pain, R-radiation, S-site of pain, T-timing of pain) was not documented. After intervention in third stage documentation of NRS was done in 70% (n=167) and documentation of PQRST were variable. Conclusions: The study revealed that existing practice of pain assessment in the emergency department is poor but after the intervention there was remarkable improvement in the pain assessment.

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Pain and Policy Studies Group: Two Decades of Working to Address Regulatory Barriers to Improve Opioid Availability and Accessibility Around the World

Cited by 19 publications

References 28 publications

Global palliative radiotherapy: a framework to improve access in resource-constrained settings

Global palliative radiotherapy: a framework to improve access in resource-constrained settings

Systematic adaptation of the Thai version of the supportive and palliative care indicators tool for low-income setting (SPICT-LIS)

Pain Assessment in Emergency Department of Teaching Hospital in Lalitpur

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