Regulation of opioid drugs in Thai government hospitals: Thailand national survey 2012

Thongkhamcharoen, Rojanasak; Phungrassami, Temsak; Atthakul, Narumol

doi:10.4103/0973-1075.125548

Cited by 12 publications

(7 citation statements)

References 9 publications

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“…A cross-sectional study in China, found that 62.8% of clinicians had concerns about regulatory investigation for prescribing opioids. 30…”

Section: Legal Regulatory and Socio-politicalmentioning

confidence: 99%

“…In China, 16.5% of clinicians reported patient inability to pay for analgesics as a barrier. 30 A review of the affordability of opioids found a negative correlation between a days’ wages and the country income category: the lower the income, the more working days required to pay for the treatment. 22 Patients paid the full cost of all medications in Bangladesh, Cambodia, Indonesia, Laos, Nepal and the Philippines.…”

Section: Opioid Accessibilitymentioning

confidence: 99%

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Perceptions and experiences of laws and regulations governing access to opioids in South, Southeast, East and Central Asia: A systematic review, critical interpretative synthesis and development of a conceptual framework

et al. 2020

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Background: Opioids are essential medicines. Despite international and national laws permitting availability, opioid access remains inadequate, particularly in South, Southeast, East and Central Asia. Aim: To review evidence of perceptions and experiences of regulatory enablers and barriers to opioid access in South, Southeast, East and Central Asia. Design: Systematic review of post-2000 research according to PRISMA guidelines. Data were subjected to critical interpretive synthesis. International, national and sub-national barriers were organised developing a conceptual framework of opioid availability. Data sources: PsycINFO, Medline, Embase, The Cochrane Library. CINAHL, Complete and ASSIA from 2000 until 20th May 2019. Results: 21/14097 studies included: quantitative n = 15, qualitative n = 3 and mixed-methods n = 3. Four barrier/enabler themes were developed: Legal, regulatory, socio-political; lack of laws explicitly enabling opioid access, restrictive international controls and clinician prescribing concerns. Opioid availability; limited availability, poor policymaker and clinician education regarding opioid benefits, poor continuity of supply. Opioid Accessibility; medicine costs, distance to prescribing centres. Prescribing; extensive bureaucratic barriers, lack of human resources for prescribing. We present a novel framework of a self-perpetuating model of inadequate opioid provision. The Single Convention on Narcotics provides the context of restrictive laws and negative attitudes amongst policymakers. A consequent lack of prescribers and clinicians’ negative attitudes at sub-national levels, results in inadequate access to and use of opioids. Data of inadequate consumption informs annual requirement estimates used by the International Narcotics Control Board to determine future opioid availability. Conclusions: Regulatory and socio-political actions unintentionally limit opioid access. International and national laws explicitly enabling opioid access are required, to assuage concerns, promote training and appropriate prescribing.

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“…A cross-sectional study in China, found that 62.8% of clinicians had concerns about regulatory investigation for prescribing opioids. 30…”

Section: Legal Regulatory and Socio-politicalmentioning

confidence: 99%

Section: Opioid Accessibilitymentioning

confidence: 99%

Perceptions and experiences of laws and regulations governing access to opioids in South, Southeast, East and Central Asia: A systematic review, critical interpretative synthesis and development of a conceptual framework

et al. 2020

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“…32 To improve accessibility and quality of palliative care service for tertiary care hospitals in Thailand, all health care staff in all inpatient care services should be prepared to perform timely specialist palliative consultations. 1 Thongkhamcharoen et al 33 surveyed the regulation of opioids in Thai government hospitals and found that physicians are the gatekeepers for patient access to opioids. Specialist palliative care teams should thus coordinate with primary physicians to achieve the best quality of care for both palliative care patients and their families.…”

Section: Discussionmentioning

confidence: 99%

Integration of Specialist Palliative Care into Tertiary Hospitals: A Multicenter Point Prevalence Survey from Thailand

Pairojkul

Thongkhamcharoen

Raksasataya

et al. 2021

Palliative Medicine Reports

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Background: Accessibility and quality of hospital-based palliative care in Thailand have received scant attention. Objective: To determine the prevalence of inpatients who require in-hospital palliative care, to identify the proportion with access to specialist palliative care, and to define the factors associated with accessibility to specialist palliative care. Design: A cross-sectional analysis of a multicenter survey. Setting/Subjects: We surveyed all hospitalized patients from Thailand's four regions admitted to 14 tertiary care hospitals. Measurements: We used the Supportive and Palliative Care Indicators Tool to identify palliative care patients then reviewed their medical records. We categorized hospitalized palliative care patients into a palliative care consultation group and a nonconsultation group. The odds ratio (OR) between patient characteristics and patient groups was estimated using binary logistic regression. Results: One-fifth (18.7%) of hospitalized patients were palliative care patients, whereas only 17.3% received a specialist palliative care consult. Of these, one-third (28.4%) received advance care planning (ACP) documentation. One-quarter of patients in pain were not prescribed analgesics. The logistic regression analysis revealed that palliative care consultations were associated with patients >65 years (OR = 1.830, 95% confidence interval [CI]:

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“…Two areas deserve particular attention, access to pain control and availability of specialised trained staff. While a lack of both health care personnel fully trained in palliative care and specialist palliative care services has been reported in Thailand[ 119 ] with difficulties in opioid access[ 120 ], Japan has been successful in increasing full-time palliative care physicians and nurses and the median number of annual referrals[ 121 ]. Although late referral to palliative care services has been described as one problem in Korea[ 122 ], long-term cancer survivors can benefit from the Health Partner Program to become health coaches[ 123 ].…”

Section: Palliative Carementioning

confidence: 99%

Cancer Control Programs in East Asia: Evidence From the International Literature

Moore¹

2014

J Prev Med Public Health

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Cancer is a major cause of mortality and morbidity throughout the world, including the countries of North-East and South-East Asia. Assessment of burden through cancer registration, determination of risk and protective factors, early detection and screening, clinical practice, interventions for example in vaccination, tobacco cessation efforts and palliative care all should be included in comprehensive cancer control programs. The degree to which this is possible naturally depends on the resources available at local, national and international levels. The present review concerns elements of cancer control programs established in China, Taiwan, Korea, and Japan in North-East Asia, Viet Nam, Thailand, Malaysia, and Indonesia as representative larger countries of South-East Asia for comparison, using the published literature as a guide. While major advances have been made, there are still areas which need more attention, especially in South-East Asia, and international cooperation is essential if standard guidelines are to be generated to allow effective cancer control efforts throughout the Far East.

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Regulation of opioid drugs in Thai government hospitals: Thailand national survey 2012

Cited by 12 publications

References 9 publications

Perceptions and experiences of laws and regulations governing access to opioids in South, Southeast, East and Central Asia: A systematic review, critical interpretative synthesis and development of a conceptual framework

Perceptions and experiences of laws and regulations governing access to opioids in South, Southeast, East and Central Asia: A systematic review, critical interpretative synthesis and development of a conceptual framework

Integration of Specialist Palliative Care into Tertiary Hospitals: A Multicenter Point Prevalence Survey from Thailand

Cancer Control Programs in East Asia: Evidence From the International Literature

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