Unplanned attendances of cancer patients to an outpatient unit in a low-income country: A prospective study from Sudan

Elhassan, Moawia Mohammed Ali; Taha, Safa I.H.; Maatoug, Maha Mirghani

doi:10.4102/sajo.v4i0.126

Cited by 3 publications

(4 citation statements)

References 27 publications

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“…Currently available data from Sudan suggest that 90% of the terminally ill cancer patients suffered from uncontrolled pain [ 14 ]. Moreover, uncontrolled pain is among the most frequent symptoms that prompted unplanned visit to the outpatient oncology unit in our limited resource setting [ 7 ]. In the current study, pain was controlled in only 36% of cases on opioids.…”

Section: Discussionmentioning

confidence: 99%

“…A previous single institution study conducted in Sudan showed that uncontrolled pain was the most frequent symptom that prompted patients with cancer to attend the outpatient unit without an appointment [ 7 ]. Data on adequacy of cancer pain management as well as adverse events related to pain medications in our limited resource settings are limited.…”

Section: Introductionmentioning

confidence: 99%

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Adverse events of opioids for cancer-related pain in a resource-limited setting: a cross-sectional study from Sudan

Elhassan¹,

Mohammed²,

Omer³

et al. 2022

ecancer

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Aim Data on the adverse events of opioids for cancer-related pain in Sudanese patients are limited. We conducted this study to evaluate the pattern and severity of adverse events of immediate release morphine, and tramadol used in the treatment of cancer-related pain. A secondary aim was to determine the response rate to opioids for pain control in cancer patients treated at the National Cancer Institute-University of Gezira (NCI-UG), Sudan. Methods This descriptive cross-sectional study was conducted at NCI-UG between 12 March 2019 and 12 May 2019. A pre-designed questionnaire was used to collect the clinical data of cancer patients on oral opioids for pain control during the study periods. Chi square test was applied to determine whether there is a significant association between the adverse events and the demographic/clinical variables. p value < 0.05 was considered statistically significant in all analyses. Results One-hundred and thirteen patients were screened in the study. Of these, three suffered from cognitive dysfunction and ten patients declined to participate in the study. Thus, 100 patients met the criteria for inclusion in this study. Breast cancer was the most frequent diagnosis (17%) followed by colorectal cancer (16%). The majority (91%) of patients had advanced or metastatic disease. The most frequently reported opioids-related adverse events were dry mouth (68%), constipation (61%), sedation (49%), nausea (31%) and vomiting (24%). Most of these symptoms were graded as mild to moderate and no patient had grade IV or V adverse events. Constipation and dry mouth were more frequent among patients received morphine compared to patients received tramadol ( p value < 0.005). Pain was controlled in 36% of patients, improved in 53% and not controlled in 11% of them. Conclusion This study shows a high prevalence of opioids-related adverse events. The majority of the opioids-related adverse events were grade I or grade II. There seem to be differences in the prevalence of opioids-related adverse events between patients receiving tramadol and those treated with morphine. Moreover, suboptimal pain control adds to the burden on already limited health resources. Therefore, the adequacy of cancer pain management in our setting should be systematically evaluated and effective cancer pain management programmes should be developed.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Adverse events of opioids for cancer-related pain in a resource-limited setting: a cross-sectional study from Sudan

Elhassan¹,

Mohammed²,

Omer³

et al. 2022

ecancer

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“…Tragically, drug shortages often most harshly impact palliative patients needing opioid analgesics for cancer-associated pain, who consequently face immense suffering with most patients ending up with disease progression because of inability to access care and not being able to access any kind of treatment such as radiotherapy, chemotherapy, immunotherapy or even hormonal therapy. Also, a big part that is affected is palliaitive care and access to pain medication which we all know is very important to any cancer patient [ 4 ]. Thus, even basic cancer and supportive care is often impossible.…”

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confidence: 99%

Refugees have cancer too

Hassan,

Maniam

2024

ecancer Journal

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Managing cancer under ideal conditions is a daunting prospect, to say the least. Treating cancer in conflict areas, war zones or being a refugee with cancer, facing complex political, economic and health-related threats presents a colossal global challenge. Managing such patients requires close coordination with international bodies, nongovernmental organisations and national governments, mitigating the burden of cancer care provision to patients and host countries alike.

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“…In Sudan, most cancer patients suffered from advanced or metastatic diseases. Among these individuals, uncontrolled pain was frequently mentioned as a prominent issue [5]. The supply chains and availability of opioid analgesics were disrupted due to the war, leading to a complete absence of these essential medications.…”

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confidence: 99%

Five months into conflict: near total collapse of cancer services in Sudan

Alrawa,

Alfadul,

Elhassan

et al. 2023

ecancer

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The onset of the Sudanese military conflict on April 15, 2023, has had a profound impact on the healthcare infrastructure across the entire nation. While wars impact all individuals with non-communicable diseases, cancer patients are particularly vulnerable. The war has influenced the treatment of Sudanese cancer patients in many ways. It has disrupted and delayed the diagnostic process, suspended surgery, and all forms of cancer management such as radiotherapy, chemotherapy and palliative care. This unfortunate situation has likely worsened the outcomes for many Sudanese cancer patients. This editorial reflects the situation of cancer services in Sudan post conflict.

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Unplanned attendances of cancer patients to an outpatient unit in a low-income country: A prospective study from Sudan

Cited by 3 publications

References 27 publications

Adverse events of opioids for cancer-related pain in a resource-limited setting: a cross-sectional study from Sudan

Adverse events of opioids for cancer-related pain in a resource-limited setting: a cross-sectional study from Sudan

Refugees have cancer too

Five months into conflict: near total collapse of cancer services in Sudan

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