Use of and barriers to access to opioid analgesics: a worldwide, regional, and national study

Berterame, Stefano; Erthal, Juliana; Thomas, Johny; Fellner, Sarah; Vosse, Benjamin; Clare, Philip; Hao, Wei; Johnson, Daniel D.; Mohar, Alejandro; Pavadia, Jagjit; Samak, Ahmed Kamal Eldin; Sipp, Werner; Sumyai, Viroj; Suryawati, Sri; Toufiq, Jallal; Yans, Raymond; Mattick, Richard P.

doi:10.1016/s0140-6736(16)00161-6

Cited by 478 publications

(425 citation statements)

References 26 publications

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“…Important strides have been made to increase palliative care services, including distribution of educational materials by the Worldwide Palliative Care Alliance (WPCA)/World Health Organization (WHO) and increased availability of opioid analgesics since it was placed on the WHO Essential Medicines list in 1977 (Global atlas of palliative care at the end of life, n.d, Cleary, 2014). However, education and training for healthcare professionals is still lacking and opioid analgesics are still inadequately utilized in many countries in Africa, Asia, Central and South America, and Eastern Europe (Berterame et al, 2016, Hu and Feng, 2016, Hannon et al, 2016). Furthermore, widespread adoption of palliative care is hindered by political, psychological, social, and cultural barriers (Hu and Feng, 2016, Hannon et al, 2016).…”

Section: High Priority Topics For Lmicsmentioning

confidence: 99%

Clinical trials in low and middle-income countries — Successes and challenges

Grover

Jhingran

et al. 2017

Gynecologic Oncology Reports

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Gynecologic malignancies affect women in low and middle-income countries (LMICs) at equal or higher rates compared to high income countries (HICs), yet practice guidelines based on clinical trials performed in HICs do not routinely account for resource disparities between these regions. There is a need and growing interest for executing clinical trials in LMICs. This has led to the creation of multinational cooperative groups and the initiation of several ongoing clinical trials in Mexico, China, and Korea. In this article we describe the challenges involved in initiating clinical trials in LMICs, review current efforts within surgical, medical, and radiation oncology, and introduce high priority topics for future research.

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Section: High Priority Topics For Lmicsmentioning

confidence: 99%

Clinical trials in low and middle-income countries — Successes and challenges

Grover

Jhingran

et al. 2017

Gynecologic Oncology Reports

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“…The international drug conventions are designed to ensure legitimate medical access to such medicines, under appropriate supervision, through a distribution chain that deters and combats illicit manufacture, sale, and diversion. Necessary steps should be taken to remove barriers to accessing controlled drugs for legitimate medical needs, such as analgesic drugs in the more than 150 countries where pain is undertreated 9 .…”

mentioning

confidence: 99%

Drug use disorders: impact of a public health rather than a criminal justice approach

et al. 2017

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“…Overall, 21% of the world's population (high income) consumed 92% of the total global morphine. And yet the majority of cancer deaths (70%) occur in low to middle income countries (LMICs), 51,52 demonstrating a desperate need to increase opioid availability and pain management efforts in these countries. However, richer nations can also have restrictions on opioids, and so each country should be individually assessed.…”

Section: Opioid Availabilitymentioning

confidence: 99%

Holistic Total Pain Management in Palliative Care: Cultural and Global Considerations

Brant¹

2017

Palliat Med Hosp Care Open J

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Pain is a significant symptom in patients with chronic and life-threatening illness. While pain is traditionally thought of as a physiological experience, total pain recognizes the interplay of psychological, cognitive, social, spiritual, and cultural factors that influence the pain perception and total experience. Comprehensive pain assessment and management are foundational goals within the scope of palliative care, and optimal management depends on addressing each domain of the total pain experience. An overview of the total pain experience is provided, and clinicians should consider psychological, cognitive, social, spiritual, and cultural aspects in assessing pain. Pain management also addresses all domains, and suggestions are provided which address pain management barriers and challenges. First, patients should be educated about the benefits of pain management and importance to adhere to the plan of care. Second, healthcare professionals need education in order to manage pain properly and should adhere to internationally recognized evidence-based guidelines to provide care. Third, barriers to overcome system issues need to be addressed, such as working with governments and Ministries of Health to increase opioid availability for those in need and to ensure that patients can have access to opioids whether in the hospital, home, city, or rural area. While pain is a complex phenomenon, a comprehensive management plan can alleviate suffering for patients and their families.

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Use of and barriers to access to opioid analgesics: a worldwide, regional, and national study

Cited by 478 publications

References 26 publications

Clinical trials in low and middle-income countries — Successes and challenges

Clinical trials in low and middle-income countries — Successes and challenges

Drug use disorders: impact of a public health rather than a criminal justice approach

Holistic Total Pain Management in Palliative Care: Cultural and Global Considerations

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