A Systematic Content Analysis of Policy Barriers Impeding Access to Opioid Medication in Central and Eastern Europe: Results of ATOME

详细信息    查看全文

• 作者：Eugenia Larjow ; MA^a ; Evangelia Papavasiliou ; PhD^b ; Sheila Payne ; PhD^b ; ^{s.a.payne@lancaster.ac.uk" class="auth_mail" title="E-mail the corresponding author} ; Willem Scholten ; PharmD ; MPA^c ; Lukas Radbruch ; MD^d
• 关键词：Opioids ; policy barriers ; pain management ; harm reduction ; palliative care
• 刊名：Journal of Pain and Symptom Management
• 出版年：2016
• 出版时间：January 2016
• 年：2016
• 卷：51
• 期：1
• 页码：99-107
• 全文大小：733 K

文摘

Reliable access to opioid medication is critical to delivering effective pain management, adequate treatment of opioid dependence, and quality palliative care. However, more than 80% of the world population is estimated to be inadequately treated for pain because of difficulties in accessing opioids. Although barriers to opioid access are primarily associated with restrictive laws, regulations, and licensing requirements, a key problem that significantly limits opioid access relates to policy constraints.

Objectives

To identify and explore policy barriers to opioid access in 12 Eastern and Central European countries involved in the Access to Opioid Medication in Europe project, funded by the European Community's Seventh Framework (FP7/2007–2013, no. 222994) Programme.

Methods

A systematic content analysis of texts retrieved from documents (e.g., protocols of national problem analyses, strategic planning worksheets, and executive summaries) compiled, reviewed, approved, and submitted by either the Access to Opioid Medication in Europe consortium or the national country teams (comprising experts in pain management, harm reduction, and palliative care) between September 2011 and April 2014 was performed.

Results

Twenty-five policy barriers were identified (e.g., economic crisis, bureaucratic issues, lack of training initiatives, stigma, and discrimination), classified under four predetermined categories (financial/economic aspects and governmental support, formularies, education and training, and societal attitudes). Key barriers related to issues of funding allocation, affordability, knowledge, and fears associated with opioids.

Conclusion

Reducing barriers and improving access to opioids require policy reform at the governmental level with a set of action plans being formulated and concurrently implemented and aimed at different levels of social, education, and economic policy change.