Addressing the Critical Gap: Ensuring Urgent Access to Palliative Care Services with Essential Medications in Nepal

References

• World Health Organization. Palliative care. [Internet]. 2020; [cited 2022 Sep 9]. Available from: https://www.who.int/news-room/fact-sheets/detail/palliative-care.
   Google Scholar
• Sleeman KE, de Brito M, Etkind S, Nkhoma K, Guo P, Higginson IJ, Gomes B, Harding R. The escalating global burden of serious health-related suffering: projections to 2060 by world regions, age groups, and health conditions. Lancet Glob Health. 2019;7(7):e883–e892. [Internet]. doi:10.1016/S2214-109X(19)30172-X.
   PubMed Web of Science ®Google Scholar
• Ministry of Health and Population. Nepal Burden Of Disease 2019. 2021. Available from: http://nhrc.gov.np/wp-content/uploads/2022/02/BoD-Report-Book-includ-Cover-mail-6_compressed.pdf.
   Google Scholar
• Shrestha G, Neupane P, Lamichhane N, Acharya BC, Siwakoti B, Subedi KP, Pradhananga KK, Mulmi R. Cancer incidence in Nepal: a Three-Year Trend Analysis 2013–2015. Asian Pac J Cancer Care. 2020;5(3):145–50. doi:10.31557/apjcc.2020.5.3.145-150.
   Google Scholar
• Gongal R, Upadhyay S, Baral K, Watson M, Kernohan G. Providing palliative care in rural Nepal: Perceptions of mid-level health workers. Indian J Palliat Care. 2018;24(2):150–5. doi:10.4103/IJPC.IJPC_196_17.
   PubMedGoogle Scholar
• Acharya PK, Baral K, Munday D, Gongal RN. Population based need assessment of palliative care in rural Nepal. J Patan Acad Health Sci. 2017;4(2):21–6. doi:10.3126/jpahs.v4i2.24580.
   Google Scholar
• Swarbrick EM, Pietroni MAC, Munday DM. The need for palliative care in adults in Nepal: projections based on modeling mortality data. Indian J Palliat Care. 2019;25(1):41–5. doi:10.4103/IJPC.IJPC_177_18.
   PubMed Web of Science ®Google Scholar
• Shrestha S, Aro AR, Shrestha B, Thapa S. Elderly care in Nepal: are existing health and community support systems enough. SAGE Open Med. 2021;9:20503121211066381. doi:10.1177/20503121211066381.
   Web of Science ®Google Scholar
• Adhikari B, Mishra SR, Schwarz R. Transforming Nepal’s primary health care delivery system in global health era: addressing historical and current implementation challenges. Global Health. 2022;18(1):8. doi:10.1186/s12992-022-00798-5.
   PubMed Web of Science ®Google Scholar
• Bhandari K. Trends in age structure and ageing population in Nepal. J Pop Dev. 2020;1(1):103–14. doi:10.3126/jpd.v1i1.33109.
   Google Scholar
• National Statistics Office. National Population and Housing Census 2021 [Internet]. CBS Nepal. 2023; [cited 2024 Jan 1]. Available from: www.censusnepal.cbs.gov.np.
   Google Scholar
• De Lima L, Krakauer EL, Lorenz K, Praill D, MacDonald N, Doyle D. Ensuring palliative medicine availability: the development of the IAHPC list of essential medicines for palliative care. J Pain Symptom Manage. 2007;33(5):521–6. doi:10.1016/j.jpainsymman.2007.02.006.
   PubMed Web of Science ®Google Scholar
• Knaul FM, Farmer PE, Krakauer EL, De Lima L, Bhadelia A, Jiang Kwete X, Arreola-Ornelas H, Gómez-Dantés O, Rodriguez NM, Alleyne GAO, et al. Alleviating the access abyss in palliative care and pain relief—an imperative of universal health coverage: the Lancet Commission report. Lancet. 2018;391(10128):1391–454. doi:10.1016/S0140-6736(17)32513-8.
   PubMed Web of Science ®Google Scholar
• Cao W-R, Shakya P, Karmacharya B, Xu DR, Hao Y-T, Lai Y-S. Equity of geographical access to public health facilities in Nepal. BMJ Glob Health. 2021;6(10):e006786. doi:10.1136/bmjgh-2021-006786.
   PubMed Web of Science ®Google Scholar
• Government of Nepal. The Constitution of Nepal [Internet]. Nepal Gaz. 2015 p. 1–226. Available from: https://ag.gov.np/files/Constitution-of-Nepal_2072_Eng_www.moljpa.gov_.npDate-72_11_16.pdf.
   Google Scholar
• Department of Drug Adhministration. National List of Essential Medicines Nepal [Internet]. 2021; [cited 2022 Jun 21]. Available from: https://scorecard.prb.org/wp-content/uploads/2022/03/National-List-of-Essential-Medicines-Nepal-2021.pdf.
   Google Scholar
• Government of Nepal. List and Price of Medicines and Facilities Available From the Health Insurance Nepal [Internet]. p. 0–60. Available from: https://pharmainfonepal.com/list-and-price-of-medicines-and-facilities-available-from-the-health-insurance-nepal/.
   Google Scholar
• Government of Nepal. Free essential drug for Health Institution [Internet]. Available from: https://publichealthupdate.com/list-of-free-essential-drugs-for-health-institutions-nepal/.
   Google Scholar
• Government of Nepal. MRP of medicines [Internet]. Available from: https://www.dda.gov.np/content/mrp-of-medicines.
   Google Scholar
• Aryal A, Dahal A, Shrestha R. Study on drug use pattern in primary healthcare centers of Kathmandu valley. SAGE Open Med. 2020;8:2050312120926437. doi:10.1177/2050312120926437.
   Web of Science ®Google Scholar
• Dhakal N, Gyanwali P, Humagain B, Bc R, Jha N, Sah P, Pradhan A, Dhimal M, Jha AK. Assessment of quality of essential medicines in public health care facilities of Nepal: findings of nationwide study. Faizi N, editor. PLOS Glob Public Health. 2023;3(5):e0001841. doi:10.1371/journal.pgph.0001841.
   PubMedGoogle Scholar
• Ranabhat CL, Subedi R, Karn S. Status and determinants of enrollment and dropout of health insurance in Nepal: an explorative study. Cost Eff Resour Alloc. 2020;18(1):40. doi:10.1186/S12962-020-00227-7/TABLES/5.
   PubMed Web of Science ®Google Scholar
• Nepalese Association of Palliative Care. National Strategy for Palliative Care in Nepal. 2016.
   Google Scholar
• Munday D. National Strategy for Palliative Care handed over to the Government of Nepal. ehospice. 2017; [cited 2022 Jul 20]. Available from: https://ehospice.com/international_posts/national-strategy-for-palliative-care-handed-over-to-the-government-of-nepal/.
   Google Scholar
• Government of Nepal. National Health Policy 2019 [Internet]. 2019. Available from: https://publichealthupdate.com/national-health-policy-2019-nepal/#:∼:text=To develop and expand a,utilization of quality health services.&text=To create opportunities for all,their constitutional rights to health.
   Google Scholar
• Shrestha R, Hayes B, Munday D. Availability of Essential Medicine for Palliative Care in Nepal: a Cross Sectional Survey. 2023. 1–2. doi:10.13140/RG.2.2.30173.79844.
   Google Scholar
• The World Bank. Out-of-pocket expenditure (% of current health expenditure) - Nepal | Data [Internet]; [cited 2023 Aug 8]. Available from: https://data.worldbank.org/indicator/SH.XPD.OOPC.CH.ZS?locations=NP.
   Google Scholar
• Brennan F, Lohman D, Gwyther L. Access to Pain Management as a Human Right. Am J Public Health. 2019;109(1):61–5. doi:10.2105/AJPH.2018.304743.
   PubMed Web of Science ®Google Scholar
• Sholjakova M, Durnev V, Kartalov A, Kuzmanovska B. Pain relief as an integral part of the palliative care. Open Access Maced J Med Sci. 2018;6(4):739–41. doi:10.3889/oamjms.2018.163.
   PubMedGoogle Scholar
• Sharma S, Jensen MP, Pathak A, Sharma S, Pokharel M, Abbott JH. State of clinical pain research in Nepal: a systematic scoping review. Pain Rep. 2019;4(6):e788. doi:10.1097/PR9.0000000000000788.
   PubMedGoogle Scholar
• Paudel BD, Ryan KM, Brown MS, Krakauer EL, Rajagopal MR, Maurer MA, Cleary JF. Opioid availability and palliative care in Nepal: influence of an international pain policy fellowship. J Pain Symptom Manage. 2014;49(1):110–6. doi:10.1016/j.jpainsymman.2014.02.011.
   PubMed Web of Science ®Google Scholar
• World Health Organization. Assessing the development of palliative care worldwide: a set of actionable indicators [Internet]. 2021. Available from: https://apps.who.int/iris/handle/10665/345532.
   Google Scholar
• Shrestha R. Opioid availability, production and supply in Nepal [Internet]; [cited 2023 Aug 8]. Available from: https://www.researchgate.net/publication/371510182_Opioid_availability_production_and_supply_in_Nepal.
   Google Scholar
• Gautam D, Adhikari S. Palliative care services for cancer patients in Nepal, a lower-middle-income country. Palliat Care Soc Pract. 2021;15:26323524211021105. doi:10.1177/26323524211021105.
   Google Scholar
• Gyawali B, Sharma S, Shilpakar R, Dulal S, Pariyar J, Booth CM, Sharma Poudyal B. Overview of Delivery of Cancer Care in Nepal: current Status and Future Priorities. J Clin Oncol Glob Oncol. 2020;6:1211–7. doi:10.1200/go.20.00287.
   PubMedGoogle Scholar
• Department of Health Services G of N. Standard Treatment Protocol (STP) For Basic Health Service (BHS) Package 2078 [Internet]; [cited 2023 Jul 10]. Available from: https://dohs.gov.np/standard-treatment-protocol-stp-for-basic-health-services-bhs-package-2078/.
   Google Scholar
• Shrestha S, Khatiwada AP, Sapkota B, Sapkota S, Poudel P, Kc B, Teoh SL, Blebil AQ, Paudyal V. What is “Opioid Stewardship”? An Overview of Current Definitions and Proposal for a Universally Acceptable Definition. J Pain Res. 2023;16:383–94. doi:10.2147/JPR.S389358.
   PubMed Web of Science ®Google Scholar
• Khanal S, Veerman L, Ewen M, Nissen L, Hollingworth S. Availability, price, and affordability of essential medicines to manage noncommunicable diseases: a National Survey From Nepal. Inquiry. 2019;56:46958019887572. doi:10.1177/0046958019887572.
   PubMed Web of Science ®Google Scholar
• Peoples N, Gong E, Gautam K, Khanal SN, Kohrt BA, Koirala S, Amatya A, Xiong S, Østbye T, Moe J. Perception and use of primary healthcare services among people with Cardiometabolic Diseases in two resource-limited Areas in Nepal: a Mixed Methods Study. Front Public Heal. 2021;9:1–11. doi:10.3389/fpubh.2021.698030.
   Web of Science ®Google Scholar
• Sapkota T, Houkes I, Bosma H. Vicious cycle of chronic disease and poverty: a qualitative study in present day Nepal. Int Health. 2021;13(1):30–8. doi:10.1093/inthealth/ihaa016.
   PubMed Web of Science ®Google Scholar
• Worldwide Hospice Palliative Care Alliance. Palliative care Toolkit - Nepali 1st Edition [Internet]. 2016; [cited 2023 Jul 9]. Available from: https://www.thewhpca.org/resources/palliative-care-toolkit/item/palliative-care-toolkit-nepali-1st-edition-2016-edition.
   Google Scholar
• Nepalese Association of Palliative Care. Guidelines For Pain Management in Palliative Care [Internet]. Second. 2017; [cited 2022 Nov 1]. Available from: http://napcare.org.np/wp-content/uploads/2020/09/pain-protocol_final.A-1.pdf.
   Google Scholar
• Bhaktapur Cancer Hospital. [Internet]; [cited 2023 Jul 10]. Available from: https://bch.org.np/.
   Google Scholar
• International Nepal Fellowship. Palliative Care; [cited 2022 Dec 21]. Available from: https://www.inf.org/our-work/palliative-care/#.
   Google Scholar
• Shrestha S, Gan SH, Paudyal V, Kc B, Sapkota S. Current practices, gaps, and opportunities on the role of clinical pharmacists in cancer pain management: Perspectives from Nepal. J Oncol Pharm Pract. 2023;29(8):2049–56. doi:10.1177/10781552231205025.
   PubMed Web of Science ®Google Scholar
• Shrestha S, Kc B, Blebil AQ, Teoh SL. Pharmacist involvement in cancer pain management: a systematic review and meta-analysis. J Pain. 2022;23(7):1123–42. doi:10.1016/j.jpain.2022.02.002.
   PubMed Web of Science ®Google Scholar
• Umar RM, Apikoglu-Rabus S, Yumuk PF. Significance of a clinical pharmacist-led comprehensive medication management program for hospitalized oncology patients. Int J Clin Pharm. 2020;42(2):652–61. doi:10.1007/s11096-020-00992-8.
   PubMed Web of Science ®Google Scholar
• Shrestha S, Shrestha S, Palaian S. Can clinical pharmacists bridge a gap between medical oncologists and patients in resource-limited oncology settings? An experience in Nepal. J Oncol Pharm Pract. 2019;25(3):765–8. doi:10.1177/1078155218784734.
   PubMed Web of Science ®Google Scholar
• Rosa WE, Gray TF, Chow K, Davidson PM, Dionne-Odom JN, Karanja V, Khanyola J, Kpoeh JDN, Lusaka J, Matula ST, et al. Recommendations to Leverage the Palliative Nursing Role During COVID-19 and Future Public Health Crises. J Hosp Palliat Nurs. 2020;22(4):260–9. doi:10.1097/NJH.0000000000000665.
   PubMedGoogle Scholar
• Hagan TL, Xu J, Lopez RP, Bressler T. Nursing’s role in leading palliative care: a call to action. Nurse Educ Today. 2018;61:216–9. doi:10.1016/j.nedt.2017.11.037.
   PubMed Web of Science ®Google Scholar
• Tait PA, Cheung WH, Wiese M, Staff K. Improving community access to terminal phase medicines in Australia: identification of the key considerations for the implementation of a ‘core medicines list. Aust J Prim Health. 2017;23(4):373–8. doi:10.1071/PY16153.
   PubMed Web of Science ®Google Scholar
• Campling N, Birtwistle J, Richardson A, Bennett MI, Meads D, Santer M, Latter S. Access to palliative care medicines in the community: An evaluation of practice and costs using case studies of service models in England. Int J Nurs Stud. 2022;132:104275. doi:10.1016/j.ijnurstu.2022.104275.
   PubMed Web of Science ®Google Scholar
• Pesut B, Thorne S, Huisken A, Wright DK, Chambaere K, Tishelman C, Ghosh S. Is progress being made on Canada’s palliative care framework and action plan? A survey of stakeholder perspectives. BMC Palliat Care. 2022;21(1):182. doi:10.1186/s12904-022-01074-4.
   PubMed Web of Science ®Google Scholar
• Azeez E, Anbuselvi G. Is the Kerala model of community-based palliative care operations sustainable? Evidence from the field. Indian J Palliat Care. 2021;27(1):18–22. doi:10.4103/IJPC.IJPC_45_20.
   PubMed Web of Science ®Google Scholar
• Luyirika E, Lohman D, Ali Z, Atieno M, Mahenge A, Mmbando P, Muinga E, Musyoki D, Mwesiga MD, Namisango E, et al. Progress Update: Palliative Care Development Between 2017 and 2020 in Five African Countries. J Pain Symptom Manage. 2022;63(5):729–36. doi:10.1016/j.jpainsymman.2021.12.026.
   PubMed Web of Science ®Google Scholar
• Hospice Nepal. [Internet]. [cited 2022 Dec 21]. Available from: https://www.hospicenepal.org.np/home.
   Google Scholar
• BP Koirala Memorial Cancer Hospital. Hospice and Palliative Care Unit [Internet]. [cited 2022 Dec 21]. Available from: https://www.bpkmch.org.np/departments/hospice.php.
   Google Scholar
• Binaytara Foundation Cancer Center, Janakpur, Nepal. [Internet]. [cited 2023 Jul 9]. Available from: https://cancer.binayfoundation.org/departments/.
   Google Scholar
• Nepal Cancer Hospital and Research Center. Palliative Overview [Internet]. [cited 2023 Jul 16]. Available from: https://www.nch.com.np/palliative-overview/.
   Google Scholar
• Nepal Hospice Care Centre, Dharan. [Internet]. [cited 2023 Jul 10]. Available from: https://www.facebook.com/p/Nepal-Hospice-Care-Center-Dharan-100083869496359/.
   Google Scholar