Access to Cancer Pain Management in Ecuador from Health Workers’ Perspective: a Qualitative Study

References

• Van Den Beuken-Van Everdingen MH , DeRijke JM , KesselsAG , SchoutenHC , Van KleefM , PatijnJ. Prevalence of pain in patients with cancer: a systematic review of the past 40 years. Ann. Oncol.18(9), 1437–1449 (2007).
   PubMed Web of Science ®Google Scholar
• World Health Organization . Model List of Essential Medicines. (Accessed 12April2023). https://list.essentialmeds.org/
   Google Scholar
• World Health Organization . WHO Guidelines for the pharmacological and radiotherapeutic management of cancer pain in adults and adolescents.WHOGeneva, Switzerland (2018).
   Google Scholar
• Ecuador. (Accessed 12April2023). https://gco.iarc.fr/today/data/factsheets/populations/218-ecuador-fact-sheets.pdf
   Google Scholar
• World Health Organization . Noncommunicable diseases country profiles 2018.World Health Organization, Geneva, Switzerland (2018).
   Google Scholar
• Knaul FM , FarmerPE , KrakauerELet al. Alleviating the access abyss in palliative care and pain relief-an imperative of universal health coverage: the Lancet Commission report. Lancet391(10128), 1391–1454 (2018).
   PubMed Web of Science ®Google Scholar
• Ministerio de Salud Pública del Ecuador . Tratamiento del dolor oncológico en adultos. Guía de Práctica Clínica. Ministerio de Salud Pública, Dirección Nacional de Normatización, Quito (2017). www.salud.gob.ec/wp-content/uploads/2017/06/Dolor-oncológico-GPC-final-12-12-2016-1.pdf;
   Google Scholar
• Ministerio de Salud Pública del Ecuador . Cuadro Nacional de Medicamentos Básico (CNMB). Registro Oficial. Órgano de la República del Ecuador, Edición Especial Año I – N° 138 (2019). https://compracorporativasalud.compraspublicas.gob.ec/wp-content/uploads/2019/11/Cuadro_Nacional_de_Medicamentos_Basicos-10ma-revision.pdf
   Google Scholar
• Pastrana T , DeLima L , SanchezMet al. Atlas de Cuidados Paliativos en Latinoamérica 2020. IAHPC Press Houston, Texas (2021).
   Google Scholar
• ATC/DDD Index 2023. ( Accessed 12April2023). www.whocc.no/atc_ddd_index/
   Google Scholar
• Witzel A , ReiterH. The Problem-centered Interview.SAGELondon (2012).
   Google Scholar
• Heckathorn DD , CameronCJ. Network Sampling: From Snowball and Multiplicity to Respondent-Driven Sampling. Annual Review of Sociology43(1), 101–119 (2017).
   Web of Science ®Google Scholar
• Mey G . Adoleszenz, Identität, Erzählung: theoretische, methodologische und empirische Erkundungen. Köster Verlag (1999). https://nbn-resolving.org/urn:nbn:de:0168-ssoar-39188
   Google Scholar
• Mayring P . Qualitative Inhaltsanalyse – Grundlagen und Techniken. Beltz PädagogikWeinheim Base (2015).
   Google Scholar
• Kaufmann J-C . L’Entretien compréhensif. Nathan, ParisParis (1996).
   Google Scholar
• Braun V , ClarkeV. Using thematic analysis in psychology. Qual. Res. Psychol.3(2), 77–101 (2006).
   Google Scholar
• Lucio R , VillacrésN , HenríquezR. Sistema de salud de Ecuador. Salud Pública Mex53, S177–S187 (2011).
   PubMed Web of Science ®Google Scholar
• International Narcotics Control Board, World Health Organization . Guide on Estimating Requirements for Substances under International Control. Developed by the International Narcotics Control Board and the World Health Organization for use by Competent National Authorities.United Nations, NY, USA (2012).
   Google Scholar
• Abu-Odah H , MolassiotisA , LiuJ. Challenges on the provision of palliative care for patients with cancer in low- and middle-income countries: a systematic review of reviews. BMC Palliat Care19(1), 55 (2020).
   PubMed Web of Science ®Google Scholar
• Makhlouf SM , PiniS , AhmedS , BennettMI. Managing Pain in People with Cancer-a Systematic Review of the Attitudes and Knowledge of Professionals, Patients, Caregivers and Public. J. Cancer Educ.35(2), 214–240 (2020).
   PubMed Web of Science ®Google Scholar
• Soto-Perez-De-Celis E , Chavarri-GuerraY , PastranaT , Ruiz-MendozaR , BukowskiA , GossPE. End-of-Life Care in Latin America. J. Glob. Oncol.3(3), 261–270 (2017).
   PubMedGoogle Scholar
• Vahos J , Rojas-CortésR , DazaDet al. Barriers of Access to Opioid Medicines within the Context of Palliative Care in Latin America: The Perception of Health Professionals. J. Palliat. Med.26(2), 199–209 (2023).
   PubMed Web of Science ®Google Scholar
• United Nation . Politicial Declaration on Universal Health Coverage. NY, USA ( Accessed 12April2023). www.un.org/pga/73/wp-content/uploads/sites/53/2019/09/UHC-HLM-silence-procedure.pdf
   Google Scholar
• Lohman D , AmonJJ. Evaluating a Human Rights-Based Advocacy Approach to Expanding Access to Pain Medicines and Palliative Care: Global Advocacy and Case Studies from India, Kenya, and Ukraine. Health Hum Rights17(2), 149–165 (2015).
   PubMed Web of Science ®Google Scholar
• Lohman D , SchleiferR , AmonJJ. Access to pain treatment as a human right. BMC Med.8, 8 (2010).
   PubMed Web of Science ®Google Scholar
• Ministerio de Salud Pública . Estrategia nacional para la atención integral del cáncer en el Ecuador. Quito (Accessed 12April2023). https://aplicaciones.msp.gob.ec/salud/archivosdigitales/documentosDirecciones/dnn/archivos/ac_0059_2017.pdf
   Google Scholar
• Srisawang P , Harun-or-RashidM , HirosawaT , SakamotoJ. Knowledge, attitudes and barriers of physicians, policy makers/regulators regarding use of opioids for cancer pain management in Thailand. Nagoya J. Med. Sci.75(3-4), 201–212 (2013).
   PubMed Web of Science ®Google Scholar
• Manjiani D , PaulDB , KunnumpurathS , KayeAD , VadiveluN. Availability and utilization of opioids for pain management: global issues. Ochsner. J.14(2), 208–215 (2014).
   PubMedGoogle Scholar
• United Nations . Single Convention on Narcotic Drugs, 1961. NY, USA (Accessed 12April2023). www.unodc.org/pdf/convention_1961_en.pdf
   Google Scholar
• Pettus K , DeLima L , MaurerMet al. Ensuring and Restoring Balance on Access to Controlled Substances for Medical and Scientific Purposes: Joint Statement from Palliative Care Organizations. Journal of Pain & Palliative Care Pharmacotherapy32(2-3), 124–128 (2018).
   PubMed Web of Science ®Google Scholar
• United Nations Office on Drugs and Crime . Outcome Document of the 2016 United Nations General Assembly Special Session on the World Drug Problem. New York, 19-21 April 2016 - Our joint commitment to effectively addressingand countering the world drug problem. NY, USA (Accessed 17March2020). www.unodc.org/documents/postungass2016/outcome/V1603301-E.pdf
   Google Scholar
• Pastrana T , WenkR , RadbruchL , AhmedE , DeLima L. Pain Treatment Continues To Be Inaccessible for Many Patients Around the Globe: Second Phase of Opioid Price Watch, a Cross-Sectional Study To Monitor the Prices of Opioids. J. Palliat. Med.20(4), 378–387 (2017).
   PubMed Web of Science ®Google Scholar
• Ortiz-Prado E , GalarzaC , LeónFC , PonceJ. Acceso a medicamentos y situación del mercado farmacéutico en Ecuador. Revista Panamericana De Salud Publica-pan American Journal of Public Health36, 57–62 (2014).
   PubMedGoogle Scholar
• Cleeland CS , JanjanNA , ScottCB , SeiferheldWF , CurranWJ. Cancer pain management by radiotherapists: a survey of radiation therapy oncology group physicians. Int. J. Radiat. Oncol. Biol. Phys.47(1), 203–208 (2000).
   PubMed Web of Science ®Google Scholar
• United Nations . Transforming our world: the 2030 Agenda for Sustainable Development A/RES/70/1. (Accessed 12April2023). https://sustainabledevelopment.un.org/content/documents/21252030%20Agenda%20for%20Sustainable%20Development%20web.pdf
   Google Scholar
• Charalambous A , ZorpasM , CloconiC , KadingY. Healthcare professionals’ perceptions on the use of opioid analgesics for the treatment of cancer-related pain in Cyprus: a mixed-method study. SAGE Open Med.7, 2050312119841823 (2019).
   Web of Science ®Google Scholar
• Miller EJ , MorganJD , BlenkinsoppA. How timely is access to palliative care medicines in the community? A mixed methods study in a UK city. BMJ Open9(11), e029016 (2019).
   PubMed Web of Science ®Google Scholar
• World Health Organization . WHO report on cancer: setting priorities, investing wisely and providing care for all. Geneve (Accessed 12April2023). www.who.int/publications/i/item/who-report-on-cancer-setting-priorities-investing-wisely-and-providing-care-for-all
   Google Scholar
• Gardiner C , GottM , IngletonC , HughesP , WinslowM , BennettMI. Attitudes of health care professionals to opioid prescribing in end-of-life care: a qualitative focus group study. J. Pain Symptom Manage.44(2), 206–214 (2012).
   PubMed Web of Science ®Google Scholar
• Maseko TN , PfaffC , MwisongoA. The understanding of healthcare workers on the content of palliative care policy in Shesilweni Swaziland: a qualitative study. Ecancermedicalscience12, 857 (2018).
   PubMedGoogle Scholar
• Barasteh S , RassouliM , ParandehA , Vahedian-AzimiA , ZaboliR , KhaghanizadehM. Palliative Care in the Health System of Iran: A Review of the Present Status and the Future Challenges. Asian Pac. J. Cancer Prev.21(3), 845–851 (2020).
   PubMedGoogle Scholar
• De Lima L , PastranaT. Evaluation of the Effectiveness of Workshops on the Availability and Rational Use of Opioids in Latin America. J. Palliat. Med.19(9), 964–971 (2016).
   PubMed Web of Science ®Google Scholar
• International Nacotics Control Board . Progress in ensuring adequate access to internationally controlled substances for medical and scientific purposes. Vienna (Accessed 12April2023). www.incb.org/incb/en/publications/annual-reports/annual-report-supplement-2018.html
   Google Scholar
• Pastrana T , DeLima L , WenkR. Estudio multicéntrico sobre la comodidad y el interés en cuidados paliativos en estudiantes de pregrado en Colombia. Med. Paliativa22(4), 136–145 (2015).
   Google Scholar
• Allende-Pérez S , Alanis-ChoA , Delgado-FernándezA , Peña-NievesA , Verástegui-AvilésE. Conocimientos básicos y percepciones en cuidados paliativos en médicos de Pregrado de la Universidad Nacional Autónoma de México: un estudio transversal. Med. Paliativa27(2), 71–78 (2020).
   Google Scholar
• Toba HA , SamaraAM , ZyoudSH. Nurses’ knowledge, perceived barriers, and practices regarding cancer pain management: a cross-sectional study from Palestine. BMC Med. Educ.19(1), 167 (2019).
   PubMedGoogle Scholar
• Cascella M , VittoriA , PetrucciEet al. Strengths and Weaknesses of Cancer Pain Management in Italy: Findings from a Nationwide SIAARTI Survey. Healthcare (Basel)10(3), 441 (2022).
   PubMedGoogle Scholar
• Atasoy A , BogdanovicG , AladashviliAet al. An international survey of practice patterns and difficulties in cancer pain management in Southeastern Europe: a Turkish & Balkan Oncology Group common initiative. J. BUON18(4), 1082–1087 (2013).
   PubMed Web of Science ®Google Scholar
• Chang YJ , YunYH , ParkSMet al. Nurses’ willingness to maximize opioid analgesia for severe cancer pain, and its predictor. Support. Care Cancer13(9), 743–751 (2005).
   PubMed Web of Science ®Google Scholar
• Kim YC , AhnJS , CalimagMMet al. Current practices in cancer pain management in Asia: a survey of patients and physicians across 10 countries. Cancer Med.4(8), 1196–1204 (2015).
   PubMed Web of Science ®Google Scholar
• Zhang Q , YuC , FengSet al. Physicians’ Practice, Attitudes Toward, and Knowledge of Cancer Pain Management in China. Pain Med.16(11), 2195–2203 (2015).
   PubMed Web of Science ®Google Scholar
• Hidalgo-Andrade P , MascialinoG. Beliefs about Morphine in Palliative Care: Results From an Ecuadorian Sample. J. Palliat. Care37(2), 73–76 (2021).
   PubMed Web of Science ®Google Scholar
• Lou F , ShangS. Attitudes towards pain management in hospitalized cancer patients and their influencing factors. Chin. J. Cancer Res.29(1), 75–85 (2017).
   PubMed Web of Science ®Google Scholar
• Cox-Seignoret K , MaharajRG. Unmet needs of patients with cancer in their last year of life as described by caregivers in a developing world setting: a qualitative study. BMC Palliat. Care19(1), 13 (2020).
   PubMed Web of Science ®Google Scholar
• Pergolizzi JV Jr , TaylorRJr , LequangJA , LaraA , OrtizAH , IbanMaR. Pain Control in Latin America: The Optimized Role of Buprenorphine in the Treatment of Cancer and Noncancer Pain. Pain Ther.8(2), 187–201 (2019).
   PubMed Web of Science ®Google Scholar
• Adam R , DeBruin M , BurtonCD , BondCM , GiatsiClausen M , MurchieP. What are the current challenges of managing cancer pain and could digital technologies help?BMJ Support Palliat. Care8(2), 204–212 (2018).
   PubMed Web of Science ®Google Scholar
• Harding R , NairS , EkstrandM. Multilevel model of stigma and barriers to cancer palliative care in India: a qualitative study. BMJ Open9(3), e024248 (2019).
   PubMed Web of Science ®Google Scholar
• Ho JFV , YaakupH , LowGSH , WongSL , ThoLM , TanSB. Morphine use for cancer pain: a strong analgesic used only at the end of life? A qualitative study on attitudes and perceptions of morphine in patients with advanced cancer and their caregivers. Palliat. Med.34(5), 619–629 (2020).
   PubMed Web of Science ®Google Scholar
• Hui D , HannonBL , ZimmermannC , BrueraE. Improving patient and caregiver outcomes in oncology: team-based, timely, and targeted palliative care. CA Cancer J. Clin.68(5), 356–376 (2018).
   PubMed Web of Science ®Google Scholar
• Oldenmenger WH , BaanMaG , VanDer Rijt CCD. Development and feasibility of a web application to monitor patients’ cancer-related pain. Support. Care Cancer26(2), 635–642 (2018).
   PubMed Web of Science ®Google Scholar
• Parker Oliver D , DemirisG , WashingtonK , KruseRL , PetroskiG. Hospice Family Caregiver Involvement in Care Plan Meetings: A Mixed-Methods Randomized Controlled Trial. Am. J. Hosp. Palliat Care34(9), 849–859 (2017).
   PubMed Web of Science ®Google Scholar
• Peng Z , LiL , ChenY , FengZ , FangX. WeChat app-based reinforced education improves the quality of opioid titration treatment of cancer-related pain in outpatients: a randomized control study. BMC Cancer20(1), 852 (2020).
   PubMed Web of Science ®Google Scholar
• Prevost V , DelormeC , HeutteNet al. Evaluation of patients’ needs to design and assess a patient education program in cancer pain. J. Pain Res.12, 1813–1823 (2019).
   PubMed Web of Science ®Google Scholar
• Qiao S , TangL , ZhangWet al. Nurse-led follow-up to outpatients with cancer pain treated with opioids at home-telephone calls plus WeChat versus telephone calls only: a quasi-experimental study. Patient Prefer Adherence13, 923–931 (2019).
   PubMed Web of Science ®Google Scholar
• Prevost V , HeutteN , LeconteA , LicajI , DelormeC , ClarisseB. Effectiveness of a therapeutic patient education program in improving cancer pain management: EFFADOL, a stepped-wedge randomised controlled trial. BMC Cancer19(1), 673 (2019).
   PubMedGoogle Scholar
• Angeletti C , GuettiC , PaesaniM , ColavincenzoS , CiccozziA , AngelettiPM. An Analysis of Italian Nurses’ Approach to Patients’ Pain: A Nationwide Online Survey. Pain Res. Manag.2018, 5165262 (2018).
   PubMed Web of Science ®Google Scholar
• Cristina Coello . ¿En realidad las mujeres dominan en el sector de la salud?. edición médicaQuito (Accessed 12April2023). www.edicionmedica.ec/secciones/profesionales/-en-realidad-las-mujeres-dominan-en-el-sector-de-la-salud--91849
   Google Scholar