Adequacy of Opioid Analgesic Consumption at Country, Global, and Regional Levels in 2010, Its Relationship With Development Level, and Changes Compared With 2006

被引:122
作者
Duthey, Beatrice [1 ]
Scholten, Willem [1 ]
机构
[1] World Hlth Org, Dept Essential Med & Hlth Prod, Access Controlled Med, Geneva, Switzerland
关键词
Opioid analgesics; pain treatment; morphine; palliative care; controlled medicines; health policy; access; PAIN MANAGEMENT; CANCER PAIN; AVAILABILITY; ACCESSIBILITY; ETHICS; EUROPE; POLICY;
D O I
10.1016/j.jpainsymman.2013.03.015
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Context. In most countries, patients do not have adequate access to opioid analgesics because of barriers resulting from the abuse potential of these medicines. Objectives. To provide an analysis for the adequacy of the consumption of opioid analgesics for countries and World Health Organization regions in 2010 as compared with 2006. Methods. We calculated the Adequacy of Consumption Measure using data for 2010 based on a method established by Seya et al. This method calculates the morbidity-corrected needs per capita for relevant strong opioid analgesics and the actual use for the top 20 Human Development Index countries. It determines the adequacy of the consumption for each country, World Health Organization region, and the world by comparing the actual consumption with the calculated need. Furthermore, the method allows us to calculate the number of people living in countries at various levels of adequacy. We compared our outcomes with data from Seya et al. for 2006. Results. Most people have no access to opioids for pain relief in case of need; 66% of the world population has virtually no consumption, 10% very low, 3% low, 4% moderate, and only 7.5% adequate. For 8.9%, no data are available. Between 2006 and 2010, 67 countries increased the adequacy of opioid consumption per capita. These changes are independent of countries' level of development. Conclusion. The consumption of opioid analgesics remains inadequate in most of the world and, as a result, patients with moderate and severe pain do not receive the treatment they need. Governments, health organizations, and nongovernmental organizations must collaborate to address this situation, targeting their efforts at educational, cultural, health policy and regulatory levels. (C) 2014 World Health Organization. Published by Elsevier Inc. All rights reserved.
引用
收藏
页码:283 / 297
页数:15
相关论文
共 31 条
[1]  
[Anonymous], AN THER CHEM ATC CLA
[2]  
[Anonymous], 2004, WORLD POP 2300
[3]  
[Anonymous], MOD LIST ESS MED CHI
[4]  
[Anonymous], 2010, HUM DEV REP 2010
[5]   Improving the availability and accessibility of opioids for the treatment of pain: The International Pain Policy Fellowship [J].
Bosnjak, Snezana ;
Maurer, Martha A. ;
Ryan, Karen M. ;
Leon, Marta X. ;
Madiye, Gabriel .
SUPPORTIVE CARE IN CANCER, 2011, 19 (08) :1239-1247
[6]   Cancer-related pain: a pan-European survey of prevalence, treatment, and patient attitudes [J].
Breivik, H. ;
Cherny, N. ;
Collett, B. ;
de Conno, F. ;
Filbet, M. ;
Foubert, A. J. ;
Cohen, R. ;
Dow, L. .
ANNALS OF ONCOLOGY, 2009, 20 (08) :1420-1433
[7]  
Brennan F, 2007, ANESTH ANALG, V105, P205, DOI 10.1213/01.ane.0000268145.52345.55
[8]   Use of opioid analgesics in the treatment of cancer pain: evidence-based recommendations from the EAPC [J].
Caraceni, Augusto ;
Hanks, Geoff Rey ;
Kaasa, Stein ;
Bennett, Michael I. ;
Brunelli, Cinzia ;
Cherny, Nathan ;
Dale, Ola ;
De Conno, Franco ;
Fallon, Marie ;
Hanna, Magdi ;
Haugen, Dagny Faksvag ;
Juhl, Gitte ;
King, Samuel ;
Klepstad, Pal ;
Laugsand, Eivor A. ;
Maltoni, Marco ;
Mercadante, Sebastiano ;
Nabal, Maria ;
Pigni, Alessandra ;
Radbruch, Lukas ;
Reid, Colette ;
Sjogren, Per ;
Stone, Patrick C. ;
Tassinari, Davide ;
Zeppetella, Giovambattista .
LANCET ONCOLOGY, 2012, 13 (02) :E58-E68
[9]   Formulary availability and regulatory barriers to accessibility of opioids for cancer pain in Europe: a report from the ESMO/EAPC Opioid Policy Initiative [J].
Cherny, N. I. ;
Baselga, J. ;
de Conno, F. ;
Radbruch, L. .
ANNALS OF ONCOLOGY, 2010, 21 (03) :615-626
[10]   Problems of opioid availability and accessibility across Europe: ESMO tackles the regulatory causes of intolerable and needless suffering [J].
Cherny, NI ;
Catane, R ;
Kosmidis, PA .
ANNALS OF ONCOLOGY, 2006, 17 (06) :885-887