Friday , November 27 2020

Misconceptions about opioids affect pain control among cancer patients: a Malaysian survey



Misconceptions about opioids affect pain control among cancer patients: a Malaysian survey

Summary 429P – Results of a cross-sectional survey at Sarawak General Hospital in Malaysia. Credit: European Medical Oncology Association

Misconceptions about the use of powerful opioids have shown that cross-sectional research in Sarawak General Hospital in Malaysia attenuates the optimal pain control among Asian cancer patients receiving chemotherapy and radiotherapy.

In a study to be presented at the ESMO Asia 2018 Congress, 133 patients with solid tumors at all stages treated with strong opioids were asked to evaluate their pain experience using a visual analog scale during the week prior to the survey questionnaire (VAS) between 0 and 10 and the short form of the Pain Inventory. (BPI-sf) to evaluate the effect of pain in daily activities by filling.

The researchers also investigated the strong opioid types and patient-related barriers to effective cancer pain management; The results were evaluated by social determinants including ethnic group, religion and education level.

Overall, good pain control was reported in 62% of survey participants (pain score).

Larger obstacles to pain control have been found in patients with higher education who can reflect the common misconception of opioid use in social media. It is seen that fear of the harmful effects of opioids is more common in Malay society, followed by China and Beating groups. "These differences may reflect some inequalities in access to optimal cancer treatment in the state, but multiple socioeconomic factors may play a critical role in the use of opioids, so further research is needed."

Although the elimination of adequate pain is the basis of supportive care, the lack of or availability of opioids in some countries, according to Prof Sumitra Thongprasert of Chiang Mai Hospital in Thailand, indicates that ESMO Asia 2018 Public Policy co-chair program. . Faiths and other cultural issues may partially explain the optimal use of opioid analgesics and several factors, including how health information providers offer information on the benefits of these drugs, may continue to be evaluated ". ”More importantly, access to opioids to be prescribed and access to governmental restrictions on the total amount that the patient can always receive can significantly affect access and use among cancer patients.“

Accessibility problems, costs and regulatory barriers that could limit the prescribing and distribution of opioid analgesics in low- and middle-income countries (LMIC) were first mapped by ESMO in 2013 by the Global Opioid Policy Initiative (GOPI), which was carried out by other international partners. In 2010 it expanded the results of a similar survey in Europe. The opioid availability was reported to be low in 20 countries in Asia, except South Korea and Japan, and the extreme regulation of opioid prescription in Asia has been proven. Passive zone that may restrict or impair access to painkiller treatments. The results of this initiative highlighted the concrete needs for developing palliative care information among clinicians in Asian countries.

"Currently, the availability of critical drugs such as opioids, potential targeted drugs and immunotherapies can potentially be improved in Asia, but accessibility issues will be difficult to overcome because of the high costs of cancer treatments," Thongprasert said. "Some countries in the Asia / Asia-Pacific region cannot provide expensive drugs to local communities. They may also be the main cause of high-cost drugs in countries where patients are required to pay for cancer treatments on their own. Cancer care."

He was the coordinator of the Global Opioid Policy Initiative for ESMO, and visited the Institute of Oncology, Shaare Zedek Medical Center, Israel. Dr. Dr. Nathan Cherny added: "According to the results in the report published in 2013, there is an agreement between the WHO and the 20 international and national palliative care and oncology community, co-operating with the International Narcotics Control Board and ESMO, that the opioid analgesic treatment is the cornerstone of cancer pain management. and there is no economic obstacle in the construction of this opioids and a public health priority. ve

Strategies to improve accessibility and accessibility of cancer drugs in LMICs will be discussed in an encouraging discussion on the ESMO Asia 2018 Congress in Singapore. Al Other potential strategies, such as the creation of different pricing depending on the economic situation, should be considered, since it may take some time to reduce cancer drug costs; Transfer of technology to LMICs to produce pharmaceutical companies that provide the Patient Access program or their own medicines; The availability of generic and biosimilar drugs with quality assurance and compulsory licensing of anti-cancer drugs: beyond regulation, the development of new drugs, the restriction of access to research projects and the lack of new technologies. "Thongprasert added.

The global commitment to providing access to anti-cancer drugs has increased in recent years and, according to ESMO President Josep Tabernero, cooperation between different stakeholders can contribute to the Asian-Pacific countries better contributing to improving access to and availability of essential drugs, vaccines, diagnoses. and medical devices.

-In general, limited resources need to prioritize the clinical benefits sufficiently, and collaborative efforts have led to the emergence of new tools and approaches to take a critical step in addressing policy issues in LMICs, such as the ESMO Clinical Benefit Scale (ESMO). MCBS (6,7) can help governments review and edit their national drug lists to ensure that patients prioritize the most cost-effective ones that provide the greatest value to patients.

"Moreover, the annual ESMO Asian Congress, launched in 2014, facilitated the training and updating of oncology specialists in the Asia-Pacific region, brought the real and necessary change to discuss and discuss the important challenges in oncology, as well as information sharing and the President of ESMO.


Explore more:
Quality cancer care – not just a matter of anti-cancer drugs

More information:
Summary 439P – & # 39; Pain control between ophthalmologists receiving powerful opioids and developing opioids in a diverse multicultural background. & # 39; will be offered by. In the Exhibition Area 00 (SGT). Annals of Oncology, Volume 29, 2018 Annex 9, DOI: 10.1093 / annonc / mdy426

Magazine reference:
Annals of Oncology

Presented by:
European Medical Oncology Association


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