JCO global oncology · 2025
I Wait for Leftover Morphine: A Qualitative Study of Barriers to Safe Opioid Access for Cancer Pain Relief in Vietnam.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Nguyen Trang, Dam Anh, Bui Linh, Pham Tung, Krakauer Eric L, Phelan Caroline
Аннотация
PURPOSE: This study explores the views of health care providers (HCPs), regulators, patients with cancer, and caregivers in Vietnam on the barriers to safe access to opioids for cancer pain relief and suggested solutions.
MATERIALS AND METHODS: We conducted a qualitative, descriptive study using semistructured interviews. Five HCPs, six patients with cancer/caregivers, and six regulators (n = 17) were purposefully sampled across Vietnam. Audio recordings were transcribed verbatim and subjected to inductive content analysis using a Framework method.
RESULTS: Five categories of barriers were identified: (1) Patient-related barriers (fear of addiction and other side effects, morphine's association with impending death); (2) professional-related barriers (knowledge and experience deficit, fear of addiction and other side effects, and concerns about diversion and liabilities); (3) medicine-related barriers (limited oral morphine availability, limited manufacturers and suppliers, and difficulties accessing parenteral opioids); (4) regulatory barriers (difficulties obtaining certifications of continued need for opioid use, overly strict regulation enforcement, lack of information on opioid distribution channels); and (5) services delivery barriers (scarce palliative and home care services). Potential solutions include strengthening education for patients, communities, and health care professionals; mandating oral morphine availability at district levels; diversifying opioid variety and enhancing domestic manufacturing; establishing an electronic prescription monitoring system; expanding palliative care training and implementation across all health care system levels; and using telemedicine.
CONCLUSION: Barriers to opioid access for cancer pain control in Vietnam are multifactorial and interrelated, necessitating interdisciplinary solutions.
MATERIALS AND METHODS: We conducted a qualitative, descriptive study using semistructured interviews. Five HCPs, six patients with cancer/caregivers, and six regulators (n = 17) were purposefully sampled across Vietnam. Audio recordings were transcribed verbatim and subjected to inductive content analysis using a Framework method.
RESULTS: Five categories of barriers were identified: (1) Patient-related barriers (fear of addiction and other side effects, morphine's association with impending death); (2) professional-related barriers (knowledge and experience deficit, fear of addiction and other side effects, and concerns about diversion and liabilities); (3) medicine-related barriers (limited oral morphine availability, limited manufacturers and suppliers, and difficulties accessing parenteral opioids); (4) regulatory barriers (difficulties obtaining certifications of continued need for opioid use, overly strict regulation enforcement, lack of information on opioid distribution channels); and (5) services delivery barriers (scarce palliative and home care services). Potential solutions include strengthening education for patients, communities, and health care professionals; mandating oral morphine availability at district levels; diversifying opioid variety and enhancing domestic manufacturing; establishing an electronic prescription monitoring system; expanding palliative care training and implementation across all health care system levels; and using telemedicine.
CONCLUSION: Barriers to opioid access for cancer pain control in Vietnam are multifactorial and interrelated, necessitating interdisciplinary solutions.