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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Provision of pain- and symptom-relieving drugs for HIV/AIDS in sub-Saharan Africa
Journal of Pain and Symptom Management, Volume 40, No. 3, Year 2010
Notification
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Description
Context: Although pain and burdensome symptoms among HIV-infected persons can be effectively managed, the availability of opioids and other symptom-controlling drugs is a particular challenge in sub-Saharan Africa. Objectives: This study aimed to identify current drug availability and prescribing practices in 12 sub-Saharan African countries and to examine the barriers and potential facilitators for use of opioids and other key HIV/AIDS symptom-controlling drugs. Methods: This was a cross-sectional survey, integrating data from palliative care facilities and competent authorities within ministries of health in 12 African countries. Results: Of 62 responding facilities, problems were reported in accessing named nonopioids, with a small number of facilities unable to dispense them. Less than half the facilities were currently prescribing opioids of any strength. Further problems were identified in terms of the availability and supply continuity of named antiemetics and anxiolytics. The data identified a number of systemic problems, suggesting that opioid supply issues are similar to less controlled drugs, such as antiemetics. Among competent authorities, there was no agreement on whether further opioid expansion was possible. Integration of data from care facilities and competent authorities highlighted a disparity in the understanding of the availability of specific drugs, with competent authorities naming drugs that were not listed by any responding facility in their respective country. Conclusion: This study shows that opioid expansion needs to balance supply and skills: Currently there are insufficient trained clinical personnel to prescribe, and supply is unreliable. Efforts to expand supply should ensure that they do not weaken current systems. © 2010 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.
Authors & Co-Authors
Harding, Richard
United Kingdom, London
King's College London
Powell, Richard Antony
Uganda, Kampala
African Palliative Care Association
Kiyange, Fatia
Uganda, Kampala
African Palliative Care Association
Mwangi-Powell, Faith N.
Uganda, Kampala
African Palliative Care Association
Statistics
Citations: 64
Authors: 4
Affiliations: 2
Identifiers
Doi:
10.1016/j.jpainsymman.2009.12.025
ISSN:
08853924
Research Areas
Cancer
Health System And Policy
Infectious Diseases
Study Design
Cross Sectional Study
Study Approach
Quantitative