TY - JOUR
T1 - Cancer pain management in developing countries
T2 - A mosaic of complex issues resulting in inadequate analgesia
AU - Koshy, Rachel C.
AU - Rhodes, Deborah
AU - Devi, Saraswathi
AU - Grossman, Stuart A.
N1 - Funding Information:
Acknowledgements This work was partially funded by grants from the Fogarty Center of the National Cancer Institute (supporting R.K.), the Robert Wood Johnson Foundation (supporting D.R.), and the International Union against Cancer (UICC) (supporting S.D.).
PY - 1998/9
Y1 - 1998/9
N2 - Cancer pain is often undertreated even in developed countries with abundant resources and easy access to oral, parenteral, and transdermal opioids. The problems in developing nations are more complex, and as a result, these medications are not available to the vast majority of patients in Latin and South America, Eastern Europe, Asia, and Africa. Some of the reasons for this are reviewed, with India cited as a case example. In spite of serious efforts by the World Health Organization and other bodies to make oral opioids available and to educate government officials and physicians, little progress has been made in relieving pain in cancer patients in the developing world. Novel approaches that address fundamental concerns regarding opioid availability in these countries are desperately needed. One such approach, which is currently under development, is presented in this manuscript. This has the potential to make opioids available to patients in rural areas, improve compliance in the poorly educated patient, reduce the number of follow-up visits necessary for medication refills, and reduce the risk that opioids will be diverted to illicit channels. The potential for relieving cancer pain and the magnitude of this problem worldwide make it imperative that innovative approaches be tailored to the complex social issues and limited resources common to developing nations.
AB - Cancer pain is often undertreated even in developed countries with abundant resources and easy access to oral, parenteral, and transdermal opioids. The problems in developing nations are more complex, and as a result, these medications are not available to the vast majority of patients in Latin and South America, Eastern Europe, Asia, and Africa. Some of the reasons for this are reviewed, with India cited as a case example. In spite of serious efforts by the World Health Organization and other bodies to make oral opioids available and to educate government officials and physicians, little progress has been made in relieving pain in cancer patients in the developing world. Novel approaches that address fundamental concerns regarding opioid availability in these countries are desperately needed. One such approach, which is currently under development, is presented in this manuscript. This has the potential to make opioids available to patients in rural areas, improve compliance in the poorly educated patient, reduce the number of follow-up visits necessary for medication refills, and reduce the risk that opioids will be diverted to illicit channels. The potential for relieving cancer pain and the magnitude of this problem worldwide make it imperative that innovative approaches be tailored to the complex social issues and limited resources common to developing nations.
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U2 - 10.1007/s005200050190
DO - 10.1007/s005200050190
M3 - Review article
C2 - 9773459
AN - SCOPUS:0031662420
SN - 0941-4355
VL - 6
SP - 430
EP - 437
JO - Supportive Care in Cancer
JF - Supportive Care in Cancer
IS - 5
ER -