A scoping review on the availability and utilization of essential opioid analgesics in Sub-Saharan Africa - 30/08/23
Abstract |
Background |
Management of acute, post-operative, and chronic pain requires access to and availability of opioids. While often oversupplied in high-income countries, significant shortages exist in low- and middle-income countries. We conducted a scoping review on availability and usage of opioids in Sub-Saharan Africa (SSA).
Methods |
The five-stage approach of Arksey and O'Malley (2005) was used. MEDLINE via PubMed, EMBASE, and SCOPUS were search and results categorized into themes: 1) Local/regional availability and supply, 2) Consumption patterns, 3) Legislation and policy, 4) Costs and financing, 5) Knowledge and cultural beliefs, and 6) Education and training.
Results |
6923 studies were identified from which 69 (1%) met inclusion criteria. Five key findings were: 1) Significant shortages exist, especially in rural areas, 2) Non-opioid analgesics commonly used as first-line acute pain management, 3) Barriers to market entry and bureaucratic processes prevent local production, 4) Significant knowledge gaps/myths exist amongst healthcare practitioners on opioid use, and 5) Continuous education and short courses will be critical.
Conclusions |
Major challenges significantly limit availability and utilization of essential opioids in SSA. Reforms needed to upscale training and education, increase uptake by professionals, and increase market entry.
Il testo completo di questo articolo è disponibile in PDF.Highlights |
• | Essential opioid analgesics are often overprescribed and abused in many high-income countries. |
• | Significant shortages exist in sub-Saharan Africa (SSA) especially in rural communities. |
• | In SSA, there is considerable stigma against palliative care and opioids, exacerbating barriers to accessing opioids. |
• | Significant knowledge gaps exist in opioid prescribing and administration among healthcare practitioners. |
• | Reforms are needed to upscale local manufacturing of opioids, to increase training and to reduce barriers to market entry. |
Keywords : Opioid analgesics, Essential opioids, Sub-Saharan Africa, Opioid availability, Low-and middle-income countries
Mappa
Vol 226 - N° 4
P. 409-421 - ottobre 2023 Ritorno al numero
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