The perception of barriers concerning opioid medicines: A survey examining differences between policy makers, healthcare professionals and other stakeholders.

Access barriers healthcare professionals opioid analgesics opioids perception policy makers questionnaire

Journal

Palliative medicine
ISSN: 1477-030X
Titre abrégé: Palliat Med
Pays: England
ID NLM: 8704926

Informations de publication

Date de publication:
04 2020
Historique:
pubmed: 24 12 2019
medline: 22 4 2021
entrez: 24 12 2019
Statut: ppublish

Résumé

In many countries, the consumption of opioid medicines is too low to meet population needs. Discussions within the Access To Opioid Medication in Europe project indicated that there may be significant differences in the perception of barriers for their adequate use, depending on the stakeholders. The aim of this study was to examine the perception of barriers and their impact concerning opioid medicines, comparing policy makers, healthcare professionals working in the field of pain management, palliative care or harm reduction and other stakeholders. Data were collected using a questionnaire partially constructed from existing surveys, reviewed for content validity by four experts and pilot-tested in Latvia. Participants of the Access to Opioid Medication in Europe national conferences were invited to complete the questionnaire. Stakeholder groups were compared using non-parametric rank-sum tests. In total, 199 participants (54%) in seven countries completed the questionnaire. Most frequently rated major barriers included lack of financial resources and inadequate knowledge, skills and training among policy makers (55%-66%). Overall, policy makers perceived issues less often as major barriers or having major impact (29% barrier, 32% impact) compared to other stakeholders (36%-42% barrier, 39%-51% impact). Significant differences were seen on several aspects. For example, excessive regulation or bureaucracy for prescribing was rated as having major impact by 55%-57% of healthcare professionals in contrast to only 20% of the policy makers ( Multiple barriers may play an important role, partly depending on the perspective of the stakeholder involved. Hence, when addressing perceived barriers, it is important to include all relevant stakeholder groups. Only then, effective and widely supported solutions can be implemented.

Sections du résumé

BACKGROUND
In many countries, the consumption of opioid medicines is too low to meet population needs. Discussions within the Access To Opioid Medication in Europe project indicated that there may be significant differences in the perception of barriers for their adequate use, depending on the stakeholders.
AIM
The aim of this study was to examine the perception of barriers and their impact concerning opioid medicines, comparing policy makers, healthcare professionals working in the field of pain management, palliative care or harm reduction and other stakeholders.
DESIGN
Data were collected using a questionnaire partially constructed from existing surveys, reviewed for content validity by four experts and pilot-tested in Latvia.
SETTING/PARTICIPANTS
Participants of the Access to Opioid Medication in Europe national conferences were invited to complete the questionnaire. Stakeholder groups were compared using non-parametric rank-sum tests.
RESULTS
In total, 199 participants (54%) in seven countries completed the questionnaire. Most frequently rated major barriers included lack of financial resources and inadequate knowledge, skills and training among policy makers (55%-66%). Overall, policy makers perceived issues less often as major barriers or having major impact (29% barrier, 32% impact) compared to other stakeholders (36%-42% barrier, 39%-51% impact). Significant differences were seen on several aspects. For example, excessive regulation or bureaucracy for prescribing was rated as having major impact by 55%-57% of healthcare professionals in contrast to only 20% of the policy makers (
CONCLUSION
Multiple barriers may play an important role, partly depending on the perspective of the stakeholder involved. Hence, when addressing perceived barriers, it is important to include all relevant stakeholder groups. Only then, effective and widely supported solutions can be implemented.

Identifiants

pubmed: 31868563
doi: 10.1177/0269216319894190
doi:

Substances chimiques

Analgesics, Opioid 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

493-503

Auteurs

Marjolein Jm Vranken (MJ)

Utrecht Institute for Pharmaceutical Sciences, Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, Utrecht, the Netherlands.

Lisa Linge-Dahl (L)

Department of Palliative Medicine, University Hospital Bonn, Bonn, Germany.

Aukje K Mantel-Teeuwisse (AK)

Utrecht Institute for Pharmaceutical Sciences, Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, Utrecht, the Netherlands.

Lukas Radbruch (L)

Department of Palliative Medicine, University Hospital Bonn, Bonn, Germany.
Centre for Palliative Care, Malteser Hospital Bonn, Bonn, Germany.

Marie-Hélène Db Schutjens (MD)

Utrecht Institute for Pharmaceutical Sciences, Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, Utrecht, the Netherlands.
Schutjens de Bruin, Tilburg, The Netherlands.

Willem Scholten (W)

Willem Scholten Consultancy, Lopik, The Netherlands.

Sheila Payne (S)

International Observatory on End of Life Care, Division of Health Research, Lancaster University, Lancaster, UK.

Saskia Jünger (S)

Research Unit Ethics, University Hospital Cologne, Cologne, Germany.
Cologne Center for Ethics, Rights, Economics, and Social Sciences of Health (ceres), University of Cologne, Cologne, Germany.

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Classifications MeSH