Department of Palliative Medicine, Medical Faculty, RWTH Aachen University, Aachen, Germany.
Sociedad de Lucha Contra el Cáncer (Society to Fight Cancer), Quito, Ecuador.
Pain Manag. 2023 Apr;13(4):219-232. doi: 10.2217/pmt-2023-0023. Epub 2023 May 23.
Ecuador is facing increasing health-related suffering due to cancer; however, the distributed opioid analgesic in the country is below the global average. This study explores the access to cancer pain management (CPM) from the healthcare professionals' perspective in a middle-income country. Thirty problem-centered interviews with healthcare providers were conducted in six cancer facilities and were analyzed thematically. Limited and unequal access to opioid analgesics was reported. Structural weaknesses of the healthcare system restrain access for the poorest, at the primary care level, and for people living in remote areas. The lack of education among the healthcare personnel, patients, and society was identified as the main barrier. Access barriers were interrelated; therefore multisectoral strategies must be considered to improve access to CPM.
厄瓜多尔因癌症而面临日益严重的健康问题；然而，该国分发的阿片类镇痛药低于全球平均水平。本研究从医疗保健专业人员的角度探讨了中低收入国家获得癌症疼痛管理（CPM）的情况。在六家癌症治疗机构中进行了 30 次以问题为中心的医疗保健提供者访谈，并进行了主题分析。报告称，阿片类镇痛药的获取受到限制且不平等。医疗保健系统的结构性弱点限制了最贫困人群、初级保健水平人群以及居住在偏远地区人群获取阿片类镇痛药的机会。医疗保健人员、患者和社会缺乏教育被确定为主要障碍。获取障碍相互关联；因此，必须考虑采取多部门战略来改善 CPM 的获取。
