世界卫生组织基本药物清单中用于治疗低收入和中低收入国家儿童恶性肿瘤的细胞毒药物的可获得性：系统评价方案。

Availability of cytotoxic medicines in the WHO essential medicine list used in treating childhood malignancies in low-income and lower-middle-income countries: a systematic review protocol.

机构信息

Centre for Cancer Research, University of Sri Jayewardenepura, Nugegoda, Sri Lanka

Department of Community Medicine, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka.

出版信息

BMJ Open. 2023 Jun 19;13(6):e071988. doi: 10.1136/bmjopen-2023-071988.

DOI:10.1136/bmjopen-2023-071988

PMID:37336532

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10314663/

Abstract

INTRODUCTION

Cancer is a leading cause of death globally with childhood cancers accounting for around 5% of the total incidence. Almost 90% of childhood cancers are recorded from low-income and lower-middle-income countries (LLMICs), where survival rates are comparatively low. The unavailability of essential medicines for childhood cancers is identified as a reason for this observed health inequity. The objectives of this review are to describe the availability of cytotoxic medicines in the WHO essential medicine list (EML) used in treating children with cancer in LLMICs and to determine the enablers and barriers to accessing WHO essential medicines for childhood cancer.

METHODS AND ANALYSIS

A systematic review will be conducted using electronic databases: MEDLINE, EMBASE and CINAHL. Additional articles and grey literature will be searched in Google Scholar and reference list of the selected articles. It will include primary studies, national/regional reports and policy documents. Review questions will be framed into different components according to the ECLIPSe framework. Children less than 19 years of age diagnosed with any malignant disorder in LLMICs will be the client group. Studies that have focused on the availability of EML for adult malignancies and care providers' knowledge of EML for childhood malignancies will not be considered. Only the studies reported in the English language will be included. Mixed methods Appraisal Tool will be used to assess the quality of included studies. Data will be presented as a narrative synthesis.

ETHICS AND DISSEMINATION

This research is exempt from ethics approval because the work is carried out on published documents. Findings of this review will be disseminated through a peer-reviewed journal for the authorities in LLMICs to understand the magnitude of the problem and to identify enablers and barriers to take evidence based decisions to improve their health system.

PROSPERO REGISTRATION NUMBER

CRD42022334156.

摘要

简介

癌症是全球主要死因，儿童癌症约占总发病率的 5%。几乎 90%的儿童癌症发生在低收入和中低收入国家（LMICs），这些国家的生存率相对较低。儿童癌症基本药物的缺乏被认为是造成这种健康不平等的原因之一。本研究的目的是描述用于治疗 LLMICs 中儿童癌症的世界卫生组织基本药物清单（EML）中细胞毒性药物的可获得性，并确定获得儿童癌症基本药物的促进因素和障碍。

方法和分析

将通过电子数据库：MEDLINE、EMBASE 和 CINAHL 进行系统评价。还将在 Google Scholar 和选定文章的参考文献中搜索额外的文章和灰色文献。它将包括主要研究、国家/地区报告和政策文件。审查问题将根据 ECLIPSe 框架分为不同的部分。客户群体将是在 LLMICs 中被诊断患有任何恶性疾病的 19 岁以下儿童。未考虑专门针对成人恶性肿瘤 EML 可获得性和儿童恶性肿瘤 EML 护理提供者知识的研究。仅包括以英文报告的研究。将使用混合方法评估工具来评估纳入研究的质量。数据将以叙述性综合的形式呈现。