Magboh Vivian Onyinyechukwu, Saba Ogheneochuko Andrew, Krause Rene, Forget Patrice
School of Medicine, Medical Sciences and Nutrition, Institute of Applied Health Sciences, University of Aberdeen, AB24 3FX Aberdeen, UK.
26 Charlotte Street, AB25 1LQ Aberdeen, UK.
Ecancermedicalscience. 2023 Dec 20;17:1650. doi: 10.3332/ecancer.2023.1650. eCollection 2023.
Although cancer is a significant issue in sub-Saharan Africa, and cancer pain is prevalent, there is insufficient data and research on the barriers to cancer pain management. Even in countries where evidence exists, few studies explore the links between these barriers, which makes it difficult to implement system-wide approaches to address them.
The search strategy was developed and conducted on databases including MEDLINE, Embase and Web of Science to identify peer-reviewed studies. Then, these retrieved studies were screened systematically to select papers that had met pre-specified criteria. The barriers were categorised into patient-, health professional- and health system-level domains. Then, the quality of the included papers was assessed using the mixed methods appraisal tool. Finally, a narrative synthesis was utilised to summarise the findings.
Fourteen relevant articles from 19 sub-Saharan African countries were included in the scoping review. All the studies highlighted barriers to optimal cancer pain management. Healthcare system-related domains had the most frequently reported barriers. Approximately half of the included studies met 100% of the methodological quality criteria in the critical appraisal.
Improving pain management for cancer patients in sub-Saharan Africa requires further high-level research evidence on regulatory policies and interventional strategies, especially at the health system level, as most barriers to cancer pain treatment essentially stem from the healthcare system.
尽管癌症在撒哈拉以南非洲是一个重大问题，且癌症疼痛普遍存在，但关于癌症疼痛管理障碍的数据和研究不足。即使在有相关证据的国家，也很少有研究探讨这些障碍之间的联系，这使得难以实施全系统的方法来解决这些问题。
制定检索策略并在包括MEDLINE、Embase和科学网在内的数据库中进行检索，以识别同行评审研究。然后，对这些检索到的研究进行系统筛选，以选择符合预先设定标准的论文。将障碍分为患者、卫生专业人员和卫生系统层面的领域。然后，使用混合方法评估工具评估纳入论文的质量。最后，采用叙述性综合方法总结研究结果。
范围综述纳入了来自撒哈拉以南非洲19个国家的14篇相关文章。所有研究都强调了最佳癌症疼痛管理的障碍。与医疗保健系统相关的领域报告的障碍最为频繁。约一半的纳入研究在批判性评价中符合100%的方法学质量标准。
改善撒哈拉以南非洲癌症患者的疼痛管理需要关于监管政策和干预策略的进一步高级研究证据，特别是在卫生系统层面，因为癌症疼痛治疗的大多数障碍基本上源于医疗保健系统。
