TY - JOUR
T1 - Access to opioid analgesics for medical use at hospital level in the Democratic Republic of Congo: an exploratory mixed-method study
AU - Zandibeni, Jacques
AU - de Béthune, Xavier
AU - Bitumba, Jean Debethel
AU - Mantempa, Jocelyn
AU - Tshilolo, Léon
AU - Ndona, Jackie
AU - Mbaya, Alain Kabemba
AU - Kabey, Donatien Kabamb
AU - Kananga, Anselme Mubeneshayi
AU - Ravinetto, Raffaella
N1 - FTX; (CC BY-NC 4.0)
PY - 2023
Y1 - 2023
N2 - Objective: To investigate the availability of and access to opioid analgesics at hospital level in the Democratic Republic of Congo.Methods: Exploratory mixed-method study combining a descriptive survey of the availability of opioid analgesics at hospital pharmacies with a qualitative survey that explored the experiences and perceptions of healthcare workers, managers, patients and caregivers, by means of a short questionnaire and of semi-structured interviews. The study was conducted in a convenience sample of 12 hospitals, located in five different provinces, in 2021.Results: The quality and completeness of stock data for opioid analgesics were generally poor. Stock-outs were frequent. Only five hospital pharmacies had records on prescriptions of opioids in 2020. In-patients and caregivers indicated they generally must purchase opioids out-of-pocket, sometimes far from the place of residence. Doctors and nurses confirmed that prescribed opioids are often unavailable at the hospital pharmacy. Furthermore, they suggested an important need of training in pain management with opioids, and of effective regulation to ensure opioid availability. Pharmacists and managers recognised important weaknesses in the processes of needs quantification, stock management, planning and supply.Conclusions: Our exploratory study suggests the need of a complex set of coordinated actions to be undertaken by all relevant actors in DRC to correct the poor practices in opioids' management and to improve opioids' availability, affordability and adequate use. This will require a change of mindset to overcome the neglect of the health needs of persons with acute and chronic pain.
AB - Objective: To investigate the availability of and access to opioid analgesics at hospital level in the Democratic Republic of Congo.Methods: Exploratory mixed-method study combining a descriptive survey of the availability of opioid analgesics at hospital pharmacies with a qualitative survey that explored the experiences and perceptions of healthcare workers, managers, patients and caregivers, by means of a short questionnaire and of semi-structured interviews. The study was conducted in a convenience sample of 12 hospitals, located in five different provinces, in 2021.Results: The quality and completeness of stock data for opioid analgesics were generally poor. Stock-outs were frequent. Only five hospital pharmacies had records on prescriptions of opioids in 2020. In-patients and caregivers indicated they generally must purchase opioids out-of-pocket, sometimes far from the place of residence. Doctors and nurses confirmed that prescribed opioids are often unavailable at the hospital pharmacy. Furthermore, they suggested an important need of training in pain management with opioids, and of effective regulation to ensure opioid availability. Pharmacists and managers recognised important weaknesses in the processes of needs quantification, stock management, planning and supply.Conclusions: Our exploratory study suggests the need of a complex set of coordinated actions to be undertaken by all relevant actors in DRC to correct the poor practices in opioids' management and to improve opioids' availability, affordability and adequate use. This will require a change of mindset to overcome the neglect of the health needs of persons with acute and chronic pain.
U2 - 10.1111/tmi.13837
DO - 10.1111/tmi.13837
M3 - A1: Web of Science-article
C2 - 36480447
SN - 1360-2276
VL - 28
SP - 53
EP - 63
JO - Tropical Medicine and International Health
JF - Tropical Medicine and International Health
IS - 1
ER -