dr kathleen foley presn to can pain summit 042412
TRANSCRIPT
International Initiatives in Cancer Pain
Kathleen M. Foley, MD
April 24, 2012
New Global Initiatives in Pain and Palliative Care
• IASP Montreal Declaration on pain relief as a
fundamental human right
• A World Medical Association Declaration on access to pain relief
• Human Rights Watch reports on access to pain relief and palliative care
-India -Kenya -Ukraine
New Global Initiatives in Pain Palliative Care
• World Medical Association calls for pain and palliative care services within the right to health framework and supports their integration as human rights issues
http://www.wma.ne
New Global Initiatives in Pain and Palliative Care
• Four Human Rights Watch Country Reports describe the human rights abuses related to lack of access to pain relieving drugs in:
India Kenya Ukraine http://www.hrw.org/
In this 47-page report Human Rights Watch said that countries could significantly improve access to pain medications by addressing the causes of their poor availability. These often include the failure to put in place functioning supply and distribution systems; absence of government policies to ensure their availability; insufficient instruction for healthcare workers; excessively strict drug-control regulations; and fear of legal sanctions among healthcare workers.
Access to Pain Treatment as a Human Right
“Please , do not make us suffer anymore…….”
http://www.hrw.org/en/reports/2009/03/02/please-do-not-make-us-suffer-any-more
http://www.hrw.org/sites/default/files/reports/health1009webwcover.pdf
http://www.hrw.org/features/kenya-government-failure-provide-palliative-care-children
http://www.hrw.org/reports/2011/05/12/uncontrolled-pain
Uncontrolled Pain Ukraine’s Obligation to Ensure Evidence-
Based Palliative Care
Vlad is suffering from incurable brain cancer. Despite his chronic pain, doctors in Ukraine are only allowed to prescribe 50 mg of pain medicine. In another country, doctors would typically prescribe more than 2,000 mg for a patient like Vlad.
50 Milligrams is Not Enough People with debilitating illnesses are left to die in excruciating pain as a result of restrictions on pain medicines. Health care workers must be allowed to provide patients with relief from severe pain
http://www.stoptortureinhealthcare.org/
New Global Initiatives in Pain and Palliative Care
• The International Association of Hospice and Palliative Care has:
• Developed an essential drug list for palliative care medications
• Consists of 34 medications, 14 currently on the WHO Essential Drug List
http://iahpcnews.com/
New Global Initiatives in Pain and Palliative Care
• WHO Essential Drug Program has created an office for addressing Access to Controlled Substances as essential medicines
• Appointed Willem Scholten as program director
• Has developed a strategic plan with NGO partnerships including the ATOME project
WHO Access to Essential Medicines Program for Controlled Substances
• To improve access for opioid drugs in low and
medium resource countries
• Published two recent documents:
• “Guidelines for Persistent Pain in Children”
“Ensuring Balance in National Policies on Controlled Substances”
New Global Initiatives in Pain and Palliative Care
• UN General Assembly Meeting on Non-Communicable Diseases:
• Calls for the integration of pain and palliative care into health care services
New Global Initiatives in Pain and Palliative Care
• New WHO Collaborating Centers in Palliative Care have been recognized:
Barcelona, Spain
Kerala, India and Trivandrum, India
Kings’ College, London
Sir Michael Sobell House, Oxford
Pain and Policy Studies Program, the University
of Wisconsin,USA
New Global Initiatives in Palliative Care
• Lien Foundation: Life Before Death initiative www. lifebeforedeath.com
• TREAT THE PAIN Campaign http://www.treatthepain.com/
• OSF Campaign: Stop Torture in Healthcare http://stoptortureinhealthcare.org/
Global Access to Pain Relief Initiative (GAPRI)
• Supported by International Union Against Cancer (UICC) -global advocacy initiative -raise awareness for policy change -focus on cancer patients (http://www.uicc.org)
Suppliers
Multi-country global health programs
National policies and programs
Facilities
GAPRI Strategy
GAPRI Fellowship Program
GAPRI Envoy Program
GAPRI Supplier Network
GAPRI Pain Treatment Advocacy Project
Intl policy
New Global Initiatives in Pain and Palliative Care
• OSF IPCI Leadership Development Initiative: supports 44 leaders in palliative care from resource limited countries to develop skills and knowledge to advance pain and palliative care globally
• International Pain and Policy Fellows: 15 healthcare professionals learn drug policy expertise to improve access to palliative care medicines in resource limited countries
Education in Palliative and End-of-Life Care in Oncology (EPEC-O)
EPEC-O Content:
Whole Patient Assessment
Communicating Effectively
Goals of Care
Withholding withdrawing
Clinical Trials
Last Hours of Living
Loss, Bereavement
Survivorship
13 Symptoms, including Pain
Nausea / vomiting
Constipation
Bowel obstruction
Dyspnea
Anorexia / cachexia
Menopausal symptoms
Pleural effusions
Ascites
Wounds
The EPEC Project of Northwestern University's Feinberg School of Medicine was created with the support of the American Medical Association and the Robert Wood Johnson Foundation, with continued support from the National Cancer Institute (R25 CA100754). The EPEC-O curriculum is produced by the EPEC Project with major funding provided by the National Cancer Institute, with supplemental funding provided by the Lance Armstrong Foundation.
New Global Initiatives in Pain and Palliative Care
End of Life Nursing Education Program - ELNEC - educates nurses globally in pain and palliative care
Has detailed curriculum with translations into 15 languages
(http://www.aacn.nche.edu/elnec)
