[e-drug] Measuring availability of opioids at health facilities

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EDRUG: Measuring availability of opioids at health facilities
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[Please send any responses by e-mail directly to douglasball@yahoo.co.uk
(don't just press 'Reply' on E-drug).]

Dear E-Druggers

I am working with WHO looking at how best to monitor availability of
essential opioids especially morphine at all levels of health care
facilities where there are patients in need of this treatment for
palliative care. The idea is that this would be an indicator which would
be able to be measured using easily available data (if available) for
ongoing monitoring of the availability of this/these essential medicines
in low- and middle-income countries.

I am NOT dealing with general policy constraints and other obstacles to
the accessibility of opioids although these would impact on the indicator.

I am soliciting opinions of:
(1) - The value of measuring availability of opiates (in your country
or globally) at health facilities. Is this helpful for monitoring
patient access to morphine/opioids. Would it be more helpful/useful than
consumption data based on International Narcotics Control Board (INCB)
reports?

(2) - Are you aware of any studies that have examined availability of
morphine or other opioids at health facilities? Have these been
published/are they available to read?

I am aware of:
- Opioid Price Watch
- Thailand national palliative care survey 2012 (Thongkhamcharoen et al.
J Palliat Med 2013; 16(5): 546-550).
- Western Kenya urgent care assessment (Burke et al. BMJ Open
2014;4:e006132.)
- WHO/HAI price/availability surveys
- WHO SARA and SPA assessments
- Use of INCB data to measure consumption

(3) - I welcome any other comments/suggestions/advice for developing a
low cost, reliable, repeatable methods for assessing opioid availability
at health facilities in countries.
- Any national data sources that could be suitable for identifying
health facilities that have morphine available/are dispensing morphine
and advantages/disadvantages to using these e.g. are these computerized,
easy to access.
- Are there any data sources that are easily available that could be
used as a proxy for health facility availability?

Thanks

Douglas Ball
Temporary Adviser, WHO.
Delhi
Douglas Ball <dr.douglasball@yahoo.co.uk>