Opioids (e.g. morphine) are affordable, effective interventions for cancer-related pain. However, equity of access to this key medication remains a global challenge, particularly in low- and middle-income countries.
We aimed to explore the views of palliative care providers and public representatives about opioid analgesia access in two States in India. We conducted a qualitative study using semi-structured interviews.
Twenty participants (10 doctors, four nurses, two pharmacists, two service managers and two public representatives) were interviewed.
Three themes were identified
- Attitudes and awareness: opioid treatments are perceived as end-of-life (last days/weeks) interventions; fears of addiction and misunderstanding of pain management goals limit access.
- Expected and unexpected inequities: patients/carers from lower socioeconomic strata accept doctor recommendations if opioids are affordable, more educated patients/families have reservations about opioids, delay access and perceive expensive medicines as better. Non-palliative care specialist doctors have negative entrenched views and require specialist training.
- Experiential learning–positive experiences can positively alter attitudes (e.g., participants in Kerala report improved attitudes, awareness and understanding influenced by exposure and community awareness, but experience can also reinforce perceptions as end-of-life care.
Outputs
Views and experiences of opioid access amongst palliative care providers and public representatives in a low-resource setting: A qualitative interview study