Cancer pain is one of the most common, feared, debilitating, and often undertreated symptoms among cancer patients. It needs attention since it has a significant impact on the quality of life (QoL) of the patients. Also, since cancer has emerged as a major health problem in developing countries, there is a need to strengthen preventive strategies for effective cancer pain management and provide comfort to cancer patients. Nonetheless, various barriers limit developing countries toward optimal cancer pain management. To bridge the gap between adequate pain management and burden of cancer pain in developing countries, a comprehensive understanding of the limitations faced and the prevalence of cancer pain should be addressed. The aim of this literature review is to provide a deeper understanding on the factors associated with cancer pain as well as barriers toward optimal cancer pain management in developing countries. Some of the barriers addressed were administrative, judicial, economic, and professional barriers. Also, estimates on the prevalence of cancer pain and detrimental effects of pain on the QoL of cancer patients have been addressed. In summary, pain, which is one of the most debilitating symptoms of cancer, remains uncontrolled and undertreated in developing countries. It has a profound impact on the patient’s QoL and can have physical, psychological, and social consequences; therefore, it needs to be managed urgently and appropriately. Most importantly, optimal treatment of cancer pain should be highlighted as a priority in developing countries and concerted efforts should be made to eliminate different barriers discussed in this review for effective and humane care.
Les douleurs neuropathiques périphériques (DN) ont fait l'objet de nombreuses recherches fondamentales et cliniques au cours des 20 dernières années. Ces travaux ont conduit à une meilleure compréhension de leur physio pathologie, au développement de nouvelles théra-peutiques, puis à la publication de recommandations pour leur diagnostic et leur traitement. Ces recommandations concernent essentiellement la prise en charge des patients européens et nord-américains, et aucune recommandation n'est disponible pour le traitement des DN dans la région du Maghreb francophone alors que cette région arbore des spé-cificités en termes de prévalence des pathologies causales des DN et des comorbidités. C'est la raison pour laquelle un groupe interdisciplinaire d'experts de l'Algérie, du Maroc et de la Tunisie s'est réuni pour élaborer, à partir des données déjà publiées et en tenant compte des particularités de leur pays respectif, des recommandations spécifiques pour la prise en charge pharmacologique des DN.
Mots clés Recommandations -Maghreb -Douleurs neuropathiques périphériques -Traitement médicamenteux
Pharmacological treatment of peripheral neuropathic pain: expert panel recommendations for the French-speaking maghrebian regionAbstract Peripheral neuropathic pain (NeP) has been a major theme of basic and clinical research over the past 20 years. Extensive research has led to an increased knowledge of underlying pathophysiological mechanisms, the development of new therapeutic agents, and the publication of treatment guidelines. Nonetheless, a significant gap in the treatment guideline literature appears to be the exclusive focus on recommendations for managing NeP patients in North America and Europe. To date there are no guidelines for NeP in the French-speaking North-African countries (Algeria, Tunisia, Morocco), while these countries display several specificities in terms of aetiologies of NeP and comorbidities. A multidisciplinary panel of experts met to reach a consensus on how best to apply evidence-based guidelines for the treatment of NeP in this region of the world. From the so far published guidelines, they propose recommendations for the pharmacological management of NeP in their countries.
La lombalgie aiguë est la pathologie rhumatismale la plus fréquente en Afrique. L’épidémiologie et la présentation clinique ne diffèrent pas de celles observées sur les autres continents. En revanche, les aspects psycho-sociaux, la disponibilité des traitements, l'accès aux soins et le poids culturel des médecines traditionnelles sont autant de spécificités qui ont conduit à la réalisation du 1er consensus d'experts en rhumatologie pour la prise en charge du patient africain. Destiné aux praticiens, ce travail collaboratif multinational a pour objectif de fournir 11 recommandations de pratiques cliniques simples, fondées sur les preuves, et adaptées aux conditions de l'exercice médical en Afrique. Leur ambition est d'améliorer la prise en charge de la lombalgie aigue par une évaluation initiale clinique pertinente, une diminution des examens radiologiques inutiles, une prescription médicamenteuse adéquate et l'abandon de procédures invasives inappropriées.
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