Access to opioid analgesics for medical use at hospital level in the Democratic Republic of Congo: An exploratory mixed‐method study

Abstract

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.

Balancing Pain Management Best Practices: A Review Opioid and Non-Opioid Strategies in Pain Management Strategies in Low-and- Middle Income Countries.

“…The severe opioid shortage was highlighted by Yao et al (2023) and Zandibeni et al (2023). The acute lack of opioids in Sub-Saharan Africa has made non-opioid analgesics more widely used since they are more difficult to find.…”