Improving cancer care in Pakistan

Jamshed, Arif; Syed, Aamir Ali; Shah, Mazhar Ali; Jamshed, Sarah

doi:10.4103/2278-330x.105892

Cited by 10 publications

(10 citation statements)

References 4 publications

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“…The initial step for cancer control and prevention is to develop the proper understanding of relationship between disease and demographics [ 25 ]. This study reported 73.2% of the cases from urban areas and 26.8% from rural areas.…”

Section: Discussionmentioning

confidence: 99%

Availability of anticancer medicines in public and private sectors, and their affordability by low, middle and high-income class patients in Pakistan

2018

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BackgroundAvailability and affordability of anticancer medicines is a matter of great concern especially for low and middle income countries e.g., Pakistan. Prime focus of this study was to evaluate the availability of anticancer medicines in public and private sectors, and their affordability among patients with different income levels.MethodsA descriptive, cross-sectional survey was conducted in 22 cancer care hospitals (18 public hospitals and 04 private hospitals) and 44 private pharmacies in Punjab, Pakistan. All (n = 4400) participants were ≥18 years of age. Data were collected at different intervals and analyzed by using Statistical Packages for Social Sciences (IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp.)ResultsA total of 4913 patients were approached, and 4400 responded to the survey (response rate = 89.6%). Non-hodgkin lymphoma (12.3%), breast cancer (8.6%), and leukemia (7.6%) were the most prevailing cancers. Conventional medicines like cisplatin, cyclophosphamide, and etoposide were the most prescribed medicines. Oncologists were reluctant to prescribe newer anticancer medicines due to high prices. Originator brands (OBs) were more readily available (52.5%) but less affordable (53.4%); whereas, lowest price generics (LPGs) were less available (28.1%) but more affordable (67.9%). Anticancer medicines were more affordable by the high income class patients than the low income class patients.ConclusionThe availability of both OBs and LPGs was greater at private hospitals and pharmacies as compared to public hospitals. The high income class had more affordability of both OBs and LPGs; however, LPGs were more affordable for all income classes.

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Section: Discussionmentioning

confidence: 99%

Availability of anticancer medicines in public and private sectors, and their affordability by low, middle and high-income class patients in Pakistan

2018

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“…19 With such a high burden of this under treated distressing symptom, cancer pain should be anticipated and responded to early in its course rather than only in crisis once it is severe. 20 Extensive literature has supported attention to pain as an institutional priority for oncology settings with established quality improvement efforts devoted to pain. 21 The experience of pain in cancer is widely accepted as a major threat to quality of life, and the relief of pain has emerged as a priority in oncology care.…”

Section: Discussionmentioning

confidence: 99%

Palliative Care

Nadeem

Qamar²,

Khokhar³

et al. 2018

TPMJ

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Pain is a devastating symptom of advanced cancers. Inadequate assessment and failure in following WHO (World health organization) guidelines for pain management are barriers to pain control in cancer patients. Objectives: To determine frequency of inadequate pain assessment leading to inadequate pain control in advanced stage cancer patients receiving palliative care. Subjects and Methods: 180 patients, within age 18 to 70 years of both genders, of cancer with stage 3 and 4 disease receiving palliative treatment for pain due to primary or metastatic disease requiring opioidanalgesics presenting to inpatient department of Medical Oncology, Mayo Hospital Lahore were selected using non probability, consecutive sampling. Study Design: Cross sectional descriptive study. Setting: Department of Medical Oncology, Mayo Hospital Lahore. Period: 6 months after approval of synopsis from 01.06.2017 to 01.01.2018. The Pain scales used were Numerical Rating Scale- NRS, followed by Visual Analogue Scale-VAS. All patients were evaluated whether or not their pain was assessed by a standard pain scale, the type of malignancy, and the stage of cancer. Results: A total of 180 patients with mean age of 49.68 years, with 62.2% females and 37.8% males were selected. Out of these 124 (68.89%) patientsreceived inadequate assessment for their pain intensity as no documented pain scale was being used to assess them. Out of them 50(49.02%) were males and 52 (50.98%) were females. 56 patients (31.11%) were receiving inadequate pain assessment. 17 (30.35%) of them were assessed using VAS and 39 (69.65%) were assessed using NRS. The median pain score was 7.8/10 with the stage 4 patients mainly presenting with a score of >7/10 (69.94%) and stage 3 patients making up majority of pain with <7/10 score (58.82%). Conclusion: This study showed that pain is poorly managed in patients with advanced malignancy as majority of patients are not assessed according to standard methods for cancer pain. There is a strong need of physicians’ education, development of proper palliative care services and implementation of WHO guidelines to achieve effective pain management for oncology patients.

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“…Ultimately, patients become part of a nationwide chronic disease burden because they are beyond cure when they do manage to seek care. 17 Because of insufficient undergraduate training in oncology, 18 physicians are mostly unaware of screening, diagnosis, and appropriate referral methods. Two other important areas in cancer management, breaking bad news and communication skills, receive little attention in the undergraduate curriculum.…”

Section: Challenges Of Practicing Radiation Oncology In Pakistanmentioning

confidence: 99%