Opioid Availability in Latin America: The Declaration of Florianópolis

Stjernswärd, Jan; Bruera, Éduardo; Joranson, David E.; Allende, Silvia; Montejo, Gustavo; Costa, Lisbeth Quesada Tristan; Castillo, Gloria; Schoeller, Teresa; Pazos, Maria Antonieta Rico; Wenk, Roberto; Pruvost, Maria; Lima, Liliana De; Mendez, Eduardo; Núñez, Juan Antonio Álvarez Pedrosa; Olalla, José Felix; Vanegas, Guillermo

doi:10.1177/082585979401000403

Cited by 12 publications

(4 citation statements)

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“…Additionally, non-governmental professional and advocacy groups have made numerous declarations over the years calling on healthcare professionals and governments to improve pain and palliative care, by addressing barriers to the availability of opioids to manage pain. Two notable examples of such efforts from the mid-1990s are the Declaration of Florianopolis [21,22] and the Report of Santo Domingo [23] which were recommendations resulting from meetings of palliative care experts, drug regulators, and leaders from the WHO for improving opioid availability.…”

Section: Barriers To Opioid Availability and Accessibilitymentioning

confidence: 99%

Improving the availability and accessibility of opioids for the treatment of pain: The International Pain Policy Fellowship

Bošnjak

Maurer

Ryan

et al. 2011

Support Care Cancer

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Opioid analgesics are simultaneously indispensable medicines for the treatment of moderate to severe pain and are harmful when abused. The challenge for governments is to balance the obligation to prevent diversion, trafficking, and abuse of opioids with the equally important obligation to ensure their availability and accessibility for the relief of pain and suffering. Over the last 30 years, significant progress has been made toward improving access to opioids as measured by increasing global medical opioid consumption. However, this progress is marked by ongoing large disparities among countries, with most increases in medical opioid consumption attributed to high-income countries, not low- and middle-income countries (LMICs). The International Pain Policy Fellowship (IPPF) was developed by the Pain & Policy Studies Group, with the central goal of developing national leaders from LMICs and empowering them to improve availability and accessibility of opioids for the treatment of pain. To date, two classes of fellows have been selected, representing 17 fellows from 15 countries. Progress achieved by the leadership of three fellows from Sierra Leone, Colombia, and Serbia is highlighted in this paper. The fellows from each country were successful at initiating collaboration with relevant governmental bodies, national authorities, and professional societies, which resulted in a new supply of oral opioids in Sierra Leone and Serbia, and improvements in the distribution of already available opioids in Colombia. All fellows were instrumental in facilitating evaluation of national policy. The IPPF program empowers fellows with the necessary knowledge, skills, and guidance to improve the availability and accessibility of opioids for the treatment of pain.

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Section: Barriers To Opioid Availability and Accessibilitymentioning

confidence: 99%

Improving the availability and accessibility of opioids for the treatment of pain: The International Pain Policy Fellowship

Bošnjak

Maurer

Ryan

et al. 2011

Support Care Cancer

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“…The Latin American Association of Palliative Care has been working to raise awareness and bring palliative care to the forefront in Latin America through its regional congresses, information dissemination programs, and advocacy. 6,34,35 It is now up to the governments, institutions, and international funding agencies to respond to the assessments of Latin American frontline providers, advocates, and their regional association by formulating and instituting palliative care policies and programs that are accessible and affordable to those most in need.…”

Section: Future Directionsmentioning

confidence: 99%

Health Care Providers' Assessments of the Quality of Advanced-Cancer Care in Latin American Medical Institutions: A Comparison of Predictors in Five Countries: Argentina, Brazil, Cuba, Mexico, and Peru

Torres-Vigil

Aday

Reyes‐Gibby

et al. 2008

Journal of Pain & Palliative Care Pharmacotherapy

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This paper describes an innovative Pan-American survey on advanced-cancer care and examines the quality-of-care provided by Latin American institutions. A convenience sample of 777 physicians and nurses who treat cancer patients in Argentina, Brazil, Cuba, Mexico, and Peru were surveyed. Providers were identified through mass mailings, distribution at professional meetings and conferences, collaboration with regional institutions, professional organizations, and PAHO and online posting. Multiple linear regression analyses were conducted to identify predictors of quality-of-care assessments in each country. The five predictive models were subsequently compared descriptively. Higher access to care ratings and greater availability of end-of-life services corresponded with improved institutional quality-of-care ratings for all five countries. Barring respondents from Cuba, providers from the other four nations who practice in public institutions rated the quality of advanced-cancer care in their own institutions lower than those practicing in private hospitals or specialized cancer centers. Other institutional quality-of-care predictors included type of city, affordability-of-care ratings, availability of opioid analgesics, where patients die, barriers to cancer pain management, and the provider's specialty and gender. These findings highlight the need for providing accessible care and services to improve the quality of advanced-cancer care in Latin American institutions. Efforts should be aimed at improving the care offered in public institutions and addressing other types of disparities that may exist within countries by creating supportive and palliative cancer care programs that are accessible and affordable to those most in need.

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“…We did this by presenting workshops, sometimes including national narcotic regulators, at the conferences of the Latin American Association for Palliative Care. 22,23 This activity did contribute to awareness of regulatory barriers in several countries, and even some progress in regulatory reforms. However, we also concluded that this approach was not strong or direct enough to produce much change because it lacked specificity and cooperative work between regulators and clinicians.…”

Section: Phase 4: Guideline Implementation: a Workhop For Latin Americamentioning

confidence: 97%

Improving Availability of Opioid Pain Medications: Testing the Principle of Balance in Latin America

Joranson¹

2004

Journal of Palliative Medicine

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Opioid Availability in Latin America: The Declaration of Florianópolis

Cited by 12 publications

References 0 publications

Improving the availability and accessibility of opioids for the treatment of pain: The International Pain Policy Fellowship

Improving the availability and accessibility of opioids for the treatment of pain: The International Pain Policy Fellowship

Health Care Providers' Assessments of the Quality of Advanced-Cancer Care in Latin American Medical Institutions: A Comparison of Predictors in Five Countries: Argentina, Brazil, Cuba, Mexico, and Peru

Improving Availability of Opioid Pain Medications: Testing the Principle of Balance in Latin America

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