I Wait for Leftover Morphine: A Qualitative Study of Barriers to Safe Opioid Access for Cancer Pain Relief in Vietnam
PURPOSEThis study explores the views of health care providers (HCPs), regulators, patients with cancer, and caregivers in Vietnam on the barriers to safe access to opioids for cancer pain relief and suggested solutions.MATERIALS AND METHODSWe conducted a qualitative, descriptive study using semistru...
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| Format: | Article |
| Language: | English |
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American Society of Clinical Oncology
2025-06-01
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| Series: | JCO Global Oncology |
| Online Access: | https://ascopubs.org/doi/10.1200/GO-25-00026 |
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| author | Trang Nguyen Anh Dam Linh Bui Tung Pham Eric L. Krakauer Caroline Phelan |
| author_facet | Trang Nguyen Anh Dam Linh Bui Tung Pham Eric L. Krakauer Caroline Phelan |
| author_sort | Trang Nguyen |
| collection | DOAJ |
| description | PURPOSEThis study explores the views of health care providers (HCPs), regulators, patients with cancer, and caregivers in Vietnam on the barriers to safe access to opioids for cancer pain relief and suggested solutions.MATERIALS AND METHODSWe conducted a qualitative, descriptive study using semistructured interviews. Five HCPs, six patients with cancer/caregivers, and six regulators (n = 17) were purposefully sampled across Vietnam. Audio recordings were transcribed verbatim and subjected to inductive content analysis using a Framework method.RESULTSFive categories of barriers were identified: (1) Patient-related barriers (fear of addiction and other side effects, morphine's association with impending death); (2) professional-related barriers (knowledge and experience deficit, fear of addiction and other side effects, and concerns about diversion and liabilities); (3) medicine-related barriers (limited oral morphine availability, limited manufacturers and suppliers, and difficulties accessing parenteral opioids); (4) regulatory barriers (difficulties obtaining certifications of continued need for opioid use, overly strict regulation enforcement, lack of information on opioid distribution channels); and (5) services delivery barriers (scarce palliative and home care services). Potential solutions include strengthening education for patients, communities, and health care professionals; mandating oral morphine availability at district levels; diversifying opioid variety and enhancing domestic manufacturing; establishing an electronic prescription monitoring system; expanding palliative care training and implementation across all health care system levels; and using telemedicine.CONCLUSIONBarriers to opioid access for cancer pain control in Vietnam are multifactorial and interrelated, necessitating interdisciplinary solutions. |
| format | Article |
| id | doaj-art-974097d515a7498399b41031d2041bdf |
| institution | OA Journals |
| issn | 2687-8941 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | American Society of Clinical Oncology |
| record_format | Article |
| series | JCO Global Oncology |
| spelling | doaj-art-974097d515a7498399b41031d2041bdf2025-08-20T02:32:25ZengAmerican Society of Clinical OncologyJCO Global Oncology2687-89412025-06-011110.1200/GO-25-00026I Wait for Leftover Morphine: A Qualitative Study of Barriers to Safe Opioid Access for Cancer Pain Relief in VietnamTrang Nguyen0Anh Dam1Linh Bui2Tung Pham3Eric L. Krakauer4Caroline Phelan5Department of Pharmacy, University Medical Center Ho Chi Minh City, Ho Chi Minh City, VietnamDepartment of Pharmacy, National Geriatric Hospital, Ha Noi, VietnamDepartment of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MAResearch Advancement Consortium in Health, Hanoi, VietnamDepartment of Ethics, Social Medicine & Palliative Care, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, VietnamCollege of Nursing and Health Sciences, Flinders University, Adelaide, SA, AustraliaPURPOSEThis study explores the views of health care providers (HCPs), regulators, patients with cancer, and caregivers in Vietnam on the barriers to safe access to opioids for cancer pain relief and suggested solutions.MATERIALS AND METHODSWe conducted a qualitative, descriptive study using semistructured interviews. Five HCPs, six patients with cancer/caregivers, and six regulators (n = 17) were purposefully sampled across Vietnam. Audio recordings were transcribed verbatim and subjected to inductive content analysis using a Framework method.RESULTSFive categories of barriers were identified: (1) Patient-related barriers (fear of addiction and other side effects, morphine's association with impending death); (2) professional-related barriers (knowledge and experience deficit, fear of addiction and other side effects, and concerns about diversion and liabilities); (3) medicine-related barriers (limited oral morphine availability, limited manufacturers and suppliers, and difficulties accessing parenteral opioids); (4) regulatory barriers (difficulties obtaining certifications of continued need for opioid use, overly strict regulation enforcement, lack of information on opioid distribution channels); and (5) services delivery barriers (scarce palliative and home care services). Potential solutions include strengthening education for patients, communities, and health care professionals; mandating oral morphine availability at district levels; diversifying opioid variety and enhancing domestic manufacturing; establishing an electronic prescription monitoring system; expanding palliative care training and implementation across all health care system levels; and using telemedicine.CONCLUSIONBarriers to opioid access for cancer pain control in Vietnam are multifactorial and interrelated, necessitating interdisciplinary solutions.https://ascopubs.org/doi/10.1200/GO-25-00026 |
| spellingShingle | Trang Nguyen Anh Dam Linh Bui Tung Pham Eric L. Krakauer Caroline Phelan I Wait for Leftover Morphine: A Qualitative Study of Barriers to Safe Opioid Access for Cancer Pain Relief in Vietnam JCO Global Oncology |
| title | I Wait for Leftover Morphine: A Qualitative Study of Barriers to Safe Opioid Access for Cancer Pain Relief in Vietnam |
| title_full | I Wait for Leftover Morphine: A Qualitative Study of Barriers to Safe Opioid Access for Cancer Pain Relief in Vietnam |
| title_fullStr | I Wait for Leftover Morphine: A Qualitative Study of Barriers to Safe Opioid Access for Cancer Pain Relief in Vietnam |
| title_full_unstemmed | I Wait for Leftover Morphine: A Qualitative Study of Barriers to Safe Opioid Access for Cancer Pain Relief in Vietnam |
| title_short | I Wait for Leftover Morphine: A Qualitative Study of Barriers to Safe Opioid Access for Cancer Pain Relief in Vietnam |
| title_sort | i wait for leftover morphine a qualitative study of barriers to safe opioid access for cancer pain relief in vietnam |
| url | https://ascopubs.org/doi/10.1200/GO-25-00026 |
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