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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Main Authors: Trang Nguyen, Anh Dam, Linh Bui, Tung Pham, Eric L. Krakauer, Caroline Phelan
Format: Article
Language:English
Published: American Society of Clinical Oncology 2025-06-01
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.
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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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