Public policy on palliative care and its implications for services, opioids, and education in Colombia
DOI:
https://doi.org/10.15649/cuidarte.2501Keywords:
Palliative Care, Public Health Policy, Health Services, Analgesics, Opioid, EducationAbstract
Introduction: Palliative care development requires the intervention of multiple dimensions of public health, including the availability of health services, essential medicines, and educational programs. In Colombia, several changes have been made in public policy to promote the care of people with palliative needs. Objective: To empirically evaluate existing public policies on palliative care and their implications for the availability of services, opioids, and educational programs during the years 2010 to 2019 in Colombia. Materials and methods: A mixed sequential exploratory study was designed in three phases: identification of empirical indicators of national policies, palliative care situational diagnosis, and qualitative assessment of the results of policy implementation in seven regional nodes in Colombia. Results: Seven standards were reviewed, yielding 12 empirical indicators for assessment, six of which had no sources of information. The national diagnosis shows a gradual increase in services and opioid use during the landmark years of policy development. Forty-four palliative care professionals perceive a positive effect of public policy on opioid use and low outcomes for service and education domains. Conclusions: There is a positive relationship between public policy and opioid use, a positive quantitative relationship with palliative care services, and a negative quantitative-qualitative relationship with educational programs. This indicates a low operational status of policies designed to alleviate the pain and suffering associated with advanced chronic diseases.
How to cite this article: Sánchez-Cárdenas Miguel Antonio, Aguilar Obregón Laura, Bernal Tovar María, Gómez Serrano Karen, Rubiano Albarracín Ana, Tarazona Álvarez Marcela, Vanegas Gutiérrez Daniela, Fuentes-Bermúdez Genny Paola. Política pública en cuidados paliativos y sus implicaciones sobre servicios, opioides y educación en Colombia. Revista Cuidarte. 2023;14(2):e2501. http://dx.doi.org/10.15649/cuidarte.2501
References
Sleeman KE, de Brito M, Etkind S, Nkhoma K, Guo P, Higginson IJ, et al. The escalating global burden of serious health-related suffering: projections to 2060 by world regions, age groups, and health conditions. Lancet Glob Health. 2019;7(7):e883-e892. https://pubmed.ncbi.nlm.nih.gov/31129125/
Sánchez-Cárdenas, M. Estado actual de los cuidados paliativos en Colombia: reporte técnico 2021. OCCP. 2022. http://hdl.handle.net/20.500.12495/7656
World Health Organisation. Assessing the development of palliative care worldwide: a set of actionable indicators. World Health Organization. WHO. 2022. https://www.who.int/publications/i/item/9789240033351
Stjernswärd J, Foley KM, Ferris FD. The public health strategy for palliative care. J Pain Symptom Manage. 2007;33(5):486-93. https://pubmed.ncbi.nlm.nih.gov/17482035/
The Economists, Intelligence Unit. The 2015 quality of death index: ranking palliative care across the world. LIEN foundation. 2021. https://impact.economist.com/perspectives/sites/default/files/2015%20EIU%20Quality%20of%20Death%20Index%20Oct%2029%20FINAL.pdf
Fischer F. Politics, values, and public policy: The problem of methodology. Routledge, 2019. https://doi.org/10.4324/9780429302558
Bauman AE, King L, Nutbeam D. Rethinking the evaluation and measurement of Health in all policies. Health Promot Int. 2014;29 (1):143-51. https://academic.oup.com/heapro/article/29/suppl_1/i143/647862
Clark D, Baur N, Clelland D, Garralda E, López-Fidalgo J, Connor S, Centeno C. Mapping Levels of Palliative Care Development in 198 Countries: The Situation in 2017. J Pain Symptom Manage. 2020; 59(4): 794-807. https://pubmed.ncbi.nlm.nih.gov/31760142/
Pastrana T, Centeno C, De Lima L. Palliative Care in Latin America from the Professional Perspective: A SWOT Analysis. J Palliat Med. 2015;18(5):429-37. https://www.liebertpub.com/doi/10.1089/jpm.2014.0120
Arias-Casais N, Garralda E, López-Fidalgo J, Rhee JY, Pons JJ, de Lima L, et al. Consensus Building on Health Indicators to Assess PC Global Development With an International Group of Experts. J Pain Symptom Manage. 2019;58 (3):445-453. https://pubmed.ncbi.nlm.nih.gov/31163260/
Sharkey L, Loring B, Cowan M, Riley L, Krakauer EL. National palliative care capacities around the world: Results from the World Health Organization Noncommunicable Disease Country Capacity Survey. Palliat Med. 2018;32(1):106-113. https://journals.sagepub.com/doi/abs/10.1177/0269216317716060?journalCode=pmja
Zhang W, Creswell J. The use of "mixing" procedure of mixed methods in health services research. Med Care. 2013;51(8): 51-7. https://pubmed.ncbi.nlm.nih.gov/23860333/
Alla K, Hall WD, Whiteford HA, Head BW, Meurk CS. How do we define the policy impact of public health research? A systematic review. Health Res Policy Syst. 2017;15(1):84. https://health-policy-systems.biomedcentral.com/articles/10.1186/s12961-017-0247-z
Ministerio de Salud y Protección Social-Republica de Colombia. Registro especial de prestadores de salud. MinSalud. 2017. https://prestadores.minsalud.gov.co/habilitacion/
Walther Center in Global Palliative Care. report on global disparities in access to essential medicines for pain and palliative care. Walthercenter. 2021. https://walthercenter.iu.edu/essential-medicines/country/colombia.html
León M, Sánchez M. Consumo de opioides. Análisis de su disponibilidad y acceso en Colombia. Cundinamarca: Universidad de la Sabana, 2019
Sánchez-Cárdenas MA, Aguilar Obregón L, Bernal Tovar M, Gomez Serrano K; Rubiano Albarracín A; Tarazona Álvarez M, et al. Datos sobre servicios, opioides y educación de Cuidados Paliativos en Colombia. Mendeley Data. 2023. https://doi.org/10.17632/g2rk4jhby2.1
Vargas-Escobar LM, Sánchez-Cárdenas MA, Guerrero-Benítez AC, Suarez-Prieto VK, Moreno-García JR, Cañón Piñeros ÁM, et al. Barriers to Access to Palliative Care in Colombia: A Social Mapping Approach Involving Stakeholder Participation. Inquiry. 2022; 59: 469580221133217. https://journals.sagepub.com/doi/full/10.1177/00469580221133217
Delgado L, Sánchez Cárdenas MX, Rodriguez Campos M, Lima L, López Vleasco L de, Gamboa Garay OA, et al. Consumo de opioides. Análisis de su disponibilidad y acceso en Colombia. Universidad de la Sabana, 2019. https://intellectum.unisabana.edu.co/handle/10818/35826
León MX, Sánchez-Cárdenas M, Rodríguez-Campos L, Moyano J, López A, Gamboa O et al. Availability and accessibility of opioids for pain and palliative care in Colombia: a survey study. Rev. colomb. anestesiol. 2022; 50(1). https://doi.org/10.5554/22562087.e1011
Leon MX, De Lima L, Florez S, Torres M, Daza M, Mendoza L, et al. Improving availability of and access to opioids in Colombia: description and preliminary results of an action plan for the country. J Pain Symptom Manage. 2009;38(5):758-66. https://www.sciencedirect.com/science/article/pii/S0885392409007052
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