RESUMO
La liberación del uso terapéutico de los opioides se ha hecho cada vez mas frecuente como una propuesta para mejorar la distribución de éstos en las instituciones de salud pública y privadas con el fin de garantizar su alcance a población que cursa con dolor. A pesar de esto, aún no se logra una distribución homogénea de estos recursos en la población requirente. El objetivo de este trabajo es dar a conocer el panorama actual de los opioides en México y algunos países sudamericanos.
The release of therapeutic opioid use is mentioned with increasing frequency as a proposal to improve their tion in Public and Private Health Care Institutions, in order to scope opioids to population who needs them. Although this, homogeneous distribution of opioids is not achieved. The aim of this paper is to present the current panorama of opioids in Mexico and Latin American countries
Assuntos
Humanos , Dor/tratamento farmacológico , Cuidados Paliativos/organização & administração , Manejo da Dor , Acesso a Medicamentos Essenciais e Tecnologias em Saúde , Analgésicos Opioides/provisão & distribuição , Analgésicos Opioides/uso terapêutico , Morfina/provisão & distribuição , Morfina/uso terapêuticoAssuntos
Neoplasias/complicações , Dor , Argentina , História do Século XX , Humanos , Morfina/provisão & distribuição , Morfina/uso terapêutico , Entorpecentes/provisão & distribuição , Entorpecentes/uso terapêutico , Programas Nacionais de Saúde/economia , Programas Nacionais de Saúde/história , Programas Nacionais de Saúde/estatística & dados numéricos , Dor/etiologia , Manejo da DorRESUMO
As in other developed and developing countries, the most common chronic disorders affecting the Chilean population are cardiovascular disease, cancer, cirrhosis, diabetes, chronic obstructive pulmo- nary disease and external injuries. Availability of oncology services is not extensive and there are no academic programs to adequately train practitioners in either palliative medicine or comprehensive palliative care for allied health professionals including nurses, psychologists and chaplains. Major efforts have been made to incorporate palliative care as an important health care focus in the last decade and in the development of effective policies for opioid availability. Chile now meets 84% of the 17 criteria outlined by the World Health Organization and the International Narcotics Control Board for opioid availability. Postgraduate medical education in symptom control, clinical use of opioids and end-of-life care remains relatively poor as judged by the results of a questionnaire administered to 158 resident physicians at the Pontificia Universidad Católica de Chile. Improvements in symptom control and the development of palliative care in Chile will depend on the effective assessment of symptom control effectiveness and improved education and training of health professionals in clinical pharmacology, symptom control, clinical ethics, and end-of-life care.
Assuntos
Analgésicos Opioides/provisão & distribuição , Doença Crônica , Política de Saúde , Cuidados Paliativos/métodos , Assistência Terminal/métodos , Analgésicos Opioides/uso terapêutico , Chile/epidemiologia , Doença Crônica/tratamento farmacológico , Doença Crônica/mortalidade , Educação de Pós-Graduação em Medicina , Humanos , Internato e Residência , Oncologia/educação , Morfina/provisão & distribuição , Morfina/uso terapêutico , Programas Nacionais de Saúde , Cuidados Paliativos/normas , Desenvolvimento de Programas , Inquéritos e Questionários , Assistência Terminal/normas , VoluntáriosRESUMO
Argentina is a large South American country with a high prevalence of chronic disease-related mortality and a clear need for implementation of palliative care. Primary concerns related to palliative care are cultural, socio-economic and educational. Increasing poverty, patients and families receiving inadequate information about their diagnosis or prognosis, drug availability and costs, and insufficient knowledge by health care providers are obstacles to palliative care. Palliative care programs are developing throughout the country and methods by which they are meeting their needs are described. Several Argentinean palliative care initiatives are described and the role of the Pallium Latinomérica training program is discussed.