Transcript Kyrgystan - Pain & Policy Studies Group

Cohort III
International Pain Policy Fellows
Opioid Availability Action
Planning Worksheet
Madison, Wisconsin, USA
6 – 10 August 2012
University of Wisconsin Pain & Policy Studies Group
World Health Organization Collaborating Center for
Pain Policy and Palliative Care
Country
Fellow(s)
PPSG
member(s)
IEC member(s)
Albania
Kristo Huta
Jody Moen
Snezana Bosnjak
* Stephen Connor
Bangladesh
Rumana Dowla
Farzana Khan
Marty Skemp
Brown
Eric Krakauer
India
Priya Kulkarni
Shalini Vallabhan
Nandini Vallath
David Joranson
Frank Ferris
M.R. Rajagopal
Kyrgyzstan
Taalaigul Sabyrbekova
Martha Maurer
Henry Ddungu
* Stephen Connor
Sri Lanka
Nadarajah Jeyakumaran
Suraj Perera
Jim Cleary
Bishnu Paudel
Ukraine
Nataliia Datsiuk
Asra Husain
* Tom Lynch
* IEC member who will not attend Training Program, but will provide follow-up technical
assistance.
University of Wisconsin Pain & Policy Studies Group
World Health Organization Collaborating Center for
Pain Policy and Palliative Care
Step 1 – Develop the Action Plan
• Section A: State the 3-5 problems that lead to inadequate patient access to
opioid analgesics.
• Section B: State the objective(s) that would address the problem. (WHAT)
• Section C: List the action steps needed to achieve the objectives. (HOW)
• Section D: List those who have the authority/responsibility to take the
necessary action. (WHO)
• Section E: Indicate an approximate timeline for completion of the action
steps. (WHEN)
• Section F: State the assistance (technical, financial) that will be needed to
achieve each objective. (HOW MUCH)
• Section G: Expected outputs, and how measured
University of Wisconsin Pain & Policy Studies Group
World Health Organization Collaborating Center for
Pain Policy and Palliative Care
Drug Distribution System Model
Level 1: International Narcotics Control Board
Level 2: National Competent Authority
Level 3. Importer/Manufacturers/Distributors
Level 4. Hospitals/Pharmacies/Hospice/PC
programs
Level 5. Physicians/Pharmacists/Other
Medication
University of Wisconsin Pain & Policy Studies Group
World Health Organization Collaborating Center for
Pain Policy and Palliative Care
Level 6. PATIENTS
Information
Action Plan for:
Kyrgyz Republic
Prepared by:
Taalaigul Sabyrbekova
Martha Maurer
Henry Ddungu
Stephen Connor
10 August 2012
University of Wisconsin Pain & Policy Studies Group
World Health Organization Collaborating Center for
Pain Policy and Palliative Care
1: State the 3-5 problems that lead to inadequate patient access to
opioid analgesics – Be as specific as you can
Problem 1:
POLICY
Problem 2:
Oral Morphine is not available
Problem 3:
No Clinical Guidelines, Clinical Protocols and SOP
on PC and Pain Relief
Problem 4:
No Palliative Care Educational Program
Problem 5:
University of Wisconsin Pain & Policy Studies Group
World Health Organization Collaborating Center for
Pain Policy and Palliative Care
PROBLEM 1
A: State the problem that leads to inadequate patient access to opioid
analgesics (What?) – Be as specific as you can in stating one problem
1.
POLICY
1.1. AIDS – Not allowed Morphine
1.2. Prescription form – 4 stamps, 2 signs
1.3. Law No 91 On Medicines uses “Addiction”
1.4. Add IR oral Morphine into the list of Government Resolution #2 (2011)
1.5. No National Palliative Care Standarts
1.5. Draft of National Cancer Control Program does not include pain relief
opioids
University of Wisconsin Pain & Policy Studies Group
World Health Organization Collaborating Center for
Pain Policy and Palliative Care
Problem 1. B: State the objective(s) that would address the problem.
Which objectives are the top priorities? (What?)
1.
2.
To advocate to amend the policy
Remove of regulatory barriers to use of opioids.
University of Wisconsin Pain & Policy Studies Group
World Health Organization Collaborating Center for
Pain Policy and Palliative Care
Problem 1 C: What action steps are needed to achieve the objectives?
(How?)
1.
2.
3.
4.
5.
6.
National Drug Policy review
Organize meeting with Drug Committee
Provide with WHO Guidelines
Highlight the changes
Participation in preparation of the documents, highlighting the changes to Parliamentary
Committee
Inclusion of PC and pain relief into the National Cancer Control Program
D: List those who have the authority and/or responsibility to take the
necessary action; and with whom they should collaborate. (Who?)
1.
2.
3.
4.
5.
6.
7.
Public Fund “Voice of Freedom”
Anti drug Committee
MoH
Member of Parliament
WHO Country office
Ministry of Justice
Public Fund Ergene
University of Wisconsin Pain & Policy Studies Group
World Health Organization Collaborating Center for
Pain Policy and Palliative Care
Problem 1 E: Timeline for completion of action steps. (When?)
1.
2.
2.
3.
4.
National Drug Policy review and Highlight the changes – 2 months
Organize meeting with Drug Committee – on November 2012
Participation in preparation of the documents, highlighting the changes to Parliamentary
Committee – November- March 2013
Present to the Parliament – March 2013
Getting approval from Parliament - ?
F: What assistance (technical, financial) will be needed to achieve each
objective under part “B”? (How much?)
1.
2.
PPSG
Soros Foundation
University of Wisconsin Pain & Policy Studies Group
World Health Organization Collaborating Center for
Pain Policy and Palliative Care
Problem 1 G: Expected outputs, and how measured
1.
2.
3.
Policy amended
Presence of approved regulations
Policy reviewed
University of Wisconsin Pain & Policy Studies Group
World Health Organization Collaborating Center for
Pain Policy and Palliative Care
PROBLEM 2
A: State the problem that leads to inadequate patient access to opioid
analgesics (What?) – Be as specific as you can in stating one problem
Oral Morphine is not available
University of Wisconsin Pain & Policy Studies Group
World Health Organization Collaborating Center for
Pain Policy and Palliative Care
Problem 2. B: State the objective(s) that would address the problem.
Which objectives are the top priorities? (What?)
To make oral morphine available and accessible in
sufficient amounts in Kyrgyzstan
University of Wisconsin Pain & Policy Studies Group
World Health Organization Collaborating Center for
Pain Policy and Palliative Care
Problem 2. C: What action steps are needed to achieve the objectives?
(How?)
1.
2.
3.
4.
5.
6.
7.
8.
9.
Analysis of regulations for OM import
Prepare list of Pharmaceutical companies – morphine manufactures
Receive documents for registration
Analysis prices and quality
Estimate by WHO methods
Register of oral Morphine
Input OM into SGP
Starting using OM in Bishkek and Osh first than disseminate for all country
Data collection (research or M&E)
D: List those who have the authority and/or responsibility to take the
necessary action; and with whom they should collaborate. (Who?)
1.
2.
3.
4.
5.
6.
7.
8.
MoH, Pharmaceutical Department
State Agency for Drug Control
National Oncology Center
Oncology Center in Osh town
Family Medicine Centers
Family Doctors Associates
PPSG/WHO
Soros Fund
University of Wisconsin Pain & Policy Studies Group
World Health Organization Collaborating Center for
Pain Policy and Palliative Care
Problem 2. E: Timeline for completion of action steps. (When?)
1.
2.
3.
4.
5.
6.
7.
8.
Analysis of regulations for CM import
Prepare list of Pharmaceutical companies – morphine manufactures
Receive documents for registration
Analysis prices and quality 1-4 September- November 2012
Estimate by WHO methods
Register of oral Morphine – October 2012
Starting using OM in Bishkek and Osh - October 2012
OM in throughout country - ?
F: What assistance (technical, financial) will be needed to achieve each
objective under part “B”? (How much?)
1.
2.
PPSG
Soros Foundation
University of Wisconsin Pain & Policy Studies Group
World Health Organization Collaborating Center for
Pain Policy and Palliative Care
Problem 2 G: Expected outputs, and how measured
1.
Oral Morphine will available and accessible
1.1. OM registered
1.2. Quantity of OM consumed
University of Wisconsin Pain & Policy Studies Group
World Health Organization Collaborating Center for
Pain Policy and Palliative Care
PROBLEM 3
A: State the problem that leads to inadequate patient access to opioid
analgesics (What?) – Be as specific as you can in stating one problem
No Clinical Guidelines, Clinical Protocols and SOP on
PC and Pain Relief
University of Wisconsin Pain & Policy Studies Group
World Health Organization Collaborating Center for
Pain Policy and Palliative Care
Problem 3. B: State the objective(s) that would address the problem.
Which objectives are the top priorities? (What?)
To ensure PC is understood and provided in streamlined way to
guarantee quality service delivery at all Heath Care Levels in KR
University of Wisconsin Pain & Policy Studies Group
World Health Organization Collaborating Center for
Pain Policy and Palliative Care
Problem 3. C: What action steps are needed to achieve the objectives?
(How?)
Develop Clinical Guidelines, Clinical Protocols and SOP on PC and Pain Relief
- Identify the existing guidelines
- Adapting to KR
- Getting approval of MoH
- Publishing
- Implementation and dissemination among health care workers throughout country
D: List those who have the authority and/or responsibility to take the
necessary action; and with whom they should collaborate. (Who?)
1.
2.
3.
4.
5.
6.
7.
KMSIP and CME
MoH
National Oncology Center
Oncology Center in Osh town
PPSG
FSK
Public Fund Ergene
University of Wisconsin Pain & Policy Studies Group
World Health Organization Collaborating Center for
Pain Policy and Palliative Care
Problem 3. E: Timeline for completion of action steps. (When?)
1. Develop Clinical Guidelines – September 30, 2012
Clinical Protocols and SOP on PC and Pain Relief – December 15, 2012
- Identify the existing guidelines
- Adapting to KR
- Getting approval of MoH
- Publishing
-Implementation and dissemination among health care workers throughout country - Ongoing process
2. Develop PC National Standards - ?
F: What assistance (technical, financial) will be needed to achieve each
objective under part “B”? (How much?)
1.
2.
3.
4.
5.
Evidence based Center of the MoH
KSMIP and CME
National Oncology Center
PPSG
Soros Foundation
University of Wisconsin Pain & Policy Studies Group
World Health Organization Collaborating Center for
Pain Policy and Palliative Care
Problem 3 G: Expected outputs, and how measured
1. Clinical Guidelines, Clinical Protocols and SOP on PC and Pain Relief will developed
2. PC National Standards will be developed
Number of published CG, CP
Number of educated health workers
University of Wisconsin Pain & Policy Studies Group
World Health Organization Collaborating Center for
Pain Policy and Palliative Care
PROBLEM 4
A: State the problem that leads to inadequate patient access to opioid
analgesics (What?) – Be as specific as you can in stating one problem
-
No Palliative Care Educational Program:
for health workers
for population
for special group
University of Wisconsin Pain & Policy Studies Group
World Health Organization Collaborating Center for
Pain Policy and Palliative Care
Problem 4. B: State the objective(s) that would address the problem.
Which objectives are the top priorities? (What?)
1. Develop and implement educational programs into under and
postgraduate medical institutions (Development of an academic
program that prepares physicians and nurses to specialize in
palliative care. Possibly a diploma program or fellowship and
certification)
2. Develop and implement public awareness campaign on pain
relief
University of Wisconsin Pain & Policy Studies Group
World Health Organization Collaborating Center for
Pain Policy and Palliative Care
Problem 4.
1.
2.
3.
4.
5.
C: What action steps are needed to achieve the objectives? (How?)
Incorporation of palliative care issues into major pre-graduation curricula (KSMA, KRSU,
medical faculty of Osh state University) and post-graduate curricula for upgrading qualification
of doctors, nurses, social workers в (KSMI and CME)
Training of family members, development of patients schools, development of peer to peer
education
Expansion of the role of public health in development and implementation of solutions of
physical, psychological problems emerging in progression of an incurable disease
Development and incorporation of palliative care educational programs for social workers,
members of patients’ families
Conducting of media campaigns on PC
D: List those who have the authority and/or responsibility to take the
necessary action; and with whom they should collaborate. (Who?)
1.
2.
3.
4.
5.
6.
7.
8.
9.
MoH
Ministry of Education
Kyrgyz State Medical Academy
Kyrgyz Russian Slavonic University
Medical faculty of Osh state University
Kyrgyz State Medical Institute and CME
Social Workers Association
National TV and Radio
NGO and PP Union
University of Wisconsin Pain & Policy Studies Group
World Health Organization Collaborating Center for
Pain Policy and Palliative Care
Problem 4. E: Timeline for completion of action steps. (When?)
1.
2.
3.
Develop/adapt educational program – 6 months
Implement educational programs into under and postgraduate medical institutions – September
2013
Develop and implement public awareness campaign on pain relief - since September 2012 -?
F: What assistance (technical, financial) will be needed to achieve each
objective under part “B”? (How much?)
1.
2.
3.
4.
KSMIP and CME
National Oncology Center
PPSG
Soros Foundation
University of Wisconsin Pain & Policy Studies Group
World Health Organization Collaborating Center for
Pain Policy and Palliative Care
Problem 4 G: Expected outputs, and how measured
1.
2.
Curriculum will be included into medical school’s educational
programs
Number of educated doctors, nurses, social workers, students
University of Wisconsin Pain & Policy Studies Group
World Health Organization Collaborating Center for
Pain Policy and Palliative Care