Focusing on the negative part of laws controlling essential drugs and failing to look at the positive effect of these drugs is hindering effective patient pain management in the country’s health care system.
The several myths surrounding the use of morphine to treat pain as well as the fear to prescribe it among health care practitioners also denies patients their right to be pain free.
Kenya Hospices and Palliative Care Association (KEHPCA) Executive Director Dr Zipporah Ali passed this message to over 120 doctors who attended a Continuing Professional Development (CPD) meeting on pain management organized by the association and the Kenya Medical Association (KMA), Nairobi Division, with support from the Global Access to Pain Relief Initiative (GAPRI).
Dr Ali said that there is need to focus on the positive effects of these analgesics in freeing patients’ pain to effectively address pain among patients with life limiting illnesses.
“This will also create demand for the Ministry of Health to order for these drugs and make them available in the country.” She said.
Dr Joe Kanja from Meru Level 5 Hospital said that medical professionals look at the side effect especially morphine addiction and say this drug is not good.
“We are not supposed to fear using morphine as our training has always emphasized on its side effects and how to go about them.” Dr Kanja said.
He said that these fears among medical practitioners make patients continue suffering from pain yet there is a remedy that can make their life more comfortable.
Dr Kanja added that Health Care Professionals barriers have ranked high in patient pain management.
“If we change this from our side, we will effectively manage pain. Were you that patient suffering from pain, would you have it managed or not?” Dr Kanja retorted.
He said that senior doctors do not want to be told that they don’t know about something adding that such forums should continue in the effort to generate disciples for a ripple effect in pain management.
“We had lacked access which KEHPCA has brought. It upon us to create the demand for these drugs by submitting reports, if the world health watch fails to see the demand, they will not give understand why we need such drugs.” Dr Kanja said.
Martindale Pharma East Africa representative Mr. Edward Obonyo said that Morphine cannot be distributed without papers and all distributors in Kenya need to have proper documentation and an account with Laborex.
“We cannot afford to be liberal and allow distribution by anyone. You need to have license to distribute these essential drugs for purposes of accountability.” Mr. Obonyo said.
On reconstitution of morphine, Mr. Obonyo said that there is need to train pharmacists in reconstituting morphine locally as reconstituted morphine has a shelf life of six months compared to the powder that has a shelf life of up to three years.
This was after attendants asked if it could be possible to have reconstituted morphine from the suppliers.
KMA National Secretary Dr Henry Wanga said that doctors have a role to play in pain management but their time with the patient is short hence they do not have time to appreciate the long term effect of pain management.
The one hour talk was delivered by Dr John Weru, a pain management specialist at Aga Khan Hospital, who emphasized on assessment of pain as an important area in analgesics.
Dr Weru said that there is need for production of mass tools of assessment including poster for hanging on walls in all health care centers.
“It is important that this message reaches the primary health systems and enhance drug provision to such centers for pain management.” He said.
Doctors were grateful for the information and promised to improve their pain management skills. They also hoped to be informed on more updates available on the same through similar forums or even half-day seminars.