The conference concluded a series of 11 conferences on access to opioids organised through the European Community funded ATOME (Access to Opioid Medication in Europe) project. The symposium was attended by 79 delegates from the fields of palliative care and harm reduction.
Professor Sheila Payne from the International Observatory on End of Life Care outlined the relatively long history of palliative care provision in Poland. Some key events in its early development include: the establishment of the first hospice run by volunteers in Krakow in 1981 and of the first palliative care service in 1987 at the University Cancer Hospital in Poznan.
Opioid use and barriers to use in Poland
Dr Willem Scholten, Consultant – Medicines and Controlled Substances, outlined the global situation in relation to opioid consumption. He highlighted the low level of opioid consumption relative to need in Poland: per capita consumption of opioids in 2010 was estimated to be only 12.25% of the actual need. He also highlighted a decline in opioid consumption between 2006 and 2010.
In his presentation, Dr Wojciech Leppert from the Polish Association for Palliative Medicine noted a decline in the consumption of some strong opioids like morphine, fentanyl, methadone and pethidine. Dr Leppert outlined the current system for reimbursement of patients using opioids and explained that cancer patients are fully reimbursed for most opioids but have to pay for some while non-cancer patients are reimbursed for only 30% of the costs.
Dr Malgarzata Krajnik, Chair of the Department of Palliative Care at Collegium Medium in Bydgoszcz, emphasised the important role that the knowledge and attitudes of health professionals can play in the prescription of opioids. In particular she identified lack of confidence among health professionals in their knowledge about opioids and their concerns about risks as barriers to use.
In working groups, delegates discussed issues relating to opioid use and palliative care provision in Poland. They identified the following as key issues to be addressed:
- Current waiting lists for palliative care patients are long and need to be reduced.
- There is limited collaboration between palliative care and other health professionals.
- Management practices within the palliative care sector could be improved.
- Palliative care provision could be broadened to include a wider spectrum of patients.
- The current tendency to distinguish between cancer and non-cancer patients is unhelpful. It would be more helpful to focus on the symptoms of the individual patient.
- There is also a tendency to focus on use of opioids for cancer patients; opioids could be used more for non-cancer patients.
- The amount and quality of information provided to patients about side effects of opioids could be improved.
Find out more about the ATOME project online.