Page 126 WHO - Guidelines on the pharmacological treatment of persisting pain in children with medical illness

A4.2 Studies retrieved on health system

recommendations A1

Opioid analgesics prescription

Country uganda
Health Palliative-care nurses and clinical officers.
professional
Intervention • Morphine prescription upon specialized training: A2
- Clinical Palliative Care Course (9 months: 8 weeks – theory, 12 weeks – hospice, 10 weeks –
HIV/palliative care, 10 weeks in their own place of work).
• Amendment of national legislation to enable nurses and clinical officers to prescribe opioid
medicines as part of their clinical practice (professional licence).
Setting Hospices/palliative-care teams in hospitals/health districts.
Bibliography • Clark D et al. Hospice and palliative care development in Africa: a multi-method review of
services and experiences. Journal of Pain and Symptom Management, 2007, 33:698–710.
• Jagwe J, Merriman A. Uganda: delivering analgesia in rural Africa – opioid availability and A3
nurse prescribing. Journal of Pain and Symptom Management, 2007, 33:547–551.
• Logie DE, Harding R. An evaluation of a morphine public health programme for cancer and
AIDS pain relief in Sub-saharan Africa. BMC Public Health, 2005, 5:82.

Country united Kingdom
Health Nurses, pharmacists.
professional A4 A4
Intervention Emergency prescription of opioid analgesics for cancer pain (when the physician is not able to
physically provide a prescription) as part of the two systems below:
• training and certification to allow nurses to prescribe any medicine that has been included in
the Clinical Management Plan made by a medical doctor (Nurse Supplementary Prescribers =
NSPs);
• training and certification to allow nurses to assess, diagnose and prescribe independently
(Nurse Independent Prescribers = NIPs). A5
Setting National health system.
Bibliography • Cherny NI et al. Formulary availability and regulatory barriers to accessibility of opioids
for cancer pain in Europe: a report from the ESMO/EAPC Opioid Policy Initiative. Annals of
Oncology, 2010, 21:615–626.
• Stenner K, Courtenay M. Benefits of nurse prescribing for patients in pain: nurses’ views.
Journal of Advanced Nursing, 2008, 63:27–35.
A6
Country Lithuania
Health Nurses, pharmacists.
professional
Intervention Emergency prescription of opioids for cancer pain (when the physician is not able to physically
provide a prescription).
Setting National health system
Bibliography • Cherny NI et al. Formulary availability and regulatory barriers to accessibility of opioids A7
for cancer pain in Europe: a report from the ESMO/EAPC Opioid Policy Initiative. Annals of
Oncology, 2010, 21:615–626.
Note: this article just refers to this intervention, but does not provide any description of the
system established for emergency prescriptions in the country.

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