Page 127 WHO - Guidelines on the pharmacological treatment of persisting pain in children with medical illness

Pain relief services and opioid analgesics supply

Country State of Sarawak, Malaysia
Health Nurses, pharmacists, community health workers, volunteers.
professional
Intervention Home-based palliative care and medicine supply.
The opioid analgesic prescription is made by an oncologist, but nurses play an important role in
medicine supply for the home-based palliative-care programme.
Setting Home-based palliative care, high turnover of medical doctors in the health districts.
Bibliography • Devi BCR, Tang TS, Corbe M. Setting up home-based palliative care in countries with limited
resources: a model from Sarawak, Malaysia. Annals of Oncology, 2008, 19:2061–2066.
Country State of Kerala, India
Health Nurses.
professional
Intervention • Medicine supply (stock and dispensing) from pharmacists to nurses.
• State exception on the requirement of a pharmacist for medicines dispensing service.
Setting State palliative-care programme
Bibliography • Rajagopal MR, Joranson DE, Gilson AM. Medical use, misuse, and diversion of opioids in India.
Lancet, 2001, 358:139–143.
Note: the full description of why a nurse instead of a pharmacist is needed is not provided in the
article (e.g. number of available pharmacists in the State and their distribution in urban and rural
areas for the medicines dispensing service).

A4.3 studies retrieved in the third step of the evidence

retrieval process

This list refers to the third step of evidence retrieval process as reported in Annex 2, Section A2.1
Development process. Listed items were retrieved while sourcing observational studies for interventions
where no systematic reviews and no randomized control trials were obtained in the first two rounds of
evidence retrieval.

For this third round of evidence retrieval, the request was forwarded to the Expanded Review Panel for
the WHO pain guidelines and also to the WHO Expert Panel on Drug Evaluation. The articles retrieved
include observational studies, pharmacokinetics and pharmacodynamics studies and also a few
additional randomized controlled studies in children.

AnAlgesics

Anderson BJ, Palmer GM. Recent pharmacological advances in paediatric analgesics. Biomedicine &
Pharmacotherapy, 2006, 60:303–309.

Berde CB, Sethna NF. Analgesics for the treatment of pain in children. New England Journal of Medicine,
2002, 347:1542.

> 124