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Oral Morphine Use in South India: A Population-Based Study
M R Rajagopal1, Safiya Karim1, Christopher M Booth1
1M.R. Rajagopal, Trivandrum Institute of Palliative Sciences and Pallium India, Trivandrum, India; and Safiya Karim and Christopher M. Booth, Queen's University, Kingston, Ontario, Canada.
Journal of Global Oncology
|December 16, 2017
Summary
Oral morphine use for pain relief in Kerala, India, increased by 27% from 2012 to 2015. Despite this rise, access to essential opioids remains low, with significant regional disparities in availability.
Area of Science:
- * Palliative Care and Pain Management
- * Public Health and Health Services Research
- * Pharmaceutical Policy and Access
Background:
- * Access to essential opioids for pain management is a critical challenge in low- and middle-income countries.
- * Understanding regional and temporal trends in opioid use is vital for improving patient care.
- * Kerala, India, serves as a key region for studying opioid access patterns.
Purpose of the Study:
- * To analyze temporal trends in oral morphine use in Kerala, India, from 2012 to 2015.
- * To investigate regional variations in morphine consumption across Kerala's districts.
- * To examine the characteristics of healthcare providers involved in morphine distribution.
Main Methods:
- * Utilized oral morphine consumption data for the State of Kerala (2012–2015).
- * Calculated annual per capita morphine use rates for each district.
- * Classified healthcare providers into government, private, non-governmental organization (NGO), and NGO partnership categories.
Main Results:
- * Oral morphine use in Kerala increased by 27% over the study period, from 1.23 to 1.56 mg/capita.
- * Significant geographic variation in morphine use was observed across districts, with a six-fold difference.
- * This regional disparity widened over time, reaching a 19-fold difference by 2015.
- * Government institutions, though fewer in number, were major distributors of morphine.
Conclusions:
- * Oral morphine consumption in Kerala has risen but remains below estimated needs.
- * Substantial geographic disparities in opioid access persist within the state.
- * Targeted interventions are necessary to enhance palliative care and reduce regional inequities in opioid availability.
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