Cultural, Social and Regulatory Issues in Managing Pain - Global Perspec...

The African Cancer Patients Dying in Unnecessary Pain - The Guardian

In Senegal [like many developing nations], more people die of cancer than malaria, tuberculosis and Aids put together, but many do not get the drugs they need:



"The doctors in Senegal's second city of Touba have long since given up trying to prescribe the drug that stops the pain of cancer. There aren't any morphine tablets in the city. The only place it can sometimes be found is in the capital, Dakar, four hours away – but government regulations prevent them from writing prescriptions for it anyway. They don't have the right kind of prescription pad. Like many cancer patients Syllah was being sent home the next day."



Link to full article:

The African cancer patients dying in unnecessary pain | Krishnan Guru-Murthy | World news | The Guardian

Potential Input Prompts for Opioid-GPS

Some of the potential input promptings we are considering (yet to be finalized):

- if app, a sliding pain scale of 0-10; if SMS, simple input (could expand to ask in the last 24 hrs, average pain out of 10, least out of 10 and worst out of 10)

- patient's diagnosis

- geographic location

- pain medication (morphine) indicated - yes or no

- morphine readily available - yes or no

- estimated time to get morphine (hours) - 0 = available now; 88 (sideways would be infinity, haha) could equate to not available in foreseeable future

- if morphine prescribed & taken by patient, was it effective: yes or no (could give info if appropriate amount available, maybe there were side effects which would mean an alternative required, etc)

Using Open-source Mapping to Help Stop Ebola

The following may be an inspiration on how our project moves forward; see link below for podcast and interactive map noted:

Using open-source mapping to help stop Ebola - SciDev.Net:

"In this podcast, two experts discuss how satellite technology and open-source mapping can help with such humanitarian work, highlighting successes and challenges.

One encouraging example is a programme coordinated by the Humanitarian OpenStreetMap Team (HOT). It has provided aid workers with an interactive map to help them keep track of the disease’s spread and of news related to the outbreaks. The collaborative map displays publicly available data and other resources that can be read or downloaded."

Feedback On "Operation Opioid-GPS" from Stanford mHealth Colleagues

Excerpts from peer reviews with our commentary to follow later:

What worked? 

• Your website is amazing. Your idea appears well thought out and seems to solve a significant problem. Interface seems easy for health care workers to use.
• Good job, ideas have been well developed and the methodology adopted is clear
• Great idea and video
• Great presentation and prototype

What could be improved? 

• No evidence of customer interviews. It looks like you have done a solid literature review, but it is unclear if you have talked with potential customers or shown them your prototype to get feedback.
• The prototype could me made more explicit and show how informations are being gathered and which alerts/warning are associated with them.
• The app functionalities
• Perhaps have a pain level input that allows users to slide from low - mild - sharp -extreme to add some info to the level of pain experienced.

What was unclear?

• The app seems to create awareness of where there are gaps in the supply chain. What is your plan to make sure someone is looking at the data and filling those gaps so that people are getting the medications they need and not suffering from needless pain? What is your revenue model?
• The Business mode is unclear
• It seems that the team identified a real problem and is moving in a right direction to address it
• It was clear

What other ideas should be considered? 

• If you get this working, there is also a huge gap in the insulin supply chain for diabetes, especially in developing countries and rural areas. Once your infrastructure is in place, with minimal modification, your technology may be able to be used to serve that very large market as well. If you get to that point, feel free to contact me and I will share the research I have already done.
• It would sometimes be difficult to prompt the location from the patient. Rather, the apps could detect it automatically.
• What algorithm should be used to decide where (which patient) to go according to location, pain level, distance to the intervention team and other associated costs or parameters?
• Your main focus maybe should focus on a kind of campaign so that those who can change those regulations change something...
• Add pain relief techniques or exercises.

__________________

Note: photo source

Global Opioid Policy Initiative (GOPI): the WHO perspective

(Published on 28 Nov 2013)

A.Ullrich highlights that the ESMO-led GOPI (Global Opioid Policy Initiative) survey brings the right data at the right moment for the WHO action plan on non-communicable diseases, to catalyse the passage from pilot project to national policy in each country.

Opioid GPS (Global Pain Solace) - Presentation for Stanford University Assignment