Ensuring palliative medicine availability: The development of the IAHPC list of Essential Medicines for Palliative Care
Ensuring palliative medicine availability: The development of the IAHPC list of Essential Medicines for Palliative Care
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DOI：
10.1016/j.jpainsymman.2007.02.006
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发表时间：
2007-05-01
影响因子：
4.7
通讯作者：
Doyle, Derek
中科院分区：
文献类型：
--
作者：
De Lima, Liliana;Krakauer, Eric L.;Doyle, Derek
应世界卫生组织（世卫组织）的要求，国际临终关怀和姑息治疗协会（IAHPC）根据世界各地姑息治疗工作者的共识制定了一份《姑息治疗基本药物清单》。IAHPC设计了一个包含五个步骤的过程，其中包括制定一套道德准则；确定姑息治疗中最常见的症状；确定治疗这些症状的药物清单；使用改进的德尔菲程序对来自发达国家和发展中国家的参与者进行调查；并召集地区、国际和科学组织的代表开会，制定最终名单。21种症状被确定为姑息治疗中最常见的症状，初步调查得出了120种药物的初步清单。来自发展中国家和发达国家的71名参与者对德尔菲调查做出了回应，并同意48种药物对21种症状中的18种的有效性和安全性。最后一步是来自26个组织的代表进行讨论，最终确定了名单。IAHPC缓和治疗基本药物清单包括33种药物，其中14种已列入世卫组织标准清单。与会者一致认为，推荐针对其中五种症状的药物的证据太少，并建议进行进一步的研究以解决这一需求。IAHPC和参与这一进程的所有组织欢迎就如何继续改进《缓和治疗基本药物清单》和改善有需要的患者获得药物的途径提出建议。
In response to a request from the World Health Organization (WHO), the International Association for Hospice and Palliative Care (IAHPC) developed a List of Essential Medicines for Palliative Care based on the consensus of palliative care workers from around the world. IAHPC designed a Process of five steps, which included developing a set of ethical guidelines; identifying the most common symptoms in palliative care; identifying a list of medications to treat those symptoms; carrying out a survey using a modified Delphi process with participants from developed and developing countries; and convening a meeting of representatives from regional, international, and scientific organizations to develop the final list. Twenty-one symptoms were identified as the most common in palliative care, and an initial list of 120 medications resulted from the initial survey. Seventy-one participants from developing and developed countries responded to the Delphi survey and agreed on the effectiveness and safety of 48 medicationsfor 18 of the 21 symptoms. The final step included discussions among representatives from 26 organizations, which led to the finalization of the list. The IAHPC List of Essential Medicines for Palliative Care includes 33 medications, of which 14 are already included in the WHO Model List. The participants agreed that there is too little evidence to recommend medications for five of the symptoms and suggested that further research be carried out to solve this need. The IAHPC and all the organizations involved in this process welcome suggestions on ways to continue to improve the List of Essential Medicines for Palliative care and to improve access to medications for patients in need.