Access to Opioids in Palliative Care in Low-and Middle-Income Countries
The Case of Burkina-Faso -How Can Blockchain and Internet of Things Assist? –
DOI:
https://doi.org/10.26415/2572-004X-vol3iss3p430-442Keywords:
Poor Access to Healthcare, Drug Supply Chain, Drug Distribution, Palliative Care, Internet of Things for Healthcare, Blockchain for Healthcare, Quality of Life, Morphine ProvisionAbstract
Background: People requesting palliative care or suffering from pain are subjected to adhere to opioid-based treatment in order to alleviate their pain. Commonly, access to opioids is strictly controlled.
Access to Healthcare delivery services remains challenging in Low-and Middle-Income Countries (LMIC). In Burkina-Faso (BF), a Sub-Saharan African (SSA) country, patients requiring palliative care (PC) are especially facing poor access to pain drugs such as morphine. Facing poor access to pain-alleviating medicine can severely impact the daily quality of life (QoL). On one hand, patients are experiencing poor opioids access. On another hand opioids abuse, leading to drug addiction is noticed. The question arising here is how can they face poor access and at the same time abuse the given drug? One plausible answer is the counterfeit chain, which provides illegal drugs. Beyond the counterfeit issues faced, the public health care system is also facing, amongst others, prescription falsification, fraud in the distribution, and stock shortage.
Method & Design: Mixed-Method-Design was applied to this study. National stipulations, regulations, and the state-of-the-art in the field of palliative care in BF were investigated and analyzed. Based on the investigation‘s outcomes and following the paradigm of design science research, and information system based improvement solution is proposed to tackle the poor access to opioids, improve the supply and distribution chain as well as to efficiently monitor the consumption of opioids in BF, and prevent patients from any health issues, drug addiction, and death.
Objectives: The main objectives are to fight against opioid addiction, counterfeits, a stock shortage, and prevent related health safety issues. The main aim is to enable the traceability of any opioids prescription, secure the supply and distribution, and thus early detect any fraud in the system.
This editorial paper would, therefore, focus on investigating the reasons underlying the poor access to opioids in palliative care in BF and make suggestions for improvement. A blockchain (BC) and the Internet of Things (IoT) based system to secure and improve opioids supply, distribution, and prescription will be proposed.
Results: The contribution analysis reveals the potential of the proposed model to assist in many ways to improve access to opioids and to secure this access. The model could contribute to preventing drug abuse, overprescription, supporting off-label-use of opioids and thus providing a knowledge database for off-label use of opioids. This model shows promise to deliver accurate data and information about the exact opioid’s needs and consumption atlas. This will assist to better distribute the product in the entire country.
A proof-of-concept of the proposed model is required. This is ongoing and will be presented in a forthcoming paper.
Conclusion: This editorial paper investigates access to opioids in Burkina Faso. It pointed out by analyzing out the computer science perspectives the different causes of the crisis. A contextualized model is provided. A test in situ needs to be performed.
Downloads
References
T. O. Edoh and G. Teege, "Using information technology for an improved pharmaceutical care delivery in developing countries. Study case: Benin," J. Med. Syst., vol. 35, no. 5, pp. 1123-1134, 2011.
https://doi.org/10.1007/s10916-011-9717-y
PMid:21519942
L. J. Paulozzi, K. A. Mack, and J. M. Hockenberry, "Variation among states in prescribing of opioid pain relievers and benzodiazepines - United States, 2012," J. Safety Res., vol. 51, pp. 125-129, 2014.
https://doi.org/10.1016/j.jsr.2014.09.001
PMid:25453186
M. M. Queiroz and S. Fosso Wamba, "Blockchain adoption challenges in supply chain: An empirical investigation of the main drivers in India and the USA," Int. J. Inf. Manage., vol. 46, no. September 2018, pp. 70-82, 2019.
https://doi.org/10.1016/j.ijinfomgt.2018.11.021
R. Casado-Vara, J. Prieto, F. De La Prieta, and J. M. Corchado, "How blockchain improves the supply chain: Case study alimentary supply chain," Procedia Comput. Sci., vol. 134, pp. 393-398, 2018.
https://doi.org/10.1016/j.procs.2018.07.193
J. Richard and M. M. Reidenberg, "The risk of disciplinary action by state medical boards against physicians prescribing opioids," J. Pain Symptom Manage., vol. 29, no. 2, pp. 206-212, 2005.
https://doi.org/10.1016/j.jpainsymman.2004.05.009
PMid:15733811
T. O. C. Edoh, A. Atchome, B. R. U. . Alahassa, and P. Pawar, "Evaluation of a Multi-Tier Heterogeneous Sensor Network for Patient Monitoring - The Case of Benin," in MMHealth '16 Proceedings of the 2016 ACM Workshop on Multimedia for Personal Health and Health Care, 2016, pp. 23-29.
https://doi.org/10.1145/2985766.2985772
T. O. Edoh, P. A. Pawar, B. Brügge, and G. Teege, "A Multidisciplinary Remote Healthcare Delivery System to Increase Health Care Access, Pathology Screening, and Treatment in Developing Countries," in Health Care Delivery and Clinical Science, IGI Global, 2017, pp. 269-302.
https://doi.org/10.4018/978-1-5225-3926-1.ch013
T. O. Edoh, Advanced Systems for Improved Public Healthcare and Disease Prevention. USA: IGI Global, Medical Information Science Reference (an imprint of IGI Global), 2018.
A. KHELASSI, V. V. Estrela, A. C. B. Monteiro, R. P. França, Y. Iano, and N. Razmjooy, "Health 4.0: Applications, Management, Technologies and Review," Med. Technol. J., vol. 2, no. 4, pp. 262-276, Jan. 2019.
https://doi.org/10.26415/2572-004X-vol2iss4p262-276
Léné SEBGO, "Manuel de gestion des déchets Médicaux," 2014.
S. Bouda, "Manuel De Gestion Des Impacts," Ougadougou, 2010.
D. Valdeolmillos, Y. Mezquita, A. González-Briones, J. Prieto, and J. M. Corchado, "Blockchain Technology: A Review of the Current Challenges of Cryptocurrency," in Blockchain and Applications, BLOCKCHAIN., vol. 1010, C. J. Prieto J., Das A., Ferretti S., Pinto A., Ed. 2020, pp. 153-160.
https://doi.org/10.1007/978-3-030-23813-1_19
M. Mettler, "Blockchain technology in healthcare: The revolution starts here," 2016 IEEE 18th Int. Conf. e-Health Networking, Appl. Serv. Heal. 2016, pp. 16-18, 2016.
https://doi.org/10.1109/HealthCom.2016.7749510
S. Saberi, M. Kouhizadeh, J. Sarkis, and L. Shen, "Blockchain technology and its relationships to sustainable supply chain management," Int. J. Prod. Res., vol. 57, no. 7, pp. 2117-2135, 2019.
https://doi.org/10.1080/00207543.2018.1533261
H. Min, "Blockchain technology for enhancing supply chain resilience," Bus. Horiz., vol. 62, no. 1, pp. 35-45, 2019.
https://doi.org/10.1016/j.bushor.2018.08.012
S. M. Riazul Islam, Daehan Kwak, M. Humaun Kabir, M. Hossain, and Kyung-Sup Kwak, "The Internet of Things for Health Care: A Comprehensive Survey," IEEE Access, vol. 3, pp. 678-708, 2015.
https://doi.org/10.1109/ACCESS.2015.2437951
F. Hu, D. Xie, and S. Shen, "On the application of the internet of things in the field of medical and health care," Xplore IEEE - 2013 IEEE Int. Conf. Green Comput. Commun. IEEE Internet Things IEEE Cyber, Phys. Soc. Comput. GreenCom-iThings-CPSCom 2013, pp. 2053-2058, 2013.
V. V Estrela, J. Hemanth, O. Saotome, E. G. H. Grata, and D. R. F. Izario, "Emergency Response Cyber-Physical System for Flood Prevention with Sustainable Electronics," in Proceedings of the 3rd Brazilian Technology Symposium, Cham: Springer International Publishing, 2019, pp. 319-328.
https://doi.org/10.1007/978-3-319-93112-8_33
T. O. Edoh and G. T. Pravin Amrut Pawar, Bernd Brügge, "A Multidisciplinary Remote Healthcare Delivery System to Increase Health Care Access , Pathology Screening , and Treatment in Developing Countries :," Int. J. Healthc. Inf. Syst. Informatics, vol. 11, no. 4, pp. 1-31, 2016.
https://doi.org/10.4018/IJHISI.2016100101
Y. Chen, S. Ding, Z. Xu, H. Zheng, and S. Yang, "Blockchain-Based Medical Records Secure Storage and Medical Service Framework," J. Med. Syst., vol. 43, no. 1, 2018.
https://doi.org/10.1007/s10916-018-1121-4
PMid:30467604
A. Ekblaw, A. Azaria, J. D. Halamka, and A. Lippman, "A case study for blockchain in healthcare: 'MedRec' prototype for electronic health records and medical research data," OBD 2016 2nd Int. Conf. Open Big Data, vol. 13, p. 13, 2016.
R. Gazzotti, C. Faron-Zucker, F. Gandon, V. Lacroix-Hugues, and D. Darmon, "Injecting Domain Knowledge in Electronic Medical Records to Improve Hospitalization Prediction," The Semant., vol. 1, H. P. et Al., Ed. Springer, Cham, 2019, pp. 116-130.
https://doi.org/10.1007/978-3-030-21348-0_8
P. Zhang, J. White, D. C. Schmidt, G. Lenz, and S. T. Rosenbloom, "FHIRChain: Applying Blockchain to Securely and Scalably Share Clinical Data," Comput. Struct. Biotechnol. J., vol. 16, pp. 267-278, 2018.
https://doi.org/10.1016/j.csbj.2018.07.004
PMid:30108685 PMCid:PMC6082774
Martin Lankoandé. Policy brief : Public and political awareness of palliative and elderly care in Burkina Faso.
URL: https://hospicecare.com/uploads/2018/6/Burkina%20Faso%20Presentation%20Martin%20Lankoande.pdf (Last time visited: November 2019)
