D. Communications

1. Pain Policy Website

The Pain & Policy Studies Group established an international section of its website (www.medsch.wisc.edu/painpolicy) to provide worldwide public access to key resource information about the WHO and its efforts to improve cancer pain, palliative care, and opioid availability.

Links are provided to many websites that contain information relevant to pain relief and palliative care.

A United States section contains extensive information about pain policy, including: model guidelines for the use of controlled substances for the treatment of pain; a bibliography of published literature; full-text of state statutes, regulations and guidelines; a criteria-based evaluation of federal and state pain related policies; a resource guide to regulatory issues in pain management; and information about pain management as an alternative to assisted suicide.

The international section contains extensive information about the international availability and use of opioid analgesics, including: national consumption trends of opioid analgesics; monographs that review the opioid availability situation in various parts of the world; recommendations for how to identify and address regulatory barriers; annotated bibliographies; and the full-text of WHO and INCB publications.

The Pain & Policy Studies Group has monitored website utilization statistics since July 1997 when the website was established (Figure 4 presents monthly data on all website "hits" and users through the year 2000). The statistics show that there is a significant and increasing use of the website as a resource for learning about pain policy. The website is visited by users from around the world, with the most frequent visitors coming from Latin America, Asia, Australia and Europe.

2. Publication of Cancer Pain Release

Methods:
The Center publishes Cancer Pain Release in print and on the Internet to:

1) inform a global audience about new developments and guidelines on cancer control and palliative care issued by WHO, and by key government and non-government organizations;

2) give visibility to programs with model and teaching value in all parts of the world;

3) recognize achievements of countries and programs according to WHO's outcome measures;

4) provide access to recent research in cancer pain and palliative care.

In 2000, Cancer Pain Release published an issue introducing Dr. Cecilia Sepulveda, the new Coordinator of the WHO Cancer Control Program and describing WHO's priorities for cancer pain and palliative care for 2000-2002.¹⁹ The issue (Volume 13, Number 1) also describes the initiatives of WHO Collaborating Centers with a mandate in palliative care, supportive care, quality of life, and opioid availability.

In 2000, Cancer Pain Release published a special issue on pain in the elderly in cancer which includes information about resources for managing pain, as well as a synopsis of recent research on pain prevalence, pain assessment, pain treatment, and patient education in this underserved patient population (Volume 13, Number 2).²⁰

Volume 13, Number 3-4, 2000, a double issue, provides health professionals with information about selected resources from around the world to educate cancer patients and their families about pain relief and palliative care.²¹ The issue lists books, videos, factsheets, CD-roms, websites and audiotapes available in several languages from organizations in international health, government, medicine, nursing, psychology, professional advocacy, patient advocacy and academic centers.

In 2000, English and Spanish editions of Cancer Pain Release were published with the support of partners from industry, the U.S. Cancer Pain Relief Committee, and individuals. Publication of the French language edition was suspended due to lack of resources.

Distribution:
Single copies of Cancer Pain Release are mailed to a growing number of clinicians and health-care organizations. Multiple copies are also mailed in bulk for distribution at many professional meetings throughout the world.^a  Figure 5 shows the distribution of Cancer Pain Release by language and by country. Figures 6 and 7 show the distribution by profession of the audience for the English and Spanish language editions in 2000.

Cancer Pain Release website:
In 2000, the Center updated the Cancer Pain Release website so that users can browse the contents of all issues published since 1988 [http://www.whocancerpain.wisc.edu/]. The English edition of Cancer Pain Release is available in full-text and plans are underway to launch a Spanish edition of the website. In 2000, the website received approximately 5,000 monthly requests for information about Cancer Pain Release and about WHO publications in pain, palliative care and symptom control.

3. Database of Professional and Patient Education Materials

Methods:
The Center collects, categorizes, assesses and summarizes patient and professional education resources and research studies.

Outcomes:
Although the Center does not have funds dedicated to this objective, a number of resources have been collected and were used to accomplish the following:

In 2000, the Center produced and presented a monograph, "La educación sobre el control del dolor de cancer y el cuidado paliativo: Recursos para profesionales, pacientes y familiares hispanohablantes"¹¹ for participants in the 6^th Latin American Congress of Palliative Care in San José, Costa Rica. The monograph summarizes Spanish-language consensus documents, national policies, medical journals, clinical guidelines, patient education tools produced by PAHO - WHO and by professional organizations in Argentina, Chile, Colombia, Costa Rica, Spain, and the U.S.

Cancer Pain Release includes a "Resources" page which lists English, French or Spanish-language educational materials that are relevant to the topic discussed in that issue. For example, Volume 13, Number 2, 2000 includes resources about pain in the elderly with cancer.²⁰ In 2000, the special double issue of Cancer Pain Release (Volume 13, Number 3-4) used resources from the database to present information about existing educational resources worldwide for cancer patients and their families, including books, videos, factsheets, CD-roms, websites and audiotapes.²¹

In 2000, the Center produced a Spanish-language edition of a colorful poster depicting the covers of relevant WHO and INCB publications along with ordering information. These publications are available in as many as 23 languages. Many copies of the poster have been distributed, including at the 6^th Latin American Congress of Palliative Care in San José, Costa Rica and to the WHO and its regional offices.

Future Goals:
The Center's goals are to issue regular updates of the educational resources database, expand the section of new resources in Cancer Pain Release, place this information on the Cancer Pain Release website [http://www.whocancerpain.wisc.edu/], and improve its capability to provide relevant information to conferences and workshops worldwide.

^a  A partial list includes the meetings of the Argentinian Association for Pain and Palliative Care (Buenos Aires, February 2000), the Latin American Congress of Palliative Care (Costa Rica, March 2000), the Venezuelan Association for the Study of Pain (May 2000), the International Society of Nurses in Cancer Care (Oslo, Norway, July 2000), a regional pain control conference in Kerala, India (July 2000), the congress of the European Federation of IASP chapters (France, September 2000), Eastern European palliative care symposia (Budapest, October 2000), a pain and pharmacology meeting in London, UK (December 2000).

Figure 4. PPSG Wesite Statistics, 1997-2000

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