1. Pain Policy Website
The Pain & Policy Studies Group established an international section of its website (http://www.medsch.wisc.edu/painpolicy) to provide worldwide public access to key resources and information about the WHO and its efforts to improve cancer pain, palliative care, and opioid availability.
The website describes the mission of the Pain & Policy Studies Group/WHO Collaborating Center and its work to address barriers to opioid availability in cooperation with national and international bodies.
Links are provided to many websites that contain information relevant to pain relief and palliative care.
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 and links to WHO and INCB publications.
In addition, 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 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 2001). The statistics show that there is a significant and increasing use of the website as a resource for learning about pain policy. In 2001, the website received over 20,000 “hits” by international users, and was accessed by an average of 55 different countries per month, with the most frequent visitors coming from Canada, Western Europe, and Australia.
2. Publication of Cancer Pain Release
Part of the Center’s mission is to improve access to professional education resources in pain control and palliative care on a global scale and actively support the WHO’s Cancer Control Program to promote pain relief and palliative care.
To accomplish this mission, the Center publishes Cancer Pain Release
in print and on the Internet in an effort 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.
2001 marks the 14th year of publication of the WHO Cancer Pain Release newsletter. Each issue presents abstracts and commentaries from the literature on pain, symptom control and palliative care; information on WHO guidelines on the use of analgesic medications in pain relief and palliative care; information about training opportunities and professional education in cancer pain and palliative care, as well as progress and issues regarding the availability of opioid analgesics. The publication documents the progress of pain relief initiatives worldwide, as well as obstacles and solutions in pain relief practice and policy.
The first issue of Cancer Pain Release in 2001 (Volume 14, No. 1) presented new guidelines from the World Health Organization designed to help health professionals and governments identify how to improve access to opioid analgesics for patient care.
The second issue (Volume 14, No. 2) discussed the new pain standards in the US and the organizational change strategies used by health-care facilities to improve pain assessment and treatment. The issue featured print, video and web-based resources to help organizations implement pain management standards and studies of models to institutionalize pain management.
“Easing pain in seriously ill children” was the focus of Volume 14, No. 3 of Cancer Pain Release. The issue discussed the reasons for the lack of available pain control and palliative care for children. The issue featured initiatives in policy, professional education and clinical practice intended to benefit children with life threatening conditions; recent print and web-based resources for health professionals concerned about improving pain management in the seriously ill child; and abstracts of the latest research findings on pain in children with a terminal illness.
Nurses’ role in prescribing for palliative care was the theme of Volume 14, No. 4. This issue reported on developments from Australia, New Zealand, Uganda, the United Kingdom and the US giving qualified nurses the opportunity to prescribe appropriate medications for pain and palliative care. The issue explained that expanding nurses’ roles in pain control and palliative care requires clarity in role definition, supportive regulations, curricula emphasizing advanced skills and positive relationships with other health professions.
Distribution:
Distribution continues to grow. Cancer Pain Release now reaches approximately
50,000 health-care providers in 173 countries through mailings to individuals
and organizations, and dissemination at professional courses and meetings throughout
the world. For 2001, a partial list includes:
In addition, the Spanish and English editions of Cancer Pain Release are inserted in Medicina Paliativa and the Journal of Pain & Symptom Management.
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 2001.
In 2001, the Center continued to reach out to health-care workers globally using email to alert colleagues who have email access about the publication of new issues of Cancer Pain Release. In 2001, we sent out over 3,900 email messages to our worldwide audience with email access, which includes 980 colleagues around the world.
Cancer Pain Release website:
The English edition of Cancer Pain Release is available in full-text
on our website (http://www.WHOcancerpain.wisc.edu).
In 2001, the Cancer Pain Release website received
multiple requests for information about Cancer Pain Release, about
WHO publications in pain, palliative care and symptom control, and other educational
resources.
3. Database of Professional and Patient Education Materials
The Center is developing an Internet-accessible annotated database of resource materials in English and Spanish for patient and professional education by collecting, categorizing, and summarizing patient and professional education resources and research studies. Although the Center does not have funds earmarked to meet this objective, Cancer Pain Release includes a “Resources” page that lists educational materials primarily from English and Spanish sources that are relevant to the topic discussed in that issue.
For example, Volume 14, Number 3, 2001 included resources about pain in seriously ill children.
In 2001, Volume 14, Number 4 used resources from the database to present information about advance practice nursing, including books, journals, videos, international fellowships, and websites.
4. Participation in International Meetings
The Center participated in the 7th Congress of the European Association for Palliative Care (EAPC) in Palermo, Italy in April 2001. The EAPC is an important non-governmental organization dedicated to promoting pain control and palliative care in Europe. The Congress brought together 1,600 health professionals from 50 different countries, offered 300 oral presentations, and approximately 400 individual poster presentations.
The Congress was an excellent opportunity for increasing delegates’ awareness of this Collaborating Center’s work to advance pain management, palliative care and pain policy on a global scale.
The Center provided copies of Cancer Pain Release that were relevant to the topics discussed at the Congress, consulted with several editorial board members of Cancer Pain Release, and acquired information for use in future issues of Cancer Pain Release. The EAPC Congress also provided an opportunity to network with colleagues from Eastern Europe and Spain.
5. Future Goals
The Center’s goals are to expand its capabilities to reach out to health-care workers electronically by issuing email alerts, to send regular updates of the educational resources database, to 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.