title: Reducing the barriers to pain management in Albania: results from an educational seminar with family doctors.
abstract: Palliative care (PC) services are a very limited service in Albania and are provided mainly from the nonprofit sector (nongovernmental organizations [NGOs]) that cover about 30% of the demand. There are very few doctors and nurses qualified in PC and pain management. Training and education programs on opioid treatment do not exist and patients cannot access opioids easily. This study evaluated the attitudes of family doctors on pain assessment, management, and opioid usage before and after seminars on opioid pain management. The Barriers Questionnaire II (BQ-II) was used to evaluate attitudes towards pain management in 227 family doctors (general practitioners) working in the state primary health care system in both urban and rural areas. Data was collected before and after one-day seminars on opioids conducted in six cities located in all the major regions of the country. The response rate was 83.3%. Barriers were measured to be high in the participating physicians, with mean scores of 3 out of 5 or above for 10 of 27 items. The danger of addiction to pain medicines as well as the fear that many people with cancer would get addicted to pain medicine received the highest scores. At the end of the seminar barriers were significantly lower, with the total mean scores (with standard deviation) reduced from 2.4±0.6 to 1.6±0.7. High barriers to the use of opioids in family physicians in Albania were reduced significantly following a one-day training, demonstrating the effectiveness of the intervention. However, more research on the sustainability of the training effect is needed.
authors.affiliation: Home Care Team, Ryder Albania Association, Tirana, Albania. alixhixha@yahoo.com
authors.forename: Ali
authors.initials: A
authors.lastname: Xhixha
authors.forename: Rudina
authors.initials: R
authors.lastname: Rama
authors.forename: Lukas
authors.initials: L
authors.lastname: Radbruch
mesh_terms: D000415:Albania; D000701:Analgesics, Opioid / Q000009:adverse effects / Q000592:standards / Q000627:therapeutic use*; D001291:Attitude of Health Personnel; D004502:Education, Medical, Continuing; D006801:Humans; D059408:Pain Management / Q000379:methods / Q000592:standards* / Q000639:trends; D010166:Palliative Care / Q000592:standards* / Q000706:statistics & numerical data; D010821:Physicians, Family / Q000193:education*
chemical_list: D000701:Analgesics, Opioid