Prescribers’ experiences of, and attitudes to, use of morphine for palliative care at a tertiary hospital in Zambia
- 26 February 2020
- journal article
- research article
- Published by Taylor & Francis Ltd in Hospital Practice
- Vol. 48 (2), 86-91
- https://doi.org/10.1080/21548331.2020.1733318
Abstract
Objective: To explore medical doctors’ experiences of, and attitudes to, use of morphine for palliative care at a tertiary hospital in Zambia. Methods: A qualitative, exploratory case study was undertaken. Semi-structured interviews were used to collect data from 14 medical doctors working in the fields of oncology, paediatrics, and internal medicine at a tertiary hospital in Lusaka, Zambia, regarding their experiences and attitudes to prescribing morphine for palliative care. Thematic analysis of interview transcripts was carried out to establish common themes in the data. The study was approved by BSMS and UNZA research ethics committees. Results: All participants agreed that doctors were becoming more comfortable with the prescribing of morphine, although experiences were notably different for doctors working in oncology, compared to other departments. Themes of difficulty discussing end-of-life, poor recognition of pain, and fear of patient addiction, were more prominent in the responses of non-cancer doctors. Morphine use was generally restricted to cancer and sickle cell disease patients, with most non-cancer doctors stating that they rarely prescribe morphine for outpatient use. Training in pain management, and the presence of a palliative care team, were perceived to be facilitators to morphine prescribing. Conclusions: Although there is an increased willingness to prescribe morphine, limited knowledge of pain management, especially for non-malignant disease, underlies many of the findings in this study. Opportunity exists for professional development in pain management to further improve the acceptance and use of opioids in palliative care, especially for out-patients.Keywords
Funding Information
- No sponsorship
This publication has 21 references indexed in Scilit:
- Does Disclosure of Terminal Prognoses Mean Losing Hope? Patient Perspectives on Palliative Care Consultations (S717)Journal of Pain and Symptom Management, 2013
- Physicians' prescribing habits for cancer pain in CyprusAnnals of Oncology, 2012
- Rising to the challenge of palliative care for non-malignant diseasePalliative Medicine, 2012
- The impact of culture and religion on truth telling at the end of lifeNephrology Dialysis Transplantation, 2011
- What Can We Learn from First-Year Medical Students' Perceptions of Pain in the Primary Care Setting?Pain Medicine, 2011
- Physicians' Beliefs and Attitudes About End-of-Life Care: A Comparison of Selected Regions in Hungary and the United StatesJournal of Pain and Symptom Management, 2010
- Sustaining hope when communicating with terminally ill patients and their families: a systematic reviewPsycho‐Oncology, 2007
- Truth-telling in discussing prognosis in advanced life-limiting illnesses: a systematic reviewPalliative Medicine, 2007
- Factors Affecting Hospital Staff Judgments About Sickle Cell Disease PainJournal of Behavioral Medicine, 2006
- Can a pain management and palliative care curriculum improve the opioid prescribing practices of medical residents?Journal of General Internal Medicine, 2002