Pain: introduction

2016 ◽  
Author(s):  
Richard D.W. Hain ◽  
Satbir Singh Jassal
Keyword(s):  
Palliative Care ◽  
World Health Organization ◽  
Pharmacological Treatment ◽  
Cultural Influences ◽  
Pain Severity ◽  
World Health ◽  
Assessment And Evaluation ◽  
Total Pain ◽  
The World ◽  
Health Organization

Pain is a subjective and multidimensional phenomenon. Diagnosis, assessment, and evaluation of pain are all complicated in children by the range of diagnoses and developmental levels, and by cultural influences. This chapter summarizes definitions and classifications of pain, including total pain. It looks at ways that children express pain, and measurement of pain severity. Pharmacological treatment of pain is considered, alongside the World Health Organization pain guidelines, which are considered to be the basis of managing pain in palliative care.

Epilogue: Making Sense of Cicely Saunders

2018 ◽  
Author(s):  
David Clark
Keyword(s):  
Palliative Care ◽  
World Health Organization ◽  
Personal Relationships ◽  
World Health ◽  
Making Sense ◽  
Self Image ◽  
The World ◽  
Health Organization

Cicely Saunders married late in life and had no children. Her closest personal relationships were complicated. Her steely look and assured manner masked years of vulnerability, poor self-image, and struggles with her femininity. She was an unlikely pioneer of an improbable movement. Stripping away the hagiography, there is no doubt that Cicely shaped a new field of medicine which was gaining significant ground by the time of her death, and one which made further progress in the decade following it. A whole generation of palliative-care professionals was trained at St Christopher’s, many of whom spread their knowledge and expertise in other places. The hospice ideal transferred and translated around the world — and eventually led to universal support through the encouragement of the World Health Organization. This chapter concludes the book with an assessment of her legacy — and the complex and demanding life that shaped it.

Essential medicines for palliative care

2021 ◽  
pp. 13-18
Author(s):  
Lukas Radbruch ◽  
Liliana De Lima
Keyword(s):  
Palliative Care ◽  
World Health Organization ◽  
Essential Medicine ◽  
Essential Medicines ◽  
World Health ◽  
Health Conditions ◽  
Health Coverage ◽  
Loved One ◽  
The World ◽  
Health Organization

The World Health Organization defines essential medicines as those which satisfy the primary healthcare needs of the population. In 2013, the World Health Organization introduced a new section on medicines for pain and palliative care in the 18th edition of the Model List of Essential Medicine including 15 medicines for the most common symptoms in life-limiting health conditions. More recently, the Lancet Commission on palliative care developed an essential package which also includes equipment and human resources in addition to the essential medicines. The Lancet Commission specified that in order to achieve universal health coverage, coverage of the essential package is recommended by dedicated, pro-poor, public or publicly mandated funding and for all relevant health conditions. However, in many regions of the world, all or some of the essential medicines are not available at all, or if they are available in the country, they are regularly out of stock in the local pharmacy, out-of-pocket costs are so high that patients cannot afford the medicines, or whole families become impoverished buying treatment for their loved one. Problems with accessibility, affordability, and availability are particularly evident with opioid analgesics such as morphine. However, accessibility, affordability, and availability of essential medicines is a pivotal prerequisite for the delivery of quality palliative care.

scholarly journals Hypertension Pharmacological Treatment in Adults: A World Health Organization Guideline Executive Summary

Hypertension ◽  
2021 ◽  
Author(s):  
Akram Al-Makki ◽  
Donald DiPette ◽  
Paul K. Whelton ◽  
M. Hassan Murad ◽  
Reem A. Mustafa ◽  
...  
Keyword(s):  
World Health Organization ◽  
Pharmacological Treatment ◽  
Treatment Guidelines ◽  
Lifestyle Modification ◽  
Guideline Development ◽  
Pharmacological Therapy ◽  
World Health ◽  
Executive Summary ◽  
The World ◽  
Health Organization

Hypertension is a major cause of cardiovascular disease and deaths worldwide especially in low- and middle-income countries. Despite the availability of safe, well-tolerated, and cost-effective blood pressure (BP)-lowering therapies, <14% of adults with hypertension have BP controlled to a systolic/diastolic BP <140/90 mm Hg. We report new hypertension treatment guidelines, developed in accordance with the World Health Organization Handbook for Guideline Development. Overviews of reviews of the evidence were conducted and summary tables were developed according to the Grading of Recommendations, Assessment, Development, and Evaluations approach. In these guidelines, the World Health Organization provides the most current and relevant evidence-based guidance for the pharmacological treatment of nonpregnant adults with hypertension. The recommendations pertain to adults with an accurate diagnosis of hypertension who have already received lifestyle modification counseling. The guidelines recommend BP threshold to initiate pharmacological therapy, BP treatment targets, intervals for follow-up visits, and best use of health care workers in the management of hypertension. The guidelines provide guidance for choice of monotherapy or dual therapy, treatment with single pill combination medications, and use of treatment algorithms for hypertension management. Strength of the recommendations was guided by the quality of the underlying evidence; the tradeoffs between desirable and undesirable effects; patient’s values, resource considerations and cost-effectiveness; health equity; acceptability, and feasibility consideration of different treatment options. The goal of the guideline is to facilitate standard approaches to pharmacological treatment and management of hypertension which, if widely implemented, will increase the hypertension control rate world-wide.

National palliative care capacities around the world: Results from the World Health Organization Noncommunicable Disease Country Capacity Survey

2017 ◽  
Vol 32 (1) ◽  
pp. 106-113 ◽  
Author(s):  
Lee Sharkey ◽  
Belinda Loring ◽  
Melanie Cowan ◽  
Leanne Riley ◽  
Eric L Krakauer
Keyword(s):  
Palliative Care ◽  
World Health Organization ◽  
Noncommunicable Disease ◽  
World Health ◽  
Noncommunicable Diseases ◽  
Large Country ◽  
The World ◽  
Organization Member ◽  
Health Organization ◽  
Care Development

Background: Previous estimates of global palliative care development have not been based on official country data. Aim: The World Health Organization Noncommunicable Disease Country Capacity Survey of World Health Organization member state officials monitors countries’ capacities for the prevention and control of noncommunicable diseases. In 2015, for the first time, questions were included on a number of palliative care development metrics to generate baseline data for monitoring global palliative care development. Design: Participants were given instructions, a glossary of terms, and 3 months to complete this closed, non-randomized, online survey. Questions were developed through a consultative process with relevant technical World Health Organization departments. Setting/participants: Health ministry officials serving as noncommunicable disease focal points from 177 out of 194 (91%) of World Health Organization Member States completed the voluntary survey. Results: This survey reveals that (a) a minority (37%) of countries have an operational national policy for noncommunicable diseases that includes palliative care, (b) palliative care is least likely to have funding available compared with other core noncommunicable disease services, and (c) there is a large country-income gradient for palliative care funding, oral morphine availability, and integration of palliative care services at the primary levels of the health system. Conclusion: Palliative care for noncommunicable disease patients must be strengthened in a majority of countries. These data provide a baseline for trend measurement of official country-level and global palliative care development. A repeat assessment is taking place in the first half of 2017.

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