Access to opioids in palliative care in low-and middle-income countries: The case of Burkina-Faso How can blockchain and internet of things assist?

Abstract

Background: People requesting palliative care or suffering from pain are subjected to adhere to opioid-based treatment in order to alleviate their pain. Commonly, access to opioids is strictly controlled. Access to Healthcare delivery services remains challenging in Low-and Middle-Income Countries (LMIC). In Burkina-Faso (BF), a Sub-Saharan African (SSA) country, patients requiring palliative care (PC) are especially facing poor access to pain drugs such as morphine. Facing poor access to pain-alleviating medicine can severely impact the daily quality of life (QoL). On one hand, patients are experiencing poor opioids access. On another hand opioids abuse, leading to drug addiction is noticed. The question arising here is how can they face poor access and at the same time abuse the given drug? One plausible answer is the counterfeit chain, which provides illegal drugs. Beyond the counterfeit issues faced, the public health care system is also facing, amongst others, prescription falsification, fraud in the distribution, and stock shortage.
Objectives: The main objectives are to fight against opioid addiction, counterfeits, a stock shortage, and prevent related health safety issues. The main aim is to enable the traceability of any opioids prescription, secure the supply and distribution, and thus early detect any fraud in the system. This editorial paper would, therefore, focus on investigating the reasons underlying the poor access to opioids in palliative care in BF and make suggestions for improvement. A blockchain (BC) and the Internet of Things (IoT) based system to secure and improve opioids supply, distribution, and prescription will be proposed.
Method & Design: Mixed-Method-Design was applied to this study. National stipulations, regulations, and the state-of-the-art in the field of palliative care in BF were investigated and analyzed. Based on the investigation‘s outcomes and following the paradigm of design science research, and information system based improvement solution is proposed to tackle the poor access to opioids, improve the supply and distribution chain as well as to efficiently monitor the consumption of opioids in BF, and prevent patients from any health issues, drug addiction, and death.
Results: The contribution analysis reveals the potential of the proposed model to assist in many ways to improve access to opioids and to secure this access. The model could contribute to preventing drug abuse, overprescription, supporting off-label-use of opioids and thus providing a knowledge database for off-label use of opioids. This model shows promise to deliver accurate data and information about the exact opioid’s needs and consumption atlas. This will assist to better distribute the product in the entire country. A proof-of-concept of the proposed model is required. This is ongoing and will be presented in a forthcoming paper.
Conclusion: This editorial paper investigates access to opioids in Burkina Faso. It pointed out by analyzing out the computer science perspectives the different causes of the crisis. A contextualized model is provided. A test in situ needs to be performed.