{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T18:14:18Z","timestamp":1780078458876,"version":"3.54.0"},"reference-count":25,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2019,12,23]],"date-time":"2019-12-23T00:00:00Z","timestamp":1577059200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100011272","name":"FP7 Health","doi-asserted-by":"publisher","award":["222994"],"award-info":[{"award-number":["222994"]}],"id":[{"id":"10.13039\/100011272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Palliat Med"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>In many countries, the consumption of opioid medicines is too low to meet population needs. Discussions within the Access To Opioid Medication in Europe project indicated that there may be significant differences in the perception of barriers for their adequate use, depending on the stakeholders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>The aim of this study was to examine the perception of barriers and their impact concerning opioid medicines, comparing policy makers, healthcare professionals working in the field of pain management, palliative care or harm reduction and other stakeholders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Data were collected using a questionnaire partially constructed from existing surveys, reviewed for content validity by four experts and pilot-tested in Latvia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting\/participants:<\/jats:title>\n                    <jats:p>Participants of the Access to Opioid Medication in Europe national conferences were invited to complete the questionnaire. Stakeholder groups were compared using non-parametric rank-sum tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>In total, 199 participants (54%) in seven countries completed the questionnaire. Most frequently rated major barriers included lack of financial resources and inadequate knowledge, skills and training among policy makers (55%\u201366%). Overall, policy makers perceived issues less often as major barriers or having major impact (29% barrier, 32% impact) compared to other stakeholders (36%\u201342% barrier, 39%\u201351% impact). Significant differences were seen on several aspects. For example, excessive regulation or bureaucracy for prescribing was rated as having major impact by 55%\u201357% of healthcare professionals in contrast to only 20% of the policy makers ( p\u2009=\u20090.002).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Multiple barriers may play an important role, partly depending on the perspective of the stakeholder involved. Hence, when addressing perceived barriers, it is important to include all relevant stakeholder groups. Only then, effective and widely supported solutions can be implemented.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0269216319894190","type":"journal-article","created":{"date-parts":[[2019,12,23]],"date-time":"2019-12-23T08:46:13Z","timestamp":1577090773000},"page":"493-503","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":9,"title":["The perception of barriers concerning opioid medicines: A survey examining differences between policy makers, healthcare professionals and other stakeholders"],"prefix":"10.1177","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2632-5386","authenticated-orcid":false,"given":"Marjolein JM","family":"Vranken","sequence":"first","affiliation":[{"name":"Utrecht Institute for Pharmaceutical Sciences, Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, Utrecht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Linge-Dahl","sequence":"additional","affiliation":[{"name":"Department of Palliative Medicine, University Hospital Bonn, Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aukje K","family":"Mantel-Teeuwisse","sequence":"additional","affiliation":[{"name":"Utrecht Institute for Pharmaceutical Sciences, Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, Utrecht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas","family":"Radbruch","sequence":"additional","affiliation":[{"name":"Department of Palliative Medicine, University Hospital Bonn, Bonn, Germany"},{"name":"Centre for Palliative Care, Malteser Hospital Bonn, Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-H\u00e9l\u00e8ne DB","family":"Schutjens","sequence":"additional","affiliation":[{"name":"Utrecht Institute for Pharmaceutical Sciences, Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, Utrecht, the Netherlands"},{"name":"Schutjens de Bruin, Tilburg, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5283-3766","authenticated-orcid":false,"given":"Willem","family":"Scholten","sequence":"additional","affiliation":[{"name":"Willem Scholten Consultancy, Lopik, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6982-9181","authenticated-orcid":false,"given":"Sheila","family":"Payne","sequence":"additional","affiliation":[{"name":"International Observatory on End of Life Care, Division of Health Research, Lancaster University, Lancaster, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saskia","family":"J\u00fcnger","sequence":"additional","affiliation":[{"name":"Research Unit Ethics, University Hospital Cologne, Cologne, Germany"},{"name":"Cologne Center for Ethics, Rights, Economics, and Social Sciences of Health (ceres), University of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2019,12,23]]},"reference":[{"key":"bibr1-0269216319894190","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2014.10.001"},{"key":"bibr2-0269216319894190","unstructured":"Department of Health and Human Services, Behavioral Health Coordinating Committee. Prescription drug abuse subcommittee: addressing prescription drug abuse in the United States: current activities and future opportunities, https:\/\/www.cdc.gov\/drugoverdose\/pdf\/hhs_prescription_drug_abuse_report_09.2013.pdf (accessed 22 October 2018)."},{"key":"bibr3-0269216319894190","unstructured":"Centers for Disease Control and Prevention, National Center for Health Statistics. Provisional drug overdose death counts, https:\/\/www.cdc.gov\/nchs\/nvss\/vsrr\/drug-overdose-data.htm (accessed 28 October 2018)."},{"key":"bibr4-0269216319894190","unstructured":"Sanger-Katz M. Bleak new estimates in drug epidemic: a record 72,000 overdose deaths in 2017. 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