{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T14:01:46Z","timestamp":1787666506931,"version":"build-2736575974"},"reference-count":69,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"11","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Glob Oncol"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>This study explores the views of health care providers (HCPs), regulators, patients with cancer, and caregivers in Vietnam on the barriers to safe access to opioids for cancer pain relief and suggested solutions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>MATERIALS AND METHODS<\/jats:title>\n                    <jats:p>We conducted a qualitative, descriptive study using semistructured interviews. Five HCPs, six patients with cancer\/caregivers, and six regulators (n = 17) were purposefully sampled across Vietnam. Audio recordings were transcribed verbatim and subjected to inductive content analysis using a Framework method.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Five categories of barriers were identified: (1) Patient-related barriers (fear of addiction and other side effects, morphine's association with impending death); (2) professional-related barriers (knowledge and experience deficit, fear of addiction and other side effects, and concerns about diversion and liabilities); (3) medicine-related barriers (limited oral morphine availability, limited manufacturers and suppliers, and difficulties accessing parenteral opioids); (4) regulatory barriers (difficulties obtaining certifications of continued need for opioid use, overly strict regulation enforcement, lack of information on opioid distribution channels); and (5) services delivery barriers (scarce palliative and home care services). Potential solutions include strengthening education for patients, communities, and health care professionals; mandating oral morphine availability at district levels; diversifying opioid variety and enhancing domestic manufacturing; establishing an electronic prescription monitoring system; expanding palliative care training and implementation across all health care system levels; and using telemedicine.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Barriers to opioid access for cancer pain control in Vietnam are multifactorial and interrelated, necessitating interdisciplinary solutions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/go-25-00026","type":"journal-article","created":{"date-parts":[[2025,6,4]],"date-time":"2025-06-04T15:59:13Z","timestamp":1749052753000},"update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":2,"title":["I Wait for Leftover Morphine: A Qualitative Study of Barriers to Safe Opioid Access for Cancer Pain Relief in Vietnam"],"prefix":"10.1200","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2805-541X","authenticated-orcid":true,"given":"Trang","family":"Nguyen","sequence":"first","affiliation":[{"name":"Department of Pharmacy, University Medical Center Ho Chi Minh City, Ho Chi Minh City, Vietnam"},{"name":"College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anh","family":"Dam","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, National Geriatric Hospital, Ha Noi, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5655-3884","authenticated-orcid":true,"given":"Linh","family":"Bui","sequence":"additional","affiliation":[{"name":"Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA"},{"name":"Research Advancement Consortium in Health, Hanoi, Vietnam"},{"name":"College of Health Sciences, VinUniversity, Hanoi, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7242-8976","authenticated-orcid":true,"given":"Tung","family":"Pham","sequence":"additional","affiliation":[{"name":"Research Advancement Consortium in Health, Hanoi, Vietnam"},{"name":"College of Health Sciences, VinUniversity, Hanoi, Vietnam"},{"name":"Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA"},{"name":"Department of Physiology, Hanoi Medical University, Ha Noi, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8868-0044","authenticated-orcid":true,"given":"Eric L.","family":"Krakauer","sequence":"additional","affiliation":[{"name":"Department of Ethics, Social Medicine &amp; Palliative Care, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam"},{"name":"Division of Palliative Care and Geriatric Medicine, Massachusetts General Hospital, Boston, MA"},{"name":"Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3036-6209","authenticated-orcid":true,"given":"Caroline","family":"Phelan","sequence":"additional","affiliation":[{"name":"College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","reference":[{"key":"e_1_3_8_2_2","doi-asserted-by":"publisher","DOI":"10.3390\/cancers15030591"},{"key":"e_1_3_8_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/papr.13098"},{"key":"e_1_3_8_4_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12904-020-00558-5"},{"key":"e_1_3_8_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/1073274819863802"},{"key":"e_1_3_8_6_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjnph-2020-000069"},{"key":"e_1_3_8_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2005.10.005"},{"key":"e_1_3_8_8_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2013.52.4827"},{"key":"e_1_3_8_9_2","volume-title":"Availability of Internationally Controlled Drugs: Ensuring Adequate Access for Medical and Scientific Purposes\u2014Indispensable, Adequately Available and Not Unduly Restricted","author":"International Narcotics Control Board","year":"2016","unstructured":"International Narcotics Control Board: Availability of Internationally Controlled Drugs: Ensuring Adequate Access for Medical and Scientific Purposes\u2014Indispensable, Adequately Available and Not Unduly Restricted. New York, NY, United Nations, 2016"},{"key":"e_1_3_8_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/20494637211013052"},{"key":"e_1_3_8_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)32513-8"},{"key":"e_1_3_8_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2014.10.012"},{"key":"e_1_3_8_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2017.03.038"},{"key":"e_1_3_8_14_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph16152656"},{"key":"e_1_3_8_15_2","first-page":"1","article-title":"Analgesic prescription patterns and pain outcomes in Southeast Asia: Findings from the analgesic treatment of cancer pain in Southeast Asia study","volume":"4","author":"Thinh DHQ","year":"2018","unstructured":"Thinh DHQ, Sriraj W, Mansor M, et al: Analgesic prescription patterns and pain outcomes in Southeast Asia: Findings from the analgesic treatment of cancer pain in Southeast Asia study. J Glob Oncol 4:1-10, 2018","journal-title":"J Glob Oncol"},{"key":"e_1_3_8_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2019.08.001"},{"key":"e_1_3_8_17_2","doi-asserted-by":"publisher","DOI":"10.1200\/JGO.2015.001859"},{"key":"e_1_3_8_18_2","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzm042"},{"key":"e_1_3_8_19_2","volume-title":"Qualitative Inquiry and Research Design Choosing Among Five Approaches","author":"Creswell JW","year":"2018","unstructured":"Creswell JW, Poth CN: Qualitative Inquiry and Research Design Choosing Among Five Approaches (ed 4). Thousand Oaks, CA, Sage Publication, 2018","edition":"4"},{"key":"e_1_3_8_20_2","volume-title":"Qualitative Research Methods","author":"Liamputtong P","year":"2020","unstructured":"Liamputtong P: Qualitative Research Methods (ed 5). Melbourne, Oxford University Press Australia & New Zealand, 2020","edition":"5"},{"key":"e_1_3_8_21_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10488-013-0528-y"},{"key":"e_1_3_8_22_2","doi-asserted-by":"publisher","DOI":"10.29090\/psa.2022.04.21.122"},{"key":"e_1_3_8_23_2","volume-title":"Qualitative Research in Nursing and Healthcare","author":"Holloway I","year":"2023","unstructured":"Holloway I, Galvin K: Qualitative Research in Nursing and Healthcare (ed 5). Hoboken, NJ, John Wiley & Sons, 2023","edition":"5"},{"key":"e_1_3_8_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmn.2019.07.011"},{"key":"e_1_3_8_25_2","doi-asserted-by":"publisher","DOI":"10.1177\/0269216320904905"},{"key":"e_1_3_8_26_2","doi-asserted-by":"publisher","DOI":"10.1002\/nop2.1093"},{"key":"e_1_3_8_27_2","doi-asserted-by":"publisher","DOI":"10.1177\/0269216319894190"},{"key":"e_1_3_8_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2019.07.002"},{"key":"e_1_3_8_29_2","volume-title":"NVivo Qualitative Data Analysis Software (Version 14)","author":"Lumivero","year":"2023","unstructured":"Lumivero: NVivo Qualitative Data Analysis Software (Version 14). Denver, CO, Lumivero, 2023"},{"key":"e_1_3_8_30_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-13-117"},{"key":"e_1_3_8_31_2","first-page":"111","article-title":"Inductive content analysis: A guide for beginning qualitative researchers","volume":"23","author":"Vears DF","year":"2022","unstructured":"Vears DF, Gillam L: Inductive content analysis: A guide for beginning qualitative researchers. Focus Health Prof Ed 23:111-127, 2022","journal-title":"Focus Health Prof Ed"},{"key":"e_1_3_8_32_2","doi-asserted-by":"publisher","DOI":"10.1177\/16094069221145282"},{"key":"e_1_3_8_33_2","volume-title":"52\/2017\/TT-BYT: Providing for Prescription of Modern Drugs and Biologicals in Outpatient Treatment","author":"Vietnam Ministry of Health","year":"2017","unstructured":"Vietnam Ministry of Health: 52\/2017\/TT-BYT: Providing for Prescription of Modern Drugs and Biologicals in Outpatient Treatment. Ha Noi, Vietnam Ministry of Health, 2017"},{"key":"e_1_3_8_34_2","doi-asserted-by":"publisher","DOI":"10.12688\/f1000research.27725.1"},{"key":"e_1_3_8_35_2","doi-asserted-by":"publisher","DOI":"10.1177\/2050312119841823"},{"key":"e_1_3_8_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2023.104078"},{"key":"e_1_3_8_37_2","doi-asserted-by":"publisher","DOI":"10.3390\/curroncol30060437"},{"key":"e_1_3_8_38_2","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000002173"},{"key":"e_1_3_8_39_2","first-page":"1838707","article-title":"Social norms and political constructions of drug use: A narrative story of Vietnam","volume":"6","author":"Tuan Truong D","year":"2020","unstructured":"Tuan Truong D, Duc Nguyen B, Van Nguyen O, et al: Social norms and political constructions of drug use: A narrative story of Vietnam. Cogent Soc Sci 6:1838707, 2020","journal-title":"Cogent Soc Sci"},{"key":"e_1_3_8_40_2","first-page":"89","article-title":"Why patients are afraid of opioid analgesics: A study on opioid perception in patients with chronic pain","volume":"128","author":"Graczyk M","year":"2018","unstructured":"Graczyk M, Borkowska A, Krajnik M: Why patients are afraid of opioid analgesics: A study on opioid perception in patients with chronic pain. Pol Arch Intern Med 128:89-97, 2018","journal-title":"Pol Arch Intern Med"},{"key":"e_1_3_8_41_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.puhe.2017.08.021"},{"key":"e_1_3_8_42_2","doi-asserted-by":"publisher","DOI":"10.4103\/IJPC.IJPC_355_20"},{"key":"e_1_3_8_43_2","doi-asserted-by":"publisher","DOI":"10.1200\/GO.23.00463"},{"key":"e_1_3_8_44_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)00161-6"},{"key":"e_1_3_8_45_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2023.1186107"},{"key":"e_1_3_8_46_2","volume-title":"Strengthening of Palliative Care as a Component of Integrated Treatment Within the Continuum of Care\u2014WHA67.19, Agenda Item 15.5","author":"World Health Organization","year":"2014","unstructured":"World Health Organization: Strengthening of Palliative Care as a Component of Integrated Treatment Within the Continuum of Care\u2014WHA67.19, Agenda Item 15.5. Geneva, Switzerland, World Health Organization, 2014"},{"key":"e_1_3_8_47_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjspcare-2019-001871"},{"key":"e_1_3_8_48_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12904-023-01181-w"},{"key":"e_1_3_8_49_2","doi-asserted-by":"publisher","DOI":"10.3332\/ecancer.2022.1486"},{"key":"e_1_3_8_50_2","doi-asserted-by":"publisher","DOI":"10.1177\/0269216320966505"},{"key":"e_1_3_8_51_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcpo.2018.12.001"},{"key":"e_1_3_8_52_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2023.04.016"},{"key":"e_1_3_8_53_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2019.10.005"},{"key":"e_1_3_8_54_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.22.02198"},{"key":"e_1_3_8_55_2","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2020.305696"},{"key":"e_1_3_8_56_2","first-page":"100122","article-title":"Pharmacists' perceptions on real-time prescription monitoring (RTPM) systems\u2014A cross-sectional survey","volume":"5","author":"Zhang Z","year":"2022","unstructured":"Zhang Z, Guo L, Si R, et al: Pharmacists' perceptions on real-time prescription monitoring (RTPM) systems\u2014A cross-sectional survey. Explor Res Clin Soc Pharm 5:100122-100130, 2022","journal-title":"Explor Res Clin Soc Pharm"},{"key":"e_1_3_8_57_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2020.06.039"},{"key":"e_1_3_8_58_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12904-021-00717-2"},{"key":"e_1_3_8_59_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12904-020-00558-5"},{"key":"e_1_3_8_60_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2020.03.212"},{"key":"e_1_3_8_61_2","doi-asserted-by":"publisher","DOI":"10.3390\/cancers15153778"},{"key":"e_1_3_8_62_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjspcare-2012-000361"},{"key":"e_1_3_8_63_2","doi-asserted-by":"publisher","DOI":"10.14475\/jhpc.2022.25.2.76"},{"key":"e_1_3_8_64_2","doi-asserted-by":"publisher","DOI":"10.3390\/pharmacy12020061"},{"key":"e_1_3_8_65_2","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2020.0117"},{"key":"e_1_3_8_66_2","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2021.0545"},{"key":"e_1_3_8_67_2","doi-asserted-by":"publisher","DOI":"10.4997\/jrcpe.2021.122"},{"key":"e_1_3_8_68_2","doi-asserted-by":"publisher","DOI":"10.1177\/02692163231182461"},{"key":"e_1_3_8_69_2","volume-title":"30\/2023\/TT-BYT Circular on the Promulgating List of Diseases and Health Conditions Subject to Telemedicine","author":"Vietnam Ministry of Health","year":"2023","unstructured":"Vietnam Ministry of Health: 30\/2023\/TT-BYT Circular on the Promulgating List of Diseases and Health Conditions Subject to Telemedicine. Ha Noi, Vietnam Ministry of Health, 2023"},{"key":"e_1_3_8_70_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0039-1677897"}],"container-title":["JCO Global Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ascopubs.org\/doi\/pdfdirect\/10.1200\/GO-25-00026","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,4]],"date-time":"2025-06-04T15:59:17Z","timestamp":1749052757000},"score":1,"resource":{"primary":{"URL":"https:\/\/ascopubs.org\/doi\/10.1200\/GO-25-00026"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6]]},"references-count":69,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,6]]}},"alternative-id":["10.1200\/GO-25-00026"],"URL":"https:\/\/doi.org\/10.1200\/go-25-00026","relation":{},"ISSN":["2687-8941"],"issn-type":[{"value":"2687-8941","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6]]},"assertion":[{"value":"2025-01-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-09","order":1,"name":"revised","label":"Revised","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e2500026"}}