Palliative care in Ukraine — formation and development

Abstract

The results of research of the Association of Palliative and Hospice Care and the Ukrainian Palliative and Hospice Care League show that every year at least 600 thousand people with incurable illnesses (cancer, HIV/AIDS, diabetes, tuberculosis) need palliative care. However, nowadays the realization of the right to a dignified death for incurable patients is somewhat difficult because of numerous problems of legislative, organizational, technical, personnel and moral-ethical nature, lack of funds for proper medical care, including a shortage of palliative care institutions in Ukraine. Based on the analysis of the provision of Ukraine by palliative care institutions, it has been established that as of June 1.2017, their bed fund is about 1,500 beds, which is just over one-third of the needs recommended by the World Health Organization. Therapy of pain syndrome is a significant problem for patients in Ukraine, which due to a number of factors such as limited availability of patients to analgesic drugs, complicated system of licensing conditions for healthcare facilities and pharmacies regarding to the storage and use of controlled substances (opioids and psychotropic medicines), and the reluctance of such establishments to obtain a license, lack of appropriate skills and experience in the treatment of chronic pain, the fear of doctors to prescribe high doses of opioids often lead to inadequate analgesia. In Ukraine morphine in tablets and in syrup was registered in 2013 and in 2017, respectively, and in 2016 oxycodone was registered. Palliat Med Pract 2018; 12, 3: 135–142