Recommendations
Recommendation 6.2 Limited
➤ Physicians and nurses may address the psychosocial needs of patients
and families and should receive the training to do so. If possible,
a social worker/counselor/volunteer/spiritual care provider should
be available to attend to patients and families with a high burden of
psychosocial issues. (Weak Recommendation; FC-Ins)
Recommendation 6.3 Enhanced
➤ Counselors with special training in palliative care should be core
members of the palliative care interdisciplinary team to provide
psychosocial services to patients and families. (Weak Recommendation;
FC-Ins)
Opioid Availability
Recommendation 7.0 General (Across All Settings)
➤ Health care systems should safely provide opioids and ensure that the
supply is readily and continually available for dispensing by trained
professionals and accessible to patients to meet their needs, following
the principals of balance through regulations, policy, and existing
recommendations. Health care systems should strive to offer all pain
control interventions on the WHO Essential Medicines List (EML).
(Moderate Recommendation; FC-I)
Recommendation 7.1 Basic
➤ Local health care institutions should have access to immediate release
(IR) oral and injectable morphine to address the pain needs of patients
with cancer as assessed, prescribed, and dispensed by appropriately
trained health care providers. (Moderate Recommendation; FC-I)
Recommendation 7.2 Limited
➤ In addition to IR oral and injectable morphine available at the basic level,
sustained-release (SR) morphine should be available in limited-resource
level settings. Health care systems at the limited-resource level should
be able to prescribe and dispense these three forms of morphine (IV, IR
and SR). (Moderate Recommendation; FC-I)
Recommendation 7.3 Enhanced
➤ In addition to the opioids available at the limited-resource level, fentanyl
and methadone (WHO EML) should be available for pain management.
(Moderate Recommendation; FC-I)
