Assessing availability of oral morphine controls and effects of oral morphine self-medication on quality of life of caregivers and sickle cell patients at Mulago Hospital

Abstract

Background. Oral morphine diversion is a potential threat to the quality of life of sickle cell patients and their caregivers. It is also pertinent to study the existing internal controls regarding oral morphine use and its home-based use. Objectives. To determine the effect of caregiver self-medication with patient’s oral morphine on the quality of life of sickle cell patients and their caregivers. To determine the availability of necessary written controls for prescribing, dispensing, and administering oral morphine by the Pediatrics Directorate of Mulago National Specialized Hospital. Justification. Findings of this study will be disseminated to the general public through presentations at national and international conferences and peer-reviewed publications of findings will be written and published. This knowledge will comprehensively improve palliative care practice, policy and controls on oral morphine use. Furthermore, lower cases of drug use disorders, patients reduced access to oral morphine and in the long run improve the quality of life of sickle cell patients as well as their caregivers. Methods. Data was collected using -administered questionnaires from the patients, caregivers, and health workers working directly with oral morphine. The data from the questionaires was enterered into EpiData and after exported to SPSS and Microsoft Excel for analysis and later summarized in form of tables, charts, piecharts and graphs. viii Results. For the availability of internal controls study, data was collected from 30 healthcare workers including pharmacists(6.7%), intern pharmacists(10%), medical officers(26.7%), nurses(46.7%), and pharmacy technicians(10%) that were handling oral morphine in the sickle cell clinics. Availability of internal controls was found to be 62.5% in prescribing, 66.67% in dispensing, 23.07% in administration. For the quality of life study, the study enrolled 210 caregivers and 210 patient participants. Self medication does not affect health related quality of life since the P value is greater than 0.05. Therefore self medication is not significant in affecting self related quality of life. Conclusions There is no significant relationship between caregiver self-medication and quality of life caregivers. It was found out that there is very minimal self-medication of oral morphine by the care givers of paediatric sickle cell patients. Additionally, a very minimal association existed between oral morphine exposure and controlled drug use. Recommendations: Home based oral morphine for palliative careshould be highly encouraged to enable palliative care and there should be relaxation of some of the controls of oral morphine and oral morphine should be more available for the patients.