Eugenia Larjow, sociologist at the University Hospital of Bonn, Germany on behalf of the ATOME Consortium.
The ATOME project comes to a close after five years of research and advocacy. The results strengthen our knowledge of barriers and challenges to access to opioid medication and more importantly how to overcome them. The project outputs include: the revised World Health Organization (WHO) policy guidelines on ensuring balance to controlled medicines and detailed reports on barriers towards access to opioid medicines in 12 European countries.
“The ATOME project certainly has raised the government’s level of awareness about the need to make opioids available and accessible. The WHO guidelines translated to Serbian are a valuable educational tool and the ATOME analysis of the presence of legislative barriers provides an excellent platform to start changing regulations and practice.” (Serbia).
“The most important contribution of the ATOME project was the adoption of the essential drug list and inclusion of most of the drugs from that list to our essential drug list. So, now we have again the prolonged release morphine in different oral formulations and many other drugs, and that makes our work easier.” (Slovenia).
These are two examples of how national key contacts and representatives of the national ATOME country teams assess the impact of the ATOME project. 1
The Access to Opioid Medication in Europe (ATOME) project was a five-year project funded under the 7th Framework Programme of the European Community (FP7/2007-2013) under grant agreement n° 222994. The overall goal of the ATOME project was to undertake applied research into the reasons why opioid medicines for moderate to severe pain, and for the treatment of opioid dependence, are not used adequately in 12 European countries where there was statistical evidence of low per capita morphine consumption (see figure below).
For each of the 12 countries, an individual situational analysis has been done, providing examples for potential barriers affecting the accessibility, availability and affordability of opioid medicines. Tailor-made recommendations were developed for each country to address barriers on different levels. Changes in national legislation and policies that have been applied during the project are mentioned as far as they were reported by the country teams. Moreover, the final report raises awareness of different perception of barriers in different stakeholder groups.
The ATOME final report describes the requirements of a balanced approach on access to opioid medication referring to the revised WHO policy guidelines ‘Ensuring balance in national policies on controlled substances: Guidance for availability and accessibility for controlled medicines’ 2 and provides data that illuminate the reasons and consequences of unbalanced national legislations and policies. Besides the self-assessment checklist as part of the WHO policy guidelines, the methodology of the review of national legislations used in the project, as well as of research activities related to the examination of national policies and circumstances, provides tools for a critical analysis of a country’s situation. The ATOME final report illustrates the results of the application of those tools.
Access to Opioid Medication in Europe – Final report and recommendations to the Ministries of Health was edited by Lukas Radbruch, Saskia Jünger, Sheila Payne and Willem Scholten on behalf of the ATOME consortium and is freely accessible via the ATOME project website.
- L Radbruch, S Jünger, S Payne, W Scholten (eds.). Access to Opioid Medication in Europe – Final report and recommendations to the Ministries of Health. Report, Pallia Med Verlag, Bonn, 2014.
- World Health Organization. WHO policy guidelines Ensuring balance in national policies on controlled substances: Guidance for availability and accessibility for controlled medicines. Geneva, 2011. (Available to download from ATOME project website).