Each year, approximately 500,000 people in Ukraine, 17,000 of whom are children, need access to pain relief

In different regions of the country, the level of provision of painkillers differs.

In most cases, it depends not on the Ministry of Health, but on local level departments and offices and doctors on the ground. According to the reports of regional and district health care managers, in most cases, of course, there are no problems with providing adequate analgesia, but in reality this is not the case, as evidenced by patients' appeals about not providing analgesia.

Providing terminally ill patients with painkillers is a complex problem and has many issues at all stages of its solution.

Since 2012, the standardization of medical care has been started in Ukraine at the state level, the basis of which is the creation of medical technological documents (MTD), which are based on the principles of evidence-based medicine, taking into account the best world experience. Compliance with the requirements Compliance with the requirements of the MTD is mandatory for all practicing doctors, regardless of the institution in which they work, as well as for individual entrepreneurs, as stated in the unified clinical protocol of palliative medical care for chronic pain syndrome ( Order of the Ministry of Health of Ukraine from April 25, 2012 No. 311).

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In accordance with the legislation, when assessing the pain syndrome, treating doctors are obliged to use a pain assessment scale, when prescribing analgesia - to be guided by a three-stage scheme for prescribing analgesia, and local health care management - to take care of ensuring the right of seriously ill patients to palliative analgesia on a preferential basis at the expense of budget funds.

Well-established communication between the patient and the doctor, communication between the doctor and the institution in which he works will speed up the provision of consultations and the preparation of an individual, effective plan to control the patient's chronic pain syndrome, however, as of now, the patient cannot always prove even his right to adequate pain relief and the right to receive painkillers at the expense of the budget.

It is quite obvious that along with problems in the supply of painkillers, timely communication between doctors and the management of medical institutions, the relief of the patient's condition comes to the fore. There may be many bureaucratic issues, but they are still solved by people, and it is the human factor in understanding the entire spectrum of the medical side of palliative care that is able to ensure the rights of people at the last stages of life as soon as possible and give them more happy moments surrounded by loved ones.

Reference information:

• By its nature, pain in palliative patients at the terminal stage is chronic.
• Chronic pain syndrome (CPS) is defined as "pain that lasts beyond the normal healing period" and lasts for more than 3 months. According to the WHO scheme, a pain assessment scale was derived according to which: 1-mild pain, 2-tolerable pain, 3-severe pain, 4-very strong pain and 5-unbearable pain.