Magazine article New African

Sickle Cell Disease Patients Should Beware of Heroin Pumps

Magazine article New African

Sickle Cell Disease Patients Should Beware of Heroin Pumps

Article excerpt

A new report published by the UK's National Confidential Enquiry into Patient outcome and Death (NCEPOD) has raised concerns about the use of morphine and its derivatives in the care of sickle cell disease patients. The report's conclusions support a long-standing campaign by some African and other doctors who have for years preached against the use of heroin pumps in sickle cell treatment. Tom Mbakwe reports.

This summer, Britain will launch a new code for the clinical care of Sickle Cell Disease in the country. Called the "Standards for Clinical Care of Adults with Sickle Cell Disease in the UK", it is expected to "improve the lives of thousands of sickle cell patients, their families and carers; and support the drive to reduce health inequalities faced by black and ethnic minorities in the UK". According to Norman Lamb, the Liberal Democrat shadow health secretary and an enthusiastic supporter of the new code, "the UK is leading the way globally by producing the first known standards for the treatment and care of adults with sickle cell disease. The production of these standards has involved the hard work of many dedicated professionals collaborating with patients over several years."

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On 9 July, Norman Lamb will host an event in Parliament with the (UK) Sickle Cell Society to celebrate the launch of the new code. In fact, the new code could not have come at a better time. In May this year, a damning 84-page report published by the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) condemned the care of sickle cell patients in the UK, stressing that "many patients [do] not receive care based on best practice".

The report, the first national survey of deaths caused by sickle cell disease, covered all hospitals and primary care trusts in the UK. It included case notes for patients who had died from sickle cell disease over a two-year period (1 January 2005-31 December 2006). And the verdict was unflattering--81 deaths had occurred during the period, and two-thirds had occurred in hospital. NCEPOD asked expert reviewers to assess the care of 55 patients then in hospital, and the final episode of care of 41 patients for whom full notes were provided. They concluded that "many patients did not receive care based on best practice". For example, "9 of 19 patients with sickle cell disease who had pain on admission and who then died had been given excessive doses of opiods," the report said.

Sickle Cell disease affects mainly people of African/black, Mediterranean and Asian origin. The report, therefore, alarmed Prof Felix Konotey-Ahulu, a UK-domiciled consultant physician of Ghanaian origin who once ran the largest sickle cell disease clinic in the world based in Ghana.

Contacting Prof Konotey-Ahulu about his comments online in the British Medical Journal (BMJ), he told New African that he had written to Prime Minister Gordon Brown drawing his attention to the NCEPOD report, and pointing out that the serious findings of NCEPOD had been what he and others had been saying for "years, nay decades".

A highly rated African doctor in the UK, with regular overseas commitments, Prof Konotey-Ahulu asked the prime minister to take a look at what he and Prof Graham Serjeant, a white doctor who was the former director of the second largest sickle cell disease clinic in the world based in Jamaica, had said over the years about the established practice in Britain where morphine or "heroin pumps" are routinely administered to sickle cell disease patients despite their "lethal consequences" as NCEPOD had just revealed. Neither Prof Konotey-Ahulu nor Prof Serjeant use the term "sickle cell disorder" because they say "it is confusing".

Dr Konotey-Ahulu wondered why leading lights in the British media did not give the NCEPOD report the high profile coverage it deserved. Apart from the British Medical Journal (BMJ) which did a piece on 24 May (and encouraged an online debate on its website), this "extremely serious" report has been roundly ignored by the British media. …

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