g. Larue et al. [41] report false beliefs of general practitioners and oncologists in France; negative attitudes of nurses in the use of morphine in pain management are reported from Australia [22] from the USA [23] and from Hong Kong [42]. The existence of false beliefs on pain, addiction and abuse of morphine have also been reported by Gilson et al. [21] in a study among 300 American physicians. Furthermore Nwokeji et al. [43] reported that among 267 general practitioners who agreed to prescribe opioïdes to patients suffering from chronic non-cancerous pains, half feared addiction and abuse. White et al. [44] studying the attitudes of hospital physicians on opiate prescription, confirm that opiophobia is often Inhibitors,research,lifescience,medical related to fears

of dependency. Devi et al. [45]

questioning 253 Malaysian physicians reported that 83% of the respondents consider a possible addiction and the fear of exceeding sedation and respiratory depression as the main obstacles in prescribing morphine. Clinical documented experiences have Inhibitors,research,lifescience,medical proven that these fears are Inhibitors,research,lifescience,medical not justified [3,46-49]. Some physicians may also lack knowledge on morphine pharmacokinetics or may be unfamiliar with morphine prescription [50]. Ripamonti et al., [16] concluded in an Italian study of cancer patients that despite the WHO guidelines and EAPC recommendations, there was an inappropriate use of transdermal opioids by Italian physicians in situations where the use of oral morphine was not contraindicated. Our results showed a rather weak relationship between socio-demographic features and the perceptions of the use of morphine in pain management. Yet morphinofobia was highest among little-educated older men living in rural areas. The cultural and geographic influences on attitudes and beliefs regarding morphine among patients Inhibitors,research,lifescience,medical with non cancerous pains have been stressed by Monsivais et al. [51] and Cicero et al. [52]. However a literature review by Turk [53] is cautious in this regard. Ripamonti et al., [16] mentioned Inhibitors,research,lifescience,medical that patients were having a problem in 3-Methyladenine research buy taking morphine but they had no cultural problems with other

opioids. Most patients knew what morphine meant but do not know the role and the potency of other opioids. Health professionals play PD184352 (CI-1040) an important role as far as morphinofobia is concerned, be it through a possible lack of knowledge regarding morphine [23,54], be it out of “more philosophical” reasons as suggested by Covington [10] and Bandieri et al., [13]. Yun et al. [55] and Edwards et al. [22] therefore suggest the necessity to develop more positive attitudes among HP regarding the use of morphine. There are limits to our study. First a generalisation to the population of Beira Interior of our observations might not be indicated because of the small sample of GP and its opportunistic nature. Second, our study focused on attitudes and perceptions on morphine of GP (potential patient) and HP and did not take in consideration the patients’ vision.