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[(egory)-385.3(were)-381.5(selected.)-383.3(When)-385.1(the)-383.1(number)-380.4(of)-382.6(individuals)]TJ
T*
[(in)-405.3(a)-397.9(socioeconomic)-410.2(category)-403.5(was)-400.8(insufcient,)-408.2(an)-401.2(indi-)]TJ
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[(vidual)-321.5(from)-317.6(the)-319.9(next)-315.7(socioeconomic)-321.7(level)-317.4(was)-318.6(selected.)]TJ
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[(The)-297.1(selected)-310.8(individuals)-304.7(were)-299.3(contacted)-311.6(by)-299.7(e-mail)-301.7(and)-303.1(in-)]TJ
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T*
[(list)-280.7(was)-280.7(invited)-280.1(to)-281.5(participate.)]TJ
1.1128 -1.2266 TD
[(An)-485.3(ethics)-494.7(review)-493.3(board)-490.9(from)-488.4(the)-490.6(Tornu)]TJ
18.1088 .0126 TD
()Tj
.9231 -.0126 TD
[(Acute)-495.6(General)]TJ
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[(Hospital)-505.7(in)-500.1(Buenos)-504.9(Aires,)-502.9(Argentina)-503.6(approved)-502.5(the)-503.3(study.)]TJ
T*
[(Participants)-330.6(were)-324.6(informed)-327.5(about)-324.7(the)-332.6(study)-326.7(through)-326.3(a)-322(letter)]TJ
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[(and)-214.6(an)-217.9(introduction)-227(to)-218.2(the)-218.7(survey.)-220(A)-216.4(signed)-217.9(informed)-220(consent)]TJ
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[(was)-539.9(submitted)-543.2(by)-540(the)-541.2(participants)-545.6(before)-539.3(completing)-547.3(the)]TJ
T*
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/F9 1 Tf
0 -2.7568 TD
(Procedure)Tj
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1.1128 -1.8336 TD
[(A)-178.4(description)-190(of)-186.6(the)-180.8(study)-187.6(and)-182.9(instructions)-185.9(for)-187.3(accessing)-189(the)]TJ
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[(survey)-343.5(was)-343.9(sent)-352.8(to)-344.7(60)-340.5(participants)-349.5(who)-349.2(accepted)-344.1(the)-351.5(invita-)]TJ
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[(initial)-219.8(contact)-220.2(for)-218.9(each)-217.1(round.)-222.8(The)-214.9(rst)-220.5(Delphi)-221.8(round)-219.9(included)]TJ
T*
[(information)-252.1(on:)-249.3(participant)-247.1(demographics;)-253.6(opioids,)-248.8(laxatives,)]TJ
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[(and)-284.1(antiemetics;)-296.3(availability)-291.8(and)-284.1(access)-291.5(to)-287.8(medications;)-295.4(laxa-)]TJ
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T*
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T*
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T*
[(pain)-210.1(due)-219.2(to)-211.9(cancer)-217(and)-214.6(other)-215.9(life-threatening)-216.7(conditions.)-222.4(They)]TJ
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[(STRATEGIC)-338.3(PAIN)-335.9(MANAGEMENT)]TJ
53.0113 0 TD
(187)Tj
ET
endstream
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[(not)-360.7(included)-358.4(in)-354.7(the)-357.8(survey.)-359.1(In)-353.3(the)-357.8(availability)-361.4(and)-353.7(access)-361(to)]TJ
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[(medications)-298.8(section,)-298.1(participants)-299(were)-293(asked)-299(if)-294.9(their)-292.5(patients)]TJ
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T*
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[(Data)-336.2(analysis)]TJ
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1.1128 -1.8336 TD
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[(statistics.)-273.4(Open)-266.9(responses)-271.2(were)-274(coded,)-263.8(categorized,)-275.2(and)-265.1(used)]TJ
T*
[(to)-294.1(inform)-299.3(the)-294.6(nal)-294(OEPP.)-296.2(The)-290.8(components)-296.7(of)-300.4(the)-294.6(nal)-294(OEPP)]TJ
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1.1128 -1.8273 TD
[(Sixty)-470.6(\(60\))-474.2(pain)-469.4(and)-473.8(palliative)-477.2(care)-467.3(physicians)-476.3(agreed)-475.3(to)]TJ
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T*
[(respectively.)-214(More)-210.8(than)-209.1(a)-208.2(half)-209.2(of)-205.6(participants)-216.8(\(57%\))-210.2(were)-210.8(from)]TJ
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[(countries)-461.6(in)-462.2(the)-459(Americas)-458.5(and)-461.1(Europe.)-460.9(Sixty-three)-462.8(percent)]TJ
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[(Preferred)-337.2(opioid)]TJ
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1.1128 -1.8336 TD
[(In)-258.4(the)-263(rst)-258.4(round,)-260.7(morphine)-265.5(was)-261.7(selected)-260.2(by)-261.8(89.4%)-256(\()]TJ
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22.7941 0 TD
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(51\))Tj
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T*
[(choice)-324.3(to)-313.1(be)-320.5(included)-320.5(in)-316.7(the)-319.9(OEPP.)-321.5(In)-321.6(the)-319.9(rst)-315.3(Delphi)-322.9(round)]TJ
T*
[(hydromorphone)-361.2(was)-350.2(not)-354.4(included,)-355(but)-354(35.1%)-350.8(\()]TJ
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20.9731 0 TD
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[(20\))-347.3(of)-357.3(the)]TJ
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[(participants)-482.3(suggested)-477.7(it.)-481.1(It)-476.8(was)-476.7(therefore)-476.1(included)-478.6(in)-481.1(the)]TJ
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[(second)-281.5(round)-283.1(as)-279(an)-281.1(alternative)-289.9(opioid)-282.5(of)-281.5(choice.)]TJ
1.1128 -1.2203 TD
[(In)-511.3(the)-515.9(second)-515.5(round,)-513.6(87.7%)-515.2(\()]TJ
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13.727 0 TD
(n)Tj
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[(43\))-518(agreed)-513.3(or)-509.3(strongly)]TJ
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[(agreed)-323.6(with)-318.8(the)-319.9(use)-325(of)-319.4(oral)-322.7(morphine)-322.4(5)-163.9(m)0(g)-324.4(every)-321.8(4)-315.7(hours)-325.7(as)]TJ
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[(the)-496.9(rst)-498.7(line)-497.2(of)-496.4(treatment.)-498.5(No)-495.9(consensus)-500.9(was)-495.6(reached)-492.5(re-)]TJ
T*
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[(availability)-468.9(of)-471.1(morphine.)-470.8(Only)-469.6(oxycodone)-469.4(and)-473.8(methadone)]TJ
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27.9978 49.5021 TD
[(Preferred)-337.2(laxative)]TJ
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1.1128 -1.8336 TD
[(After)-262.2(both)-257.6(rounds,)-255.7(there)-257.3(was)-255.4(no)-259.1(clear)-255.8(consensus)-260.6(regarding)]TJ
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[(29\),)-584.1(followed)-586.7(by)-590.5(bisacodyl)-584.5(\(24.5%;)]TJ
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16.8 0 TD
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[(treatment)-286.9(is)-283.1(started)-283.6(\(93%;)]TJ
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[(Availability)-336.8(and)-338.2(access)-330(to)-336.6(medications)]TJ
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T*
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T*
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[(0.0)10.8(5)-7.2(\).)-346.2(No)-352.4(signicant)]TJ
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T*
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T*
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T*
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T*
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(Conclusion)Tj
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T*
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T*
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ET
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f
59.754 604.516 239.074 .28351 re
f
131.244 690.803 65.14 .28345 re
f
202.961 690.803 61.228 .28345 re
f
59.754 673.115 239.074 .28351 re
f
BT
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[(Morphine)-4566.3(27)-2629.4(87.1)-2511.7(17)-2401.7(84.4)]TJ
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[(Methadone)-4430.8(9)-2629.8(29.0)-3011.2(3)-2402.2(16.7)]TJ
T*
[(Senna/docusate)-1798.3(19)-2629.4(61.3)-2511.7(10)-2401.7(55.6)]TJ
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[(income;)-331.8(LI,)-328.1(low)-329.6(income.)]TJ
ET
59.754 166.961 239.131 .28348 re
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59.754 57.317 239.131 .28348 re
f
BT
/F8 1 Tf
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(Table)Tj
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[(IAHPC)-332.4(Opioid)-334.2(Essential)-336.2(Prescription)]TJ
3.1804 -1.1128 TD
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(\(OEPP\))Tj
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(Opioid:)Tj
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[(Morphine,)-339.2(oral,)-331.9(5)-170.2(m)0(g)-330.8(every)-334.4(4)-334.6(hours)]TJ
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(Laxative:)Tj
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1.0053 -1.1065 TD
[(every)-334.4(12)-334.1(hours.)]TJ
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(OR:)Tj
T*
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(Antiemetic:)Tj
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[(STRATEGIC)-338.3(PAIN)-335.9(MANAGEMENT)]TJ
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ET
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[(Zipporah)-598.6(Ali;)]TJ
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[(:)-236.9(Rosa)-235.5(Buitrago;)]TJ
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[(Mary)-237.4(Jocylyn)]TJ
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[(Aleksandra)-611(Kotlinska-Lemieszek;)]TJ
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[(Elena)-717.5(Sokolova,)-713.4(Elena)-717.5(Vvedenskaya;)]TJ
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[(Saudi)-717.7(Arabia)]TJ
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[(:)-717.4(Mo-)]TJ
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[(hammad)-291.4(Al-shahri;)]TJ
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[(:)-287.4(Snezana)-288.2(Bosnjak;)]TJ
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-23.7109 -1.2203 TD
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[(South)-317.9(Africa)]TJ
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[(:)-319.1(Janet)-326.2(Stanford;)]TJ
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[(South)-317.9(Korea)]TJ
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[(:)-312.7(Doris)-325.9(Man-)]TJ
-21.0553 -1.2266 TD
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[(Florian)-416.2(Strasser;)]TJ
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