GPs should consider opioid medication for
patients with chronic non-cancer pain, according to a patient study
published in this month’s British Journal of General Practice.
A strong GP-patient relationship and the
importance of coping strategies in the long term management of pain
are also highlighted in the research, which was initiated by a
patient at the Honiton Research Practice in East Devon.
Based on the views of a patient focus group
and interviews with individuals at the Honiton practice, the study
examined the attitudes and experiences of those receiving long-term
medication for chronic non-cancer pain in primary care.
All had been using opioid medication for
between 8-108 months (a median of 15-28 months). They were asked
about the type of pain they suffered; the duration and impact of
the pain on their lives and relationships; and their experiences of
using strong opioid analgesia.
Despite evidence-based guidelines for the
appropriate use of strong opioids*, doubts have been expressed
about their use for chronic non-cancer pain with concern focusing
on problems such as intolerance and addiction.
In addition, little work has been done about
the experiences of patients receiving these drugs in a primary care
setting.
Attitudes to opioid medication were both
positive and negative. Concerns about intolerance and fears of
addiction were tempered with an appreciation of the medication
dramatically decreasing their pain and allowing them to lead a
nearer-to-normal existence.
All patients described coping strategies they
had developed themselves or had learned from outside influences,
such as pain clinic courses and support from their GP. They
realised that total pain relief was not possible, but that a
workable balance could be struck between levels of pain relief and
possible side effects such as sedation and nausea.
The study concluded patients in the study
appreciated the benefits of strong opioid medication, having
adopted coping strategies and overcome fears of addiction.
Study author Dr David Seamark says: “The
prevalence of chronic pain is likely to increase with an ageing
population and the use of strong opioid medication in primary care
may increase.
“There is a need for further studies examining
the potential barriers to initiating prescribing of strong opioids
by GPs and the degree of confidence and comfort they have in
monitoring patients receiving long-term opioids for chronic
pain.”
Ends
For more information please contact
Lorna Fletcher, RCGP Press Office, 020 7344 3136 / lfletcher@rcgp.org.uk
NOTES TO EDITORS
- Experiences of patients requiring strong opioid drugs for
chronic non-cancer pain: a patient-initiated study is authored
by Sue Blake, Brian Ruel, Dr Clare Seamark and Dr David
Seamark of The Honiton Group Practice, Honiton
- *Kalso E, Allan L, Dellemijn PLI et al. Recommendations for
using opioids in chronic non-cancer pain (Eur J Pain 2003)
British Pain Society. Recommendations for the
appropriate use of opioids for persistent non-cancer pain
(2006)