'Patchy' access to chronic pain management therapies must be addressed if new NICE guidelines are to make a difference

Publication date: 03 August 2020

Responding to the National Institute for Health and Care Excellence’s (NICE) draft clinical guideline published today on the assessment and management of chronic pain in over 16s Professor Martin Marshall, Chair of the Royal College of GPs, said: "Diagnosing and managing the care of patients in chronic pain can be challenging in general practice, not least because in many cases pain starts as an acute problem, which becomes chronic at a later stage. Once diagnosis has been made, there is also currently a lack of access to some of the evidence-based interventions, that could be of benefit for patients, recommended in these guidelines.

"GPs and our teams are aware that prescribing pain medication to patients comes with risks, including addiction, and this is something we will discuss with them when developing a treatment plan – and as part of subsequent medication reviews. Most patients in pain do not want to take medication long-term, and GPs do not want this either, but sometimes medication has been the only thing that brings relief. As such these new guidelines, which focus on alternative therapies, have the potential to be beneficial for patients - but they will need to be guaranteed appropriate access to them. We should also be mindful not to disregard some medications completely as a lack of evidence may be due to a lack of high-quality research, particularly for older drugs, such as paracetamol.

"GPs are open to alternatives, as long as there is evidence of their benefit and effectiveness, and already do explore treatments for chronic pain, such as referrals to psychological therapies or pain management clinics, but currently access is patchy at community level across the country. Therefore, any NICE guidance that suggests an alternative to medication must go hand-in-hand with adequate access to them at community level in order to really make a difference to the lives of our patients living in chronic pain.

"Patients who have been prescribed medication for their chronic pain should not be alarmed as a result of these draft guidelines, which now need to be consulted on and may change. If patients are concerned they should make a non-urgent appointment to discuss this with their doctor or do so at their next medication review. They should not stop taking medication that has been prescribed without seeking medical advice."

Further Information

RCGP Press office: 020 3188 7494/7633/7574/7575
Out of hours: 020 3188 7659
press@rcgp.org.uk

Notes to editor

The Royal College of General Practitioners is a network of more than 52,000 family doctors working to improve care for patients. We work to encourage and maintain the highest standards of general medical practice and act as the voice of GPs on education, training, research and clinical standards.

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