The NICE outlines that exercise should be recommended to patients with chronic primary pain

Consumer

The National Institute for Health and Care Excellence's proposed guidance notes that psychological therapies, exercise and acupuncture should be recommended to patients with chronic primary pain as an alternative to common analgesics.

The guidance clarified that there was very little evidence to indicate that widely prescribed medications differentiated the quality of life of the patient; however, there was evidence to suggest that they could lead to complications, such as addiction.

“The NICE outlines that exercise should be recommended to patients with chronic primary pain.“

Also, the guidance suggests avoiding the use of antiepileptic drugs due to the insignificant evidence to support the suggestion they provide relief. Despite this, various antidepressants, including selective serotonin reuptake inhibitors, can be administered off-label after the prescriber and patient have undertaken a thorough review of the risks and benefits.

The Head of Professional Standard, Royal Pharmaceutical Society, Wing Tang, stated: “The recommendations presented in this draft guidance should be looked at carefully and we will consider the underlying evidence. Pharmacists are often the first port of call in helping those with chronic and acute pain and will always want to provide the best possible advice, based upon the latest evidence to support people to manage pain.”

Chair of the Royal College of General Practitioners, Martin Marshall, stated: “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. 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.”

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