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The National Institute for Health and Care Excellence (NICE) has called on healthcare professionals, including community pharmacists, to recognise and provide unique treatment to their patients with chronic pain.

In its latest guideline published today (April 7), the NICE has also recommended a range of effective treatments for the people with chronic primary pain.

“We want this guideline to make a positive difference to people with chronic pain, and their families and carers,” Dr Paul Chrisp, director of the Centre for Guidelines at NICE.

“It highlights that achieving an understanding of how pain is affecting a person’s life and those around them and knowing what is important to the person is the first step in developing an effective care and support plan that recognises and treats a person’s pain as valid and unique to them.”

Although the NICE guideline covers the assessment and development of a care and support plan for all types of chronic pain, it focuses on treatments for chronic primary pain. Pain management as part of palliative care is not covered in the guideline.

The guideline emphasises the need for shared decision making, putting patients at the centre of their care, and fostering a collaborative, supportive relationship between patients and healthcare professionals.

The NICE recommends that a care and support plan should be developed based on the effects of pain on day-to-day activities, as well as a person’s preferences, abilities and goals.

It also highlights the importance of being honest with the person about the uncertainty of the prognosis.

The guideline makes recommendations for treatments that have been shown to be effective in managing chronic primary pain. These include exercise programmes and the psychological therapies, CBT and acceptance and commitment therapy (ACT). Acupuncture is also recommended as an option.

“People with chronic primary pain should not be started on commonly used drugs including paracetamol, non-steroidal anti-inflammatory drugs, benzodiazepines or opioids. This is because there is little or no evidence that they make any difference to people’s quality of life, pain or psychological distress, but they can cause harm, including possible addiction,” the NICE has suggested.

The guideline does recommend that an antidepressant can be considered for people aged 18 years and over to manage chronic primary pain, after a full discussion of the benefits and harms.

“This is because the evidence shows antidepressants may help with quality of life, pain, sleep and psychological distress, even in the absence of a diagnosis of depression,” the guideline added.

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