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New chronic pain guideline for Scotland

Peo­ple on painkillers for chron­ic pain should have at least an annu­al review of their med­ica­tion to ensure they are being giv­en the best drugs to treat their con­di­tion, accord­ing to new advice to be issued to GPs and oth­er health­care professionals.

The rec­om­men­da­tions – issued by the Scot­tish Inter­col­le­giate Guide­lines Net­work (SIGN), which is part of Health­care Improve­ment Scot­land – also calls for patients to be encour­aged to take reg­u­lar exer­cise and to attend pain man­age­ment pro­grammes to help man­age their conditions.

Pain Con­cern played an impor­tant role in rep­re­sent­ing the views of peo­ple in pain at the con­sul­ta­tion stage and our chair Heather Wal­lace reviewed the book­let for patients and car­ers. Heather said: ‘I hope peo­ple liv­ing with pain will use this book­let to become more aware of the treat­ment they are enti­tled to receive and to empow­er them in their appoint­ments with health­care professionals.’

The guideline’s key rec­om­men­da­tions include:

• Ensur­ing all patients with chron­ic pain under­go a com­pre­hen­sive assess­ment to help inform the best treat­ment options
• Direct­ing patients to the best self-help advice and infor­ma­tion resources that they can access either from home or at com­mu­ni­ty health cen­tres
• Con­duct­ing at least an annu­al review of patient med­ica­tion to deter­mine the suc­cess of a par­tic­u­lar drug – more fre­quent­ly if drug treat­ments change or pain con­tin­ues
• Reg­u­lar­ly review­ing the use of strong opi­oid med­ica­tions – such as mor­phine – to treat patients with chron­ic low back pain or osteoarthri­tis; and secur­ing spe­cial­ist advice if there are con­cerns about patients hav­ing no pain relief despite increased med­ica­tion dos­es.
• Refer­ring patients with chron­ic pain to under­take a pain man­age­ment pro­gramme
• Encour­ag­ing patients to be active and to try out all forms of exer­cise and exer­cise therapies

Dr Les­ley Colvin, who chaired the Guide­line Devel­op­ment Group, said the rec­om­men­da­tions should play a major part in help­ing patients whose lives are blight­ed by ongo­ing pain.

She said: “The rec­om­men­da­tions recog­nise that the best per­son to both under­stand chron­ic pain and to work to find ways to man­age it, is the patient.

“Every­one is dif­fer­ent – while one par­tic­u­lar treat­ment may work very effec­tive­ly in one indi­vid­ual, it may not work at all in anoth­er. As well as the phys­i­cal sen­sa­tions of pain, patients also often expe­ri­ence changes in their mood and what they are able to do, impact­ing on their work, fam­i­ly and friends.

“That is why it is impor­tant GPs and health­care pro­fes­sion­als use these guide­lines to find the best treat­ments spe­cif­ic to patient and to address their over­all con­di­tion, rather than just treat­ing the pain itself.”

Each of Scotland’s NHS Boards will now be encour­aged to ful­ly share and imple­ment the rec­om­men­da­tions from the Guide­line work­ing through ded­i­cat­ed Ser­vice Improve­ment Groups in their local communities.

To read the patient book­let and for the full guide­line, go to