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23-05-2012 | General practice | Article

NICE backs first-line opioids


Opioids in Palliative Care (CG140) – clinical guideline and supporting material

MedWire News: NICE has said that opioids should be considered a first-line option for patients receiving palliative care for chronic or incurable diseases.

In a new clinical guideline, NICE states that strong opioids are the only effective analgesic for some patients and notes that good communication between healthcare professionals and patients is the key to safe and consistent prescribing of these drugs.

Professor Mark Baker, Director of the Centre for Clinical Practice at NICE, said: "Many people with chronic or advanced conditions will experience a high level of pain which can only be treated by opioids such as morphine as weaker forms of pain relief will no longer be effective.

"However, we understand that patients can be anxious about using these medicines for a number of reasons. Likewise, healthcare professionals may not always be sure about when to prescribe certain types of opioids," he added.

"The new guideline aims to address all those fears and provide clear advice to the NHS to ensure a consistent approach to treatment and ultimately help to drive up standards of care."

The guideline contains recommendations for GPs and other nonspecialists on how to initiate strong opioids, optimising the dose for maintainance therapy, alternatives to oral opioids (transdermal patches, subcutaneous delivery), managing breakthrough pain, and dealing with common side effects (nausea, drowsiness, constipation).

It also contains detailed advice on communicating with patients and suggests that when offering patients pain treatment with strong opioids, clinicians should discuss concerns such as addiction, tolerance, and side effects.

Dr Damien Longson, Chair of the NICE Guideline Development Group, said: "This guideline puts a strong emphasis on good communication between healthcare professionals and patients, which is key to ensuring any worries or uncertainties are addressed with timely and accurate information."

A care pathway and other tools to help with guideline implementation are also available.

MedWire News is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2012

By Joanna Lyford