The 2021 NICE guidelines for assessment and management of chronic pain: A cross-sectional study mapping against a sample of 1,000* in the community

Zoe Zambelli; Elizabeth J Halstead; Ray Iles; Antonio R Fidalgo; Dagmara Dimitriou

doi:10.1177/20494637221083837

The 2021 NICE guidelines for assessment and management of chronic pain: A cross-sectional study mapping against a sample of 1,000* in the community

Br J Pain. 2022 Aug;16(4):439-449. doi: 10.1177/20494637221083837. Epub 2022 Apr 5.

Authors

Zoe Zambelli¹, Elizabeth J Halstead¹, Ray Iles², Antonio R Fidalgo³, Dagmara Dimitriou^{1

2}

Affiliations

¹ Sleep Education and Research Laboratory, Psychology and Human Development, University College London-Institute of Education, London, UK.
² The National Institute for Stress, Anxiety, Depression and Behavioural Change (NISAD), Helsingborg, Sweden.
³ Department of Psychology, University of East London, London, UK.

Abstract

Objectives: To characterise the prevailing pharmacological and non-pharmacological pain management strategies among adults with chronic pain, comparing these against the newly published NICE guidelines NG-193, and examine these pre-NG-193 pain management strategies in relation to pain severity, pain interference, sleep quality and mental health outcomes.

Design: This study was conducted using a cross-sectional online survey study design.

Setting: This study was conducted on a community-dwelling cohort.

Participants: Adults aged 18+, living in the UK, with diagnosis of chronic pain by a health care professional.

Main outcome measures: Primary outcomes were characterisation of the pain management strategies utilised. Secondary outcomes were related to pain severity, pain interference, sleep quality, depression and anxiety via validated self-report measures.

Results: Several strategies were employed by respondents to manage their chronic pain condition including physical therapy, exercise, psychological therapy and pharmacological therapy. The data also indicated a high level of joint-care planning among patients and their clinicians. Some group differences were found in relation to pain, sleep and mental health outcomes.

Conclusion: This study set a comparative starting baseline to which the efficacy of the NG-193 may be compared in future years. There is evidence that NICE recommendations are being followed for the management of chronic primary pain conditions; however, pharmacological use of opioid drugs is still reported by 47%. Despite the confirmed evidence in this study of small efficacy of chronic pain by pharmacological agent, the reduction in the use of pain relief medications be it over the counter medications or prescription opioids, as recommended by NG-193, may be slow to be adopted. The data suggest that more care provision is needed to meet the recommendations around pharmacological management and review.

Keywords: Pain management; healthcare guidelines; mental health; primary care.