Better approach needed in chronic non-cancer pain: NPS


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A multimodal approach to managing chronic non-cancer pain is needed, says NPS MedicineWise, as the number of scripts for opioids continues to rise.

Around one in five Australians experience chronic pain—a complex medical issue with varied causes, pathology and presentation. Many people with chronic pain also report their pain interferes with daily activities.

“Managing chronic pain is challenging for both health professionals and their patients,” says Dr Jeannie Yoo, NPS MedicineWise Clinical Adviser.

“Current evidence supports using a combination of different treatment modes to allow a more individualised approach. The program recommends broadening the treatment focus from reducing pain alone to include achieving adequate functional improvement.

“Open communication with patients is key. Collaborative approaches for managing pain can lead to improved outcomes and adherence through the use of tools like management plans.”

For many people, non-pharmacological therapies reduce pain to a level that is easier to control, says NPS MedicineWise.

Non-pharmacological modalities include advice on active self-management strategies with input as appropriate from a physiotherapist, occupational therapist, psychologist, and/or social worker.

The number of prescriptions for opioids is rising in Australia despite insufficient evidence to support their long-term efficacy.

During the last decade there has been a 15-fold increase in opioids dispensed. Over the course of a year, 20% of Australians over 45 years of age will be prescribed at least one opioid for either acute or chronic pain.

“The insufficient evidence for long-term use, and the issues of central sensitisation and tolerance which reduce the effectiveness of opioids over time, need to be taken into account when recommending these medicines,” says Dr Yoo.

The NPS MedicineWise learning program products are now available to assist doctors and other healthcare providers consolidate knowledge on chronic pain management, current guidelines and practices, and earn continuing professional development (CPD) points. Resources and tools for the program include:

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