We are delighted to be joined by an expert panel (Pain Clinic Consultant Dr Jason Brooks, GPwSI Jim McMullan, SPPG, Federation and GP Pharmacist leads) to look at – Key evidence and Practical Tips in Managing Chronic Pain – Chronic Pain and Opioid reduction – Opioid reduction in GP Practice We hope to present some practical strategies, resources and approaches for supporting patients and practices in managing chronic pain and reviewing opioid use with chronic (non-malignant) pain. This will be suitable for the whole practice team and MDT with the opportunity to ask questions 

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GPNI Clinical Update : Chronic Pain

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QI approach to opioid reduction

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GPNI Opioid webinar SPPG Introduction AMG

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EA Fed Tapentadol - Jan 2024

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GPNI Clinical Update : Chronic Pain - GPP Resources

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Risky Opioid combinations Auto Report

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FPM-About-Pain PIL

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East Antrim Federation Tapentadol Review Tool

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EA Fed Tapentadol - Jan 2024

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Clinical Guidance/Resources for Prescribers and other Healthcare Professionals

 

Name

 Organisation

PDF version

link

Top Tips for Opioid Deprescribing (from GPP) and social media messages – Newsletter Article Oct 23

 

SPPG

Attached Below

https://niformulary.hscni.net/prescribing-newsletters/medicines-management-newsletters/volume-14-2023/

Avoid Opioids for Chronic Non-Malignant Pain – Newsletter article Jan 23

 SPPG

Attached Below

https://niformulary.hscni.net/prescribing-newsletters/medicines-management-newsletters/volume-14-2023/

Chronic non-malignant pain – pharmacological options

NI Formulary

N/A

https://niformulary.hscni.net/formulary/4-0-central-nervous-system/4-7-analgesics/4-7-b-chronic-non-malignant-pain/

Opioid Prescribing for Chronic Pain Resources

SPPG

N/A

https://primarycare.hscni.net/pharmacy-and-medicines-management/resources/pain/

Chronic pain (primary and secondary) in over 16s: assessment of all chronic pain and management of chronic primary pain (Guidance)

NICE

N/A

https://www.nice.org.uk/guidance/NG193

Northern Ireland guidelines on converting doses of opioid analgesics for adults use 2023

NI Palliative Care Pharmacy Group

Attached Below

N/A

Opioids Aware Checklist for Prescribers

Faculty of Pain Medicines

Attached Below

https://beta.fpm.ac.uk/sites/fpm/files/documents/2019-08/OA%20checklist%20for%20prescribers.pdf

PrescQIPP Pain Management Webkit 

Resources to support management of chronic pain and reduction of opioid prescribing

Prescqipp

Attached Below

Summarised in pages 4-6 of this Tapentadol bulletin

Pain | PrescQIPP C.I.C

–        Bulletins

–        Webinars

–        Audit Tools

–        Examples of Innovation and Good Practice

–       Elearning

MHRA alerts: Opioids and Gabapentinoids – risk of respiratory depression

 

 

https://www.gov.uk/drug-safety-update/gabapentin-neurontin-risk-of-severe-respiratory-depression

Pregabalin (Lyrica): reports of severe respiratory depression – GOV.UK (www.gov.uk)

 

Deprescribing Resources

 

Name

 Organisation

PDF version

link

Clinical practice guideline for deprescribing opioid analgesics: summary of recommendations

Medical Journal of Australia

Attached Below

http://www.mja.com.au/journal/2023/219/2/clinical-practice-guideline-deprescribing-opioid-analgesics-summary

How to reduce medications for people with multiple long-term conditions

National Institute for Health and Care Research NIHR

Attached Below

https://evidence.nihr.ac.uk/alert/how-to-safely-deprescribe-medications-for-people-with-multiple-long-term-conditions/

Attached Below  

Patient Resources

 

Name

 Organisation

PDF version

link

Patient –specific Pain Resources

NI Formulary

 

https://niformulary.hscni.net/patient-area/pain-topics/

Explain Persistent Pain

NI Formulary

Attached Below

https://niformulary.hscni.net/patient-area/pain-topics/understanding-pain/

Faye’s story: good practice when prescribing opioids for chronic pain

NHS England

Attached Below

http://www.england.nhs.uk/patient-safety/fayes-story-good-practice-when-prescribing-opioids-for-chronic-pain/

Opioids Aware – wide range of resources aimed at patients and healthcare professionals

Faculty of Pain Medicines

N/A

https://fpm.ac.uk/opioids-aware-sitemap

Wide range of resources for people living with chronic pain and HCPs

 N/A

Attached Below

https://livewellwithpain.co.uk

www.flippinpain.co.uk

Pain Support Programmes/Information Sessions

 N/A

Attached Below

http://www.hlcalliance.org/content/pain-support

 

www.versusarthritis.org

OPIOID MEDICINES AND THE RISK OF ADDICTION

MHRA

Attached Below

https://assets.publishing.service.gov.uk/media/5f6a078ed3bf7f7238f23100/Opioid-patient-safety-information-leaflet-v2-Aug2021.pdf

 

 

Learning from Other Areas

 

Name

 Organisation

PDF version

link

All Wales Analgesic Stewardship Guidance

All Wales Medicines Strategy Group

Attached Below

https://awttc.nhs.wales/files/guidelines-and-pils/all-wales-analgesic-stewardship-guidancepdf/

Opioid Prescribing for Chronic Pain: A Quality Improvement Resource

NHS Scotland

Attached Below

https://www.therapeutics.scot.nhs.uk/wp-content/uploads/2021/12/Draft-Opioid-Guide.pdf

Pharmaceutical Journal Articles:

~ How I reduced opioid prescribing in my GP practice by more than 450,000mme in less than a year

~ ‘Painkillers don’t exist’: how our campaign helped to reduce opioid prescribing

 N/A

Attached Below

 N/a

Chronic pain management; time to think differently

 

N/A

Attached Below

N/a

Ouch pain sparing discharge summaries

N/A

Attached Below

N/A

Training Resources for Healthcare Professionals

 

Name

 Organisation

PDF version

link

Chronic pain and dependence –forming medication

Chronic pain – communication skills and self-management

Red Whale

Attached Below

http://www.gp-update.co.uk

Medication safety across the system: opioid safety

Specialist Pharmacy Service

Attached Below

http://www.sps.nhs.uk/articles/medication-safety-across-the-system-opioid-safety/

Clinical Masterclass – Chronic pain management (Dr Roger Knaggs)

PrescQIPP

 

https://www.prescqipp.info/our-resources/clinical-webinars/clinical-masterclass-oct-2021/

 

Slides from Opioid Improvement Collaborative Engagement Workshop (4th August 2023)

Slides from Opioid Improvement Collaborative Engagement Workshop (4th August 2023)

 

 HSCQI and Transforming Medication Safety in Northern Ireland (TMSNI) Programme Teams

Attached Below

Of particular note:

–       Slide 43 (summary of opioid place in therapy for chronic pain)

–       Slides 57-70 (Local Better days Pain Support Programmes )

–       Slides 75-104 (how 2 local practices reduced their opioids and gabapentinoids – latter by QI method)

 

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Chronic Pain Management

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Versus Arthritis Resources

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Versus Arthritis - GPNI Resources Summary January 2024

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SPS Webinar - System Safety Update Resources

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SPS Webinar - Reducing Harm From Opioids

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SPS Webinar - Medication Safety Across The System

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Ouch pain sparing discharge summaries

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Opioid patient safety information leaflet - August 2021

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Opioid Side Effects

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Opioid Equivalence Guidance 2023

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OA checklist for prescribers

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Newsletter January 2023 final

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NHS Newsletter - Fayes story

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Explaining Persistent Pain - Kirklees PIL

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Chronic pain management - time to think differently

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