Excerpt

This clinical guideline covers the management of neuropathic pain conditions in adults (aged 18 or over) in primary care and secondary care, excluding specialist pain management clinics. The aim of the guideline is to provide clear recommendations to healthcare professionals in non-specialist settings on the treatment and management of neuropathic pain. This includes recommendations on appropriate and timely referral to specialist pain services and/or condition-specific services. In general, regarding neuropathic pain as a ‘blanket condition’, irrespective of the underlying cause, is helpful and practical for both non-specialist healthcare professionals and patients. However, condition-specific recommendations and research recommendations have been made where robust evidence on clinical and cost effectiveness exists for specific conditions, or where the evidence is clearly uncertain. The guideline excludes acute pain arising directly (in the first 3 months) from trauma or orthopaedic surgical procedures.

Contents

• Disclaimer
• How to read this guideline
• Introduction
• Patient-centred care
• 1. Summary
  • 1.1 List of all recommendations
  • 1.2 Care pathway
  • 1.3 Overview
• 2. How this guideline was developed
  • 2.1 Introduction
  • 2.2 Evidence statements
  • 2.3 Clinical evidence reviews
  • 2.4 Health economics evidence review
  • 2.5 Evidence to recommendations
  • 2.6 Recommendations
• 3. Research recommendations
  • 3.1 Carbamazepine for treating trigeminal neuralgia
  • 3.2 Monotherapy versus combination therapy for treating neuropathic pain
  • 3.3 Factors influencing quality of life of people with neuropathic pain
  • 3.4 Relationship between cause of neuropathic pain and its treatment
• 4. Other versions of this guideline
  • Quick reference guide
  • ‘Understanding NICE guidance’
• 5. Related NICE guidance
  • Published
• 6. Updating the guideline
• 7. References, glossary and abbreviations
• 8. Contributors
  • 8.1 The Guideline Development Group
  • 8.2 The short clinical guidelines technical team
  • 8.3 The Guideline Review Panel
  • 8.4 Declarations of interest
  • 8.5 Authorship and citation
• Appendices
  • Appendix 9.1 Scope
  • Appendix 9.2 Key clinical issues, review questions and review protocol
  • Appendix 9.3A Results of GDG short questionnaires
  • Appendix 9.3B GDG Declarations of Interest
  • Appendix 9.4 Lists of excluded studies
  • Appendix 9.5 Meta-analyses forest plots
  • Appendix 9.6 Literature search
  • Appendix 9.7 Search strategy
  • Appendix 9.8 Presenting intervention studies with modified GRADE
  • Appendix 9.9 Evidence tables

NICE clinical guidelines are recommendations about the treatment and care of people with specific diseases and conditions in the NHS in England and Wales.

This guidance represents the view of NICE, which was arrived at after careful consideration of the evidence available. Healthcare professionals are expected to take it fully into account when exercising their clinical judgement. However, the guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, and informed by the summary of product characteristics of any drugs they are considering.

Implementation of this guidance is the responsibility of local commissioners and/or providers. Commissioners and providers are reminded that it is their responsibility to implement the guidance, in their local context, in light of their duties to avoid unlawful discrimination and to have regard to promoting equality of opportunity. Nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.