An article in the British Medical Journal (BMJ) this month debates how recent research on the treatment of chronic pain suggests social prescribing – including exercise and psychological and social support – could have a positive impact for patients living with the condition.
Questioning how helpful medical interventions continue to be for the treatment of chronic pain, the article references a review published this month by Dr Giovanni Ferreira and his colleagues at The University of Sydney (doi:10.1136/bmj-2022-072415), which studied the efficacy of antidepressants for the treatment of back pain and osteoarthritis.
Ferreira’s research looked at the effectiveness of medical intervention, namely antidepressants, in 22 pain conditions, and while in around a quarter of cases, there was some evidence of effectiveness, it wasn’t high quality – suggesting that for those enduring chronic pain, antidepressants as a treatment might not be transformative.
The most recent guidelines from NICE (UK National Institute for Health and Care Excellence) also urges that clinicians “consider” the use of antidepressants while gaps in evidence on their efficacy remain.
The article said: ‘Clinicians continue to prescribe medicines for which the evidence is poor because they observe that some people respond to them, albeit modestly. But all medicines carry risk of harm and there are other, less potentially harmful options more likely to help people to live well with pain.’
Alternative interventions, the article said, found to improve pain included group exercise, and psychological and social influences were also found to have an impact – patients who were well supported on issues such as money, social isolation and mobility were found to have better outcomes.
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The authors also warn that evidence for the effectiveness of such social prescribing interventions remains promising but inconclusive – but suggests that a strong patient/professional relationship is key to finding the most effective treatment.
The article says: ‘For people with pain, compassionate and consistent relationships with clinicians remain the foundations of successful care. Research shows that what people want most is a strong, empathic relationship with their care provider. They want time to discuss what matters to them and they want easy access to support.’
To read the full article in the British Medical Journal, click here
OUR BEYOND PILLS CAMPAIGN: It’s thought that around 1.1 billion medicines are currently prescribed unnecessarily, and last summer, supported by eminent voices in both the Government and our healthcare system, The College of Medicine launched the Beyond Pills campaign, calling for the Government to address unsustainable medical prescription through re-prescribing and social prescribing. Read the latest stories on our campaign here: www.collegeofmedicine.org.uk/beyondpills
