Persistent pain is a huge world-wide health challenge. It is the primary reason people in the UK see their GP. The World Health Organisation (WHO) recognised it as a priority disease in 2019. NICE has also recently accepted that current chronic pain medications have limited use, and in fact carry serious safety concerns. Reducing opioid prescriptions (for non-cancer pain) to zero by 2024 is a priority for Public Health England (PHE).
The Durham university WRIHW/LiveWellwithPain led AHSN Bright Ideas award winning GOTT Pain self-management 10-Footsteps programme was set up and validated in a large practice in a deprived part of central Darlington .The GOTT programme managed to raise confidence in the medical staff and initiated the reduction in reliance on both opioids and gabapentinoids.
Why it matters: There is little evidence that opioids are helpful in long term pain management, and the risk of harm increases significantly above 120mg morphine (or equivalent) per day (termed high dose), with little or no increase in benefit. As of this week (December 2022) our GOTT programme has achieved, for the first time, a major milestone of zero patients on high dose opioids in the test case GP practice in Darlington.
In parallel, we have reduced gabapentinoid prescriptions by half.
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