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Content Article
Lucy Cohen recently had a contraceptive device (IUD) fitted, during which she suffered extremely high levels of pain. Following her experience, she decided to launch a survey to understand how others had found the procedure. In this interview, Lucy shares her findings and calls for better pain management and improved consent processes, in order to reduce avoidable harm. -
Content ArticleNICE guidance on the management of chronic pain no longer recommends the initiation of many medications (e.g. NSAID’s, gabapentinoids etc) for primary chronic pain. However, there are many patients in the community who are already using these medications and it is important that when implementing this guideline, the recommendations are not used out of context. This joint statement aims to provide information that will help doctors and patients when reviewing medications.
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Content Article
The biopsychosocial approach (March 2021)
PatientSafetyLearning Team posted an article in Pain management
Authors of this article, published in Practical Pain Management, argue: "The biopsychosocial model has led to the development of the most therapeutic and cost-effective interdisciplinary pain management programs and makes it far more likely for the chronic pain patient to regain function and experience vast improvements in quality of life." -
News Article
‘I was told to live with it’: women tell of doctors dismissing their pain
Patient Safety Learning posted a news article in News
As a teenager, Kelly Moran was incredibly sporty: she loved to run and went to dancing lessons four times a week. But by the time she hit 29, she could barely walk or even drive, no longer able to do all the activities she once enjoyed. She had pain radiating into her legs. Her pain was repeatedly dismissed by doctors, who told her it was in her head. She moved back to her parents’ house in Manchester and left her job. She decided to seek treatment privately and was told she had endometriosis. Soon, with the right treatment, her life improved. Kelly is among dozens of women who got in touch to share their stories with the Guardian on the topic of women’s pain. Women are almost twice as likely to be prescribed powerful and potentially addictive opiate painkillers than men, a Guardian analysis shows. Data from the NHS Business Services Authority, which deals with prescription services in England, shows a large disparity in the number of women being given these drugs compared with men, with 761,641 women receiving painkiller prescriptions compared with 443,414 men, or 1.7 times, and the pattern is similar across broad age categories. The women who reached out said they felt that they were often “fobbed off” with painkillers when their problems required medical investigation. Read full story Source: The Guardian, 16 February 2021 -
Content ArticleFollowing a lengthy consultation, the National Institute for Health and Care Excellence (NICE) has published new guidelines on chronic pain in over 16s. In the new guidelines, NICE made some recommendations for people whose chronic pain has no known cause, including the use of acupuncture. Dr Alice Howarth takes a closer look at the guidelines.
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News ArticleA 23-year-old woman who begged doctors to remove her womb to relieve chronic pain says the surgery is being refused due to her age and childless status. Hannah Lockhart has endometriosis, a condition that can cause debilitating pain, heavy periods and infertility. Although she has always wanted her own children, Hannah says her daily pain is now so severe she wants a hysterectomy. "It's heartbreaking that just because I'm so young I have to keep suffering," she told the BBC's Evening Extra. Ms Lockhart, from Bangor in County Down, has been in hospital seven times in the past year because of crippling pain from endometriosis. "Every single day I'm taking morphine, I'm taking different tablets for nerves to try and stop the pain and nothing works," she said. Read full story Source: BBC News, 14 April 2021
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Content ArticleNew NICE guidelines recommend exercise, rather than medication, for those suffering with chronic pain. Writer Grace Holliday explains why movement alone isn’t enough to help those dealing with symptoms in an article for Stylist.
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News ArticleNew guidance from health officials on the treatment of chronic pain could be devastating for women already struggling to get doctors to take their pain seriously, write Sarah Graham, The guidelines, published last week by the National Institute for Health and Care Excellence (NICE), say that patients suffering from chronic pain that has no known underlying cause (known as chronic primary pain) should not be prescribed painkillers. Instead, it suggests, these patients should be offered exercise, antidepressants, talking therapies and acupuncture. This has huge implications for the future treatment of anyone living with unexplained chronic pain – the majority of whom are women – and runs the risk of patients being viewed as hysterical until proven otherwise. Read full story Source: iNews, 7 April 2021
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News Article
Doctors raise concerns about NICE guidelines on chronic primary pain
Patient Safety Learning posted a news article in News
Doctors in pain management have raised concerns about the National Institute of Health and Care Excellence’s guidance on treating chronic primary pain, which they said do not reflect clinical practice or current evidence. Patients could be left in “despair,” said the British Pain Society, because of the recommendation that the only drugs that doctors should prescribe are certain antidepressants. Commonly prescribed drugs, including paracetamol, non-steroidal anti-inflammatory drugs, benzodiazepines, and opioids, should not be used to treat chronic primary pain, said NICE. Instead patients should be offered exercise programmes, therapy, and acupuncture. Read full story (paywalled) Source: BMJ, 9 April 2021 -
Content ArticleIn April 2021, The National Institute for Health and Care Excellence (NICE) released new guidance on the management of chronic pain. In The British Pain Society's (BPS) initial statement on the NICE guideline, they conclude: "In summary, the new NICE guideline NG193 acknowledges that individual and indeed specialised chronic pain assessment and management is required. However, The British Pain Society feels that the guidance as it stands could lead to the withdrawal of supervised short-term therapies which can work safely in carefully selected and monitored patients with forms of chronic primary pain." Follow the link below to access the statement in full.
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Content ArticleDr Ian Carroll discusses neuropathic pain, which involves damage to the nerve. The condition causes the nerves to fire incessantly, even if the initial source of the pain has been remedied. The brain responds by creating an ongoing message of pain.
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News Article
Covid: Unpaid carers 'struggled to get pain relief' for terminally ill
Patient Safety Learning posted a news article in News
Unpaid carers looking after terminally ill friends and relatives during the pandemic struggled to access pain relief, with some patients dying in unnecessary pain, a survey has found. The survey of 995 unpaid carers by Marie Curie also found people had difficulties getting personal care and respite nursing for loved ones. Figures show the number of people dying at home rose by 42% in the past year. Nearly two-thirds of carers surveyed by the charity said their loved one did not get all the pain relief they needed when they were dying. Susan Lowe, from Solihull, cared for her mother Sheila before she died with bowel cancer in April last year, aged 74. She said caring for her mum during lockdown was hard as "the system was just under so much pressure that we had to manage largely on our own". The public health worker says she struggled to get the right pain relief medication for her mother in her final weeks and spent hours travelling to different chemists. Susan, 50, told the BBC: "My biggest regret is that my mum died in pain - more pain than she needed to be. She really wanted to be comfortable at the end. She knew she was dying." "What she really wanted - and this is what she was assured would happen - was to be comfortable. She was told she would get the drugs that she needed for it to be as bearable as possible... I remember breaking down in tears a couple of times in the pharmacy when I was told the medication mum needed wasn't in stock." Read full story Source: BBC News, 8 April 2021 -
Content ArticleThe National Institute for Health and Clinical Excellence (NICE) guideline covers assessing all chronic pain (chronic primary pain, chronic secondary pain, or both) and managing chronic primary pain in people aged 16 years and over. Chronic primary pain is pain with no clear underlying cause or pain (or its impact) that is out of proportion to any observable injury or disease. Download the full guidance from link below or click on the image for a visual summary. We have also included links to supporting evidence and to useful tools and resources.
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News ArticlePeople suffering from chronic pain that has no known cause should not be prescribed painkillers, the medicines watchdog has announced, recommending such patients be offered exercise, talking therapies and acupuncture instead. In a major change of pain treatment policy, the National Institute for health and Care Excellence (NICE) say that in future, doctors should advise sufferers to use physical and psychological therapies rather than analgesics to manage their pain. Painkillers such as aspirin 'do more harm than good' for chronic primary pain Medical teams can also consider prescribing antidepressants, the government health advisers suggest. NICE’s new guidance potentially affects the way many hundreds of thousands of people in England and Wales tackle their condition because between 1% and 6% of the population of England is estimated to have chronic primary pain. Read full story Source: The Guardian, 7 April 2021
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Content ArticleThis study, published by the Proceedings of the National Academy of Sciences (PNAS), found that Black Americans are systematically undertreated for pain relative to white Americans.
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Content ArticleOn International Women’s Day 2021, feminist journalist Sarah Graham presented to the St Mary’s Women’s Network about the gender pain gap and how it harms women's health. The link below will take you to the slides and notes shared at the event.
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Content Article
Mesh: Denial, half-truths and the harms (March 2021)
Patient Safety Learning posted an article in Women's health
In this article, Sharon Hartles, a member of the Harm and Evidence Research Collaborative, critically discusses the harmful impacts of mesh medical devices against the backdrop of disempowerment, denial and half-truths. Surgical meshes have been in use since the late 19th century. In the mid-20th century the clinical usage of mesh increased. Now, in the early 21st century, procedures involving mesh implantation are common surgeries that are performed around the world. Despite the frequency and worldwide usage of mesh medical devices, the debate about whether or not the benefits outweigh the alleged harms remains highly contested. Read the full article Further recommended reading: Dangerous exclusions: The risk to patient safety of sex and gender bias Healing after harm: A restorative approach to incidents Analysing the Cumberlege Review: Who should join the dots for patient safety? Findings of the Cumberlege Review: informed consent Findings of the Cumberlege Review: patient complaints -
Content Article
Endometriosis: one woman’s story
PatientSafetyLearning Team posted an article in Women's health
It affects an estimated 176 million women worldwide, yet endometriosis can take years to be diagnosed. In this blog, published on the Boots website, Terri White, author, journalist and Editor in Chief of Empire magazine, shares her story of the pain, frustration and delays in diagnosis she has faced. She also offers advice on how to get listened to. -
Content ArticleThis is a presentation detailing the manuscript which investigated the presence of pain during hysteroscopy, delivered by pain researcher, Richard Harrison to the annual meeting of the Royal College of Obstetricians and Gynaecologists in 2021.
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News Article
Hundreds of patients with chronic pain waiting a year for first NHS appointment
Patient Safety Learning posted a news article in News
NHS clinics were still seeing just two-thirds of the number of chronic pain patients they normally would by the end of last year, with some patients having waited a year or more. In Ayrshire and Arran, 94 of the 112 chronic pain patients seen between October and December – equivalent to nearly 84% – had been on the waiting list for their first appointment for 52 weeks or longer. Only nine were seen within the 18-week target. This was by far the worst performance for any health board in Scotland. Pain relief clinics across NHS Scotland were paused for four months at the beginning of the pandemic, leading to reports that some patients with problems such as nerve damage and arthritis were paying thousands of pounds to travel to private facilities in England for medical infusions or injections to ease their symptoms. In a statement at the end of last year, Joanne Edwards, the director of acute service at NHS Ayrshire and Arran, apologised for the delays, saying the coronavirus pandemic "has had a significant impact on the capacity of the chronic pain service". Ms Edwards said the health board was increasing the number of face to face and telephone clinics that the chronic pain team can undertake, adding that an "enhanced clinical review" of the waiting list was also being carried out to prioritise patients for appointment based on clinical need. Read full story Source: The Herald, 10 March 2021 -
Content ArticleThis presentation was submitted by the patient group Campaign Against Painful Hysteroscopy, as an oral presentation to the British Society for Gynae Endoscopy’s Annual Scientific Meeting 2021. It includes patient testimonials and statistical data gathered around painful hysteroscopies and informed consent.
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Content ArticleIn this blog, pain researcher, Richard Harrison, reflects on the presentation he recently made to the Royal College of Obstetricians and Gynaecologists, based on his research into pain during hysteroscopy. Follow the link below to read Richard's blog, or you can watch the RCOG presentation here.
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News ArticleNew stats from Endometriosis UK this week for Endometriosis Awareness Month reveal that 62% of women (aged 16-54) would put off going to a doctor with symptoms of endometriosis. Reasons include they don’t think it’s serious enough to bother a doctor with, they’d be embarrassed, they don’t think they’d be taken seriously, or they think symptoms including painful periods are normal. This statistic rises to 80% of 16-24-year-olds. 1.5 million UK women are currently living with endometriosis, with average diagnosis time standing at an unacceptable 8 years Endometriosis UK says it is vital that Governments, society, the NHS and workplaces wake-up and recognise the symptoms and impact endometriosis can have, and afford those with the condition the support and access to treatment they need to manage their symptoms. Commenting on the new research, Emma Cox, CEO of Endometriosis UK said: “Endometriosis is a long-term chronic health condition affecting 1.5 million in the UK, yet it still all too often considered a taboo or not important due to links with the menstrual cycle. Symptoms including chronic pelvic pain, painful periods, painful bladder and bowel movements, and infertility, can have a major, life-long impact, physically and mentally. But far too many find their symptoms are not believed nor taken seriously." “Myths such as “chronic period pain is normal” or “you must have a low pain threshold” manifesting in society, workplaces, schools, and even healthcare settings contribute to those experiencing symptoms being put off from seeking medical advice and contribute to diagnosis taking on average a shocking 8 years. “The impact of delayed diagnosis on people’s physical and mental health can’t be overstated. If undiagnosed, the disease may progress, and negatively impact people’s careers, education, relationships and all aspects of their life.” Read full story Source: Endometriosis UK, 1 March 2021
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Content Article
Getting diagnosed with endometriosis: personal stories
Patient Safety Learning posted an article in Women's health
Women share their personal experiences to Endometriosis UK of getting diagnosed with endometriosis. -
Content ArticleIn this blog Patient Safety Learning reflects on responses received from Robin Swann MLA, Minister of Health (Northern Ireland), Jeane Freeman MSP, Cabinet Secretary for Health and Sport (Scotland) and Vaughan Gething MS, Minister for Health and Social Services (Wales), regarding concerns about painful hysteroscopy procedures in the NHS.
