Neuropathic pain in adults: pharmacological management in non-specialist settings

Evidence

We found 84 studies in a search for systematic reviews and randomised controlled trials published between 31 July 2012 and 24 January 2017.

We also checked for relevant ongoing research, which will be evaluated again at the next surveillance review of the guideline.

See appendix A: summary of evidence from surveillance for details of all evidence considered, and references.

Views of topic experts

We considered the views of topic experts, including those who helped to develop the guideline.

Views of stakeholders

Stakeholders commented on the decision not to update the guideline. Overall, 6 stakeholders commented. See appendix B for stakeholders' comments and our responses.

Six stakeholders commented on the proposal including 2 NHS foundation trusts, British Pain Society, Royal College of Anaesthetists, Royal College of Nursing and Cochrane Pain Palliative and Supportive Care Review Group. Three stakeholders agreed with the decision; 2 disagreed; and 1 stated that they had no comments on the proposals.

Of the 2 stakeholders who disagreed, 1 provided reference for a relevant ongoing systematic review which has been added to our event tracker. Two other stakeholders that disagreed with the proposal suggested that oxycodone and tapentadol should be included in the list of initial treatment for neuropathic pain in recommendations 1.1.8–1.1.11; current evidence on oxycodone and tapentadol is very limited and was judged to be insufficient to trigger an update to the guideline. One stakeholder asked for a clearer statement promoting cannabinoids as a safe medicine to be used outside of medical control but new evidence on cannabinoids was also judged to be insufficient to trigger an update of this topic and addition of new recommendations. All these areas will be examined again at the next surveillance point.

Three stakeholders disagreed with the decision to remove 2 of the research recommendations from the NICE version of the guideline and NICE research database because of evidence of research activities; therefore these recommendations will be retained.

See ensuring that published guidelines are current and accurate in developing NICE guidelines: the manual for more details on our consultation processes.

NICE Surveillance programme project team

Kay Nolan
Associate Director

Phil Alderson
Consultant Clinical Adviser

Judith Thornton
Technical Adviser

Maryam Gholitabar
Technical Analyst

The NICE project team would like to thank the topic experts who participated in the surveillance process.

ISBN: 978-1-4731-0788-5