NICE Opioids in Palliative Care (Clinical Guideline 140) - A Guideline Summary.

Abstract

The following article summarises the recent National Institute of Clinical Evidence (NICE) clinical guidelines for opioid use in palliative care.1 With the population rapidly ageing, cancer is becoming more common. As such, there is an increasing need to address the pain associated with severe and progressive disease. The updated NICE guidance (CG 140) targets non-specialists initiating treatment with strong opioids for adults with advanced and progressive disease.1 It addresses step three of the pain ladder for malignancy according to the World Health Organization pain ladder.2 It does not address treatment in patients’ final days of life or second-line treatment. An adapted pathways is presented in Figure 1. Fig 1 Opioid pathway (adapted from NICE guideline CG 140).1 Professionals should be aware of patients’ preferences and needs and aid them in making informed decisions. Informed consent is required and practitioners should refer to the Mental Capacity Act if necessary.