Pain management in people with inflammatory arthritis: British Society for Rheumatology guideline scope

Executive Summary Pain is a common symptom in people with inflammatory arthritis (IA), which has far-reaching impacts on their lives. Recent electronic health record studies demonstrate that UK-based pain care in people with IA commonly involves the prescribing of long-term opioids and gabapentinoids, despite an absence of trial evidence for their efficacy. Patient surveys suggest that non-pharmacological pain management is underused. A UK-specific guideline on pain management for people with IA is required to resolve this. This scoping document outlines the context and prioritized clinical questions for the first British Society for Rheumatology (BSR) guideline on pain management for people with IA. The guideline aims to provide evidence-based recommendations on how pain can be best managed in people with IA (including its assessment, and pharmacological and non-pharmacological treatments), ensuring that people with IA in the UK are offered evidence-based pain management strategies. The guideline is for healthcare professionals involved in the care of people with IA of all ages and genders, people with IA and their families and carers, NHS managers and healthcare commissioners, and other relevant stakeholders such as patient organizations. It will be developed using the methods outlined in the BSR’s ‘Creating Clinical Guidelines’ protocol. Lay Summary What does this mean for patients? Inflammatory arthritis includes conditions causing swollen and painful joints. The main types are rheumatoid arthritis, psoriatic arthritis, axial spondyloarthritis and juvenile idiopathic arthritis. It is common, affecting over 1 in 100 adults and 4 in 10 000 children and young people in the UK. Despite the availability of effective medicines to reduce joint inflammation, many people with inflammatory arthritis continue to experience daily pain. This has a great impact on their lives. They often receive strong pain medicines called opioids, despite little evidence that they help pain in inflammatory arthritis. The British Society for Rheumatology is the UK’s main medical society for healthcare professionals providing care to people with inflammatory arthritis. It provides guidelines that recommend how healthcare professionals can best treat people with specific conditions. This paper outlines the plan to develop the first guideline from the British Society for Rheumatology about how pain should be managed in people with inflammatory arthritis. It will be developed by a grou