Clinical characteristics and pain management among patients with painful peripheral neuropathic disorders in general practice settings

Mugdha Gore, Ellen Dukes, David J. Rowbotham, Kei Sing Tai, Douglas Leslie

Research output: Contribution to journalArticle

82 Citations (Scopus)

Abstract

Alleviating chronic pain is a global healthcare priority. Understanding the medical profile and current treatment patterns in patients with painful neuropathic disorders (PNDs) is crucial to the development of effective pain management strategies. Thus, our objective was to describe the demographic and clinical characteristics of persons with PNDs and their use of pain medications. Using the general practice research database, we categorized PNDs in two ways: Pure PNDs (which include diabetic neuropathy, postherpetic neuralgia, etc.; N = 16,690) and Mixed PNDs (which include back/neck pain with neuropathic involvement; N = 14,309). On average, PND patients were 55 years old (Pure, 55.4 [SD = 16.9] years; Mixed, 54.3 [SD = 16.4] years). Over a third had other chronic pain-related (Pure, 37.5%; Mixed, 37.1%) and nearly a quarter had non-pain related (Pure, 28.1%; Mixed, 24.1%) comorbidities. Use of medications with clinically demonstrated efficacy in PNDs was higher among patients with Pure PNDs (tricyclic antidepressants [Pure, 16.6%; Mixed, 10.1%]; 2nd generation antidepressants [Pure, 11.0%; Mixed, 9.7%]; and antiepileptics [Pure, 12.2%; Mixed, 2.6%]), whereas use of NSAIDs (Pure, 43.1%; Mixed, 65.2%) and opioids (Pure, 8.5%; Mixed, 14.3%) was higher among patients with Mixed PNDs. Average daily doses of select neuropathic pain-related medications among PND patients (Pure and Mixed) were lower than those recommended for neuropathic pain. Among both Pure and Mixed PND patients, use and doses of evidenced-based neuropathic pain-related medications was low, and lower than the use of NSAIDs (a medication class with no proven efficacy for PNDs) in each group, suggesting possible sub-optimal neuropathic pain management among these patients.

Original languageEnglish (US)
Pages (from-to)652-664
Number of pages13
JournalEuropean Journal of Pain
Volume11
Issue number6
DOIs
StatePublished - Aug 1 2007

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Pain Management
General Practice
Neuralgia
Non-Steroidal Anti-Inflammatory Agents
Chronic Pain
Postherpetic Neuralgia
Diabetic Neuropathies
Neck Pain
Tricyclic Antidepressive Agents
Back Pain
Anticonvulsants
Opioid Analgesics
Antidepressive Agents
Comorbidity
Demography
Databases
Delivery of Health Care
Pain
Research

All Science Journal Classification (ASJC) codes

  • Anesthesiology and Pain Medicine

Cite this

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title = "Clinical characteristics and pain management among patients with painful peripheral neuropathic disorders in general practice settings",
abstract = "Alleviating chronic pain is a global healthcare priority. Understanding the medical profile and current treatment patterns in patients with painful neuropathic disorders (PNDs) is crucial to the development of effective pain management strategies. Thus, our objective was to describe the demographic and clinical characteristics of persons with PNDs and their use of pain medications. Using the general practice research database, we categorized PNDs in two ways: Pure PNDs (which include diabetic neuropathy, postherpetic neuralgia, etc.; N = 16,690) and Mixed PNDs (which include back/neck pain with neuropathic involvement; N = 14,309). On average, PND patients were 55 years old (Pure, 55.4 [SD = 16.9] years; Mixed, 54.3 [SD = 16.4] years). Over a third had other chronic pain-related (Pure, 37.5{\%}; Mixed, 37.1{\%}) and nearly a quarter had non-pain related (Pure, 28.1{\%}; Mixed, 24.1{\%}) comorbidities. Use of medications with clinically demonstrated efficacy in PNDs was higher among patients with Pure PNDs (tricyclic antidepressants [Pure, 16.6{\%}; Mixed, 10.1{\%}]; 2nd generation antidepressants [Pure, 11.0{\%}; Mixed, 9.7{\%}]; and antiepileptics [Pure, 12.2{\%}; Mixed, 2.6{\%}]), whereas use of NSAIDs (Pure, 43.1{\%}; Mixed, 65.2{\%}) and opioids (Pure, 8.5{\%}; Mixed, 14.3{\%}) was higher among patients with Mixed PNDs. Average daily doses of select neuropathic pain-related medications among PND patients (Pure and Mixed) were lower than those recommended for neuropathic pain. Among both Pure and Mixed PND patients, use and doses of evidenced-based neuropathic pain-related medications was low, and lower than the use of NSAIDs (a medication class with no proven efficacy for PNDs) in each group, suggesting possible sub-optimal neuropathic pain management among these patients.",
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Clinical characteristics and pain management among patients with painful peripheral neuropathic disorders in general practice settings. / Gore, Mugdha; Dukes, Ellen; Rowbotham, David J.; Tai, Kei Sing; Leslie, Douglas.

In: European Journal of Pain, Vol. 11, No. 6, 01.08.2007, p. 652-664.

Research output: Contribution to journalArticle

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