Localised neuropathic pain in the primary care setting: a cross-sectional study of prevalence, clinical characteristics, treatment patterns, quality of life and sleep performance. (1st February 2021)

• Record Type: Journal Article
• Authors: Mick, Gerard; Serpell, Mick; Baron, Ralf; Mayoral, Victor; Hans, Guy; Mendez, Ignacio; Artime, Esther; Qizilbash, Nawab; Sohns, Melanie
• Is Part Of: Current medical research and opinion. Volume 37:Number 2(2021)
• Page Start: 293
• Page End: 302
• Publication Date: 2021-02-01
• Subjects: Localized neuropathic pain -- analgesics -- primary care -- prevalence -- quality of life -- sleep performance; Clinical medicine -- Periodicals; Therapeutics -- Periodicals; 615.5
• DOI: 10.1080/03007995.2020.1846174
• Languages: English
• ISSNs: 0300-7995

Abstract

Abstract: Background: Localised Neuropathic Pain (LNP) is challenging to diagnose and manage in primary care. Objective: To describe clinical characteristics, treatment patterns, quality of life and sleep performance of patients with LNP and estimate its prevalence in primary care. Methods: Cross-sectional study in 4 European countries. Patients were identified using a screening tool for LNP. Patients completed the EQ-5D VAS score and Chronic Pain Sleep Inventory (CPSI). Results: There were 1030 LNP patients for analysis. They presented a median pain intensity of 6.0 (IQR 4.0–7.0) with a median duration of 30.9 months (IQR 12.0−75.3), despite 97% receiving pain treatment. Main sites affected were the limbs (62% upper/58% lower) and spine (41%). Main aetiologies were neuropathic low back pain (47%), post-surgical neuropathic pain (17%), and diabetic poly-neuropathy (12%). Thirty percent received a single analgesic (2% topical), while combinations comprised 43% systemic-systemic, 24% topical-systemic, 1% topical-topical. Medications included NSAIDs (45%), anticonvulsants (38%), WHO step 2 opioids (35%), and topical analgesics (27%). In the previous 6 months, 40% had switched treatment. The mean (SD) EQ-5D VAS score was 58 (22.3) and the mean (SD) EQ-5D summary score (UK tariff) was 0.62 (0.25). Patients had a CPSI mean index of 41/100, and sleeping pills were used by 33% of patients. The standardized prevalence of LNP by age and sex was 2.01% in the general population and 43.3% among chronic pain patients. Conclusions: Many LNP patients reported pain intensities of six on a ten-point scale in average for durations longer than 2.5 years, with quality of life and sleep performance affected, with frequent treatment combinations and switches, suggesting suboptimal pain management.