Clinical characteristics and patterns of healthcare utilization in patients with painful neuropathic disorders in UK general practice: a retrospective cohort study.

Ariel Berger,John Edelsberg,Ellen Dukes,Gerry Oster,Alesia Sadosky

doi:10.1186/1471-2377-12-8

Ariel Berger, John Edelsberg + Show 3 more

Open Access

https://doi.org/10.1186/1471-2377-12-8

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Abstract

BackgroundClinical characteristics and patterns of healthcare utilization in patients with painful neuropathic disorders (PNDs) who are under the care of general practitioners (GPs) in the UK are not well understood.MethodsUsing a large electronic UK database, we identified all adults (age ≥ 18 years) with any GP encounters between 1 January 2006 - 31 December 2006 at which a diagnosis of PND was noted ("PND patients"). An age-and gender-matched comparison group also was constituted consisting of randomly selected patients with one or more GP encounters-but no mention of PNDs-during this period. Characteristics and patterns of healthcare utilization of patients in the two groups were then examined over the one-year study period.ResultsThe study sample consisted of 31,688 patients with mention of PNDs and an equal number of matched comparators; mean age was 56 years, and 62% were women. The prevalence of various comorbidities was higher among patients in the PND group, including digestive disorders (31% vs. 17% for comparison group), circulatory disorders (29% vs. 22%), and depression (4% vs. 3%) (all p < 0.01). Receipt of prescriptions for pain-related pharmacotherapy also was higher among PND patients, including nonsteroidal anti-inflammatory drugs (56% of PND patients had one or more such prescriptions vs. only 22% in the comparison group), opioids (49% vs. 12%), tricyclic antidepressants (20% vs. 1%), and antiepileptics (12% vs. 1%) (all p < 0.01). PND patients also averaged significantly more GP visits (22.8 vs. 14.2) and referrals to specialists (2.8 vs. 1.4) over one year (both comparisons p < 0.01).ConclusionsPatients with PNDs under the care of GPs in the UK have relatively high levels of use of healthcare services and pain-related pharmacotherapy.

Highlights

Clinical characteristics and patterns of healthcare utilization in patients with painful neuropathic disorders (PNDs) who are under the care of general practitioners (GPs) in the UK are not well understood
We identified a total of 31,688 patients with one or more encounters at which PNDs were recorded between 1 December 2006 and 31 January 2006; a comparison group of the same size was constituted, matched on age and gender
Eighty-eight percent of patients with PNDs had two or more comorbidities noted by their GPs during the study period, versus 56.9% for the comparison group

Summary

Introduction

Clinical characteristics and patterns of healthcare utilization in patients with painful neuropathic disorders (PNDs) who are under the care of general practitioners (GPs) in the UK are not well understood. In contrast to the growing body of literature on the etiology, pathophysiology, and treatment of neuropathic pain, relatively little has been reported about the clinical characteristics and costs of patients with painful neuropathic disorders (PNDs) in clinical practice, including their levels of use of pain-related pharmacotherapy and healthcare services. These issues were examined by the authors in two prior studies in which patients with PNDs were compared with an equal number of age-and sex-matched comparators [7,8].

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