Abstract
BackgroundSince few studies have characterized painful diabetic peripheral neuropathy (pDPN) symptoms in multicultural populations, this study fielded a survey to better understand pDPN and its impact in African-American, Caucasian, and Hispanic populations.MethodsKelton fielded a survey by phone or Internet, in English or Spanish, among adults with pDPN symptoms in the United States between August and October 2015; African-Americans and Hispanics were oversampled to achieve at least 500 subjects for each group. Patients were required to have been diagnosed with pDPN or score ≥ 3 on ID Pain validated screening tool. The survey elicited information on pDPN symptoms and interactions with healthcare providers (HCPs), and included the Brief Pain Inventory and pain-specific Work Productivity and Assessment Questionnaire (WPAI:SHP).ResultsRespondents included 823 Caucasians, 525 African-Americans, and 537 Hispanics; approximately half of African-Americans and Hispanics were <40 years of age, vs 12% of Caucasians. Pain was less likely to be rated moderate or severe by African-Americans (65%) and Hispanics (49%) relative to Caucasians (87%; p < 0.05). African-Americans and Hispanics were less likely than Caucasians to report experiencing specific pDPN sensory symptoms. Significantly fewer African-Americans and Hispanics reported receiving a pDPN diagnosis relative to Caucasians (p < 0.05), and higher proportions of African-Americans and Hispanics reported difficulty communicating with their HCP (p < 0.05). WPAI:SHP activity impairment was lower in Hispanics (43%) relative to African-Americans (53%) and Caucasian (56%; p < 0.05).ConclusionsMulticultural patients reported differences in pDPN symptoms and pain relative to Caucasians, and fewer received a pDPN diagnosis. While further evaluation is needed to understand these differences, these data suggest a need to broaden pDPN educational initiatives to improve patient-HCP dialogue and encourage discussion of pDPN symptoms and their impact in a multicultural setting.
Highlights
Since few studies have characterized painful diabetic peripheral neuropathy symptoms in multicultural populations, this study fielded a survey to better understand pDPN and its impact in African-American, Caucasian, and Hispanic populations
Pain and sensory symptoms African-American and Hispanic patients were less likely than Caucasians to experience a range of sensory symptoms (Fig. 1) that are characteristic of neuropathic pain including some symptoms that appear to drive pain severity such as sensitivity to touch and shooting pain
The layered cross-tabulations of the six symptoms that were significant by ethnicity show that these differences by ethnicity generally hold for stabbing pain, with a significant effect of ethnicity for 12 of the 16 strata (p < 0.05); shooting pain, which was significant for 11 strata p < 0.05); and electric shock pain (p < 0.05: for 9 strata) (Table 2)
Summary
Since few studies have characterized painful diabetic peripheral neuropathy (pDPN) symptoms in multicultural populations, this study fielded a survey to better understand pDPN and its impact in African-American, Caucasian, and Hispanic populations. When DPN presents with painful symptoms the condition is known as painful diabetic peripheral neuropathy (pDPN). Despite studies evaluating quality of life and other patient-reported outcomes in pDPN, there are limited data on the severity and impact of painful pDPN symptoms from the patient’s perspective.
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