Abstract
To describe clinical characteristics, treatment patterns, quality of life (QoL) and sleep performance of localized neuropathic pain (LNP) patients. Cross-sectional study in primary care of 4 EU countries. Patients were identified using a screening tool for LNP. At screening, clinical and treatment information was collected, and patients completed the EQ-5D and CPSI (sleep performance) questionnaires. Results are presented overall and by type of analgesia at screening (topical and systemic monotherapies, combinations of topical-systemic and systemic-systemic). Of 1102 patients that screened positive for LNP, 1030 were included in the study. Despite 97% of patients were under pain treatment, they presented moderate pain (median pain intensity 6.0) with a median duration of 30.9 months. Main sites of pain were the limbs (62% upper/58% lower) and spine (41%). Main etiologies were: neuropathic low back pain (47%), post-surgery neuropathic pain (17%), and diabetic poly-neuropathy (12%). In the previous 6 months 40% switched treatment. At screening, 32% were receiving a single analgesic (2% topical), while combinations comprised: 43% systemic-systemic, 24% topical-systemic, 1% topical-topical. Most frequent medications were NSAIDs (45%), anticonvulsants (38%), WHO step II opioids (35%) and topical treatments (26%). The mean (SD) EQ-5D VAS score was 58 (22.3), significantly lower than in general population, and the mean (SD) EQ-5D summary score (UK tariff) was 0.62 (0.25). Patients showed sleeping problems of mild severity (CPSI mean index=41/100), however sleeping pills were used by 33% of patients. The results provide a better understanding of clinical characteristics and current pain management strategies for LNP in the primary care setting. Many LNP patients suffered from moderate pain intensity for long durations, with QoL and sleep performance affected. Combinations and switches were frequent. This highlights the need for early diagnosis of LNP and use of appropriate treatment regimens to relieve pain in LNP.
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