Burden of Illness Associated with Peripheral and Central Neuropathic Pain among Adults Seeking Treatment in the United States: A Patient-Centered Evaluation

Abstract

ObjectiveThe aim of this study was to evaluate patient-reported burden associated with peripheral and central neuropathic pain (NeP) by pain severity and NeP condition.DesignSix hundred twenty-four subjects with one of six NeP conditions were recruited during routine office visits. Subjects consented to retrospective chart review and completed a one-time questionnaire (including EuroQol-5 dimensions, 12-item Short-Form Health Survey, Brief Pain Inventory-Short Form, Medical Outcomes Study Sleep Scale, Hospital Anxiety and Depression Scale, and demographic and clinical characteristics). Pain severity scores were used to stratify subjects by mild, moderate, and severe pain. Summary statistics and frequency distributions were calculated. Differences by severity level were compared using Kruskal–Wallis (continuous variables) and chi-square or Fisher's exact test (categorical variables). Effect size was computed with Cohen's d (mild vs severe).ResultsSubjects' mean age was 55.5. The majority (80.8%) had moderate or severe pain. Patient-reported outcomes (health status, physical and mental health, pain interference with function, sleep, anxiety, and depression) were significantly worse among subjects with greater pain severity (all P < 0.0001). Severe pain subjects were negatively impacted by ≥30% in each outcome compared with mild pain subjects; standardized effect size was moderate for anxiety (0.59) and large (>0.95) for all others. The observed burden was most substantial among chronic low back pain-NeP, although the pattern of disease burden was similar across the six NeP conditions.ConclusionsSubjects across NeP conditions exhibited high pain levels, which were significantly associated with poor function, compromised health status and sleep, and increased anxiety and depression. Results indicate substantial patient burden across broad NeP, particularly among subjects with severe pain.

Neuropathic pain depends upon d-serine co-activation of spinal NMDA receptors in rats

“…Neuropathic pain is frequent, with prevalence that varies from 6.9 to 10% [1], has a disruptive influence on the quality of life of patients [2], and is difficult to treat successfully. It thus presents a major therapeutic challenge to healthcare professionals [3].…”

Burden of Chronic Low Back Pain with a Neuropathic Pain Component: Retrospective Chart Review and Cross-sectional Survey among Adults Seeking Treatment in the United States

“…Note: Two subjects did not respond to all required items needed to calculate a BPI average pain severity score and thus were not included in any analysis by pain severity category. Distribution of pain severity in the CLBP-NeP sample has appeared in previous publications [12,13]. Table 5: Overall work impairment, activity impairment, and impact of CLBP-NeP on employment status, overall and by average pain severity.…”

“…Resource utilization over the past four weeks Note: Two subjects did not respond to all required items needed to calculate a BPI average pain severity score and thus were not included in any analysis by pain severity category. Distribution of pain severity in the CLBP-NeP sample has appeared in previous publications [12,13]. b Among subjects with a reduced work schedule due to NeP and provided a response to the item.…”

“…The CLBP-NeP subjects were recruited as part of a larger observational study assessing the burden of neuropathic pain; previous publications have reported data from the overall NeP sample, including certain characteristics of the CLBP-NeP sub-group [12,13]. This analysis presents detailed results from the CLBP-NeP sub-group.…”

“…Distribution of pain severity in the CLBP-NeP sample has appeared in previous publications. [12,13] Citation across pain severity levels. The medication classes most prescribed in the overall CLBP-NeP cohort ( Figure 5) and in the severe pain group, respectively, were opioids (81.1% and 83.7%), muscle relaxants (33.0% and 37.2%), antiepileptics (28.3% and 25.6%), and non-steroidal antiinflammatory drugs (NSAIDs) (14.2% and 14.0%).…”