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An observational descriptive study of the epidemiology and treatment of neuropathic pain in a UK general population

BACKGROUND: This study updated our knowledge of UK primary care neuropathic pain incidence rates and prescribing practices. METHODS: Patients with a first diagnosis of post-herpetic neuralgia (PHN), painful diabetic neuropathy (PDN) or phantom limb pain (PLP) were identified from the General Practic...

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Autores principales: Hall, Gillian C, Morant, Steve V, Carroll, Dawn, Gabriel, Zahava L, McQuay, Henry J
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3599764/
https://www.ncbi.nlm.nih.gov/pubmed/23442783
http://dx.doi.org/10.1186/1471-2296-14-28
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author Hall, Gillian C
Morant, Steve V
Carroll, Dawn
Gabriel, Zahava L
McQuay, Henry J
author_facet Hall, Gillian C
Morant, Steve V
Carroll, Dawn
Gabriel, Zahava L
McQuay, Henry J
author_sort Hall, Gillian C
collection PubMed
description BACKGROUND: This study updated our knowledge of UK primary care neuropathic pain incidence rates and prescribing practices. METHODS: Patients with a first diagnosis of post-herpetic neuralgia (PHN), painful diabetic neuropathy (PDN) or phantom limb pain (PLP) were identified from the General Practice Research Database (2006 – 2010) and incidence rates were calculated. Prescription records were searched for pain treatments from diagnosis of these conditions and the duration and daily dose estimated for first-line and subsequent treatment regimens. Recording of neuropathic back and post-operative pain was investigated. RESULTS: The study included 5,920 patients with PHN, 5,340 with PDN, and 185 with PLP. The incidence per 10,000 person-years was 3.4 (95% CI 3.4, 3.5) for PHN; and 0.11 (95% CI 0.09, 0.12) for PLP. Validation of the PDN case definition suggested that was not sensitive. Incident PHN increased over the study period. The most common first-line treatments were amitriptyline or gabapentin in the PDN and PLP cohorts, and amitriptyline or co-codamol (codeine-paracetamol) in PHN. Paracetamol, co-dydramol (paracetamol-dihydrocodeine) and capsaicin were also often prescribed in one or more condition. Most first-line treatments comprised only one therapeutic class. Use of antiepileptics licensed for neuropathic pain treatment had increased since 2002–2005. Amitriptyline was the only antidepressant prescribed commonly as a first-line treatment. CONCLUSION: The UK incidence of diagnosed PHN has increased with the incidence of back-pain and post-operative pain unclear. While use of licenced antiepileptics increased, prescribing of therapy with little evidence of efficacy in neuropathic pain is still common and consequently treatment was often not in-line with current guidance.
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spelling pubmed-35997642013-03-17 An observational descriptive study of the epidemiology and treatment of neuropathic pain in a UK general population Hall, Gillian C Morant, Steve V Carroll, Dawn Gabriel, Zahava L McQuay, Henry J BMC Fam Pract Research Article BACKGROUND: This study updated our knowledge of UK primary care neuropathic pain incidence rates and prescribing practices. METHODS: Patients with a first diagnosis of post-herpetic neuralgia (PHN), painful diabetic neuropathy (PDN) or phantom limb pain (PLP) were identified from the General Practice Research Database (2006 – 2010) and incidence rates were calculated. Prescription records were searched for pain treatments from diagnosis of these conditions and the duration and daily dose estimated for first-line and subsequent treatment regimens. Recording of neuropathic back and post-operative pain was investigated. RESULTS: The study included 5,920 patients with PHN, 5,340 with PDN, and 185 with PLP. The incidence per 10,000 person-years was 3.4 (95% CI 3.4, 3.5) for PHN; and 0.11 (95% CI 0.09, 0.12) for PLP. Validation of the PDN case definition suggested that was not sensitive. Incident PHN increased over the study period. The most common first-line treatments were amitriptyline or gabapentin in the PDN and PLP cohorts, and amitriptyline or co-codamol (codeine-paracetamol) in PHN. Paracetamol, co-dydramol (paracetamol-dihydrocodeine) and capsaicin were also often prescribed in one or more condition. Most first-line treatments comprised only one therapeutic class. Use of antiepileptics licensed for neuropathic pain treatment had increased since 2002–2005. Amitriptyline was the only antidepressant prescribed commonly as a first-line treatment. CONCLUSION: The UK incidence of diagnosed PHN has increased with the incidence of back-pain and post-operative pain unclear. While use of licenced antiepileptics increased, prescribing of therapy with little evidence of efficacy in neuropathic pain is still common and consequently treatment was often not in-line with current guidance. BioMed Central 2013-02-26 /pmc/articles/PMC3599764/ /pubmed/23442783 http://dx.doi.org/10.1186/1471-2296-14-28 Text en Copyright ©2013 Hall et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Hall, Gillian C
Morant, Steve V
Carroll, Dawn
Gabriel, Zahava L
McQuay, Henry J
An observational descriptive study of the epidemiology and treatment of neuropathic pain in a UK general population
title An observational descriptive study of the epidemiology and treatment of neuropathic pain in a UK general population
title_full An observational descriptive study of the epidemiology and treatment of neuropathic pain in a UK general population
title_fullStr An observational descriptive study of the epidemiology and treatment of neuropathic pain in a UK general population
title_full_unstemmed An observational descriptive study of the epidemiology and treatment of neuropathic pain in a UK general population
title_short An observational descriptive study of the epidemiology and treatment of neuropathic pain in a UK general population
title_sort observational descriptive study of the epidemiology and treatment of neuropathic pain in a uk general population
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3599764/
https://www.ncbi.nlm.nih.gov/pubmed/23442783
http://dx.doi.org/10.1186/1471-2296-14-28
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