An observational descriptive study of the epidemiology and treatment of neuropathic pain in a UK general population.
BMC Fam Pract
; 14: 28, 2013 Feb 26.
Article
em En
| MEDLINE
| ID: mdl-23442783
ABSTRACT
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 licensed 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.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Membro Fantasma
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Prescrições de Medicamentos
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Atenção Primária à Saúde
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Padrões de Prática Médica
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Neuropatias Diabéticas
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Neuralgia Pós-Herpética
Tipo de estudo:
Guideline
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Incidence_studies
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Prognostic_studies
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Screening_studies
Limite:
Adolescent
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Adult
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Aged
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Child
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Child, preschool
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Female
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Humans
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Infant
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Male
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Middle aged
País/Região como assunto:
Europa
Idioma:
En
Revista:
BMC Fam Pract
Ano de publicação:
2013
Tipo de documento:
Article
País de afiliação:
Reino Unido