BMC Family Practice | |
An observational descriptive study of the epidemiology and treatment of neuropathic pain in a UK general population | |
Research Article | |
Henry J McQuay1  Gillian C Hall2  Steve V Morant3  Dawn Carroll4  Zahava L Gabriel4  | |
[1] Emeritus Fellow Balliol College, University of Oxford, Oxford, UK;Grimsdyke House, EN5 4ND, Ravenscroft Park, London, UK;Independent Statistician, Hadenham, Bucks, UK;Outcomes Research and Evidence Based Medicine, Pfizer Ltd, Tadworth, UK; | |
关键词: Neuropathic pain; Incidence; Post-herpetic neuralgia; Painful diabetic neuropathy; Phantom limb pain; Treatment; Antidepressant; Antiepileptic; Primary care; | |
DOI : 10.1186/1471-2296-14-28 | |
received in 2012-05-28, accepted in 2013-02-15, 发布年份 2013 | |
来源: Springer | |
【 摘 要 】
BackgroundThis study updated our knowledge of UK primary care neuropathic pain incidence rates and prescribing practices.MethodsPatients 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.ResultsThe 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.ConclusionThe 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.
【 授权许可】
CC BY
© Hall et al; licensee BioMed Central Ltd. 2013
【 预 览 】
Files | Size | Format | View |
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RO202311105474689ZK.pdf | 325KB | download |
【 参考文献 】
- [1]
- [2]
- [3]
- [4]
- [5]
- [6]
- [7]
- [8]
- [9]
- [10]
- [11]
- [12]
- [13]
- [14]
- [15]
- [16]
- [17]
- [18]
- [19]
- [20]
- [21]
- [22]
- [23]
- [24]
- [25]
- [26]
- [27]