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


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.

SUBMITTER: Hall GC 

PROVIDER: S-EPMC3599764 | biostudies-literature | 2013 Feb

REPOSITORIES: biostudies-literature

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Publications

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

Hall Gillian C GC   Morant Steve V SV   Carroll Dawn D   Gabriel Zahava L ZL   McQuay Henry J HJ  

BMC family practice 20130226


<h4>Background</h4>This study updated our knowledge of UK primary care neuropathic pain incidence rates and prescribing practices.<h4>Methods</h4>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  ...[more]

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