Clinical Characteristics, Patient-Reported Outcomes, and Previous Therapeutic Management of Patients with Uncontrolled Neuropathic Pain Referred to Pain Clinics
Table 7
Pharmacological treatment, reasons for uncontrolled pain, and treatment satisfaction by clinical entity.
Characteristic
Diabetic neuropathy
Other neuropathies
Trigeminal neuralgia
Other neuralgia
Radiculopathy
Nerve entrapment syndrome
Plexopathy
Complex regional pain syndrome
Postsurgery/trauma
Oncological pain
Central neuropathic pain
VAS, mean ± SD
WHO-DAS II Interference with life (severe/extreme), %
52.0
52.7
42.9
39.1
46.7
38.3
52.4
67.7
33.4
30.4
66.7
Number of previous treatments, mean ± SD
Treatment at the time of inclusion, %
Paracetamol
17.4
5.6
6.3
23.8
32.0
28.6
22.7
20.0
25.5
20.9
10.0
NSAIDs
17.4
33.3
21.9
47.6
49.6
48.6
40.9
48.6
44.7
22.0
10.0
Opiods
34.8
27.8
28.1
23.8
44.9
45.7
50.0
37.1
27.7
31.9
50.0
Tramadol
21.7
22.2
28.1
14.3
33.5
34.3
45.5
25.7
14.9
24.2
35.0
Others
13.0
11.1
3.1
9.5
15.1
14.3
18.2
20.0
12.8
13.2
30.0
AED
52.2
72.2
90.6
47.6
45.6
42.9
45.5
54.3
36.2
70.3
85.0
Pragabalin
26.1
38.9
25.0
14.3
28.3
14.3
27.3
31.4
19.1
24.2
35.0
Gabapentin
30.4
33.3
31.3
19.0
16.9
25.7
18.2
11.4
17.0
38.5
60.0
Carbamazepine/ oxcarbazepine
0.0
0.0
56.3
14.3
1.1
0.0
4.5
5.7
0.0
12.1
10.0
Other
4.3
5.6
12.5
0.0
2.6
2.9
0.0
5.7
0.0
6.6
20.0
Antidepressants
17.4
22.2
18.8
19.0
16.2
14.3
45.5
28.6
14.9
23.1
20.0
Duloxetine
8.7
5.6
0.0
4.8
6.6
2.9
0.0
5.7
4.3
5.5
5.0
Tricyclics
8.7
22.2
15.6
9.5
5.9
8.6
31.8
20.0
8.5
16.5
5.0
Other
0.0
0.0
3.1
4.8
4.4
5.7
13.6
5.7
2.1
1.1
10.0
Other drugs
34.8
44.4
43.8
52.4
50.0
37.1
40.9
37.1
44.7
48.4
55.0
Causes for uncontrolled pain, %
Misdiagnosis
15.4
18.2
3.1
12.5
8.4
10.3
20.8
11.1
27.8
9.1
4.8
Nonoptimized treatment
80.8
77.3
78.1
83.3
91.2
89.7
95.8
86.1
77.8
87.9
85.7
Use of ineffective drugs
61.9
29.4
20.0
45.0
48.7
57.1
39.1
48.4
69.0
36.8
11.1
Subtherapeutic dose
47.6
41.2
52.0
25.0
46.1
40.0
43.5
38.7
28.6
57.5
55.6
Other
9.5
41.2
44.0
40.0
24.4
17.1
30.4
25.8
19.0
21.8
50.0
Lack of compliance
15.4
4.5
0.0
12.5
6.1
7.7
4.2
11.1
1.9
5.1
9.5
Intolerance
0.0
9.1
12.5
4.2
7.7
5.1
4.2
2.8
3.7
6.1
19.0
Other
11.5
9.1
12.5
4.2
6.4
0.0
0.0
5.6
7.4
10.1
9.5
SATMED-Q
Total score, mean ± SD
Efficacy, mean ± SD
AED: antiepileptic drugs; NSAIDs: nonsteroidal anti-inflammatory drugs; SATMED-Q: Treatment Satisfaction with Medicines Questionnaire; SD: standard deviation; VAS: visual analog scale; WHO-DAS II: World Health Organization Disability Assessment Schedule II; Yrs: years.
