BackgroundThe prevalence of neuropathic pain (NeP) has been estimated within specific health conditions; however, there are no published data on its broad prevalence in the US. The current exploratory study addresses this gap using the validated PainDetect questionnaire as a screener for probable NeP in a general-population health survey conducted with a multimodal recruitment strategy to maximize demographic representativeness.Materials and methodsAdult respondents were recruited from a combination of Internet panels, telephone lists, address lists, mall-based interviews, and store-receipt invitations using a random stratified-sampling framework, with strata defined by age, sex, and race/ethnicity. Older persons and minorities were oversampled to improve prevalence estimates. Results were weighted to match the total adult US population using US Census data. Demographic information was collected, and respondents who experienced physical pain in the past 12 months completed the PainDetect and provided additional pain history. A cutoff score of 19 or greater on the PainDetect was used to define probable NeP.ResultsA total of 24,925 respondents (average response rate 2.5%) provided demographic data (52.2% female, mean age 51.5 years); 15,751 respondents reported pain (63.7%), of which 2,548 (15.7%, 95% confidence interval 14.9%–16.5%) had probable NeP based on the PainDetect, which was 10% (95% confidence interval 9.5%–10.5%) of all respondents. Among those reporting pain, the prevalence of probable NeP among Blacks and Hispanics was consistently higher than Whites in each age- and sex group. The highest prevalence among those with pain was among male Hispanics 35–44 years (32.4%) and 45–54 years (24.2%) old. The most commonly used medications reported by those with probable NeP were nonsteroidal anti-inflammatory drugs (44.2%), followed by weak opioids (31.7%), antiepileptics (10.9%), and strong opioids (10.9%).ConclusionThis is the first study to provide an estimate of the prevalence of probable NeP in the US, showing significant variation by age and ethnicity.

Young and elderly adults heard recorded words that had been computer-edited from connected speech so as to be heard in isolation from their linguistic surround. Word identification was tested for words in isolation and when heard with increasing amounts of linguistic context that had either preceded or followed them in their original utterances. Although the elderly subjects were poorer in identifying the words in isolation compared to young adults, both age groups showed similar increases in correct word identification as increasing amounts of prior context were presented. By contrast, context that followed the target words was less effective for the elderly subjects than it was for the young. It is argued that a memory trace of the unclear stimulus must be maintained for effective utilization of following context in a retrospective analysis. The elderly subjects' relative inability to utilize following context implicates an age-related memory deficit operating at the sentence level.

BackgroundSince few studies have characterized painful diabetic peripheral neuropathy (pDPN) symptoms in multicultural populations, this study fielded a survey to better understand pDPN and its impact in African-American, Caucasian, and Hispanic populations.MethodsKelton fielded a survey by phone or Internet, in English or Spanish, among adults with pDPN symptoms in the United States between August and October 2015; African-Americans and Hispanics were oversampled to achieve at least 500 subjects for each group. Patients were required to have been diagnosed with pDPN or score ≥ 3 on ID Pain validated screening tool. The survey elicited information on pDPN symptoms and interactions with healthcare providers (HCPs), and included the Brief Pain Inventory and pain-specific Work Productivity and Assessment Questionnaire (WPAI:SHP).ResultsRespondents included 823 Caucasians, 525 African-Americans, and 537 Hispanics; approximately half of African-Americans and Hispanics were <40 years of age, vs 12% of Caucasians. Pain was less likely to be rated moderate or severe by African-Americans (65%) and Hispanics (49%) relative to Caucasians (87%; p < 0.05). African-Americans and Hispanics were less likely than Caucasians to report experiencing specific pDPN sensory symptoms. Significantly fewer African-Americans and Hispanics reported receiving a pDPN diagnosis relative to Caucasians (p < 0.05), and higher proportions of African-Americans and Hispanics reported difficulty communicating with their HCP (p < 0.05). WPAI:SHP activity impairment was lower in Hispanics (43%) relative to African-Americans (53%) and Caucasian (56%; p < 0.05).ConclusionsMulticultural patients reported differences in pDPN symptoms and pain relative to Caucasians, and fewer received a pDPN diagnosis. While further evaluation is needed to understand these differences, these data suggest a need to broaden pDPN educational initiatives to improve patient-HCP dialogue and encourage discussion of pDPN symptoms and their impact in a multicultural setting.Electronic supplementary materialThe online version of this article (10.1186/s40842-017-0051-2) contains supplementary material, which is available to authorized users.

Opioids are commonly prescribed to employees with injury-related WC/STD claims. Employers may benefit from proactively addressing the issue of opioid abuse in these populations.

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