Evaluation of Treatment Patterns and Direct Costs Associated with the Management of Neuropathic Pain

Abstract

Background. Neuropathic pain has a prevalence of 2–17% in the general population. Diagnosis and treatment of neuropathic pain are not fully described in different populations. The aim was to determine the treatment patterns and direct costs of care associated with the management of neuropathic pain from the onset of the first symptom to up to two years after diagnosis. Methods. From a drug-claim database, a cohort of randomly selected outpatients diagnosed with neuropathic pain was obtained from an insurer in Colombia and followed up for two years after diagnosis. The clinical records were reviewed individually to identify the study variables, including the time needed to make the diagnosis, the medical and paraclinical resources used, the pharmacological therapy for pain management, and the direct costs associated with care. Results. We identified 624 patients in 49 cities, with a mean age of 50.3 ± 14.1 years, of which 324 were men (51.9%). An average of 90 days passed from the initial consultation until the diagnosis of neuropathic pain, the most frequent being lumbosacral radiculopathy (57.9%). 34.5% of the cohort had at least one diagnostic imaging procedure, and 16% had an electromyography. On average, they were treated by a general practitioner twice. 91.7% received initial treatment with tramadol, carbamazepine, amitriptyline, imipramine, or pregabalin, and 60.4% received combined therapy. The mean cost of care for two years for each patient was US$246.3. Conclusions. Patients with neuropathic pain in Colombia are being diagnosed late, are using therapeutic agents not recommended as first-line treatment by clinical practice guidelines, and are being treated for short periods of time.

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“…Neuropathic pain, which is experienced by 2% to 17% of patients each year, 7 can lead to chronic pain syndromes, such as postherpetic neuralgia and diabetic peripheral neuropathic pain. 1 Current options do not eliminate pain for most patients and are typically accompanied by adverse effects (eg, dizziness, drowsiness, and cognitive and motor impairment).…”

Neurodynamic Treatment Promotes Mechanical Pain Modulation in Sensory Neurons and Nerve Regeneration in Rats

“…In particular, when PNS injuries occur, they are often associated with sensory and motor impairment or loss of function distal to the lesion site. Unfortunately, the interventional procedure improvement and opioid prescriptions did not reduce the burden of neuropathic pain, which is still a clinical challenge in terms of making a diagnosis and defining and maintaining an adequate therapy [ 3 , 4 , 5 ].…”