Painful diabetic neuropathy: A cross-sectional survey of health state impairment and treatment patterns

Aims: To determine the patient burden of painful diabetic peripheral neuropathy (DPN) with respect to pain intensity and impact on patient functioning and to characterize relevant DPN treatment patterns. Methods: Patients (n=140) with painful DPN identified during an observational survey of neuropathic pain syndromes in six European countries were included in the current analysis. Patients primarily recruited from community-based general practices answered a questionnaire that included pain severity and interference items from the modified Short-Form Brief Pain Inventory, the EuroQol survey, and questions related to productivity and health resource utilization. Physicians provided information on disease duration and current medications prescribed for painful DPN and pain-related comorbidities. Results: The mean patient age was 65.6±11.2 years; 58% of the patients were ≥65 years. Duration of painful DPN was >1 year in 74% of patients. The mean Pain Severity Index was 5.0±2.0; 57% of patients reported moderate pain and 25% reported severe pain. Patients reported moderate interference with functioning despite 91% of patients reporting use of prescription medications for painful DPN including antiepileptics (56%), standard analgesics (63%), and amitriptyline (26%). Use of prescription medication for concomitant anxiety, depression, or sleep disturbance was reported for 43% of the patients. Disruption in employment was reported by 35% of the patients. Pain severity was significantly associated with reduced health state valuation (P<.001), greater pain interference scores (P<.001), greater employment disruption (P<.05), and more physician visits (P<.05). Conclusions: Painful DPN is associated with substantial patient burden resulting from interference with daily functioning, especially in patients with suboptimal pain management.