An observational descriptive study of the epidemiology and treatment of neuropathic pain in a UK general population. Hall, G. C., Morant, S. V., Carroll, D., Gabriel, Z. L., & McQuay, H. J. BMC family practice, 14:28, 2013. doi abstract bibtex 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.
@article{hall_observational_2013,
title = {An observational descriptive study of the epidemiology and treatment of neuropathic pain in a {UK} general population},
volume = {14},
issn = {1471-2296},
doi = {10.1186/1471-2296-14-28},
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.},
language = {eng},
journal = {BMC family practice},
author = {Hall, Gillian C. and Morant, Steve V. and Carroll, Dawn and Gabriel, Zahava L. and McQuay, Henry J.},
year = {2013},
pmid = {23442783},
pmcid = {PMC3599764},
keywords = {Acetaminophen, Adolescent, Adult, Aged, Amines, Amitriptyline, Analgesics, Non-Narcotic, Analgesics, Opioid, Anticonvulsants, Capsaicin, Child, Child, Preschool, Codeine, Cyclohexanecarboxylic Acids, Diabetic Neuropathies, Drug Combinations, Drug Prescriptions, Female, Great Britain, Humans, Hydrocodone, Infant, Male, Middle Aged, Neuralgia, Postherpetic, Phantom Limb, Physician's Practice Patterns, Primary Health Care, Sensory System Agents, Young Adult, gamma-Aminobutyric Acid, incidence},
pages = {28}
}
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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.","language":"eng","journal":"BMC family practice","author":[{"propositions":[],"lastnames":["Hall"],"firstnames":["Gillian","C."],"suffixes":[]},{"propositions":[],"lastnames":["Morant"],"firstnames":["Steve","V."],"suffixes":[]},{"propositions":[],"lastnames":["Carroll"],"firstnames":["Dawn"],"suffixes":[]},{"propositions":[],"lastnames":["Gabriel"],"firstnames":["Zahava","L."],"suffixes":[]},{"propositions":[],"lastnames":["McQuay"],"firstnames":["Henry","J."],"suffixes":[]}],"year":"2013","pmid":"23442783","pmcid":"PMC3599764","keywords":"Acetaminophen, Adolescent, Adult, Aged, Amines, Amitriptyline, Analgesics, Non-Narcotic, Analgesics, Opioid, Anticonvulsants, Capsaicin, Child, Child, Preschool, Codeine, Cyclohexanecarboxylic Acids, Diabetic Neuropathies, Drug Combinations, Drug Prescriptions, Female, Great Britain, Humans, Hydrocodone, Infant, Male, Middle Aged, Neuralgia, Postherpetic, Phantom Limb, Physician's Practice Patterns, Primary Health Care, Sensory System Agents, Young Adult, gamma-Aminobutyric Acid, incidence","pages":"28","bibtex":"@article{hall_observational_2013,\n\ttitle = {An observational descriptive study of the epidemiology and treatment of neuropathic pain in a {UK} general population},\n\tvolume = {14},\n\tissn = {1471-2296},\n\tdoi = {10.1186/1471-2296-14-28},\n\tabstract = {BACKGROUND: This study updated our knowledge of UK primary care neuropathic pain incidence rates and prescribing practices.\nMETHODS: 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.\nRESULTS: 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.\nCONCLUSION: 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.},\n\tlanguage = {eng},\n\tjournal = {BMC family practice},\n\tauthor = {Hall, Gillian C. and Morant, Steve V. and Carroll, Dawn and Gabriel, Zahava L. and McQuay, Henry J.},\n\tyear = {2013},\n\tpmid = {23442783},\n\tpmcid = {PMC3599764},\n\tkeywords = {Acetaminophen, Adolescent, Adult, Aged, Amines, Amitriptyline, Analgesics, Non-Narcotic, Analgesics, Opioid, Anticonvulsants, Capsaicin, Child, Child, Preschool, Codeine, Cyclohexanecarboxylic Acids, Diabetic Neuropathies, Drug Combinations, Drug Prescriptions, Female, Great Britain, Humans, Hydrocodone, Infant, Male, Middle Aged, Neuralgia, Postherpetic, Phantom Limb, Physician's Practice Patterns, Primary Health Care, Sensory System Agents, Young Adult, gamma-Aminobutyric Acid, incidence},\n\tpages = {28}\n}\n\n","author_short":["Hall, G. 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