EPIDEMIOLOGY OF PHYSICIAN-DIAGNOSED NEUROPATHIC PAIN IN BRAZIL

Author(s)

Udall M1, Kudel I2, Cappelleri JC3, Sadosky A1, Concialdi K2, Parsons B1, Hlavacek P1, Hopps M1, Salomon P4, DiBonaventura M5, Clark P6, Garcia JB7
1Pfizer Inc., New York, NY, USA, 2Kantar Health, New York, NY, USA, 3Pfizer Inc., Groton, CT, USA, 4Pfizer Inc., Bosques de las Lomas, Mexico, 5Ipsos Healthcare, New York, NY, USA, 6Hospital Infanti de México, Cuauhtémoc, Mexico, 7University of Maranhão, São Luís, Brazil

OBJECTIVES:: Estimate the prevalence of neuropathic pain (NeP) among chronic pain patients attending Brazilian hospitals and pain clinics in São Paulo, Ceara, and Bahia and explore the clinical characteristics of six principal subtypes. METHODS:: Physicians used Douleur Neuropathique-4 and exam to diagnose NeP in patients reporting chronic pain for ≥3 months (n=2,118). They also reported NeP subtype(s) and symptoms. Diagnosed patients completed a questionnaire that included treatment experiences, the EuroQoL-5D-3L (EQ-5D), Brief Pain Inventory (BPI), and the Work Productivity and Activity Impairment questionnaire. Descriptive analyses were performed. RESULTS:: NeP prevalence was 14.5% (n=307). Patients were mostly female (80.5%), middle-aged (Mean=52.5, Standard Deviation=13.9), and Pardo ethnicity (44.3%). Of those diagnosed with a NeP subtype (n=206), the largest proportion were diagnosed with chronic low back pain with a neuropathic component (36.8%). Others were diagnosed with diabetic peripheral (DPN; 18.7%), central neuropathic pain (CNP; 17.7%), post-trauma neuropathy (PTN; 17.2%), followed by post-surgical neuropathy (PSN; 13.4%), and post-herpetic neuralgia (PHN; 3.3%). The most widely reported symptoms across subtypes were numbness (62.2%-88.9%) and hyperalgesia (32.1%-75.0%). The most widely used pain analgesics across subtypes were nonsteroidal anti-inflammatory drugs (NSAID; 14.3%-47.2%) and opioids (0.0%-35.7%). PTN and PSN patients reported the lowest EQ-5D index scores (M=0.42, SD=0.19) and BPI-Severity scores (M=6.98, SD=1.92), respectively. Those diagnosed with CNP had the highest BPI-Interference Scale scores (M=6.03, SD=2.74) and Overall Work Impairment (M=77.13, SD=18.21). Patients with PHN reported the least impairment based on EQ-5D index scores (M=0.60, SD=0.04). Those with DPN had the lowest BPI scores (BPI-severity: M=4.55, SD=2.32; BPI-interference: M=4.65, SD=2.68) and Overall Work Impairment (M=24.4%, SD=26.94%). CONCLUSIONS::  Evaluation of chronic pain patients in Brazil yielded a NeP prevalence of 14.5%. NSAIDs and opioids were commonly used to treat NeP. Additionally, there was a high incidence of NeP-related symptoms across all subtypes, but varying levels of dysfunction on all measures.

Conference/Value in Health Info

2017-09, ISPOR Latin America 2017, Sao Paulo, Brazil

Value in Health, Vol. 20, No. 9 (October 2017)

Code

PSY38

Topic

Patient-Centered Research

Topic Subcategory

Patient-reported Outcomes & Quality of Life Outcomes

Disease

Diabetes/Endocrine/Metabolic Disorders, Systemic Disorders/Conditions

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