Australian Neuropathic Pain Study

Today's post from racgp.org.au (see link below) looks at the results of an Australian study of people with neuropathic pain problems. Very often, surveys like this can be difficult to understand for people looking for quick information but this one gives clear information and a useful insight into how many neuropathy patients react to their disease. Of course, a study of Australian patients doesn't mean that this applies to the rest of the world; regional differences and circumstances will provide different results depending on where you are but I would guess that most people living with neuropathy across the world will recognise much of the information shown here.

Neuropathic Pain
Volume 42, No.3, March 2013 Pages 91-91

Allan Pollack FMRC University of Sydney, New South Wales.

Christopher Harrison Australian GP Statistics & Classification Centre, University of Sydney, New South Wales.

Joan Henderson Family Medicine Research Centre, University of Sydney, New South Wales.

Helena Britt Family Medicine Research Centre, University of Sydney, New South Wales.

Neuropathic pain (NP) may result from a lesion, disease or dysfunction of the somatosensory system (peripheral or central nervous system). Examples include diabetic polyneuropathy, postherpetic and trigeminal neuralgias, spinal cord injury pain and painful radiculopathy. While general population surveys in the United Kingdom and France indicate a prevalence of 7–8%, information is scant in Australia, as the existence of NP may be subsumed within the diagnostic label of the associated condition.

This lack of information led us to design a sub-study of the BEACH program, surveying 2654 patients from 91 general practitioners in late 2012, to determine the prevalence of NP among patients seen in Australian general practice, its most commonly described symptoms, the time between the onset of symptoms and consulting a GP, reasons prompting the patient to seek help and reasons for the patient delaying this. The prevalence of NP (or its symptoms) was 8.5% (n=226), comprising 6.6% formally diagnosed NP and 1.9% symptoms of (undiagnosed) NP. There was no difference in the prevalence between the sexes.

Patients aged 45–64 years had the highest rate of NP (15.8%, Figure 1), accounting for 109 (48.7%) of the 224 respondents with NP. There were 439 responses by 225 patients describing the nature of the NP. The three most common were ‘shooting pain’ (52.9% of patients), ‘burning’ (47.6%) and ‘pins and needles’ (44.0%). Time between NP symptom onset and first seeking GP care was reported by 205 respondents. The majority of patients (84.9%) sought help within 6 months of symptom onset. The most frequent reasons to seek GP help were intolerable pain or interference with normal routine, sleep or physical activity (Table 1). The most common single reason (given by 12 of 30 patients) for waiting more than 6 months was that the patient ‘hoped pain would self-resolve’. These results indicate a prevalence of NP similar to that of the European population surveys.


Figure 1 (above). Age-specific rates of neuropathic pain (with 95% confidence limits)

Table 1(below).

Table 1. What finally prompted patients to seek help from their GP (multiple responses allowed

Reason                       Responses    Proportion of 204 patients(%)

Unable to tolerate pain      121               59
Pain was interfering with:
- normal daily routine        114               56

-sleep                              104               51

-physical activity               104               51

-family/friends                   32                16

-relationships                    30                 15

TOTAL                              505 responses

Acknowledgements Competing interests: None.
Provenance and peer review: Commissioned; not peer reviewed.

The authors thank the GP participants in the BEACH program, and all members of the BEACH team. Funding contributors to BEACH from April 2012 to March 2013: Australian Government Department of Health and Ageing; AstraZeneca Pty Ltd (Australia); CSL Biotherapies Pty Ltd; Merck, Sharp and Dohme (Australia) Pty Ltd; National Prescribing Service; Novartis Pharmaceuticals Australia Pty Ltd; Pfizer Australia Pty Ltd. This SAND sub-study was undertaken in collaboration with Pfizer Australia Pty Ltd. BEACH and all SAND sub-studies are approved by the Human Research Ethics Committee of the University of Sydney.

References
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Bouhassira D, Lantéri-Minet M, Attal N, Laurent B, Touboul C. Prevalence of chronic pain with neuropathic characteristics in the general population. Pain 2008;136:380–7. Search PubMed
International Association for the Study of Pain. Available at www.iasp-pain.org/AM/Template.cfm?Section=Home&Template=/CM/ContentDisplay.cfm&ContentID=12215 [Accessed 11 January 2013].
McBeth J, Prescott G, Scotland G, et al. Cognitive behavioural therapy, exercise, or both for treating chronic widespread pain. Arch Intern Med 2012;172:48–57. Search PubMed

http://www.racgp.org.au/afp/2013/march/neuropathic-pain/