Limits...
Burden of illness associated with painful diabetic peripheral neuropathy among adults seeking treatment in the US: results from a retrospective chart review and cross-sectional survey.

Sadosky A, Schaefer C, Mann R, Bergstrom F, Baik R, Parsons B, Nalamachu S, Nieshoff E, Stacey BR, Anschel A, Tuchman M - Diabetes Metab Syndr Obes (2013)

Bottom Line: Subjects with pDPN exhibited high pain levels, which were associated with poor sleep, function, and productivity.Health care resource utilization in pDPN was prevalent and costs increased with greater pain severity.The burden of pDPN was greater among subjects with greater pain severity.

View Article: PubMed Central - PubMed

Affiliation: Pfizer Inc, New York, N Y.

ABSTRACT

Background: The purpose of this study was to characterize the burden of illness among adult subjects with painful diabetic peripheral neuropathy (pDPN) seeking treatment in the US.

Methods: This observational study recruited 112 subjects with pDPN during routine visits from general practitioner and specialist sites. Subjects completed a one-time questionnaire, which included demographics, symptom duration, health care resource use, out-of-pocket costs, employment status, and validated measures that assessed pain, functioning, sleep, anxiety and depression, health status, and productivity. Investigators completed a case report form based on a 6-month retrospective chart review to capture clinical information, pDPN-related treatments, and other pDPN-related health care resource use over the past 6 months. Annualized costs were extrapolated based on reported 6-month health care resource use.

Results: The mean age of the subjects was 61.1 years, 52.7% were female, and 17.9% were in paid employment. The most common comorbid conditions were sleep disturbance/insomnia (43.8%), depressive symptoms (41.1%), and anxiety (35.7%). The mean pain severity score was 5.2 (0-10 scale), and 79.5% reported moderate or severe pain. The mean pain interference with function score was 5.0 (0-10 scale) overall, with 2.0 among mild, 5.1 among moderate, and 7.0 among severe. The mean Medical Outcomes Study sleep problems index score was 48.5 (0-100 scale). The mean health state utility score was 0.61. Among subjects employed for pay, mean overall work impairment was 43.6%. Across all subjects, mean overall activity impairment was 52.3%. In total, 81.3% were prescribed at least one medication for their pDPN; 50.9% reported taking at least one nonprescription medication. Adjusted mean annualized total direct and indirect costs per subject were $4841 and $9730, respectively. Outcomes related to pain interference with function, sleep, health status, activity impairment, prescription medication use, and direct and indirect costs were significantly worse among subjects with more severe pain (P < 0.0020).

Conclusion: Subjects with pDPN exhibited high pain levels, which were associated with poor sleep, function, and productivity. Health care resource utilization in pDPN was prevalent and costs increased with greater pain severity. The burden of pDPN was greater among subjects with greater pain severity.

No MeSH data available.


Related in: MedlinePlus

Use of prescription treatments for pDPN, overall.*Notes: *Subjects may be taking more than one class of prescription medication; †Weak SOA, Strong SAO, and LAO were also collapsed into “All Opioids” class; proportion prescribed = 33.0% overall, 9.1% mild, 31.6% moderate, 53.1% severe (P = 0.0027).Abbreviations: AEDs, antiepileptics; SAO, strong-acting opioids; NSAIDs, nonsteroidal anti-inflammatory drugs; LAO, long-acting opioids; SNRIs, Serotonin–norepinephrine reuptake inhibitors; TCAs, tricyclic antidepressants; SSRI, selective serotonin re-uptake inhibitors.
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC3569051&req=5

f3B-dmso-6-079: Use of prescription treatments for pDPN, overall.*Notes: *Subjects may be taking more than one class of prescription medication; †Weak SOA, Strong SAO, and LAO were also collapsed into “All Opioids” class; proportion prescribed = 33.0% overall, 9.1% mild, 31.6% moderate, 53.1% severe (P = 0.0027).Abbreviations: AEDs, antiepileptics; SAO, strong-acting opioids; NSAIDs, nonsteroidal anti-inflammatory drugs; LAO, long-acting opioids; SNRIs, Serotonin–norepinephrine reuptake inhibitors; TCAs, tricyclic antidepressants; SSRI, selective serotonin re-uptake inhibitors.

Mentions: Ninety-one (81.3%) of the subjects were prescribed at least one medication for the treatment of pDPN (Figure 3A). As pain severity increased, the proportion of subjects prescribed one or more medications increased significantly (P = 0.0004), with 96.9% of subjects in the severe pain group prescribed at least one prescription medication for pDPN. Overall, subjects were prescribed 1.6 ± 1.3 medications; across pain severity groups, the mean number of prescription medications per subject increased (mild 0.9 ± 1.0; moderate: 1.5 ± 1.1; severe, 2.2 ± 1.4; P = 0.0004, Table 3). The top four medication classes prescribed were antiepileptics (55.4%), weak short-acting opioids (17.0%), strong short-acting opioids (14.3%), and nonsteroidal anti-inflammatory drugs (14.3%, Figure 3B). Among subjects prescribed antiepileptics, the most commonly prescribed medications were gabapentin (61.3%) and pregabalin (38.7%, data not shown). Among subjects prescribed weak short-acting opioids, all (100%) were prescribed hydrocodone-acetaminophen (data not shown). Among subjects prescribed strong short-acting opioids, the most commonly prescribed medications were oxycodone-acetaminophen (37.5%) and oxycodone hydrochloride immediate-release (31.3%, data not shown). Among subjects prescribed nonsteroidal anti-inflammatory drugs, the most commonly prescribed medications were ibuprofen (56.3%) and meloxicam (25.0%, data not shown). Thirteen (11.6%) subjects were prescribed a transcutaneous electrical nerve stimulation home device for neuropathic pain (data not shown).


Burden of illness associated with painful diabetic peripheral neuropathy among adults seeking treatment in the US: results from a retrospective chart review and cross-sectional survey.

Sadosky A, Schaefer C, Mann R, Bergstrom F, Baik R, Parsons B, Nalamachu S, Nieshoff E, Stacey BR, Anschel A, Tuchman M - Diabetes Metab Syndr Obes (2013)

Use of prescription treatments for pDPN, overall.*Notes: *Subjects may be taking more than one class of prescription medication; †Weak SOA, Strong SAO, and LAO were also collapsed into “All Opioids” class; proportion prescribed = 33.0% overall, 9.1% mild, 31.6% moderate, 53.1% severe (P = 0.0027).Abbreviations: AEDs, antiepileptics; SAO, strong-acting opioids; NSAIDs, nonsteroidal anti-inflammatory drugs; LAO, long-acting opioids; SNRIs, Serotonin–norepinephrine reuptake inhibitors; TCAs, tricyclic antidepressants; SSRI, selective serotonin re-uptake inhibitors.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3569051&req=5

f3B-dmso-6-079: Use of prescription treatments for pDPN, overall.*Notes: *Subjects may be taking more than one class of prescription medication; †Weak SOA, Strong SAO, and LAO were also collapsed into “All Opioids” class; proportion prescribed = 33.0% overall, 9.1% mild, 31.6% moderate, 53.1% severe (P = 0.0027).Abbreviations: AEDs, antiepileptics; SAO, strong-acting opioids; NSAIDs, nonsteroidal anti-inflammatory drugs; LAO, long-acting opioids; SNRIs, Serotonin–norepinephrine reuptake inhibitors; TCAs, tricyclic antidepressants; SSRI, selective serotonin re-uptake inhibitors.
Mentions: Ninety-one (81.3%) of the subjects were prescribed at least one medication for the treatment of pDPN (Figure 3A). As pain severity increased, the proportion of subjects prescribed one or more medications increased significantly (P = 0.0004), with 96.9% of subjects in the severe pain group prescribed at least one prescription medication for pDPN. Overall, subjects were prescribed 1.6 ± 1.3 medications; across pain severity groups, the mean number of prescription medications per subject increased (mild 0.9 ± 1.0; moderate: 1.5 ± 1.1; severe, 2.2 ± 1.4; P = 0.0004, Table 3). The top four medication classes prescribed were antiepileptics (55.4%), weak short-acting opioids (17.0%), strong short-acting opioids (14.3%), and nonsteroidal anti-inflammatory drugs (14.3%, Figure 3B). Among subjects prescribed antiepileptics, the most commonly prescribed medications were gabapentin (61.3%) and pregabalin (38.7%, data not shown). Among subjects prescribed weak short-acting opioids, all (100%) were prescribed hydrocodone-acetaminophen (data not shown). Among subjects prescribed strong short-acting opioids, the most commonly prescribed medications were oxycodone-acetaminophen (37.5%) and oxycodone hydrochloride immediate-release (31.3%, data not shown). Among subjects prescribed nonsteroidal anti-inflammatory drugs, the most commonly prescribed medications were ibuprofen (56.3%) and meloxicam (25.0%, data not shown). Thirteen (11.6%) subjects were prescribed a transcutaneous electrical nerve stimulation home device for neuropathic pain (data not shown).

Bottom Line: Subjects with pDPN exhibited high pain levels, which were associated with poor sleep, function, and productivity.Health care resource utilization in pDPN was prevalent and costs increased with greater pain severity.The burden of pDPN was greater among subjects with greater pain severity.

View Article: PubMed Central - PubMed

Affiliation: Pfizer Inc, New York, N Y.

ABSTRACT

Background: The purpose of this study was to characterize the burden of illness among adult subjects with painful diabetic peripheral neuropathy (pDPN) seeking treatment in the US.

Methods: This observational study recruited 112 subjects with pDPN during routine visits from general practitioner and specialist sites. Subjects completed a one-time questionnaire, which included demographics, symptom duration, health care resource use, out-of-pocket costs, employment status, and validated measures that assessed pain, functioning, sleep, anxiety and depression, health status, and productivity. Investigators completed a case report form based on a 6-month retrospective chart review to capture clinical information, pDPN-related treatments, and other pDPN-related health care resource use over the past 6 months. Annualized costs were extrapolated based on reported 6-month health care resource use.

Results: The mean age of the subjects was 61.1 years, 52.7% were female, and 17.9% were in paid employment. The most common comorbid conditions were sleep disturbance/insomnia (43.8%), depressive symptoms (41.1%), and anxiety (35.7%). The mean pain severity score was 5.2 (0-10 scale), and 79.5% reported moderate or severe pain. The mean pain interference with function score was 5.0 (0-10 scale) overall, with 2.0 among mild, 5.1 among moderate, and 7.0 among severe. The mean Medical Outcomes Study sleep problems index score was 48.5 (0-100 scale). The mean health state utility score was 0.61. Among subjects employed for pay, mean overall work impairment was 43.6%. Across all subjects, mean overall activity impairment was 52.3%. In total, 81.3% were prescribed at least one medication for their pDPN; 50.9% reported taking at least one nonprescription medication. Adjusted mean annualized total direct and indirect costs per subject were $4841 and $9730, respectively. Outcomes related to pain interference with function, sleep, health status, activity impairment, prescription medication use, and direct and indirect costs were significantly worse among subjects with more severe pain (P < 0.0020).

Conclusion: Subjects with pDPN exhibited high pain levels, which were associated with poor sleep, function, and productivity. Health care resource utilization in pDPN was prevalent and costs increased with greater pain severity. The burden of pDPN was greater among subjects with greater pain severity.

No MeSH data available.


Related in: MedlinePlus