Evaluation of Treatment Patterns and Direct Costs Associated with the Management of Neuropathic Pain

Background. Neuropathic pain has a prevalence of 2–17% in the general population. Diagnosis and treatment of neuropathic pain are not fully described in different populations. The aim was to determine the treatment patterns and direct costs of care associated with the management of neuropathic pain...

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Main Authors: Manuel E Machado-Duque, Andres Gaviria-Mendoza, Jorge E Machado-Alba, Natalia Castaño
Format: Article
Language:English
Published: Hindawi Limited 2020-01-01
Series:Pain Research and Management
Online Access:http://dx.doi.org/10.1155/2020/9353940
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spelling doaj-4160f1bba6dd440b988eb746e1bec8d12020-11-25T02:51:08ZengHindawi LimitedPain Research and Management1203-67651918-15232020-01-01202010.1155/2020/93539409353940Evaluation of Treatment Patterns and Direct Costs Associated with the Management of Neuropathic PainManuel E Machado-Duque0Andres Gaviria-Mendoza1Jorge E Machado-Alba2Natalia Castaño3Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S.A. Pereira, Pereira, ColombiaGrupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S.A. Pereira, Pereira, ColombiaGrupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S.A. Pereira, Pereira, ColombiaPfizer S.A.S, Bogotá, ColombiaBackground. Neuropathic pain has a prevalence of 2–17% in the general population. Diagnosis and treatment of neuropathic pain are not fully described in different populations. The aim was to determine the treatment patterns and direct costs of care associated with the management of neuropathic pain from the onset of the first symptom to up to two years after diagnosis. Methods. From a drug-claim database, a cohort of randomly selected outpatients diagnosed with neuropathic pain was obtained from an insurer in Colombia and followed up for two years after diagnosis. The clinical records were reviewed individually to identify the study variables, including the time needed to make the diagnosis, the medical and paraclinical resources used, the pharmacological therapy for pain management, and the direct costs associated with care. Results. We identified 624 patients in 49 cities, with a mean age of 50.3 ± 14.1 years, of which 324 were men (51.9%). An average of 90 days passed from the initial consultation until the diagnosis of neuropathic pain, the most frequent being lumbosacral radiculopathy (57.9%). 34.5% of the cohort had at least one diagnostic imaging procedure, and 16% had an electromyography. On average, they were treated by a general practitioner twice. 91.7% received initial treatment with tramadol, carbamazepine, amitriptyline, imipramine, or pregabalin, and 60.4% received combined therapy. The mean cost of care for two years for each patient was US$246.3. Conclusions. Patients with neuropathic pain in Colombia are being diagnosed late, are using therapeutic agents not recommended as first-line treatment by clinical practice guidelines, and are being treated for short periods of time.http://dx.doi.org/10.1155/2020/9353940
collection DOAJ
language English
format Article
sources DOAJ
author Manuel E Machado-Duque
Andres Gaviria-Mendoza
Jorge E Machado-Alba
Natalia Castaño
spellingShingle Manuel E Machado-Duque
Andres Gaviria-Mendoza
Jorge E Machado-Alba
Natalia Castaño
Evaluation of Treatment Patterns and Direct Costs Associated with the Management of Neuropathic Pain
Pain Research and Management
author_facet Manuel E Machado-Duque
Andres Gaviria-Mendoza
Jorge E Machado-Alba
Natalia Castaño
author_sort Manuel E Machado-Duque
title Evaluation of Treatment Patterns and Direct Costs Associated with the Management of Neuropathic Pain
title_short Evaluation of Treatment Patterns and Direct Costs Associated with the Management of Neuropathic Pain
title_full Evaluation of Treatment Patterns and Direct Costs Associated with the Management of Neuropathic Pain
title_fullStr Evaluation of Treatment Patterns and Direct Costs Associated with the Management of Neuropathic Pain
title_full_unstemmed Evaluation of Treatment Patterns and Direct Costs Associated with the Management of Neuropathic Pain
title_sort evaluation of treatment patterns and direct costs associated with the management of neuropathic pain
publisher Hindawi Limited
series Pain Research and Management
issn 1203-6765
1918-1523
publishDate 2020-01-01
description Background. Neuropathic pain has a prevalence of 2–17% in the general population. Diagnosis and treatment of neuropathic pain are not fully described in different populations. The aim was to determine the treatment patterns and direct costs of care associated with the management of neuropathic pain from the onset of the first symptom to up to two years after diagnosis. Methods. From a drug-claim database, a cohort of randomly selected outpatients diagnosed with neuropathic pain was obtained from an insurer in Colombia and followed up for two years after diagnosis. The clinical records were reviewed individually to identify the study variables, including the time needed to make the diagnosis, the medical and paraclinical resources used, the pharmacological therapy for pain management, and the direct costs associated with care. Results. We identified 624 patients in 49 cities, with a mean age of 50.3 ± 14.1 years, of which 324 were men (51.9%). An average of 90 days passed from the initial consultation until the diagnosis of neuropathic pain, the most frequent being lumbosacral radiculopathy (57.9%). 34.5% of the cohort had at least one diagnostic imaging procedure, and 16% had an electromyography. On average, they were treated by a general practitioner twice. 91.7% received initial treatment with tramadol, carbamazepine, amitriptyline, imipramine, or pregabalin, and 60.4% received combined therapy. The mean cost of care for two years for each patient was US$246.3. Conclusions. Patients with neuropathic pain in Colombia are being diagnosed late, are using therapeutic agents not recommended as first-line treatment by clinical practice guidelines, and are being treated for short periods of time.
url http://dx.doi.org/10.1155/2020/9353940
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