New Global Survey Shows Effective Patient-Physician Communication Critical to Accurate and Timely Recognition of Neuropathic Pain
- Diagnosis Often Takes a Year or More Even After Seeing a Physician
LONDON, March 01, 2007 /PRNewswire/ --A new seven-country global survey reveals that effective patient-physician communication is key to earlier, accurate diagnosis and treatment for patients with neuropathic pain (NeP). NeP is a debilitating condition characterised by chronic, often severe nerve pain and is often a complication of common conditions including diabetes, herpes, cancer, HIV, multiple sclerosis, stroke, traumatic injury or surgery. The survey results, released today by the Neuropathic Pain Network (NPN), a coalition of patient advocacy organisations, found that in some countries patients wait up to 19 months on average and visit as many as two or more doctors before they receive an accurate diagnosis. Countries surveyed included the United Kingdom, Germany, Italy, Korea, Mexico, Spain and Finland.
Neuropathic Pain Difficult to Recognise
Many patients need to visit more than one physician before their pain is recognised as neuropathic pain. Of physicians surveyed in the seven countries, the majority of whom were general practitioners, most do not find it very easy to recognise neuropathic pain. A majority of physicians in all countries report that a main factor in the delay is difficulty differentiating NeP from other pain conditions. This is important because treatments that may be effective in other types of pain often do not provide relief for NeP patients.
Patient and Physician Checklist: Cover Three Key Areas
According to the survey, patients wait on average between 5.7 to 19.5 months after they experience their first symptom before going to a physician; most patients believe the pain will 'go away by itself.' Once patients consult a physician about their pain, limited or ineffective communication can further delay recognition of neuropathic pain.
The survey found that physicians who recognise their patient's NeP are more likely to discuss the following three key areas with their patient. Physicians who do not ask questions covering these three key areas are less likely to identify their patient's condition as neuropathic pain.
1. Symptom Characteristics: Characterise the intensity and duration and describe how the pain feels with specific adjectives (e.g. "pins and needles," "burning," "stabbing," "numb," or "like electrical shocks")
2. Medical History: Share all medical history; NeP can be a complication of diabetes, herpes, cancer, HIV, traumatic injury or surgery
3. Location of Pain in the Body: Explain where on the body the pain is felt
"Crippling neuropathic pain affects every aspect of patients' lives, often even limiting their ability to work, and yet it is typically under-diagnosed," said Ian Semmons, Board Member, Neuropathic Pain Network and Chairman, UK Action on Pain. "The survey suggests there are things patients can do to hasten their diagnosis and treatment. By sharing their pain symptom characteristics, medical history and location of pain in their body, patients can help their physicians more readily differentiate if their pain is neuropathic. We urge all pain patients, particularly those with diabetes, herpes, cancer or HIV to discuss these topics with their physicians."
Screening Tools Not Widely Used
To help physicians screen patients with pain, researchers have developed questionnaires for patients to complete in the waiting room prior to seeing the physician. Patients answer several questions about their pain experience, including questions covering the key topics uncovered in the survey. The tools can assist physicians in making a rapid, yet detailed assessment of a patient's pain experience. Of the seven countries in the survey, only in Mexico do a majority of physicians currently use available screening tools for most or all of their patients, although in all countries, there is great interest among physicians to learn more about them.
"In many countries, physicians have increasingly limited time with patients, posing a particular challenge with neuropathic pain, which has been historically difficult to identify," said Michael Bennett, M.D., Senior Clinical Lecturer in Palliative Medicine and Honorary Senior Research Fellow, University of Leeds, Leeds, UK. "For these physicians, screening tools may be one solution, alerting physicians to the possibility of neuropathic pain in a timely manner. Whether through the use of these tools, or by simply engaging in thorough conversations, improving communication about symptoms of neuropathic pain can help us meet the needs of these long-suffering patients."
Neuropathic Pain: A Debilitating Condition
Neuropathic pain is a debilitating condition that is estimated to impact between 2.8 percent and 4.7 percent of people globally. NeP can have a significant impact on patients' lives, leaving many unable to work, walk or even wear clothes, as contact with their skin can cause an unbearable burning pain. Neuropathic pain is often under-diagnosed and under-treated. NeP is initiated or caused by a lesion or dysfunction of the nervous system (either peripheral or central). Patients often describe their symptoms as burning, stabbing or shock-like sensations. In recent years, a number of screening tools (e.g., Pain DETECT, LANSS, DN4, ID Pain) have been developed to help physicians identify this often-elusive condition.
About the Survey
In July 2006, the Neuropathic Pain Network and Pfizer Inc commissioned Harris Interactive to conduct a multi-country survey of NeP patients and the physicians who treat them. A survey of approximately 700 diagnosed NeP patients and 700 physicians was conducted in seven countries including: Finland, Germany, Korea, Italy, Mexico, Spain and UK. Fieldwork was conducted from August 18, 2006 through January 29, 2007. The results of any survey are subject to sampling variation. For a sample of 100, maximum potential sampling variation is + or - eight percentage points at the 95% confidence level. Funding for the survey was provided by Pfizer Inc.
About the Neuropathic Pain Network
The Neuropathic Pain Network (NPN) is a coalition of organisations that actively support people with neuropathic pain by enabling them to cope better with their pain, to obtain the best treatment and, ultimately, to improve the quality of their lives. The NPN has developed the first website solely dedicated to providing support for people with neuropathic (nerve) pain.
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Posted: March 2007