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Pharmacological Treatment Patterns in Neuropathic Pain-Lessons from Swedish Administrative Registries
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care.
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2013 (English)In: Pain medicine (Malden, Mass.), ISSN 1526-2375, E-ISSN 1526-4637, Vol. 14, no 7, 1072-1080 p.Article in journal (Refereed) Published
Abstract [en]

Objective. To explore the treatment patterns of patients with a diagnosis related to chronic pain (DRCP) initiating pharmacological treatment indicated for neuropathic pain (NeuP: tricyclic antidepressants, serotonin-norepinephrine reuptake inhibitors, and anticonvulsants). Design. Retrospective study on administrative registers. Setting. General population in Western Sweden (one sixth of the country). Subjects. All patients with a DRCP (N = 840,000) in years 2004-2009. Outcome Measures. Treatment sequence, continuation, switching, and comedication. Results. In total, 22,997 patients with a first NeuP in 2007 or 2008 were identified, out of which 2% also had epilepsy and 39% had a mood disorder. The remaining 13,749 patients were assumed to be treated for neuropathic pain, out of which 16% had a neuropathy diagnosis, 18% had a mixed pain diagnosis, and the remaining 66% had another DRCP. The most common first prescription was amitriptyline (40%) followed by pregabalin (22%) and gabapentin (19%). More than half had discontinued treatment after 3 months, and 60-70% at 6 months. Seven percent received another NeuP drug within 6 months of the discontinuation of their first NeuP treatment, 11% had another analgesic and 22% had a prescription indicating psychiatric comorbidity (selective serotonin reuptake inhibitors or benzodiazepine). Conclusions. Treatment initiation of currently available drugs indicated for neuropathic pain less frequently lead to long-term treatment in clinical practice compared with clinical trial, and few try more than one drug. We suggest our findings to be indications of a need for better routines in diagnosing patients to ascertain optimal treatment and follow-up.

Place, publisher, year, edition, pages
2013. Vol. 14, no 7, 1072-1080 p.
Keyword [en]
Chronic Pain, Tricyclic Antidepressants, Serotonin-Norepinephrine Reuptake Inhibitors, Anticonvulsants, Treatment Pattern, Psychiatric Comorbidity
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Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-219882DOI: 10.1111/pme.12095ISI: 000330245100021OAI: oai:DiVA.org:uu-219882DiVA: diva2:703663
Available from: 2014-03-07 Created: 2014-03-06 Last updated: 2017-12-05Bibliographically approved

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