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Family Practice Advance Access originally published online on August 1, 2007
Family Practice 2007 24(5):481-485; doi:10.1093/fampra/cmm042
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© The Author 2007. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

Medication and treatment use in primary care patients with chronic pain of predominantly neuropathic origin

Nicola Torrancea, Blair H Smitha, Margaret C Watsona and Michael I Bennettb

a Aberdeen Pain Research Collaboration, Department of General Practice and Primary Care, University of Aberdeen, Foresterhill Health Centre, Westburn Road, Aberdeen AB25 2AY
b Clinical Teaching and Research Unit, St Gemma's Hospice and University of Leeds, UK

Correspondence to Nicola Torrance, Department of General Practice and Primary Care, University of Aberdeen, Foresterhill Health Centre, Westburn Road, Aberdeen AB25 2AY, UK; Email: n.torrance{at}abdn.ac.uk

Received 26 July 2006; Revised 21 December 2006; Accepted 18 June 2007.


  Abstract

Background. Neuropathic pain is widely recognized as one of the most difficult pain syndromes to treat and presents a significant challenge for pain clinicians and GPs.

Methods. The Self-complete Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) questionnaire, recently validated for identifying pain of predominantly neuropathic origin (POPNO), was sent to 6000 adults identified from general practices in the UK. The questionnaire also contained items about chronic pain identification, medications and treatments received for pain and the pain relief these provided.

Results. In total, 1420/3002 (48%) of respondents indicated that they suffered with any chronic pain. These were further categorized as those with chronic pain who were S-LANSS negative [‘chronic pain (non-POPNO)’ group, n = 1179] and those with chronic pain who were S-LANSS positive, indicating the presence of POPNO (‘chronic POPNO’ group, n = 241). Questions relating to treatments and medications were completed by 88% of the respondents (1244/1420). The chronic POPNO group was more likely to receive multiple pain medications (37% versus 21% took two or more pain medications, P < 0.001) and stronger painkillers [e.g. opioids odds ratio 1.94; 95% confidence interval 1.10, 3.42]. Despite this, they reported less effective pain relief than the non-POPNO chronic pain group.

Conclusion. Patients in primary care reporting chronic pain were found generally to obtain incomplete relief from their medication with chronic POPNO patients reporting less relief. It is important that patients with any chronic pain are identified and managed appropriately according to their distinct treatment needs.

Keywords. Chronic pain, neuropathic pain, primary care, S-LANSS, treatment.

Torrance N, Smith BH, Watson MC and Bennett MI. Medication and treatment use in primary care patients with chronic pain of predominantly neuropathic origin. Family Practice 2007; 24: 481–485.


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Management of patients with chronic neuropathic pain
Sotirios Giannopoulos
Family Practice, 9 Aug 2007 [Full text]

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