Skip to main content
SpringerLink
Log in

Prevalence and Characterization of Neuropathic Pain in a Primary-Care Setting in Spain

A Cross-Sectional, Multicentre, Observational Study

  • Original Research Article
  • Published:
Clinical Drug Investigation Aims and scope Submit manuscript

Abstract

Background and objective: Different studies have shown pain to be one of the most frequent causes of health-care resource utilization, and a major public health concern because of its social repercussions. In Spain there are no recent data on the prevalence and management of neuropathic pain in the general primary-care setting. This study aimed to gain epidemiological insight into neuropathic pain in the Spanish primary-care setting.

Methods: This was a cross-sectional, one-day, multicentre, observational epidemiological study involving 623 primary-care physicians in Spain. Patients who experienced pain were classified into three groups: pure neuropathic pain, mixed neuropathic pain or nociceptive pain. Pain intensity was evaluated on a visual analogue scale (VAS), range 0–10. Information on the location, duration, aetiology and current treatment of pain was obtained, together with data on whether the patients were referred to specialized care and to which type of specialist.

Results: In a single day, 23 529 patients received primary care, and of these, 7220 experienced pain (30.7% [95% CI 29.5, 31.7]). Patients with pure neuropathic pain comprised 11.8% (95% CI 10.5, 13.2) of the 3044 patients for whom pain was the reason for consultation and the type of pain was documented, patients with mixed neuropathic pain accounted for 13.4% (95% CI 12.0, 14.8) of this group, and patients with nociceptive pain for 74.9% (95% CI 73.1, 76.7). Patients with pure neuropathic pain mostly received exclusively pharmacological treatment (84.6% [95% CI 80.3, 89.0]), with anti-epileptic drugs being the most widely used substances (52.5% [95% CI 47.3, 57.7]), followed by non-opioid analgesics (35.2% [95% CI 30.2, 40.1]) and NSAIDs (26.8% [95% CI 22.2, 31.4]). The mean duration of neuropathic pain was 11.7±23.3 months. The mean pain intensity on the VAS exceeded 6 in all groups. Over half of the patients were diagnosed in the primary-care centre, and a large proportion in turn were referred to a specialist, most frequently an orthopaedist.

Conclusion: The results of the present study show the high prevalence of neuropathic pain at the primary-care level in Spain. In addition, the data presented here point to a need to improve the management of outpatients with neuropathic pain in the Spanish primary-care setting, particularly in relation to the higher than recommended use of NSAIDs (which are not indicated for neuropathic pain) and the lower than recommended use of antiepileptic drugs with an analgesic indication for pain with a neuropathic component.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Table I
Table II
Fig. 1
Table III
Table IV
Fig. 2

Similar content being viewed by others

References

  1. Breivik H, Collett B, Ventafridda V, et al. Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. Eur J Pain 2006; 10(4): 287–333

    Article  PubMed  Google Scholar 

  2. Gureje O, Von Korff M, Simon GE, et al. Persistent pain and well-being: a World Health Organization study in primary care. JAMA 1998; 280(2): 147–51

    Article  PubMed  CAS  Google Scholar 

  3. Portenoy R. Development and testing of a neuropathic pain screening questionnaire: ID Pain. Curr Med Res Opin 2006; 22(8): 1555–65

    Article  PubMed  Google Scholar 

  4. Catalá E, Reig E, Artés M, et al. Prevalence of pain in the Spanish population: telephone survey in 5000 homes. Eur J Pain 2002; 6: 133–40

    Article  PubMed  Google Scholar 

  5. Bassols A, Bosch F, Campillo M, et al. An epidemiological comparison of pain complaints in the general population of Catalonia (Spain). Pain 1999; 83(1): 9–16

    Article  PubMed  CAS  Google Scholar 

  6. López-Silva MC, Sánchez de Enciso M, Rodríguez-Fernández MC, et al. Cavidol: de vida y dolor en atención primaria. Rev Soc Esp Dolor 2007; 14(1): 1–19

    Google Scholar 

  7. IASP Task Force in Taxonomy. Pain terms: a current list with definitions and notes on usage. In: Merksey H, Bogduk N, editors. Classification of chronic pain syndromes and definitions of pain terms. Seattle: IASP Press, 1994; 206–13

    Google Scholar 

  8. Saarto TWP. Antidepressants for neuropathic pain. Coch-rane Database Syst Rev 2005; (3): CD005454

  9. Wiffen P, Collins S, McQuay H, et al. Anticonvulsant drugs for acute and chronic pain. Cochrane Database Syst Rev 2005(3):CD001133

  10. Dworkin RH, O’Connor AB, Backonja M, et al. Pharmacologic management of neuropathic pain: evidence-based recommendations. Pain 2007; 132: 237–51

    Article  PubMed  CAS  Google Scholar 

  11. McDermott AM, Toelle TR, Rowbotham DJ, et al. The burden of neuropathic pain: results from a cross-sectional survey. Eur J Pain 2006; 10(2): 127–35

    Article  PubMed  Google Scholar 

  12. Galvez R, Marsal C, Vidal J, et al. Cross-sectional evaluation of patient functioning and health-related quality of life in patients with neuropathic pain under standard care conditions. Eur J Pain 2007; 11: 244–55

    Article  PubMed  Google Scholar 

  13. Hans G, Masquelier E, De Cock P. The diagnosis and management of neuropathic pain in daily practice in Belgium: an observational study. BMC Public Health 2007; 7: 170

    Article  PubMed  Google Scholar 

  14. Smith BH, Torrance N, Bennett MI, et al. Health and quality of life associated with chronic pain of predominantly neuropathic origin in the community. Clin J Pain 2007; 23: 143–9

    Article  PubMed  Google Scholar 

  15. Bennett M. The LANSS pain scale: the Leeds assessment of neuropathic symptoms and signs. Pain 2001; 92: 147–57

    Article  PubMed  CAS  Google Scholar 

  16. Torrance N, Smith BH, Bennett MI, et al. The epidemiology of chronic pain of predominantly neuropathic origin: results from a general population survey. J Pain 2006; 7: 281–9

    Article  PubMed  Google Scholar 

  17. Torrance N, Smith BH, Watson MC, et al. Medication and treatment use in primary care patients with chronic pain of predominantly neuropathic origin. Fam Pract 2007; 24: 481–5

    Article  PubMed  Google Scholar 

  18. Galvez R, Rejas J, Perez M, et al. Prevalence of neuropathic pain in Spain: clinical, working and health care implications. Med Clin (Barc) 2005; 125: 221–9

    Article  Google Scholar 

  19. Montero Homs J, Gutierrez-Rivas E, Pardo Fernandez J, et al. Epidemiological study of prevalence, incidence and neuropathic pain characterization in neurology units: Prevadol study. Neurologia 2005; 20: 385–9

    Google Scholar 

  20. Pardo J, Gutierrez-Rivas E, Montero J, et al. Estudio de prevalencia, adherencia farmacológica y calidad de vida en pacientes con dolor neuropático. Estudio Neuropathic. Neurología 2006; 21: 445–50

    Google Scholar 

  21. Gore M, Dukes E, Rowbotham DJ, et al. Clinical characteristics and pain management among patients with painful peripheral neuropathic disorders in general practice settings. Eur J Pain 2007; 11: 652–64

    Article  PubMed  Google Scholar 

  22. Povedano M, Gascon J, Galvez R, et al. Cognitive function impairment in patients with neuropathic pain under standard conditions of care. J Pain Symptom Manage 2007; 33: 78–89

    Article  PubMed  Google Scholar 

  23. Berger A, Dukes EM, Oster G. Clinical characteristics and economic costs of patients with painful neuropathic disorders. J Pain 2004; 5: 143–9

    PubMed  Google Scholar 

  24. Wolfe GI, Trivedi JR. Painful peripheral neuropathy and its nonsurgical treatment. Muscle Nerve 2004; 30: 3–19

    Article  PubMed  CAS  Google Scholar 

  25. Tolle T, Dukes E, Sadosky A. Patient burden of trigeminal neuralgia: results from a cross-sectional survey of health state impairment and treatment patterns in six European countries. Pain Practice 2006; 6: 153–60

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

This study was supported by an unrestricted grant from Pfizer España (Pfizer Spain). Dr Pérez, Dr Saldaña and Dr Navarro have received honoraria from Pfizer as consultants. Dr Rejas is employed by Pfizer Spain. Inma Vilardaga is employed by the European Biometric Institute, a clinical research organization contracted by Pfizer to conduct the study. The authors wish to thank all the physicians who participated in the study for their contribution to the goals of study.

Author information

Authors and Affiliations

  1. Pain Clinic, University Hospital ‘La Princesa’, C/Diego de León, 62, 28006, Madrid, Spain

    Concepción Pérez

  2. Primary-Care Health Centre ‘Raíces’, Castrillón, Asturias, Spain

    María Teresa Saldaña

  3. Primary-Care Health Centre ‘Puerta del Ángel’, Madrid, Spain

    Ana Navarro

  4. Department of Biometrics, European Biometrics Institute, Barcelona, Spain

    Inma Vilardaga

  5. Health Outcomes Research Department, Medical Unit, Pfizer España, Alcobendas, Spain

    Javier Rejas

Authors
  1. Concepción Pérez
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. María Teresa Saldaña
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ana Navarro
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Inma Vilardaga
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Javier Rejas
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Concepción Pérez.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Pérez, C., Saldaña, M.T., Navarro, A. et al. Prevalence and Characterization of Neuropathic Pain in a Primary-Care Setting in Spain. Clin. Drug Investig. 29, 441–450 (2009). https://doi.org/10.2165/00044011-200929070-00002

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00044011-200929070-00002

Keywords

Search

Navigation