New Global Survey Shows Effective Patient-Physician Communication Critical to Accurate and Timely Recognition of Neuropathic Pain

New Global Survey Shows Effective Patient-Physician Communication Critical to Accurate and Timely Recognition of Neuropathic Pain

March 01, 2007

Diagnosis Often Takes a Year or More Even After Seeing a
Physician

    LONDON, March 1 /Xinhua-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.


    For more information, please contact: 

     Sejal Sedani
     Resolute Communications
     Tel:   [phone]
     Email: [e-mail]


SOURCE  The Neuropathic Pain Network; Pfizer