Burden of Neuropathic Pain in Indian Patients Attending Urban, Specialty Clinics: Results from a Cross Sectional Study

Abstract

Background and Objective: Recent studies in Western populations have reported high patient burden of neuropathic pain. No data are currently available on the burden of neuropathic pain in Indian patients. Our study evaluated the burden of neuropathic pain in patients attending urban, private-sector, specialty clinics. Methods: This cross-sectional, observational study surveyed 467 patients with neuropathic pain to assess the burden of pain (pain severity, patient-reported treatment effectiveness, impact of hypothetical pain relief on overall health rating), burden because of quality of life impairment (EuroQoL health state, pain interference with daily living, sleep and mood disturbances, medication-related adverse events), and economic burden (treatment cost, impact on employment and productivity). Physicians filled out a clinical case report form to provide information on patient’s neuropathic pain disorder and treatment provided. The data were analyzed to assess the overall burden of neuropathic pain. Results: Painful diabetic neuropathy was the most common cause of neuropathic pain (72%). Majority (64%) of patients reported moderate to severe pain, and about 50% reported moderate to severe pain-related interference in activities of daily living. Substantial sleep impairment was reported as compared with general population. About 50% of patients reported co-morbid mood disorders, while 67% reported medication-related adverse event in the preceding week. Fifty-seven per cent of patients reported an adverse impact on their employment status, including 13% who retired early or were unemployed. Among those currently working, 72% reported reduced productivity, including 22% who reported reduced productivity “most” or “all” of the time. Conclusions: In Indian patients with access to urban, privatesector, specialty clinics neuropathic pain (particularly painful diabetic neuropathy) remains a significant medical condition with substantial negative impact on their quality of life.