title: Clinical characteristics and patterns of healthcare utilization in patients with painful neuropathic disorders in UK general practice: a retrospective cohort study.
abstract: BACKGROUND
  Clinical characteristics and patterns of healthcare utilization in patients with painful neuropathic disorders (PNDs) who are under the care of general practitioners (GPs) in the UK are not well understood.
  
  
  METHODS
  Using a large electronic UK database, we identified all adults (age ≥ 18 years) with any GP encounters between 1 January 2006-31 December 2006 at which a diagnosis of PND was noted ("PND patients"). An age-and gender-matched comparison group also was constituted consisting of randomly selected patients with one or more GP encounters-but no mention of PNDs-during this period. Characteristics and patterns of healthcare utilization of patients in the two groups were then examined over the one-year study period.
  
  
  RESULTS
  The study sample consisted of 31,688 patients with mention of PNDs and an equal number of matched comparators; mean age was 56 years, and 62% were women. The prevalence of various comorbidities was higher among patients in the PND group, including digestive disorders (31% vs. 17% for comparison group), circulatory disorders (29% vs. 22%), and depression (4% vs. 3%) (all p < 0.01). Receipt of prescriptions for pain-related pharmacotherapy also was higher among PND patients, including nonsteroidal anti-inflammatory drugs (56% of PND patients had one or more such prescriptions vs. only 22% in the comparison group), opioids (49% vs. 12%), tricyclic antidepressants (20% vs. 1%), and antiepileptics (12% vs. 1%) (all p < 0.01). PND patients also averaged significantly more GP visits (22.8 vs. 14.2) and referrals to specialists (2.8 vs. 1.4) over one year (both comparisons p < 0.01).
  
  
  CONCLUSIONS
  Patients with PNDs under the care of GPs in the UK have relatively high levels of use of healthcare services and pain-related pharmacotherapy.
authors.affiliation: Policy Analysis Inc., Brookline, MA 02445, USA.
authors.forename: Ariel
authors.initials: A
authors.lastname: Berger
authors.forename: Alesia
authors.initials: A
authors.lastname: Sadosky
authors.forename: Ellen
authors.initials: E
authors.lastname: Dukes
authors.forename: John
authors.initials: J
authors.lastname: Edelsberg
authors.forename: Gerry
authors.initials: G
authors.lastname: Oster
mesh_terms: D000328:Adult; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D000927:Anticonvulsants / Q000627:therapeutic use; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use; D001007:Anxiety / Q000453:epidemiology; D016022:Case-Control Studies; D015331:Cohort Studies; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology; D005260:Female; D005767:Gastrointestinal Diseases / Q000453:epidemiology*; D058006:General Practice; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D008012:Lidocaine / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000188:drug therapy / Q000453:epidemiology*; D010523:Peripheral Nervous System Diseases / Q000188:drug therapy / Q000453:epidemiology*; D012140:Respiratory Tract Diseases / Q000453:epidemiology*; D012189:Retrospective Studies; D006113:United Kingdom
chemical_list: D000700:Analgesics; D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000927:Anticonvulsants; D000929:Antidepressive Agents, Tricyclic; D008012:Lidocaine